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The Role Of Health Insurance In NZ

Given recent media attention about resourcing issues in the public health care system, this article is aimed at helping to clear up confusion about public and private health care in New Zealand. 


Who Pays For Healthcare?


Simply put, money to pay for any health needs that arise will need to come from one of these three areas: • The public health system (which is not entirely free; there can be part-charges). • A private health insurance company. • Your own personal savings.


The Difference Between Private And Public Healthcare


New Zealand has a public healthcare system that will usually look after your acute (urgent) needs for free and A.C.C. will cover you for accidental injury. You may still be partly charged for services you use in the public healthcare system and through A.C.C. If you need an elective procedure (which are generally those that can be put off for at least a week and are not as urgent), you are put on a waiting list.

The public healthcare system considers many factors when determining whether your condition requires immediate treatment or not. The severity of your condition and your needs are not the only factors influencing their decision. Other factors which play a part are things like which region of the country you are in, how well resourced the hospital is and how busy they are at the time you need care. The consequences of this is that people can wait months, even years, for procedures that could greatly improve their quality of life (e.g. hip & knee replacements) [1].

Having to live with an untreated illness/injury not only negatively affects your health and wellbeing, but it can also prevent you from returning to work and getting back to doing the things you love. One study found that New Zealanders took an average of five weeks off work while they were waiting for treatment and required help from family members, who also had to take time off of work[2].

Excessive waiting times for treatment and the resulting problems from this is what has gained a lot of media attention recently. It also highlights how private healthcare can be used to alleviate these delays in the public healthcare system. Having health insurance is the most affordable way to access private healthcare.


How Does Health Insurance Fit In?


Health insurance helps to cover the cost of your medical and surgical expenses. It can pay for a range of things from day-to-day medical costs like GP visits and contact lenses/glasses to more expensive healthcare needs like surgical treatment.

Two of the benefits of health insurance is that you receive quicker access to treatment and you have more choice over when and where you receive the treatment.

One study found that it took on average 100 days longer for surgery if you were on the public waiting list rather than on a private waiting list. Additionally, in the public system, the average time from the first GP referral to having surgery was 224 days; those going private would generally be seen by a surgeon a couple of weeks after their first visit. [2]

This means that there are cases where, if you have health insurance, you can receive treatment, recover and be back at work before you would have been seen in the public system.

Not everyone can afford health insurance but — with the right advice — a lot of people can. Ultimately, it is worth having a think about how you will fund your immediate and future healthcare needs so that you aren’t left worrying about money when illness/injury occurs. 



Resources Used:

1. https://sorted.org.nz/must-reads/is-health-insurance-worth-it/

2. See above.