Tuesday, 24 November 2009

Jon Voight is right: NZ’s die-while-you wait health system creates “many deaths”

Protesting what he calls Barack Obama’s “obsession with trying to ram this health bill through to create a socialist America,” actor Jon Voight told thousands of anti-ObamaCare protestors in Washington recently:

    _quote We would be no better off than the European countries and Canada and New Zealand who suffer greatly from a poor healthcare system. Their rationing system creates many deaths."

For my American readers who might think that’s hyperbole, that’s certainly true of New Zealand’s die-while-you-wait health “system.” Here’s some posts from NOT PC that demonstrate the point:

  • They died of it
    Three Hawkes Bay people have died waiting for coronary bypass surgery . . .
  • Cold comfort in die-while-you-wait hospitals
    . . .  figures were released revealing that up to one in eight patients at Wellington's hospitals "is the victim of a medical accident, error or mishap," and up to twenty-three patients of Wellington's Capital Coast Health were either killed or endured serious harm through inattention, incompetence and bungling. . . Capital Coast Health apologists issued the airy dismissal that "these problems occur everywhere" . . .
  • The "human face" of New Zealand's socialist medical system
    The Herald has three more tales showing the "human face" of New Zealand's socialist medical system . . .
  • Capital Coast: Not just a die-while-you-wait health system
    Following the death of a one-day old baby after her and her mother were released from Wellington hospital just six hours after giving birth, details have now been released under the Official Information Act showing that up to one in eight patients at Wellington's hospitals "is the victim of a medical accident, error or mishap," and up to twenty-three patients of Wellington's Capital Coast Health were either killed or endured serious harm through inattention, incompetence and bungling.
    Radio NZ story here. Dom Post story here.
    The information describes the standard of care at Capital Coast Health as "a shambles." An independent November audit stated that "crisis management was the normal operating environment at Wellington Hospital." And all while government spending on the government's health system has rocketed. The answer is clearly not more of our money.
  • The Wellington solution
    "It must be wearing," says Stephen Franks, "to work in a spiritless atmosphere - hating management but being cynical about all solutions." Giving a talk to the Auckland Medico-Legal Association, he was told afterwards that “hospital productivity had probably dropped 20% as many medical professionals had given up going the extra mile to cover for system deficiencies.” And all this while govt spending on the govt's die-while-you-wait health system has rocketed.
  • New ministers, same old failure
    . . . health spending has doubled in the last ten years while education spending has ballooned by 7% a year every year for the last ten years -- an enormous spending binge -- but with almost nothing to show for the deluge of taxpayer money beyond inflated public sector prices and emptier taxpayer pockets: all major health indicators for example have either held steady or declined as waiting lists have continued to climb, while all literacy studies show either decreases in functional literacy or only negligible improvements.
  • Rationed health care is hardly health care at all
    The Government won't fund Herceptin, a an early-stage drug for breast cancer that has saved lives overseas. It won't fund Gardasil, a vaccine for cervical cancer that promises to save the lives of hundreds of NZ women every year. Hospital waiting lists get ever longer, and hospital salaries here less and less attractive compared to what can be earned elsewhere.
    Lives are being lost, and the people who are saving lives are not being given the tools to do the job. Such is the result of the rationing of health care, which is precisely how government health care is delivered.
  • When more patients is a good thing
    . . . When this architect is hired by profit-making businesses to design their emergency rooms, his clients actually want him to attract more people inside. In their view, attracting more customers is a good thing, since more customers equals greater profits, and and increased ability to treat even more patients.
    Such are the incentives in private medicine.
    By contrast, when the government builds emergency rooms, more people are a nuisance. More patients equals an increasing strain on limited resources. More people in the emergency room is a problem.
    Such are the disincentives in state-run medicine.
  • Lindsay Perigo: Wankers, wowsers, waiting lists and Islamofascists
    Ronald Reagan used to tell the story, though not to Mikhail Gorbachev, of the fellow in the late unlamented Union of Soviet Socialist Republics, who bought a car. He was told by a clerk behind a desk that delivery would be seven years three months and five days away. “Morning or afternoon?” asked the buyer. “Morning or afternoon?” echoed the clerk … what difference does it make when it’s seven years three months and five days away?” “Well,” said the buyer, “it has to be the afternoon. The plumber’s coming in the morning.”
    That’s about what it’s like now in the Soviet Socialist Republic of Aotearoa. No, you don’t have to wait for a plumber. You don’t have to queue for bread. There’s no toilet paper shortage. . .  But here in the Soviet Socialist Republic of Aotearoa, Nanny State runs the health system. What does she give us? Waiting lists. How does she reduce the waiting lists? By tearing them up! You don’t get your surgery but you’re no longer on a waiting list because Nanny says you’re not. She’s sent you back to your GP. Now isn’t that reassuring when you’ve got skin cancer. Fat lot of use your GP is there, but Nanny is saying you have to wait till your tumour is really big, by which time it’s more difficult to remove and will probably have metastasised. Nanny’s die-while-you-wait health system is also currently serving up chronic staff shortages and, of course, strikes. Be very … healthy.
  • The culling fund
    ”People got so upset over a cull of a few hundred horses, yet relatively little protests over 35,000 humans being culled from hospital waiting lists last year. It is mind bloggling that Labour can literally throw billions and billions of dollars into this black hole [what you might call the 'Culling Fund'], and not get any significant improvement in terms of elective operations. No wonder so many people have private medical insurance.”
  • I wonder how many of you have private health insurance? (Yes, I do.) How do you feel about it? And how do you feel about paying twice -- once for your health insurance, and once for a die-while-you-wait health system which is slowly becoming a die-while-you-wait-to-get-on-their-list system.

