Today it comes in the shape of my former Adjunct Professor colleague, who popped up a few years later as a Professor at Auckland University of Technology, 70 year old Lester Levy. He was appointed by Key to Chair Counties Manukau District Health Board in 2016, having previously been appointed by my former Auckland Grammar class-mate, Jonathan Coleman (who was Minister of Health) to Chair both Waitemata & Auckland District Health Boards, as well as Auckland Transport. Levy has now been selected to run the newly-created Health NZ.
Isn't it great how things run in NZ? Luxon quietly calls Key for advice about health-care & universities - and John says to Chris, "Look mate, Peter and Lester were great when they served me as PM - why not give them another whirl?" For Gluckman & Levy, it must seem like nothing has changed since the Key Glory Days. So what's the problem? Shouldn't the best person get the job, regardless of age, gender or race? Of course. But changing the deck chairs, shuffling faces & names of people at the top, and declaring an outfit "Under New Management" has little to do with solving our health system's woes. Whether NZ has one centralized authority like Health NZ, or several slightly more decentralized ones (in the form of District Health Boards, as National prefers) won't fix the problems. Our UK-style National Health System is a failing model of health-care. The UK's one is falling apart along the same lines as ours. Systems based upon single state provision of health-care services, as well as single state payments for health bills, are defunct.
A broad outline of the solution is straightforward. Universal health-care is vital to ensure an equitable society. Everyone must be insured for health-care needs. However the supply of such services should come substantially, but not entirely, from the private sector. Providers must compete on quality. Unlike NZ's system, people should have choice as to who is their provider. Every Kiwi should be able to go private if they wish. Bills should be paid by social insurance so no-one is denied the best health-care on affordability grounds. Such a system is running successfully in many nations. For an example of how it can work in NZ, see my Treasury presentation. Whether it's Levy or a Man from Mars, shifting bosses won't work. When will the PM realize his latest job is different from his corporate ones? His new job is to change the rules to achieve the best outcomes, not just change the players & management.
Isn't it great how things run in NZ? Luxon quietly calls Key for advice about health-care & universities - and John says to Chris, "Look mate, Peter and Lester were great when they served me as PM - why not give them another whirl?" For Gluckman & Levy, it must seem like nothing has changed since the Key Glory Days. So what's the problem? Shouldn't the best person get the job, regardless of age, gender or race? Of course. But changing the deck chairs, shuffling faces & names of people at the top, and declaring an outfit "Under New Management" has little to do with solving our health system's woes. Whether NZ has one centralized authority like Health NZ, or several slightly more decentralized ones (in the form of District Health Boards, as National prefers) won't fix the problems. Our UK-style National Health System is a failing model of health-care. The UK's one is falling apart along the same lines as ours. Systems based upon single state provision of health-care services, as well as single state payments for health bills, are defunct.
A broad outline of the solution is straightforward. Universal health-care is vital to ensure an equitable society. Everyone must be insured for health-care needs. However the supply of such services should come substantially, but not entirely, from the private sector. Providers must compete on quality. Unlike NZ's system, people should have choice as to who is their provider. Every Kiwi should be able to go private if they wish. Bills should be paid by social insurance so no-one is denied the best health-care on affordability grounds. Such a system is running successfully in many nations. For an example of how it can work in NZ, see my Treasury presentation. Whether it's Levy or a Man from Mars, shifting bosses won't work. When will the PM realize his latest job is different from his corporate ones? His new job is to change the rules to achieve the best outcomes, not just change the players & management.
Professor Robert MacCulloch holds the Matthew S. Abel Chair of Macroeconomics at Auckland University. He has previously worked at the Reserve Bank, Oxford University, and the London School of Economics. He runs the blog Down to Earth Kiwi from where this article was sourced.
5 comments:
Mr Luxon may never realize that his job is now different - because he does not really see that this is the case.
His plan is to continue the Key legacy.... although he is hindered by lACT and NZF because the voters supported these parties over National.
He - and National - still do not get that economic recovery - however urgent and complex - will fail if NZ continues transitions to a society based on ethnocracy ( i.e. superior rights for one minority).
But he and his National colleagues all expect to be long gone when the disastrous results of this process appear. He may get a shock in 20026.
PS The review of universities includes a question on how these institutions should " honour the Treaty".... Say no more. This is an accepted " fait accompli". So nothing has changed from the Key era.
National are still using Labour Health policy even at considerable cost. Large corporates in USA ie
"McDonalds" etc use NZ stores to test new styles of hamburgers as the population is small and reasonably intelligent .
The South Island would be an excellent place to trial Health care as Professor Robert MacCulloch opines . Two larger hospitals , two medium and numerous small hospital facilities each giving exemplary care to patients whose purpose is to get better and not complain about trivialities .
At the least we could argue that National is doing better than rearranging the deck chairs.
Oh darn! I thought we might be getting somewhere. SURELY that excellent interview of Plunket's with the Min. of Health was 'real'?
I usually agree with you Basil, but the NZ population is "reasonably intelligent"? Some 12% vote the Greens; well over 20% Labour, and then there's TPM and others. A fair chunk of the populous are patently fools, but then, I suppose compared to the US...?
Typical of National, everything has to make a profit.
First they cut the budget allocation do a department they want to sell off, accuse them of "Overspending", sack the board and replace it with their man. Then they will claim it is uneconomic and sell it of.
This raises several questions.
If it is uneconomic, who would want to buy it?
The private sector can make all the profit it wants to, regardless of the damage to the service, and then go cap in hand to the National Party to make up the shortfall on the grounds that it is a core service to the people of New Zealand. Why would any Government take such a short sighted approach?
We were doing ok under Labour, we need more Doctors, more nurses and ancillary staff. Not "Jobs for the Boys" and more people at the top, on high salaries.
This is just another step back for NZ.
The next thing you know they will be stirring up trouble with Maori by messing with the Foreshore and Seabed legislation...
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