The big cull

January 29th, 2007 at 9:02 am by David Farrar

People got so upset over a cull of a few hundred horses, yet relatively little protests over 35,000 humans being culled from hospital waiting lists last year.

It is mind bloggling that Labour can literally throw billions and billions of dollars into this black hole, and not get any significant improvement in terms of elective operations.

No wonder so many people have private medical insurance.

No tag for this post.

67 Responses to “The big cull”

  1. hayman () says:

    The “billions and billions” are NOT going into non acuter care.
    The permanent disability sector gest about 15-20% of the health budget. This is spent on Crippled Children (CCS) and IHC and so on . But to DPF its just a ‘black hole’
    Pharmac has to strictly ration its share of the helath budget. But to DPF its a ‘black hole’.
    Primary care at GPs has to care for a much larger portion of people who live on well past retirement age but still need GP services. But to DPF its a ‘black hole’
    Mental health services were very poorly funded but have had substantial boost under Labour. But to DPF its a ‘black hole’.
    The meningacocal vacine cost more than $200 million to develop and implement. To DPF its a ‘black hole’

    And for those that think private helath insurance is the answer, in the US where full private insurance is available ( not like NZ where it only covers non acute) the average ( ie half pay more half pay less) is $11500 PER YEAR PER FAMILY ( allmost entirely paid for by employers. And these are are the low risk people, the healthy working.)

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  2. Adolf Fiinkensein () says:

    hayman – to the 35,000 people (most of whom vote)it IS a black hole. Add on their families and you’ve probably got 100,000 voters adversely affected.

    Your comment on health insurance indicates you know nothing about it, so everything else you have to say must be regarded as an equal crock of shit. For your information, a typical NZ family with health insurance covering hospitalisation and specialist consultations and tests(for any reason – nothing to do with acute or non-acute) will pay between $150 and $200 per month. Insurers in NZ do not offer cover for ‘rare and major’ events such as lung transplants for example, because the private sector is not equipped to carry out this type of surgery. If you have a heart attack or a stroke the insurer pays. If you don’t have a heart attack but go into hospital for observation, the insurer pays. If you need a hip replaced the insurer pays. Yes, there are some insurers which don’t pay for non surgical hospitalisation. If you have one of those policies you need a brain transplant, for which the state will pay.

    DPF can you get some figures on the number of people amongst the culled 35,000 who died while waiting for their surgery? Their families will consider the health system a ‘black hole.’

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  3. Sam Dixon () says:

    “It is mind bloggling that Labour can literally throw billions and billions of dollars into this black hole, and not get any significant improvement in terms of elective operations.”
    - massive international over-demand for medicial tech and skills, resulting in very rapid inflation in the sector is partly to blame. The other point is that the number of elective surgeries performed is a poor measure of the total amount of healthcare provided. As medical technology advances, more operations are less invasive and are handled as day ops instead, more conditions can be treated medically, and those elecive surergies that are conducted become more complex- a qualitative, not quantiative improvement.

    Still wondering after 8 years of Ryall and co, what is National’s health policy? All we ever here is vague talks or ‘choice’ and syergies with the private sector. Of course, the plan is really to gut public healthcare, as in the 1990s, but it’s one of those policies that can’t really be talked about because the Nats know the public would reject it.

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  4. Adolf Fiinkensein () says:

    Sam Dixon, you forgot to mention massive increases in the numbers of Health Dept drones making rules for DHBs who in turn have to employ even more drones to comply with the rules which in turn means they can’t afford to pay nurses, junior doctors or radiographers a decent wage which in turn means there’s no one around to perform any more real health care.

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  5. Seamonkey Madness () says:

    So Hayman et al, I suppose according to Labour, getting pay parity across the DHBs for radiographers is considered a “black hole”.
    I guess that (and the comparitively low wage for a western country) among others reasons is why so many of them are flocking off to the UK/Australia after they have completed their compulsary stint in our system.

    I would love to see what your reaction would be if your Mum/Dad had a broken hip, was on a waiting list for 6-12 months for an op, then got told by letter that they weren’t acute enough and would have to toddle down to their GP to get re-assessed and chucked back on the bottom of the waiting list.

    I am also not saying that National’s health policy (not that they have broadcast too widely what it actually is) would be a better or worse solution, but surely the only culling that should be done here is the middle-management in the hospitals that have been installed during Labour’s tenure.

