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The Minister of Health, Andrew Little, has this week announced that the system "shake-up" was designed to end "postcode lottery" care - which he says means that the quality of treatment can be affected by where you live. And the Labour Party's website describes it as being vital to eliminate such "barriers" to make things more "equitable".

Hang on. Our entire school system is based on a "postcode lottery", whereby you go to school according to which zone you happen live in. Should you live in a poor part of town then you can't apply for public schools in a posher part of town, which maybe better. Yet the government has insisted for decades that its in our own best interests, even though many of us believe that more competition should be built into the system to help drive up standards. So which is it? Is there some profound difference between health-care and education?

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  • Robert MacCulloch

The Government's recently announced changes to the heath system amount to a board reshuffle. A management re-arrangement. A bureaucratic re-alignment. Incentives within the health system will remain unchanged. Power seems to be shifting ever higher, becoming more centralized and moving further away from doctors and patients. When the Auckland Super City was announced and a similar amalgamation - in that case of local councils - was implemented, it was meant to solve Auckland's problems. Though nothing much changed.

What is instead required is a genuine reform that changes incentives and paves the way to higher quality health-care for all Kiwis at lower costs. The best way to do so is by enabling the funding of mandatory savings accounts out of which individuals can make payments for their own welfare needs, whereby they get to make the best choice for themselves, with help from their doctor, instead of the government on their behalf. The accounts can also be used to help low income families build up significant capital of their own and solve our inequality problems. To see how it works in the case of New Zealand, complete with a fully costed government budget, then you can download the file below. It is joint work between myself and a former Kiwi Finance Minister:

Download PDF • 199KB




Robert MacCulloch

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