Since both Rebecca and I have two-year work visas here, our health care is covered under the New Zealand health system. New Zealand has essentially a fully public health-care system funded by the government where citizens are treated in public hospitals free of charge.
Even though Rebecca deals with the health system daily, today we both had our first appointments with a general practitioner. The receptionist directed us to wait in the reception area, as it is called here, and said that the doctor would personally come out to get us. And he did. A few minutes, a pleasant physician came out and escorted me back. He took my blood pressure himself and we chatted for a few minutes. He wanted to do a spirometry test as a baseline for my asthma. He said he’d order it but it would take a few months before it could be done (so far two months later I haven’t heard anything). He wrote prescriptions for my blood pressure medications. Cost of visit $40. Three-month supply of blood pressure pills cost $5.
Some people receive their doctor visits for free: elderly, children and the poor.
It remains to be seen how all this will work out if one of us gets very sick or needs hospitalization. I have already gotten some sense from Rebecca that because of the delay in getting tests and procedures done, an illness such as a cancer can progress significantly before it is accurately diagnosed and treatment begun. I have also read some articles about people waiting months for elective procedures such as hip replacement surgery.
Procedures like CT scans which are done at the drop of a hat in the US are not ordered or done as cavalierly here. In fact, many hospitals here don’t have the equipment. In our visit to the South Island last year, we discovered that Queenstown, a relatively large city noted for its action sports and with several nearby ski areas, did not have a CT scanner. Patients in need of a scan had to be transferred several hours away.
Am I seeing Obamacare and the future of health care in the US? I don’t know yet.
In part because of all this a secondary health insurance market exists in New Zealand. As a supplement, Rebecca and I signed up for private insurance with a New Zealand company. Apparently a fair number of Kiwis do this, somewhere around 30%. On the application under penalty of being refused coverage, you must list all previous medical conditions that you have had, and then these are all promptly excluded in the coverage they provide. The coverage does provide for most diagnostic studies, surgery and specialist consultation all supposedly in a more-expeditious manner. Cost is about $150/month for each of us.
For what it is worth, for health care New Zealand spent US$3182 per capita vs. $8508 in the US in 2011 (OECD data).
Another difference here is what’s called the Accident Compensation Corporation (ACC). This state-run program established in 1974 covers the cost of treatment for all cases deemed “accidents” for all residents and for all people (including tourists) who are legally in New Zealand. It covers both work and non-work injuries including motor vehicle accidents. That means if you fall down and break your leg while walking down the street, you are covered. It does not matter whose fault the accident was. If you can no longer do your job because of an on-the-job injury, a compensatory amount, ‘compo’, is paid to you monthly based on the extent of your injury. How reasonable this amount is, I don’t know. My understanding is that the ACC obviates most or almost all lawsuits.
Medical malpractice insurance premiums for physicians in the US vary according to location and specialty. The minimum premium for less at risk specialties can be around $10,000/year while in certain areas, high-risk specialties such as Neurosurgery, Ob-Gyn and Orthopedics can pay many times that amount sometimes over $100,000/year.
Here is New Zealand medical malpractice is also covered by the Accident Compensation Corporation, which covers any personal injury caused by medical error or mishap by a registered health professional. Medical practitioners pay a small amount, usually less than $1000/year, to help support this.
A curious note is what we may term malpractice, the ACC euphemistically calls “medical misadventure.” I guess the physician might say something like this:
“Yes, I’m a tad sorry you had a bad outcome. It was a bit of a medical misadventure, you see.”
For now, I think I’ll try and stay healthy.