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  6. hayman () says:

    seamonkey, a ‘broken hip’ would mean you would go into hospital immediately. So get your metaphors right

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  7. hayman () says:

    Adolf, I repeat ‘full’ health insurance is not available in NZ.( full pregnancy cover NOT available)

    The very very limited insurance that is available has so many exclusions. ( heart stents not included)

    In any hospital system ( the tertiary sector which is only a small portion of the full health budget) the top 1000 people per year would use 50% of the budget. None of these conditions would be on health insurance. Kidney dialysis , forget it.
    Why even the private hospitals unload their sickest patients every day into the public system. As they dont have round the clock acute care ( cant afford it).
    As for those ‘people who die on the waiting list’ People die in hospital too all the time . ITS A NATURAL OCCURRENCE. If you are saved from one thing you will die from something else. A lot of people have other conditions which means surgery is not not a valid option ( obesity, habitual smokers).

    Any government unloading $12000 -$15000 per year onto families for full health insurance would be asking for political suicide.

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  8. ross () says:

    What is truly mind-boggling is that Labour spent more than $200 million on a meningococcal vaccine that was totally unnecessary. It’s the biggest health inititive ever and yet there is no evidence that it has saved any lives. Safety concerns have been raised about this vaccine with a number of people going to ACC for compensation. And where is the National Party on this issue?

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  9. Fred () says:

    The US is a poor reference for an alternate health system. Try looking at Aust.
    Medicare covers everyone for all scheduled costs, at a 1.5% levy on income + general tax revenue. Waiting lists for some procedures are too long. As is the case for hip replacements in the public system.
    However for about $1600/year/4 person family you get quick access to the private hospitals attached to the teaching hospitals for instant anything. Flaw is there may be an uninsurable gap between sched fee and actual charge, this is changing. Insurance gives speed of access and some bells and whistles accommodation.

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  10. ross () says:

    > The meningacocal vacine cost more than $200 million to develop and implement. To DPF its a ‘black hole’

    To anybody with a smidgen of nous it’s a black hole. The incidence of the disease has increased by 150% since roll-out of the vaccine began. If it was introduced at all, it should have been done on a user pays basis.

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  11. hayman () says:

    The Australian example of ‘$1600 per four person family’ is like NZ covers only a limited amount of care.
    This is from from a company offering a full healthcare for people on temporary visas. Thse people are not eligible for government subsidys
    http://www.austhealth.com/?gclid=CKuY88mghIoCFQi8YAodSX8JNg

    The ‘family’ rate for the best plan is $4992 per year.
    the coverage seems to be fairly extensive as shown here.
    100% In-Hospital (In-Patient) expenses covered (eg. medical, accommodation, specialists etc)
    Rehabilitation programmes following hospitalisation
    100% ambulance cover
    Medical repatriation to your home country
    Funeral Expenses
    100% Out-Patient medical expenses (eg. doctor’s visits, x-rays, blood tests)
    Cover for prescribed pharmaceuticals
    Cover for physiotherapy / osteopathy / chiropractic
    Extras cover e.g. dental, optical and more
    100% Cover for pregnancy (waiting period applies)

    Thse are of course the pre screened working healthy. Elderly people would be out the door so fast.
    And costs for that age cohort are the highest.
    So I could easily see $12,000 to $15,000 per year for coverage for faimilies where you arent excluded because of age. Or if they can rate groups on risk then the elderly could be paying $25,000 plus per couple

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  12. Adolf Fiinkensein () says:

    hayman, why do all leftie dolts persist in dodging a difficult issue by fabricating some other issue?

    This thread is not about health insurance, it’s about wasted money in our health system. The Wastemaster General – remember? So you proceed to burble on about health insurance as though that’s got anything to do with it. Then you compound your folly by prattling that ‘full’ health insurance is not available here and insinuate that if pregnancy was covered it would cost every family an extra $12k.
    The simple unpalatable truth you are unprepared to face is that you and all the other shrill Labour shills have a problem on your hands. Your problem is your burgeoning beauracracy which soaks up money faster than a swab in your thoracic cavity.

    I can tell you now what National’s policy will be. Chop the beauracracy, slash the health budget and increase the delivery of real healthcare to sick and dieing people. You see, it’s not difficult.

    The only commendable thing about your comments is your extraordinary courage in defending the patently indefensible.

    Oh by the way, would you care to list the standard exclusions in health insurance policies offered by Southern Cross, Sovereign, AIA, Tower and ING, just to name a few?

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  13. Fred () says:

    Nonsense, no-one insures for 100% care, not even socialists who can’t add up. Try spending $3300 each and ever year on peripherals. It happens in some elderly and chronic patients….that is what the public system is for
    The take up in Aust. is for major care insurance which means instant access to private hospital care.

