Health care in New Zealand
Encyclopedia
The healthcare system of New Zealand
has undergone significant changes throughout the past several decades. From an essentially fully public system in the early 20th century, reforms have introduced market and health insurance elements primarily in the last three decades, creating a mixed public-private system for delivering healthcare.
In 2005, New Zealand spent 8.9% of GDP on health care, or US$2,403 per capita. Of that, approximately 77% was government expenditure. In a 2010 study, New Zealand came last in a study for the level of medications use in 14 developed countries (i.e. used least medicines overall), and also spent the lowest amount on healthcare amongst the same list of countries, with US$2510 ($3460) per capita, compared to the United States at US$7290.
The boards for each DHB are elected in elections held every three years, with the exception of one of the eight board members, who is appointed by the Ministry of Health.
The DHBs oversee the forty six Primary Health Organizations established throughout the country. These were first set up in July, 2002, with a mandate to focus on the health of communities. Originally there were 81 of these, but this has been reduced down to 46 in 2008. They are funded by DHBs, and are required to be entirely non-profit, democratic bodies that are responsive to their communities' needs. Almost all New Zealanders are enrolled in a PHO, as there are financial incentives for the patients to become enrolled.
Damage as a result of "accidents", ranging from minor to major physical and psychological trauma, is generally completely covered by the Accident Compensation Corporation
(ACC). This may include coverage for doctors visits and lump-sum payments.
Those earning less than certain amounts, depending on the number of dependents in their household, can qualify for a Community Services Card (CSC), which reduces the upfront fee for visiting a doctor.
Hospital and specialist care, on the other hand, is totally covered by the government if the patient is referred by a general or family practitioner.
The following statistics are a sample from the World Health Organization Statistical Information System (WHOSIS). The year on which the data were sampled follows the statistic in brackets.
is legal in New Zealand, if certain criteria are met. In general, either the health of the mother or the foetus must be in jeopardy. Additionally, two doctors must give their consent to the procedure. There were 18,380 abortions carried out in 2007, following a general increase in both the absolute number and per capita rate since 1991.
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
has undergone significant changes throughout the past several decades. From an essentially fully public system in the early 20th century, reforms have introduced market and health insurance elements primarily in the last three decades, creating a mixed public-private system for delivering healthcare.
- The Accident Compensation CorporationAccident Compensation CorporationThe Accident Compensation Corporation is a New Zealand Crown entity responsible for administering the Accident Compensation Act 2001. The Act provides support to citizens, residents, and temporary visitors who have suffered personal injuries....
covers the costs of treatment for cases deemed 'accidents', including medical misadventure, for all people legally in New Zealand (including tourists), with the costs recovered via levies on employers, employees and some other sources such as car registration.
- The relatively extensive and high-quality system of public hospitals treats citizens or permanent residents free of charge and is managed by District Health Boards. However, costly or difficult operations often require long waiting list delays unless the treatment is medically urgent. Because of this, a secondary market of health insurance schemes exists which fund operations and treatments for their members privately. Southern Cross Health InsuranceSouthern Cross Healthcare (New Zealand)Southern Cross Healthcare Group is a collection of independent, health-oriented businesses founded on not-for-profit principles, and is New Zealand’s largest non-public healthcare organisation. The Group’s main areas of business include health insurance, private hospitals and travel insurance...
, a non-profitNonprofit organizationNonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...
-scheme, is the largest of these at about 60% of the health insurance market and covering almost a quarter of all New Zealanders in 2007, even operating its own chain of hospitals.
- Primary care (non-specialist doctors / family doctors) and medications on the list of the New Zealand government agency PHARMAC require co-payments, but are subsidised, especially for patients with community health services cards or high user health cards.
- Emergency services are primarily provided by St. John New Zealand charity (as well as Wellington Free Ambulance in the Wellington Region), supported with a mix of private (donated) and public (subsidy) funds.
In 2005, New Zealand spent 8.9% of GDP on health care, or US$2,403 per capita. Of that, approximately 77% was government expenditure. In a 2010 study, New Zealand came last in a study for the level of medications use in 14 developed countries (i.e. used least medicines overall), and also spent the lowest amount on healthcare amongst the same list of countries, with US$2510 ($3460) per capita, compared to the United States at US$7290.
Structure
The Ministry of Health is responsible for the oversight and funding of the twenty District Health Boards (DHBs). These are responsible for organizing healthcare in the district and meeting the standards set by the Ministry of Health. Twenty-one DHBs came into being on January 1, 2001 with Southland and Otago DHBs merging into Southern DHB on 1 May 2010.The boards for each DHB are elected in elections held every three years, with the exception of one of the eight board members, who is appointed by the Ministry of Health.
