Health Care System in New Zealand - Case Study Example

Health Care System in New Zealand Name: Course: Tutor: Date: Health care system in New Zealand Introduction The growing population from 20th century made it difficult for countries to provide proper healthcare for its people. Some countries are still faced with such problems up-to-date. In 2013, United Nations (UN) claimed that the world experienced lack of 4.3 million health care professionals needs for providing basic health care services. According to UN, in 2013 the situation challenges the article 25 of the United Nations Universal Declaration of Human Rights which provides that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family”. Despite the challenges, the foundation of healthcare sector across the globe has changed over the years. One of countries which has undergone the changes is New Zealand. New systems of healthcare have been brought into place to replace the ineffective methods (Cumming et al 23). From a fundamentally completely public system introduced in the 20th century, recent reforms have led to adoption of health and market insurance components mainly in the past three decades, generating a mixture of public-private system for healthcare provision (Davis & Ashton 23). Based on the information, this report seeks to analyze Health care system in New Zealand. The report will majorly focus on health status and demographics and the health system organization of New Zealand. History of New Zealand healthcare New Zealand is an island country in the Pacific which has a population of 4.49 million individuals, largely people of New Zealand European origin (67%), Māori (14%), Asian (10%) and Pacific island (6%) (Cumming et al., 1). Cumming et went ahead to claim that within this population, nearly 20 percent belong to an age group of 0–14 years, whilst the a section of the people aged above 65 years is growing gradually and make 13 percent of that total population (1). Generally, New Zealanders enjoy high quality health status by global comparisons. At present, the women life expectancy is almost 82 years while that of men is 78 years (see figure 1). Pacific island and Maori status of health among people is lower in general compared to New Zealanders of European origin. The country has currently made numerous reforms on healthcare. McCoy, Chand & Sridhar contends that today, New Zealand healthcare system is predominantly tax-funded, offering universal coverage to the citizens (408). The citizens enjoy high quality health status, but with noteworthy inequalities in both Pacific health and Māori. In 2009, Croxson, Smith & Cumming claimed that back in olden days when Europeans settled in New Zealand, there was a mix of healthcare providers who provided services including the government, “for-profit” and voluntary organizations. The health care system offered was founded on the English model similar to that of new settlers, integrating its poor laws which obligated local duty for the poor. In 2006, Blumberg stated that medical practitioners operated separately and were salaried directly by the patients. Public institutions of healthcare were set up to take care of the people who could not pay for nursing and medical care in private institutions or could not be treated at home. With health care institution treatment turned out to be more efficient, middle class population progressively visited and paid for their personal care (Sridhar, & Gostin 1585). Whilst some districts and towns funded their institutions, as done by other voluntary institutions, some found it unfeasible to maintain adequate support, and this led to government funding of every hospital by the 1880s (Cumming et al., 17). Boards of Public health had previously been established in districts and provinces. During this time, the Public Health Act enforced in 1900 recommended for the Department of Public Health which would be headed by the Chief Health Officer whilst medical practitioners were to be appointed at the local district level (Cumming et al., 17). New Zealand therefore established the department of health at a national level to monitor the health of its citizens. In 1909, this department progressively took over wide-ranging roles, combining with Department of Hospitals and Charitable Aid and ultimately changed its name to Department of Public Health later in 1920. The change culminates how hospitals became a major aspect of healthcare system in mid 20th century. Improvement in medical technology and knowledge implied that the hospitals were capable to provide effective care than just treatment, whilst caring for critically ill patients at home died down to a norm (Ashton, Mays & Devlin 254). The organization of institutions of health transformed as they grew and became expensive. According to Cumming et al, the government continuously increased its funding while patient charges contribute smaller share of the profits (23). Figure 1: health and mortality indicators Health care status and demographics The New Zealand Public Health and Disability Act enforced in 2000 established the strategic goals and directions for the healthcare sector in the country (Cumming et al., 4). This Act obligates the minister in charge to