    Perhaps Cuba can help with free osteopathy/funerals/repatriation etc…but in the real world of Aust around $1600 covers what most people want….it’s a bargain.

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  14. soniconic () says:

    “I can tell you now what National’s policy will be….. slash the health budget”

    Now that is going to make a lovely billboard! make sure you publicise that policy far and wide.

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  15. David Baigent () says:

    Sonic, if you were an honest socialist you would always quote accurately.

    …Adolf’s quote my emphasis..

    “Chop the BEAURACRACY, slash the health budget and increase the delivery of REAL healthcare to sick and dieing people.”

    But ??

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  16. Adolf Fiinkensein () says:

    Why thank you soniconic. (Sorry about your stutter there. I’d go and see your subsidised GP about it if I were you.)

    Yes it will make an excellent billboard. I can see it now.

    On the red side, the churlish and haggard bug eyed leader with her slogan for health

    More money, more beauracrats, slash the waiting lists.

    On the blue side, the smiling, relaxed, telegenic PM in waiting with his slogan for health

    More operations, less money, slash the beauracracy.

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  17. sonic () says:

    “Chop the BEAURACRACY, slash the health budget”

    You go for that line Adolph old bean, that is going to be a winner?

    Do you hear that noise? it is the sound of National party strategists wondering how they are going to keep their rabid right wing from spilling the beans before the election?

    Do try and keep on message mate, Key is trying to build a new, shiny, voter friendly, not loony tunes image, what a pity that you and yours will blow it long before polling day.

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  18. hayman () says:

    The give details of what ‘full’ coverage in Australia costs ( ie without sort of government subsidys) which is what people who apply for work visas have to pay. It is around the $5000 per family per year .
    But obviously others here posting are in need of blidness medical care. (paid for by the state of course). This doesnt ever cover the elderly and chronic sick who would still have to be paid for out of taxes
    If you want no waiting lists for the working healthy this is what is costs . ‘Slashing budgets’ is just ravings from incompetetant lunatics.
    A hospital is essentially a ‘bureacracy with beds’ unless its a bush hospital in Africa. Patient records, forms, test results, appointments, payrolls, toilet paper by the truckload, medicines by the millions, cleaners, electricians, computer administrators all need to be managed, organised.

    This cottage hospital myth is strongly held by ranters in the ACT and National parties. Who are ignored by those who have to make policy of course ( Dons emails show the derision those in the higher reaches have for people like Adolf)

    AS I keep repeating the tertiary health only uses a small prtion of the ‘black hole’ health budget.
    And the reality is more access costs a lot more.

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  19. Jeff () says:

    Fred, Oz healthcare may be excellent if you live in a city, but God help you if you get sick in the country (where i’m currently working) as some hospitals don’t even have basic life saving equipment and are seriously underfunded. Proberly due to having to pay locums huge amounts of dollars to work there :) And NZ inability to get to everyone on the waiting list is totally due to staff shortages. Theatres cannot operate without theatre nurse etc. Will this improve under a National Govt with their history of taking a scalpel to the heath budget? Or will we continue to seek higher wages elsewhere and avoid the ridiculous mentality that hospitals should be run within a “business” model

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  20. Jeff () says:

    and the BEAURACRACY you refer to has increase at a lower rate than medical staff so it would appear that labour is on the right track. With our aging population and huge increase in obesity related illness, the 35000 people should be blaming the baby boomers and fat people for using the chunk of the resources.

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  21. iiq374 () says:

    Of course hayman you should learn to do simple math before starting to quote figures.

    You do realise that the $5000 figure for an median family = $4 billion to cover all of New Zealand’s populace. What was Labours increase in health spending? 4.2 billion.
    The incompetent bureaucratic public health service you defend can’t even provide the cover the private example does with how much extra funding in total? (PS – it isn’t like the Labour increase was from a zero starting budget)

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  22. Fred () says:

    Correct Jeff…in Aust. it’s the tyranny of distance. Which accounts for the large number of flying hours spent doing evacuations. No way around it, only major centres can support major hospitals.

    The Aust. private hospital system works pretty well, much to the horror of the local left.

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  23. Jeff () says:

    No Fred, i’m talking about regional hospitals servicing hundreds of thousands all along the eastern seaboard.

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  24. sonic () says:

    iiq, the public health service also has to cover those who private insurance will not touch with a 10 foot bargepole (for example those with chronic conditions)

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  25. hayman () says:

    Talking of waiting lists.

    there are 1000′s waiting on TELECOMS list for broadband in Auckland urban area alone.
    And if you live in rural areas, just give up since it will be pointless even ‘waiting’

    Come on Telecom slash your bureacracy and increase your services!

