Robert MacCulloch
A native of New Zealand, Robert worked at the Reserve Bank of NZ, before he travelled to the UK to complete a PhD in Economics at Oxford University.
Enough is enough. Former PMs Helen Clark and Jacinda Ardern should come clean about how they were the chief architects of the omni-shambles that has become our health system. They should take responsibility for the folks who suffered from long waiting lists and declining health-care quality, some of whom didn’t make it. The person who wrote the report, “Health and Disability System Review” – the inspiration behind the disaster that is Health NZ – was Heather Simpson, Clark’s chief of staff for nine years, who followed her to the United Nations in New York. Nine years after Clark was voted out, her chief of staff got reincarnated by Labour to advise Ardern and Hipkins on healthcare. Why was Simpson ever chosen to write the report? Anything to do with her being well-connected to the party? The report was the inspiration behind the centralization of NZ’s health system. It advocated for a cut in district health boards. After Ardern’s Health Minister Little got hold of the report, he went all the way and got rid of them entirely.
I read the report. No intellectual basis is built for its suggested re-design of healthcare delivery. No wonder our system is failing. It keeps repeating the word equity, seemingly in the hope that by writing that word on paper is enough to deliver it in practice. The report bizarrely repeats equity 219 times (!?) By contrast, the word competition, which is a requirement to ensure quality and efficiency in nearly every economic system, is not mentioned one time. The report thereby seeks to deliver equally awful healthcare to everyone. The economics behind the report is embarrassingly simple-minded. Its half-baked idea is that the monolithic super-structure it invents, called “Health NZ” would create “economies of scale”. Its uses the jargon, scaling up. Health NZ has succeeded only at being a large scale disaster.
Simpson's report refuses to acknowledge that her chosen single public payer/single public provider model is not the only way equity can be delivered. It can also be achieved by the government being the single payer but (unlike Simpson’s silly single provider preference) with private and public suppliers competing to provide the highest quality service at set prices (that the government pays). It’s that competition which ensures the best outcomes. It’s how our health system already works for drugs, courtesy of Pharmac, which negotiates prices with pharma companies. That was how we got the Pfizer vaccine during Covid. If we’d relied on the NZ government to invent a vaccine, we’d still locked down, waiting. Ardern’s only contribution to the pandemic was her comms-PR-marketing job. The vaccine had nothing to do with her, aside from her ordering it late. Our entire health system can be run on the above lines, with Kiwis choosing which health-provider they prefer, public or public, going to the one that best satisfies their needs (including cultural ones). It doesn’t constitute privatization of our existing public hospitals, since they would not be privatized.
When the inventor of well-being economics, Richard Easterlin, visited NZ and I invited Grant Robertson to meet him, Robertson pulled out a few days before, even though that agenda was central to his budgets. What he missed was the following: Easterlin argued there are three main sources of well-being: close family, good health, and satisfying job. Because Labour stands unambiguously for the destruction of the traditional family unit, has wrecked healthcare due to Clark and Ardern’s useless reform, and has ruined the careers of talented Kiwis by ending meritocracy (by giving preference to identity, not ability, causing the best of our youth to leave NZ). This past Labour government has done more to crush well-being than any other. Six years of carnage will require a decade of re-building.
Source:
