Enough is enough. Former PMs Helen Clark and Jacinda Ardern should come clean about how they were the Chief Architects of the omni-shambles that has become our health system. They should take responsibility for the folks who suffered from long waiting lists and declining health-care quality, some of whom didn't make it. Why?
Because the person who wrote the report called "Health and Disability System Review" - which was the inspiration behind the disaster that is Health NZ - is Heather Simpson, Helen Clark's Chief of Staff for 9 years, who followed her to the United Nations in New York. Nine years after Clark was voted out, her Chief of Staff got reincarnated by Labour to advise Ardern and Hipkins on health-care. Why was Simpson ever chosen to write the report? Anything to do with her being well-connected to the Party? The report formed the inspiration behind the centralization of NZ's health system, advocating for a cut in the number of District Health Boards. After Ardern's Health Minister Little got hold of the report, he went all the way, and got rid of them entirely.
I read Simpson's report. No intellectual basis is built for its suggested re-design of health-care delivery. No wonder our system is falling apart. It keeps repeating the word "equity", seemingly in the hope that by writing that word on paper is enough to deliver it in practice. The report bizarrely repeats "equity" 219 times (!?) By contrast, the word "competition", which is a requirement to ensure quality and efficiency in nearly every economic system, is not mentioned one time. The report thereby seeks to deliver equally awful health-care to everyone. The economics behind the report is embarrassingly simple-minded. Its half-baked idea is that the monolithic super-structure it invents, "Health NZ" would create "economies of scale". Its uses the jargon, "scaling up" - a line dictators who want to control it all use to justify their existence. In Health NZ's case, its succeeded only at being a big scale disaster.
Simpson's report refuses to acknowledge that her chosen single public payer / single public provider model is not the only way equity can be delivered. It can also be achieved by the government being the single payer but (unlike Simpson's silly single provider preference) with private and public suppliers competing to provide the highest quality service at set prices (that the government pays). It's that competition which ensures the best outcomes. It's how our health system already works for drugs, courtesy of Pharmac, which negotiates prices with pharma companies. That was how we got the Pfizer vaccine during Covid. If we'd relied on the NZ government to invent a vaccine, we'd still locked down, waiting. Ardern's only contribution to the pandemic was her Comms-PR-marketing job. The vaccine had nothing to do with her, aside from her ordering it late. Our entire health system can be run on the above lines, with Kiwis choosing which health-provider they prefer, public or public, going to the one that best satisfies their needs (including cultural ones). It doesn't constitute privatization of our existing public hospitals, since they would not be privatized.
When the inventor of well-being economics, Richard Easterlin, visited NZ and I invited Grant Robertson to meet him, Robertson pulled out a few days before, even though that agenda was central to his budgets. What he missed was the following: Easterlin argued there are three main sources of well-being: close family, good health, and satisfying job. Because Labour stands unambiguously for the destruction of the traditional family unit, has wrecked health-care due to Clark and Ardern's useless reform, and has ruined the careers of talented Kiwis by ending meritocracy (by giving preference to identity, not ability, causing the best of our youth to leave NZ) this past Labour government has done more to crush well-being than any other. Six years of carnage will required a decade of re-building.
I read Simpson's report. No intellectual basis is built for its suggested re-design of health-care delivery. No wonder our system is falling apart. It keeps repeating the word "equity", seemingly in the hope that by writing that word on paper is enough to deliver it in practice. The report bizarrely repeats "equity" 219 times (!?) By contrast, the word "competition", which is a requirement to ensure quality and efficiency in nearly every economic system, is not mentioned one time. The report thereby seeks to deliver equally awful health-care to everyone. The economics behind the report is embarrassingly simple-minded. Its half-baked idea is that the monolithic super-structure it invents, "Health NZ" would create "economies of scale". Its uses the jargon, "scaling up" - a line dictators who want to control it all use to justify their existence. In Health NZ's case, its succeeded only at being a big scale disaster.
Simpson's report refuses to acknowledge that her chosen single public payer / single public provider model is not the only way equity can be delivered. It can also be achieved by the government being the single payer but (unlike Simpson's silly single provider preference) with private and public suppliers competing to provide the highest quality service at set prices (that the government pays). It's that competition which ensures the best outcomes. It's how our health system already works for drugs, courtesy of Pharmac, which negotiates prices with pharma companies. That was how we got the Pfizer vaccine during Covid. If we'd relied on the NZ government to invent a vaccine, we'd still locked down, waiting. Ardern's only contribution to the pandemic was her Comms-PR-marketing job. The vaccine had nothing to do with her, aside from her ordering it late. Our entire health system can be run on the above lines, with Kiwis choosing which health-provider they prefer, public or public, going to the one that best satisfies their needs (including cultural ones). It doesn't constitute privatization of our existing public hospitals, since they would not be privatized.
When the inventor of well-being economics, Richard Easterlin, visited NZ and I invited Grant Robertson to meet him, Robertson pulled out a few days before, even though that agenda was central to his budgets. What he missed was the following: Easterlin argued there are three main sources of well-being: close family, good health, and satisfying job. Because Labour stands unambiguously for the destruction of the traditional family unit, has wrecked health-care due to Clark and Ardern's useless reform, and has ruined the careers of talented Kiwis by ending meritocracy (by giving preference to identity, not ability, causing the best of our youth to leave NZ) this past Labour government has done more to crush well-being than any other. Six years of carnage will required a decade of re-building.
Sources:
https://www.health.govt.nz/system/files/documents/publications/health-disability-system-review-final-report.pdf
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.
https://www.health.govt.nz/system/files/documents/publications/health-disability-system-review-final-report.pdf
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.
7 comments:
A decade - if the system can actually be re-built. We must hope that it is not ruined beyond repair.
"Equity".... that woke word again. What in the hell is it supposed to mean?
In the case of health, equal outcomes of a course of treatment? How is that even possible in the real world? Equal opportunity to get proper treatment is good goal, but even that is not completely possible in the real world. If I live 5km up a dirt road which is routinely flooded in winter, I'll never have the same opportunity to get medical treatment as someone living in a city.
just another example of women bought up in the Labour/Union political machine with no real world experience. The scary thing is that they are still regaling against change despite all the evidence of their past sisters failed ideology.
No, they were just "selected puppets" fulfilling the States agenda, and were then rewarded for it.
In response to Nuku. Equity is a Marxist term. The word Communism has gone out of vogue.
One small point Professor: if we had refused to pay anything for the Covid ‘vaccine’ they would have given it to us for free. Apart from that I agree with everything else you so clearly outline.
Health, education, policing, the economy have all suffered the same fate in New Zealand.
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