Roger Partridge: Health innovators face the structural question
- Administrator
- 3 hours ago
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Treasury projects public health spending will rise from 7.1 to 10 per cent of GDP by 2065. Over the same period, the ratio of working-age taxpayers to superannuitants will halve. Something has to give.
The question at this week’s third nib-New Zealand Initiative Health Innovators’ Summit was: “What?”
The answer was different from the two earlier conferences.
In 2024 and 2025, the lesson had been “not to wait for government.” Lloyd McCann’s Tāmaki Health, our largest privately-owned primary-care network, was building team-based care across 52 clinics. Sir Bill English was championing the social-investment ventures, Manawanui and Impact Lab.
The room had been told, in effect, that better operators would have to save the system. Both returned this year, but the conference mood had changed.
Health Minister Simeon Brown opened with recent Government commitments, but was honest about the scale of the problems that remain.
Ezekiel Emanuel, the American health policy academic, told the room New Zealand was “solidly middle” by rich-country standards. The country did not need to spend vastly more, but to spend better – by fixing incentives, infrastructure and information.
Hamiora Bowkett, the government-appointed Crown Observer at Health New Zealand, asked whether compulsory insurance, national, social or private, should fund more of the system. Most high-performing systems use compulsory insurance. New Zealand does not.
Brent Pattison, the new CEO of Heritage Lifecare, argued for aged residential care as step-down infrastructure that eases hospital pressure.
Claudia Wyss, a former health-sector chief executive, made the strongest structural case. She wanted a ring-fenced health levy modelled on ACC, insulating funding from annual budgets. And she wanted a review of the boundary between ACC and Health New Zealand, which funds patients with identical needs differently depending on whether their condition arose from an accident.
Neither is something a primary-care network or aged-care provider can deliver. They are statutory questions only Parliament can answer.
The bottom-up case has not weakened. But every entrepreneur in the room was operating inside funding arrangements not designed for the next forty years.
A fifteen-minute primary-care consultation cannot be funded out of an eight-minute payment. An older New Zealander cannot insure herself in a market that prices her out.
Two years ago, the room was excited about what entrepreneurs could achieve. This year, no one believed it would be enough.
This piece first appeared in the weekly New Zealand Initiative newsletter. Roger Partridge also writes at Plain Thinking
The issue of whether we call it a 'health care industry' or something like a 'disease cure or mitigation industry' is essentially irrelevant. The vast majority of people do not want to ever be unwell, or to die.
These outcomes reach us all, no matter how healthy our lifestyle might be.
The is no conceivable system of funding, given what now exists in terms of high tech invstigation and treatment apparatus, and in regards to ever more difficult, and therefore expensive to produce drugs, that can ever possibly meet what we want, given what is potentially available and might be helpful in restoring one's 'health'.
Perhaps folk giving presentations such as the one Rogar Partridge has reported on, might make…
Must be just about time to charge ALL MAORI INCORPORATIONS the standard company tax. Afterall all Māoris access the health system as do all other taxpayers or superannuitants.
We always hear about the burgeoning Maori economy riding on the whales back of the rest of the taxpayers!!
Our government must get bold and go searching for better ways to increase our national income streams
Ever heard of coal, gas or oil exploration….. fortunately it is back to open business ……….until Labour and the Greens get in again.
Greens want to tax the hell out of us but have no idea where the hard earned daily bread comes from!!
Scandinavian countries thrive on North Sea underground resources and we are alwa…
I often wondered why we call a system that results in more people needing or wanting more medical services and products a "health" system? It is certainly beneficial for the people who manage and receive the payments for the services and products but not so beneficial for those that consume and pay for them. Wouldn't a "health" system result in less sick people requiring less medical services and products? Health is a state of physical, mental and social wellbeing. It is not a commodity that consumers can purchase form providers of goods and services. That state of wellbeing is related to individual genetic and environmental influences that either maintain or disrupt the physical, emotional mental and social harmony if internal and external system. Evolution or…
Seems like an appropriate time to raise the subject of voluntary euthanasia. Let us oldies quietly toddle off of our own volition before life becomes unpleasant and healthcare expensive …
Claudia Wyss, a former health-sector chief executive, made the strongest structural case. She wanted a ring-fenced health levy modelled on ACC, insulating funding from annual budgets
what she's really saying is: health funding shouldn't be a political decision year to year; it should be a social contract, like accident insurance.
It seems though we just pour more and more cash into "healthcare" or should we just say "disease-mitigation"? Nothing too healthy for the poor souls with multiple diseases;