    My basic broadband ( got in early) and phone service is $900 -$1000 per year. And doesent include mobile.

    Yet some think increased healthcare can come from insurance of $600 per year per family

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  26. iiq374 () says:

    Sonic – a fallacious argument which the left seem determined to abuse.

    It doesn’t account for the scale of magnitude difference. And especially once you realize that
    they won’t touch people with known chronic conditions, which means that for the median household where people are entering schemes before conditions become apparent (or even contracted) the cost still holds.

    The public health service should actually be able to work at a lower per-capita cost as they still have premiums of those who have “opted out”, and don’t have the self-selection bias of not receiving the most healthy sections of the community.

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  27. John Cawston () says:

    A fair comment on health care and elective surgery in NZ can be seen in this report:

    http://www.scoop.co.nz/stories/BU0701/S00083.htm

    “Southern Cross Group Chief Executive, Dr Ian McPherson, said today that in the first six months of its financial year to December 31, 2006, the not-for-profit health insurer had increased membership by 12,756. This six-month growth exceeds by 5,397 Southern Cross’ total membership growth of 7,359 in the financial year to June 30, 2006.

    The combination of new members, coupled with lower-than expected cancellations, meant the Society had 821,125 members at December 31, 2006. The growth has put Southern Cross ahead of budget for this financial year, with Dr McPherson saying he’s “quietly pleased” with the result.

    “Our membership gains are telling us that that people are acknowledging the value of health insurance, particularly as the realisation sets in that the public system cannot fund everything for everyone on demand.”

    It’s finally started to cross peoples’ minds that the health service is not what it was under National and earlier and they are heading for the private sector.

    JC

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  28. sonic () says:

    “they won’t touch people with known chronic conditions”

    Which for people with chronic conditions is the majority. Go try and get health insurance for someone with chronic heart problems or someone who is HIV positive.

    Another couple of facts. The private sector can parasite off the public sector, patient gets too ill? send them back to the state health care system. Need staff? don’t train them yourself just recruit those trained at public expense.

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  29. iiq374 () says:

    sonic – not facts, more fallacies.

    When they get sent back to the public sector for treatment the public sector gets paid what they decide to charge for it. So it is actually hiding the true cost of the public sector. If private actually did use all their own facilities then the costs of public would balloon further.

    Staff – works other way too. Oh except the public sector keeps their staff at artificially low wages because of the bureaucrats they have to pay.

    The vast majority of chronic conditions you were referring to have not been chronic since birth. So you are trying to use those that have left trying to enter the private system until they have a chronic condition as an argument against the premium calculations which are based on the contraction of chronic conditions. It doesn’t affect what the median cover could be for any family.

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  30. Fred () says:

    Jeff… What.. Bathurst, Lismore, Kempsey etc? These are always going to be lesser service hospitals. For anything else you want to get to a teaching hospital, that means a uni. city with a medical school.

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  31. sonic () says:

    “Staff – works other way too”

    Care to tell us the % of staff trained by the private sector in NZ?

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  32. iwikiwi () says:

    All i know , is my mother in law ,a good women had a gangoris big toe , and after stuffed up appointments ,WAITING,WAITING,ended up removing the leg below the knee,instead of big toe, family dosnt have a high opinion,of helens health service.

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  33. phil u () says:

    mmm..!..adolf..

    slashed health budget….=…..more healthcare..

    bit of a ‘disconnect’ there..eh..?

    phil(whoar.co.nz)

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  34. iiq374 () says:

    Care to tell us the % of staff trained by the private sector in NZ?

    About the same % as employed in the private sector.

    Oh – you mean who got their initial training in the private sector? Very few as the private sector would be required to pay people that were working for it (even if that work consisted of training). Also the public sector tends to have more of an issue over liability…

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  35. RedRag () says:

    Dipweed righties ranting again basing their whole argument on the totally unsupported idea that managing the health system wastes vaste sums of money, ie SLASH THE BEAURACRACY brand of froth….and that they have some magic formula to tap into this huge pool of money and magically solve all the problems. Such unmitigated bollocks.

    Last time we got some actual numbers I recall that the total spend on all health sector “beauracracy” was about $426m, which is a bit under 4% of the total public sector health spend of $11b. Which I suggest is a remarkably low number. And yet these same pillocks would never dream that they could eliminate all the management functions from their own businesses and then expect to see it’s productivity improve.

