1.

\Private providers may look low cost, but that’s only because they transfer huge amounts of cost to the public sector in terms of both management and back-stop services.

Well sure, but that’s a money-go round. If the private provider were to pay for the insurance on the chance of a complication, the money would just be going back to the DHB anyway. And you’d essentially be punishing people for going private – in no other case do you charge for the public service.

The second is that there is additional cost in transferring a patient with complications from a private provider to a public ICU.

That can’t be large, surely.

Third problem? No matter who actually does the surgery “bureaucrats” are required to manage the provision, the eligibility, the bookings, the payments, etc.

See this is a fundamental difference between the two. You don’t need these people in the private system – this is an extra cost for the public and the private system isn’t “feeding” off the public system.

Ultimately the public system has a number of benefits, as does the private system and they both have their challenges. I don’t understand why so many people seem to hate the existence of the private health system.

The best, an aunt having to choose between a long wait for a hip op or go private. My aunt went private with a ten day wait, surgery and home within a week and a 10/10 recovery.

The worst, an in-law with knee problems exacerbated by a weight problem and getting bigger by the month because of mobility problems and despite making it to the front of the public queue it was catch 22, to big for surgery but unable to lose the weight.
So of course the private sector said sure, we’ll do you, weight, no problem.
So a long story short, post -op life threatening respiratory problems, to hard basket, and off he goes to the public system where he spent three months in ICU and another seven weeks in a medical ward.

The best of the private lets my aunt return to a normal life and the worst is cherry picking of the most cynical nature.

http://www.commonwealthfund.org/usr_doc/1027_Davis_mirror_mirror_international_update_final.pdf?section=4039

Main thing to remember in the NZ public/private debate is that it’s like comparing a contractor responsible for every aspect of every single building in the country, with a few subbies gibstopping a few rooms here and there. Money to be made if you’re in with the top brass….

Thanks! :) I suggest reading this article by Toni Ashton, she points out two additional concrete problems from increase private provision; firstly both public and private are competing for the same tight labour pool – so increases in private sector provision will flow on to increased understaffing in the public sector (and presumably increase public sector wages as they try to retain staff).

Secondly, we train our health force in our public hospitals, so letting the private sector cherry pick the easy high volume work with damage our teaching and research capacity.

She also has a good argument for why increasing private health insurance (through tax breaks) will actually increase the public health care costs.

Claim and counterclaim on health is one of the areas where I’ve had most trouble sorting out for myself what’s going on – your post here and Marty G’s have both been enormously helpful.