The DHBs oversee the forty six Primary Health Organizations established throughout the country. These were first set up in July, 2002, with a mandate to focus on the health of communities. Originally there were 81 of these, but this has been reduced down to 46 in 2008. They are funded by DHBs, and are required to be entirely non-profit, democratic bodies that are responsive to their communities' needs. Almost all New Zealanders are enrolled in a PHO, as there are financial incentives for the patients to become enrolled.
Public vs. private payment
The burden for the core of the healthcare system rests with government expenditure (approx. 77%). Private payment by individuals also plays an important role in the overall system although the cost of these payments are comparatively minor.Damage as a result of "accidents", ranging from minor to major physical and psychological trauma, is generally completely covered by the Accident Compensation Corporation
Accident Compensation Corporation
The Accident Compensation Corporation is a New Zealand Crown entity responsible for administering the Accident Compensation Act 2001. The Act provides support to citizens, residents, and temporary visitors who have suffered personal injuries....
(ACC). This may include coverage for doctors visits and lump-sum payments.
Those earning less than certain amounts, depending on the number of dependents in their household, can qualify for a Community Services Card (CSC), which reduces the upfront fee for visiting a doctor.
Hospital and specialist care, on the other hand, is totally covered by the government if the patient is referred by a general or family practitioner.
Health statistics
- Demographics
- Population (in thousands): 4,334 (2009)
- Total fertility rate (per woman): 2 (2006)
- Adolescent fertility rate (%): 27 (2004)
- Funding
- Per capita government spending (PPPPurchasing power parityIn economics, purchasing power parity is a condition between countries where an amount of money has the same purchasing power in different countries. The prices of the goods between the countries would only reflect the exchange rates...
Int $Geary-Khamis dollarThe Geary-Khamis dollar, more commonly known as the international dollar, is a hypothetical unit of currency that has the same purchasing power that the U.S. dollar had in the United States at a given point in time. It is widely used in economics. The years 1990 or 2000 are often used as a...
): 1,905 (2006) - Per capita total spending (PPP Int $): 2,447 (2006)
- Total expenditure (% of GDP): 9.4 (2006)
- Per capita government spending (PPP
- Life expectancy
- Life expectancyLife expectancyLife expectancy is the expected number of years of life remaining at a given age. It is denoted by ex, which means the average number of subsequent years of life for someone now aged x, according to a particular mortality experience...
at birth (years): 80 (2006) - Life expectancy for females (years): 82 (2006)
- Life expectancy for males (years): 78 (2006)
- Neonatal mortality (per 1,000 live births): 3 (2004)
- Infant mortalityInfant mortalityInfant mortality is defined as the number of infant deaths per 1000 live births. Traditionally, the most common cause worldwide was dehydration from diarrhea. However, the spreading information about Oral Re-hydration Solution to mothers around the world has decreased the rate of children dying...
(per 1,000 live births): 5 (2006) - Years of life lost to communicable diseases (%): 5 (2002)
- Years of life lost to injuries (%): 17 (2002)
- Years of life lost to non-communicable diseases (%): 79 (2002)
- Life expectancy
Abortion
AbortionAbortion
Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...
is legal in New Zealand, if certain criteria are met. In general, either the health of the mother or the foetus must be in jeopardy. Additionally, two doctors must give their consent to the procedure. There were 18,380 abortions carried out in 2007, following a general increase in both the absolute number and per capita rate since 1991.
Medications
The Pharmaceutical Management Agency of New Zealand (PHARMAC) was set up in 1993 to decide which medications the government will subsidise. In general, PHARMAC will select an effective and safe medication from a class of drugs, and negotiate with the drug manufacturer to obtain the best price. There are approximately 2,000 drugs listed on the national schedule that are either fully or partially subsidised.Emergency service
Except in the Wellington region, emergency and non-urgent ambulance transportation is primarily carried out by the charitable organization, St. John New Zealand. Ambulance services in metropolitan Wellington and in Kapiti are provided by the Wellington Free Ambulance organisation. The Wairarapa DHB maintains its own ambulance service.See also
- Euthanasia in New ZealandEuthanasia in New ZealandEuthanasia is illegal in New Zealand and two attempts at passing legislation on legalised euthanasia failed to get through Parliament. It is also illegal to 'aid and abet suicide' under Section 179 of the New Zealand Crimes Act 1961...
- HIV/AIDS in New ZealandHIV/AIDS in New ZealandThere is a relatively low prevalence of HIV/AIDS in New Zealand. The rate of newly diagnosed HIV infections was stable at around 100 annually through the late 1980s and the 1990s, but rose sharply from 2000 to 2005. It has since stabilised at roughly 180 new cases annually...
- Water safety in New ZealandWater safety in New ZealandNew Zealand has one of the worst drowning rates in the world. The New Zealand Curriculum now does not have learn to swim as an objective. This means that not as many children are being taught to swim as formerly. By 2030 New Zealand can expect 150-180 drownings per year -Deaths in New...