    Or the next time some minor contract isn’t audited and reviewed in triplicate, they’ll be screaming “corruption” and “incompetence”.

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  36. iiq374 () says:

    RedRag –
    you are right it isn’t just about slashing Bureaucracy, it’s about introducing efficiencies as well – something that all our Governments of any political persuasion have historically been incapable of.

    The most striking example for me has always been the Taranaki base hospital pharmacy where it took until 1999 for them to get a computer system that was actually capable of finding a patient faster than re-entering all their details.
    Any private operation with that level of inefficiency would have gone out of business years before. Any private operation with that exposure to risk would have been closed down by the authorities years before…

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  37. Flashman () says:

    Hear hear redrag!

    Which is why helen’s healthcare system [sic] requires legions of “media communications officers”, “iwi liaision advisors”, “smoking and community healthcare advocates”, “statistical and service analysts” and “community communications departments” in order to deliver hip replacements.

    Check the jobs adverts in this sector sometime. For every five of these non-jobs, there is about one for a nurse.

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  38. John Cawston () says:

    “Which for people with chronic conditions is the majority. Go try and get health insurance for someone with chronic heart problems or someone who is HIV positive.”

    I have had a “chronic heart condition” for nine years.. no problem for the insurers, and my premiums are the same as any other of my age.
    My wife has had MS for 20 years.. again no problem.

    “Another couple of facts. The private sector can parasite off the public sector, patient gets too ill? send them back to the state health care system.”

    Which is what it was set up to handle.

    “Need staff? don’t train them yourself just recruit those trained at public expense.”

    Which is what it was set up to do.

    For most of it’s history, private health was the norm for NZ, and it was only after WW2 that the public allowed the State to become dominant. Today, about a quarter of NZ has a private health scheme.. down from earlier years when it was up around (IIRC) 40%, but this is growing again.

    Quite simply, it defies logic and national interest to have outpatients in public health, free elective surgery of a minor nature, ACC or a dozen other free health services. The role of the State should be in information, education, training, audit and perhaps the big jobs in operations.

    JC

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  39. Adolf Fiinkensein () says:

    Good God! You idiots are spending $11 bil on healthcare for 4 million people? That’s $2,750 for every living soul in the country? Thats $11k for every real family (Mum Dad and two kids)?

    And you still have to send 35,000 people back to their GPs to pay another thirty bucks and wait another six months to get onto another waiting list?

    Just as well you haven’t got phil u running the health service. By his logic you’d spend $20 bil and cull 70,000 people off the waiting list.

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  40. Gooner () says:

    Adolf, you don’t need to slash the health budget. You can simply maintain the spending at current levels plus inflation. DPF is right. For the extra billions spent by Labour in the last six years there has not been a single more operation per capita nor has there been any reduction in the waiting lists: King just gave the waiting list a new name and then said there were less on them. Of course there was, they didn’t exist as waiting lists!

    Labour’s ideological indifference to using the private sector is sickening. Its ideological indifference to de-monopolising ACC is equally sickening.

    And Hayman’s analogy with Telecom is quite apt from the point of view that the health system and Telecom are pretty much monopolies in this country and both have huge waiting lists for their services, and both are nearing third world standard. Says it all really.

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  41. Andrew Bannister () says:

    Chop the beauracracy, slash the health budget and increase the delivery of real healthcare to sick and dieing people. You see, it’s not difficult.

    Adolf, those are just words. you haven’t actually done anything, so don’t tell us how easy it is.

    And please, it’s BUREAUCRACY. Once okay, but it’s getting silly now.

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  42. Fred () says:

    What the Reds really hate about private medical choices is that a govt bureaucrat doesn’t get to allocate its resources and useage, as in “proper” socialism.

    Choice is the left’s Achilles heel…people love it, they despise it.
    Of course the market will win.

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  43. Adolf Fiinkensein () says:

    Getting a bit touchy there, are we Andrew? Sorry about the spelling and thanks for the kick in the head on that one.

    And I suppose what you have to say is not also ‘just words’? If ‘having done something’ is to be a criterion for making a comment here then most of the lefties who go on and on would be silent for a bloody long time.

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  44. iiq374 () says:

    ideological indifference? pathological hatred.

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  45. Adolf Fiinkensein () says:

    Further to last Andrew B. It really is quite simple. You go to the CEO of the Health Department and you tell him:-

    Here are the terms of your continued employment.