  • Life-saving private cancer unit opens in Auckland
    . . . contract cancer in Eastern Europe or the UK, for example, and your chances of survival are less than half; but contract cancer in the US, and your chances vault up to nearly two-thirds. The reason Brits are more likely to die? "Cancer experts blamed late diagnosis and long waiting lists." Despite this being all too clear, little has been or can be done to speed up diagnosis or cut waiting times in the die-while-you-wait public system NZ shares with the UK. In other words, people have been dying for the sake of a failed ideology.
  • Death by ideology
    People are dying because of a failed ideology, says MacDoctor - "an attitude that places ideology above patient care" . . .

15 comments:

Moneo said...

Well there are forty million uninsured in the USA, who never get onto a waiting list.

It is not really fair to compare apples with oranges, in my opinion.

So, if we factor in people who die in America because of lack of health insurance, how does that stack up against NZ where basically everyone is covered? Other factors to consider are overall cost (Americans spend vastly more than us both per capita and as a percentage of GDP, without even covering everyone) and right to access; is it fair that someone from a decent middle class background who has worked hard has to wait in line while people who have been bludgers all their life are ahead of them?

Richard McGrath said...

Sorry STC, you've been taken for a ride there.

The figure recently touted by Obama was 47 million, based on 2007census figures that suggested just under 46 million were uninsured.

However, if we take out:

1) The 18 million who earn over $50,000 p.a. (half of whom earn over $75k) and who choose to pay as they go;

2) The 13 million illegal aliens;

3) The 8 million Americans under the age of 18 who are eligible for taxpayer-funded cover but whose parents haven't signed them up;

4) And the 18-20 year olds who consider themselves invincible and haven't purchased health insurance;

Then we are left with 8 million low-income Americans, 3 percent of the population, most of whom are eligible for subsidised care under state Medicaid or federal Medicare programmes, or (heaven forbid!) help from charities.

Despite a far from perfect health and economic system in the U.S., 92% of American citizens are covered by health insurance or taxpayer funded schemes.

Not exactly a crisis, is it?

Peter Cresswell said...

Well, I certainly wouldn't be calling 13 million people in search of a better life "illegal aliens."

But that said, let's not forget that, as doctors Lin Zinser and Paul Hsieh say,

"Although health care and health insurance are often conflated, there is a crucial difference between the two. Whereas health care consists of the actual goods and services necessary for medical care, health insurance is one means of affording such care. The two are closely related but distinct, as are the services of an auto-body repair shop and an automobile insurance company.

Their point is that the important number is not those without health insurance, but those who can't get treatment. And that number is . . . small, though growing.

"The systematic violation of the rights of health care providers and insurers to freely produce and trade goods and services has created a dysfunctional system that has harmed countless providers, insurers, employers, and patients. . . More government control of medicine and health insurance is not the solution. Evidence and logic show that government interference in the market leads only to rising costs, rationing, and needless suffering and death.

