I wonder when NZ will move away from the quasi-free-market-but-funded-by-the-government system in health (and education). It leads to outcomes like this which are clearly inefficient. I’d like to see more centralisation.

6 points
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Primary health organisations and their general practices are paid according to the number of people enrolled - not the number of times they see them.

"Human behaviour predictably will be to enrol as many people as possible who will never come in and see you, and to make yourself unavailable.

I presume the idea was that you get base funding for the number enrolled, then charge a fee to cover appointments. But they have a point, it comes across as a bit WTF in the current environment.

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5 points

Honestly we couldn’t get into a good GP practice when we moved about 5 years ago, they were pretty much all not taking new enrolments. In fact the one that we did want to enrol at is still not taking new patients.

Some of them are now really strict and enforce time limits for appointments, not allowed to bring up more than one issue unless you make a double appointment. We had an amazing GP when my first daughter was born, always took time to answer any questions and never rushed us and gave lots of recommendations to look at.

Since moving away we haven’t had great experiences through a few different practices.

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3 points

Yeah I think that’s becoming a more common experience. A lack of doctors makes things pretty difficult.

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5 points

I’d like to see free GP visits for anyone low income and standard prices for everyone else.

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2 points

Huh. I had assumed this was already the case, but it seems Community Services Card holders get cheaper visits but not free ones. That’s probably a good election promise for someone to offer.

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2 points

Nope, and people on benefit who are sick get the same jobseekers rate but are expected to keep bringing medical certificates regularly, which of course their GP charges for. That stops if they can get on the supported living payment, but the last National made that extra difficult.

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2 points

I have to deal with WINZ from time to time, and it has made me a big supporter of a Universal Basic Income. They are so difficult to deal with by design. It’s horrible.

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1 point
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Why not free for everyone? Higher earners already pay higher and more tax. And it avoids that people wait too long before going to a GP, saving costs as well.

I’m from Europe where a GP is free for everyone and it’s amazing.

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1 point

Mostly just because I think we should be eating the rich anyway.

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2 points

The only credible solution on the horizon for a small country like ours is AI. I am deadly serious. An AI tied to your smart watch or health monitor can literally observe you 24X7 and catch many problems before they occur. One AI can be the first line of defence for all of NZ. Also AI can answer many question online for people who are worried about various symptoms. Even is the answer is “make an appointment with your GP”.

We need more lower level tiers in our system like A&E too. Clinics where people can walk into 24X7

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1 point

Yeah, healthcare with its heavy staff shortages is an ideal industry for some AI help. The ethical concerns involved present a high barrier to implementation though, I think.

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1 point

I don’t see why there would be any ethical concerns. An app that detects your heart rate has been higher than normal and asks you a series of questions to diagnose why would be far superior to you not even noticing the problem until the day you pass out behind the wheel right?

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1 point
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