    1 You will reduce your staff numbers and expenditure by 15% within twelve months and you will not increase current levels of expenditure on consultants. (defacto staff)

    2 You will ensure that DHBs produce a minimum of 5% more measurable delivered health care within the next twelve months.

    3 When you achieve the above targets you will be generously rewarded financially.

    4 How you do it is your business. That’s what we pay you for.

    5 If you do not achieve the above targets you are out on your arse with no golden parachute and no new sinecure somewhere else in the public service.

    Now, to you accept the new reality or would you prefer to resign now?

    See? It really is easy.

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  46. RedRag () says:

    The simple unvarnished truth is that there is NO nation on earth that delivers to ALL it citizens on ALL of the expectations that we nowadays demand.

    Some of the very wealthiest such as Canada and Australia do quite well, and others such as the USA do well for some and poorly for others. NZ is not one of the wealthiest nations. There is no developed nation on earth whose “health system” model is so outstandingly superior or more notably efficient than anywhere else, upon which you can build a case to justify the wholesale upheaval of the NZ system in order to implement some ideological new model.

    All human endeavour is imperfect, this is true both of public and private sector enterprises. The main difference is that the public sector is usually more tranparent and visible, whereas the private sector gets to hide it’s inefficiencies and is far less accountable at the same time. In the USA, if your medical insurer will not pay, then you are stuffed or at the least you face a major legal battle…at least in our public system you always have some access to public accountability. There is no clear-cut case for the wholesale dismantling of our public health system in the expectation that a fully privatised replacement would be any better.

    Health care is by far and away the largest single budget item in the public sector. The biggest components of that spend is on plant and labour. Both of these are very expensive and are in high demand worldwide. All the effective ideas around improving the system revolve around reducing the unecessary burdens on the system with improved primary health care to ensure that more people present a minimal burden on the system for as much of their life as possible.

    If most of us reached the age of 80 or so in reasonable health, this would change the picture totally. Much past this age and we are all inevitably faced with death in one form or another, and most of us will accept our fate without demanding excessive intervention to stave off the inevitable. It is the 40-80 yr old group, who have some decades of life expectancy remaining, when presenting with expensive (and yet largely avoidable, lifestyle induced) illnesses, who consume the big dollars. (For instance iwikiwi above mentioned an aunt’s gangrenous big toe…most likely due to smoking and or diabetes.) The system groans under the burden that these people create. Of course the doctors would have preferred to operate sooner on the big toe rather than amputate from the knee….but they couldn’t because there were a hundred other cases they judged more urgent.

    There are four straighforward measures that would make access to health care in this country a doddle:

    1. Eliminate all alcohol abuse and related crime.

    2. Eliminate all smoking.

    3. Educate consumers and legislate the food industry so that we eat real food with real nutrition.

    4. Get people out of their cars and walking 30 mins a day to the bus or train stop.

    Until we choose to do these things, it is dishonestly hypocritical of us to collectively whine as a nation that our health system is expensive and isn’t coping with the demands we place upon it.

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  47. sonic () says:

    ” – you mean who got their initial training in the private sector? Very few”

    Thanks for the admission, pity it had to be dragged out of you eh?

    As for adolf, go on mate tell the truth. You hate the fact that your tax money is being paid to help people get well, some of them may even be the underserving poor for goodness sake. What you guys all hate about state provision is that things get done and no-one makes a big, fat profit.

    ” Hayman’s analogy with Telecom”

    Telecom, lets see which part of the government owns that again? A picture perfect example of the wonders of privatisation that is.

    Will National to go into an election promising cuts in the health budget?

    Not a chance.

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  48. sonic () says:

    Adolf, a hospital is not a branch of the Warehouse. Trying to do more operations with less staff leads to lots of dead people.

    Funny how you guys always accuse the left of being driven by “ideology” yet it is you who seem driven by blind hatred of public services (as the CYFS argument showed)

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  49. David Farrar () says:

    Hayman lists lots and lots of inputs where the money has gone yet is unable to point to any actual improvements in outputs, let alone outcomes!

    He shows us exactly what is wrong with the system. People think the more money you spend, the better it must be. If only.

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  50. Adolf Fiinkensein () says:

    RedRag, you are dissembling again. You avoid the issue that the expenditure has increased over six years by how much? while the number of procedures has not increased.

    You need to be reminded that if your heroes had not stolen some $25 million to buy the last election; poured over a billion down the wananga/polytechnic black hole; given millions away to Jim Anderton’s failed business friends,thrown away how many million on election bribes to uni students and their wealthy parents, then the good lady could have received her operation in good time.

    You remind me of the people in New York who used to extol the virtues of the Mafia in the 30s and 40s.