create general health care policies for the nation, which presently consist of He Korowai Oranga: Māori Health Strategy (2002), The New Zealand Disability Strategy (2001), The Primary Health Care Strategy (2001) and The New Zealand Health Strategy (2000) (Cumming et al., 7). At the moment, the current regime is emphasizing on six healthcare targets together with effective services, financial management, clinical integration and keeping quality. Reforms carried in recent years have improved the status in the healthcare industry, making New Zealand one of the countries putting effort on health of the citizens. In 2009, Croxson Smith & Cumming claimed that the report conducted on New Zealand demonstrated an improvement in health expectancy and life expectancy and a reduction in death rates, which results from cardiovascular disease and cancer, and also comparatively stable conditions of obesity in adults and children. This is attributed to continuing increase in rates of immunization and sensitization on smoking rates. This has been provided by the doctors whose numbers have been on the rise. By 2012, New Zealand had 2.6 physicians working within a population of 1000 and 10 nurses in a population of 1000 (Cumming et al., 86). The government has also allowed migrant doctors to work in the country in improving health status. Currently, New Zealand host the largest number of immigrant doctors within OECD countries. In 2009, Barnett, Smith & Cumming posited that generally, New Zealand citizens receive a good health care coverage and social needs by means of public health services. Cost of pharmaceuticals and primary health care has been continuously recognized as an impediment to healthcare access in the previous. These costs have been decreased by extra government financing access since the integration of Primary Health Care (Ashton, Mays & Devlin 256). The government funds its healthcare fundamentally via government sources while the remainder being the direct payments from patients, non-profit institution contributions and private insurance premiums. Today, New Zealand is ranked as the 12th in terms of healthcare spending by Organization for Economic Co-operation and Development (OECD) based on the spending from GDP (see figure 2) (Cumming et al., 45). In 2010, health funding based on GDP increased from 6.8 percent to 10.1 percent from 1990 to 2010 (Cumming et al., 57). However, the expenditure in New Zealand health in terms of per capita is equal to USNZ$ 3022 PPP and is lower compared to OECD average of USNZ$ 3268. In 2014, Cumming et al., (57) claimed that total approximation for healthcare funding in 2013/2014 financial year in the Crown Budget is equal to NZ$ 14 656 millions representing an increase of 4.8 percent or NZ$671 million compared to 2012/2013 budget (25). The majority of health services expenditure (80%) goes to District healthcare boards, while the balance is used on the national services bought directly by Ministry of Health. In 2006, Blumberg pined that the New Zealand healthcare system offers universal access to an array of healthcare services. Within the population, nearly 40 percent of adults have a supplementary private healthcare insurance. In 2009, Barnett, Smith & Cumming asserted that the ministry of health of New Zealand currently finances 20 district healthcare boards via a population-oriented financing formula and district healthcare boards then finance a wide range of healthcare providers by means of service contracts including having personal hospital services. The government has set inpatient and outpatient hospital services as well as maternity services to accessible free of charge. Barnett, Smith & Cumming claimed further that after the ratification of the Primary Health Care Strategies in 2001, the capitation financial support has come to replace fee-for-service financing of general policy and practice. In fact, major prescriptions are co-paid at NZ$5. Fundamental dental care for children is currently free while adult dental treatment is paid privately. However, patient pays extra fees which is not always high. Some patients also seek insurance covers. Here, the Health insurance firms insure individuals against “supplementary” charges as opposed to offering comprehensive healthcare cover (Cumming et al 67). Consumers have the freedom of insuring against all or some of the gaps between the charges levied by healthcare providers and government subsidy and on various healthcare services. Also, insurers offer the supplementary insurance to compensate people for surgeries and other care by the private institutions and specialists (Davis & Ashton 27). Even though there are several private healthcare insurance within New Zealand, Southern Cross has remained the leading provider with approximate market share of 75%. Some of the insurance packages include the Accident Compensation Corporation. Cumming et al (74) state that it offers 24-hour full no-fault insurance, encompassing medical charges, social and vocational rehabilitation, benefits such as death and funeral expenses and reimbursement of up to 85% of the weekly earnings. According to Sridhar & Gostin, the New Zealand government established competitive and effective insurance