The current system is unsustainable. Unless policy changes are made, American health care and health insurance will not remain in their currently dysfunctional conditions; they will necessarily get worse (recall that health care costs are rising far more rapidly than the rate of inflation). One way or another, the current situation will change. We do not have a choice in that matter, but we do have a choice as to the direction of that change.

America stands at a crossroads. We can continue to recycle the failed ideas of the past, continue to violate individual rights, and impose more government control on medicine and health insurance in a futile attempt to salvage a fundamentally flawed system by extending and building on its flaws. Or we can stand on moral principle, respect individual rights, begin dismantling the broken system, and start working toward a free and therefore thriving market in medicine and health insurance.
"

Sanctuary said...

On practically any public health measure you care to examine New Zealand handily outperforms the United States. Our life expectency ranks 18th in the world to the United States 50th. Our child mortality rate is 33rd in the world to the United States 46th. We have managed to free all New Zealanders of the fear of financial ruin when illness strikes. We have achieved all this in a country which has a GDP per capita rank of 34th in world compared to the United States ranking at 6th. Our health system has achieved these mighty outcomes despite us only spending half on health as a percentage of GDP the United States does (8% vs.15%). We have a health system we can be proud of in this country. Jon Voight might be happy with a system the rest of the civilised world regards as insane. That is fine by me, he can wallow in his own Americo-centric ignorant bullshit. But when it comes to ignorantly running our health system to try and prove a pathetic point in his country, Jon Voight and the rest of his mis-informationists can just fuck right off.

Ayrdale said...

Given that health professionals; nurses, doctors, physio's, radiographers etc, etc are all bound by their professional ethics to "always work in the best interests of their patients", their professional bodies are all silent as our heath care system falls apart. All they really work for is their own self interest. It's time that they were all called to account, to honour their ethical obligations.
Meanwhile, ACC trundles on...

Peter Cresswell said...

@Sanctuary: Or to quote the actual figures from the CIA World Factbook from whence you lifted them: NZ has a life expectancy of 80.36 to the United States' 78.11. And San Marino has a life expectancy of 81.97 and Andorra of 82.51 -- which is to say, really, that (given the problems with figures like this to three significant figures) that most western countries have a very similar life expectancy.

Which is about more than just a country's health system.

And you ignore that for all of New Zealand's multi-billion dollar spending binge on the socialised system in the last decade, "available social indicators we have show negligible improvements since 2000. Life expectancy,
infant mortality, hospital outputs [etc] . . . have barely changed despite a massive increase [of around $20 billion] in social spending." [ref: NZ's 'New Zealand’s Spending Binge'

But that's hardly the main point here, is it, since what you're really doing with your anti-American rant is to conflate a free-market in health with the US healthcare system, which are demonstrably not the same thing.

But that said, the extent of freedom that does still exist in the US still allows it to be host to so much of the world's medical research and innovation - on which most of the rest of the more socialised systems like ours play parasite.

So to that extent, we're all reliant on a functioning and effective US healthcare system.

And your proud claims of help to all New Zealanders "when illness strikes" are of little help to those in the stories above who were to told essentially to fuck off and wait in the queue -- and to wait there until they die.

Which was Jon Voight's point, really, even if you did manage miss it.

Anonymous said...

My Father in-law has just been diagnosed has having a Tumor in the Bowel (cancerous). He chose to get this diagnosis done privately because to wait may have been the death of him.
He is now paying for a private operation costing $6000 as the waiting lists are to long.
He is 91 and wants to hang around for a few more years.

At least if we are going to ration health outcomes can at least the country be upfront and honest about it and not pretend that people don't die while waiting their turn.

David

Callum said...

Sanctuary: your claims about life expectancy are dead wrong (excuse the pun).

First of, life expectancy doesn't simply take into account healthcare: there are also statistics about suicide, murder, and rates of disease that can affect the life expectancy significantly. The US has higher rates of murder than NZ (5-6 per 100,000 compared to NZ's 1-2) and AIDS is a big problem in some communities. This has a downward force on life expectancy.