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  51. sonic () says:

    Adolf actually means they could have given his rich chums huge tax cuts, but we’ll let him pretend to be the great humanitarian, weeping over the fate of the poor and sick..

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  52. Adolf Fiinkensein () says:

    Sonic, there is a kinda ‘loosing’ stench about your last comment. In point of fact hospitals have many similarities with branches of the Warehouse. The Warehouse does not stint on the employment of frontline staff. The difference between the Warehouse (highly successful) and your dopey health system (disastrously unsuccessful)is that Stephen Tindall has enough brains to know he won’t get anywhere employing legions in his head office to make rules for his front line staff to follow so that they spend more time writing reports than they do in serving customers at the check out. Substitute patients in operating theatres for customers at the check out and you might just start to understand. Of course you won’t understand because you are a socialist.

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  53. Andrew Bannister () says:

    Further to last Andrew B. It really is quite simple. You go to the CEO of the Health Department and you tell him:-

    blah blah blah

    See? It really is easy.

    Yep, still just words.

    If ‘having done something’ is to be a criterion for making a comment here then most of the lefties who go on and on would be silent for a bloody long time.

    I was just pointing out that 100 words on a blog do not fix a health system. I sure as hell know that you don’t have the solution.

    Anyway, must go. Tonight I get to assist in my first carotid artery stentosis. Cool!

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  54. RedRag () says:

    The difference between the Warehouse (highly successful) and your dopey health system (disastrously unsuccessful)is that Stephen Tindall has enough brains to know he won’t get anywhere employing legions in his head office to make rules for his front line staff to follow so that they spend more time writing reports than they do in serving customers at the check out.

    First of all your line about our health system being disastrously unsuccessful is deeply and offensively wrong. The system actually works incredibly well for the large majority of people who urgently or acutely require it. The outcomes are overwhelmingly positive, as huge numbers of happy ex-patients routinely testify. The Warehouse by comparison has merely made Steven Tindall a rich man, a trivial accomplishment by comparison.

    If Tindall’s staff stuff up it only amounts to a few dollars here or there….when the Health system stuffs up badly enough there are lives at stake and demands for the Minister to resign. Comparisons with a big box retailer are odious.

    You avoid the issue that the expenditure has increased over six years by how much? while the number of procedures has not increased.

    Produce the evidence. As I understand it the total number of procedures both in and out-patient has increased markedly. You are just making stuff up.

    The extra cash over the last six years has gone in three main directions:

    1. Catch-up in plant and assets after a decade of National’s incompetent slash and burn.

    2. Substantially increased pay across the whole industry in order to retain essential skilled staff in the face of huge international competition.

    3. An actual increase in outcomes. The notion that nothing real has been achieved is right wing puffery. The problem of course is that in common with all other developed nations, the demand is increasing even faster than the supply.

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  55. Bogusnews () says:

    I have read with a great deal of interest the treasury reports regarding the appalling ballooning of state expenditure under Labour. Health is a classic example. They are spending an extra 16Bil a year on the state service, an increase of 40%, yet where is the increase in productivity?

    From where I sit, I see that Health (4.2Bil more is spent every year) yet the waiting list has gone up from 100,000 under National, to 180,000 under Labour in only 7 years.

    An interesting report on health was delivered to Parliament in the middle of last year which had some interesting observations. Among them:
    Administrators, there are now 12,000 – one for every hospital bed. It listed several public hospitals where it costs because of the admin overhead up to five times more to stay one night than in an equivalent private hospital, up to six times more to call an ambulance.

    If I had my way, I’d love to see health spending stay pretty much where it is, but cut the majority of beuraucrats and spend the money instead on increased pay for doctors and nurses. They sure as hell deserve it.

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  56. pdq () says:

    “Adolf actually means they could have given his rich chums huge tax cuts, but we’ll let him pretend to be the great humanitarian, weeping over the fate of the poor and sick..”

    And folks, that’s the sound of a burst nappy hitting the tarmac.

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  57. sonic () says:

    Adolf wants to run our hospitals along the lines of the Warehouse, low paid low skilled staff, cheap equipment and, no doubt, having to operate on yourself with a rusty knife.

    Odd that this man is not on charge of the National party’s health policy, I can see a couple of excellent billboards that could be made from his contributions today.

    (excellent for Labour that is)

    “An interesting report on health was delivered to Parliament in the middle of last year which had some interesting observations. Among them:
    Administrators, there are now 12,000 – one for every hospital bed. It listed several public hospitals where it costs because of the admin overhead up to five times more to stay one night than in an equivalent private hospital”

    Details please?