industry for job-related injuries under Insurance Act of 1998 and was enforced in 1999 (1586). When the new Labour government came to power 2000, it re-nationalized this insurance scheme. Figure 2: Health expenditure of GDP in OECD Source (Cumming et al 167) Health system organization of New Zealand According to Cumming et al (103), the federal state in unitary government of New Zealand holds the general duty of providing proper healthcare services that are majorly financed by taxation. The duties of offering such services have however been divided among public, voluntary and private sectors over the years. Nevertheless, The Minister for Health holds the overall obligation for the healthcare system (Davis & Ashton 47). Within this system, the Ministry of Health is the major organization which advises the government on healthcare policies (see figure 3). Other government bodies which also contribute to healthcare-related projects comprise of the Ministry of Social Development, the Ministry of Māori Development (Te Puni Kōkiri), Office for Disability Issues, the Accident Compensation Corporation and Ministry of Pacific Island Affairs (Cumming et al 118). McCoy, Chand & Sridhar hold that Twenty District Health Boards are in charge of planning and financing healthcare services within their geographical locations (412). The healthcare institution within the districts is managed by the boards of appointed and elected members which are answerable to the Health Minister. The law needs them to carry out strategic planning practices and to collaborate with neighboring district healthcare boards. Since the funds come from the state, the government has established a body which ensures the finances are used appropriately (McCoy, Chand & Sridhar 413). For that reason, in 2009, the government sets the National Health Board within Ministry of Health and mandated it with roles such as planning, funding and monitoring operations District Healthcare Boards. The national board also ensures effective alignment of service linkage of information technology and reducing bureaucracy. From 2001, primary healthcare is being managed by primary health organizations which currently stand at and gets capitation funding for populations they have registered (Cumming et al 124). Patients are also allowed to enroll for free with any general practitioner who deems fit. This process gives the patients the choice to access publicly or privately finance secondary health care services, even though this could be limited in some areas. Professionalism matters most in the healthcare industry with consumer expect to find the best and qualified health practitioners to attend to them. According Barnett, Smith & Cumming statement of 2009 the accreditation for the healthcare professionals is managed by the Health Practitioners Competence Assurance Act of 2003. Cumming et al maintain that he 16 bodies set up under this Act have been given the role of overseeing qualified healthcare practitioners appropriately registered (113). Figure 3: Organization and health systems in New Zealand Source: (Cumming et al 178) Conclusion New Zealand healthcare industry has experienced key structural and systematical changes in that past two decades, more than other OECD nations. The system has changed from the conventional and central “welfare state” form, all the way through regionalized based in the 80s, disparities on the quasi-market form in the 90s, to the present model in which regional governance system is the major characteristic. Due to such changes, New Zealand citizens today enjoy high quality healthcare status, even though some considerable inequalities can still be noticed in Pacific island and Māori. Therefore, equity in healthcare must be tackled and districts be funded according to the number of population. Works Cited Ashton T, Mays, N & Devlin, N. Continuity through change: the rhetoric and reality of health reforms in New Zealand. Social Science and Medicine, 61(2005):253–262. Print Barnett P, Smith, J & Cumming, J. The roles and functions of primary health organizations. Wellington. Health Services Research Centre. 12 Jan 2009 Web. 14 Dec. 2014 Blumberg , L.J. The effect of private health insurance coverage on health services utilization in New Zealand. Wellington, Fulbright New Zealand. 9 March 2006 Web. 15 Dec. 2014 Croxson B, Smith J & Cumming, J. Patient fees as a metaphor for so much more in New Zealand’s primary health care system. Wellington, Health Services Research Centre, Victoria University of Wellington. 17 June 2009 Web. 15 Dec. 2014 Cumming, J, McDonald, J, Barr, C, Martin, G, Gerring, Z, Daubé, J. New Zealand Health System Review. Health Systems in Transition 4(2014): 1-242. Print Davis, P & Ashton, T. Health and Public Policy in New Zealand. Auckland: Oxford University Press, 2001. Print McCoy, D., Chand, S., & Sridhar, D. Global health funding: how much, where it comes from and where it goes. Health Policy and Planning, 24(2009): 407-417. Print Sridhar, D., & Gostin, L. O. Reforming the world health organization. The Journal of the American Medical Association, 305(2011): 1585-1586. Print UN. United Nations Universal Declaration of Human Rights. 21 Feb 2013. Web. 14 Dec. 2014 Read More