Also, life expectancy figures are almost always life expectancy from birth. Although that figure is lower in the US than elsewhere, as people get older the US life expectancy figure actually overtakes European figures (sorry I can't link to the article with the hard data). A 60 year old American is expected to live longer than his counterpart in Europe. This is because most factors that push downward on the US life expectancy disappear by the time Americans pass 30.
__________

It would be interesting to see statistics about health insurance for different age groups. As the US is a very upwardly-mobile society, it wouldn't surprise me if the people who don't have insurance are mainly young adults.

Of course, as you get older the need for health insurance increases as health deteriorates, so maybe the figures for health insurance coverage are overblown.

Richard McGrath said...

PC said: Well, I certainly wouldn't be calling 13 million people in search of a better life "illegal aliens."



Agreed. In fact the expression could be made obsolete overnight if immigrants were allowed to settle and become citizens on the understanding that they had no claim on the public welfare system.

Richard McGrath said...

Callum is right in that life expectancy is no longer regarded as an accurate measure of the efficacy of a country's health system.

What I do remember reading is that treatment of various sorts of cancer, and heart disease, is far superior in the U.S. compared to the UK and Europe, due to earlier and more aggressive treatment.

Peter Cresswell said...

@ Richard: "What I do remember reading is that treatment of various sorts of cancer, and heart disease, is far superior in the U.S. compared to the UK and Europe, due to earlier and more aggressive treatment."

Indeed. And that's the salient point made in several of those links above.

Monsieur said...

The Commonwealth Fund: Mirror Mirror Report compares NZ and US health systems.
Among the six nations studied—Australia, Canada, Germany, New Zealand, the United Kingdom, and the United States—the U.S. ranks last, as it did in the 2006 and 2004 editions of Mirror, Mirror. Most troubling, the U.S. fails to achieve better health outcomes than the other countries, and as shown in the earlier editions, the U.S. is last on dimensions of access, patient safety, efficiency, and equity.

Barry said...

In my opinion the New Zealand healthcare system needs to be privatised.

Those who cannot afford care can have their insurance premiums subsidised.

But although I have not personall had or heard of any problems with NZ's healthcare system I agree that it would be better if it were completely privatised and those who could not pay be helped by the state in other ways or by charity.

Jack said...

It is a common criticism that the U.S. spends so much on health-care but has a life-expectancy just about the same as most rich countries (in fact a little lower, if it takes a year or two to be meaningful). The problem with this is that much of the money in healthcare is *not* being spent on prolonging life.

For instance, many older people need cataract operations. People who are on Medicaid are allowed to get the conventional lenses-replacement. After this surgery, they can see perfectly fine if they wear prescription glasses. Not a big inconvenience, right? Well, if one has Medicare instead of Medicaid, it will pay for a lens that will adjust, so that one does not have to wear glasses. Folks on Medicaid can pay an extra $2000 - $3000 to "upgrade". The additional money does not show up in life-expectancy.

It is the same when an older pill for allergies is replaced with one that makes one less drowsy, or when a new type of surgery achieves the same bodily result as the old one, except that one can get back to work 2 weeks earlier.

A huge number of improvements in healthcare are of this type, and simply do not show up in the life-expectancy numbers.

Anonymous said...

Life expectancy is lower in the States because among other reasons there is a large violent urban underclass. They die young because they do drugs and shoot one another. They have poor diets (they could eat cheaply and healthily like Indian people do, but they choose not to). This drags down total American life expectancy.

WHO's shelf-life figures for NZers are lower than those of the UN. In 2007 for instance the figure was 77 years(?):
http://salaswildthoughts.blogspot.com/2007/05/latest-life-expectancy-statistics-from.html

What changed? Calculation method? Definition of terms? New Zealand's participation in UN committees?

What New Zealand is very good at is trumpeting and spinning its figures to carefully manage its brand image, because it makes so much revenue from tourism. New Zealand's figures are less stellar for child poverty and abuse, drug use, youth suicide, meningococcal meningitis, and public sanitation (New Zealand had unimpressive per capita statistics for campylobacteriosis for instance, and when it became known, it finally decided to do something about them, at which point it began beating its chest all over the Internet about its world-class impressive efforts to fight campylobacter, scattering public relations all over the net about its efforts - has it fixed the problem?).

Knowing what I do about the way New Zealand public and private sectors grease one another's palms to co-operatively manage The Brand in such a way as to ensure the flow of foreign revenue, I'd take its life expectancy figures with the same grain of salt I'd take all its other P.R.