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  58. iiq374 () says:

    Thanks for the admission, pity it had to be dragged out of you eh?
    Sonic – for some reason you still see this as a victory point of any kind? As I pointed out virtually all initial doctors training is done because:

    a) Universities tend to be next to Public Hospitals (private hospitals can’t tend to afford being built on multi-million dollars of real estate)
    b) Public hospitals get new doctors next to free through subsidization
    c) Public hospitals get to absorb the liability of when a doctor without experience screws up and kills someone (or hey, just maims). Mainly through such bad accountability systems that the perpetrator can never be identified and like most public entities duck the vicarious responsibility.

    If private hospitals were put on equal footing in these respects they would probably train a vast majority more staff.
    Of course I should have qualified my statement that it is only few if you are talking about doctors and nurses – otherwise your pharmacists, midwives et al tend to be private. Oh and the GP phase of advanced doctor / surgeon training also tends to be private.

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  59. iiq374 () says:

    The main difference is that the public sector is usually more transparent and visible, whereas the private sector gets to hide it’s inefficiencies and is far less accountable at the same time.
    Umm – what have you been smoking RedRag?

    At least I can sure the private enterprise that screws up – public hospital screws up I have no recourse. The private sector is accountable to all sorts of people; the Government included – while the public sector has proven again and again that its only regulators are itself, and they are certainly crap at that.

    And when the private sector *really* screws up – it can’t legislate nor bail itself out of trouble either.

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  60. iiq374 () says:

    Adieu till the morrow – work tomorrow awaits ;-)

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  61. Rumpole () says:

    As Doctors & Dentists exit training with the largest student loans you need to net off this against the public sector cost of training.

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  62. RedRag () says:

    Umm what rock have YOU been hiding under all your life jig? Have you not noticed that the Public Health system is the regular old whipping boy for every fledgling shit-stirrer who fancies to froth up some quick attention for themselves?

    Like just today we were treated to yet another non-story about how Pharmac had “allowed” the supply of a drug to run short because of it’s “single provider contract” policy…and all the usual axe-grinders and agenda chisellers came out to play. When someone finally got to the facts it turned out that the drug in question actually had two registered suppliers, and actually hadn’t run out at all, and the whole thing the as per normal “let’s run a health story beat-up because we have no real news” media hackery. As for “sueing” your private medical provider…don’t make me laff…when was the last time anyone got anywhere with that? The private sector has it’s own share of screw-ups just as does the public….except it is a lot easier to keep them away from public attention.

    We’ve been over this ground over and over; BOTH public and private health provision have their strong and weak points; BOTH are far from perfect having their own specific failings….and yet in the whole neither system can be shown to be dramatically superior to the other. What we do know is that heavily privatised systems while offering a wide range of desirable services, struggle to provide equality of access, and public systems by contrast tend to do well at providing a lesser range of of more critical services, but to everyone who comes in the door.

    I seem to recall reading a while back, that the single most common precipitating factor in personal bankrupcy and homelessness in the USA was a health crisis, and the subsequent arrival of a medical bill that couldn’t be paid. Most other civilised nations find that sort of thing unacceptable. All humans collectivise risks that as individuals would wipe us out, but as a whole we can easily sustain. This is what public health provision does best…and yet if you are wealthy enough in NZ you have the choice of 100% access to whatever additional health services you desire. But please…lay off the crocodile tears because the rest of us (neither individually, nor collectively) are not able to afford such a priviledge.

    The public health sector is just another favourite big soft slow moving target for bored righties who have never been actually seriously ill a day in their lives.

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  63. Sonic () says:

    iiq, my point was that the private system is in some ways parasitical on the public system. All your figures about how ‘efficient” the private hospitals are has to take that into account.

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  64. ross () says:

    > Trying to do more operations with less staff leads to lots of dead people.

    The trouble is, trying to do more operations with more and more money leads to lots of dead people.

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  65. Adolf Fiinkensein () says:

    Hey, Sonic, hayman, redrag, phil u and other leftie dribblers, keep an eye on the quality and quantity of TV programmes coming from TVNZ over the next twelve months. Two hundred beauracrats (woops! bureaucrats) are to lose their jobs. They are getting rid of the drones. Do you have any idea what percentage of total staff numbers and budget these represent?Then go head hunt the CEO and send him along to your beloved Health Department.

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  66. AlfredeNewman () says:

    If you think the situation would change under national, think again, national were the one who started cutting health funds in a big way during the 90s.

    Just the way of the woprld unfortunately, USA/UK has the same problem if not worse.

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