New Zealand’s Health and Disability Systems

• Adrian Capalad

NEW ZEALAND

New Zealand’s health and disability system has encountered lots of changes in the past decade. In fact, New Zealand spends almost nine percent of its gross domestic product (GDP) on health care which is roughly USD 2,403 per capita. Approximately seventy seven percent of health expenditure by its citizens is shouldered by the government (WHO, 2008). In a more recent study, 2010, in which 14 developed countries were compared side by side on the basis of health spending and medicine use. The result was that New Zealand came in last among other countries which spends USD 3,460 per capita against United States at USD 7,290 (Johnston, 2010)

Figure 1: Overall Expenditures on Health http://www.commonwealthfund.org/News/News-Releases/2010/Jun/~/media/Images/Publications/Fund%20Report/2010/jun/MM2010l.gif

New Zealand’s Ministry of Health is solely responsible for managing and funding the twenty District Health Boards (DHBs) (Ministry of Health, 2014). The DHBs meanwhile, are responsible for organizing healthcare in their own districts which aims to carry out specific standards that were promulgated by the Ministry of Health. In addition, each DHB district is composed of eight members, in which one is appointed by the Ministry of Health and the other seven are elected every three years (Ministry of Health, 2014). Each DHB then supervises the forty six local Primary Health Organizations throughout the country. These Primary Health Organizations were only introduced to the system midyear of 2002 wherein its main objective was to focus on the status of the communities under its jurisdiction (Ministry of Health, 2014).

New Zealand health system does not enclose itself on the health alone but, it includes disability as well. Thus, the health and disability services in New Zealand are delivered synonymously through a complex network of organizations and people (Ministry of Health, 2014).

According to the Ministry of Health (2014), these are the key organizations and people in New Zealand’s health and disability system:

• Appointments to statutory bodies
• Crown entities & agencies
• District health boards
• Health alliances
• Ministerial health committees
• NASO
• Non-governmental organisations
• Primary health organisations
• Professional and regulatory bodies

Health Targets:

In New Zealand each individual will be issued a National Health Index (NHI) number however, only permanent residents and its citizens have access to free health and disability services that are mostly financed through taxes (Ministry of Health, 2011). Non-residents such as tourist and illegal migrants are charged fully for the cost provided by health institutions. Private voluntary insurance is mostly used to cover cost sharing requirements and elective surgery.

Health Coverage:

New Zealand’s health and disability services includes all disability support services, long term care, mental health care, primary care, preventive care, outpatient care, prescription drugs for all its citizens and dental care for school children. However, there are numerous of services that are not included like adult dental care and orthodontics, optometry care, and physiotherapy. Although there are health services not included, the National Health Service tries to compensate through preventive actions like dental care, eye care, immunization and vaccination programs, inpatient and outpatient hospital care, screening, medications, mental health care, palliative care, long term care, rehabilitation and physiotherapy after a stroke.

Safety Net:

Patients who often visits their physicians or accumulates more than ten visits per year are given a card in which they can avail a lower service rate. Local children under six years are free from consultation and prescription while the rest of the general population is subsidized by the government provided they are enrolled in the Primary Health Organization (PHO).

Figure 1: Overview of New Zealand Health and Disability System. Retrieved from http://www.health.govt.nz/sites/default/files/images/nz-health-system/structure-health-disability-sector.png

New Zealand health and disability system parts of the structure:

• “The Accident Compensation Corporation (ACC) mostly covers the costs of cases deemed as ‘accidents’, it may be from medical misadventure or otherwise. The ACC service applies for all people legally in New Zealand (including tourists and students), in which the costs of accidental benefits will be recovered via levies on employers, employees and some other sources such as car registration (Parliamentary Counsel Office, 2013).”

• Southern Cross Health Insurance is a non-profit-scheme and is one of the largest health insurance provider composing at about three-fourth’s of the health insurance market and covering almost a quarter of all New Zealanders in 2007, even operating its own chain of hospitals.

• PHARMAC is a government pharmaceutical company that requires co-payments, but are also subsidised by private shareholders. The objective of the government was for patients with community health services cards or high user health cards (Pharmaceutical Management Agency, n.d.).

• St. John New Zealand charity in Auckland and Wellington Free Ambulance based in the Wellington Region are both primarily emergency oriented services that are supported with a mix of private (donated) and public (subsidy) funds (St. John, 2014).

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