What I’ve learned about healthcare in New Zealand

April 7, 2014

When we first got to New Zealand, I kept getting sick. Just little colds and other afflictions, but back to back viruses can really get to you. I don’t know if it’s actually a fact or not, but I’ve decided I was sick a lot because I didn’t have the antibodies to fight any of the germs on this side of the world. It makes sense that you develop antibodies over time and can eventually resist circulating strains of illness in your community. But being on the other, bottom left corner side of the world, I apparently have the immune system of a newborn.

So I should have a few immunities 16 months later, right?  Well, it seems I’m collecting ALL the antibodies. Like a game of Monopoly, I’m collecting them all. I’ve got full sets of antibodies and I’m looking into how to put a hotel on them and charge rent. For the record, Scott’s got none. He never gets sick. He’s losing at Viral Monopoly.

(Read between the lines- I’m sick again.)

 

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Anyways, that’s my segue into another discussion (er, monologue) about healthcare in New Zealand. As I’ve mentioned before, according to my page views and stats, all you mystery readers really care about is a) How to move to New Zealand and b) Nursing/Healthcare in New Zealand. (Oddly, it’s not baby ducks.) So lets talk again about the latter. And if you haven’t caught up on Nursing in New Zealand Part 1 and Part 2, go do that. Otherwise don’t pass go, and don’t even think about collecting $200.

The Role of the GP in NZ Healthcare

Wow. I don’t really know where to start and I obviously don’t know everything about this topic. But here’s what I do know. As a nurse and solid member of middle class America, I did not have a GP. If I had a medical problem I either saw a specialist (dermatologist, gynecologist) or I went to Prompt Care. I don’t think this is the ideal method of healthcare for young Americans, but I know its what everyone my age did. I don’t think a generally healthy 20-something female with no major medical issues could even get a GP. In fact, if I remember right, a lot of GPs were leaving the practice because of the rising rates of malpractice insurance, increased MediCare denial, etc.

So, uh, here’s a contrast… nearly every person has a GP here. (Ok, Scott technically doesn’t have one, but see above- he’s collected no viruses, illnesses, or other medical problems.) I’ve got one and I’ve seen her several times, although each time she kind of pretends she doesn’t remember me even though we also work together…

Anyways. Just about everyone has a GP. Also, you can usually get a same or next day appointment with your GP or another doctor at the practice. There is a charge for each visit to your GP, which you can avoid by going to Emergency and waiting 2-6 hours. (Hello downside of socialized medicine.) They will see you for free, and then bark at you for not going to your GP for a measly sore throat. (And then they will talk about you being a time waster behind your back, I promise.) The charge for seeing a GP is lower for enrolled patients. The government kicks in some money each time the GP sees an enrolled patient- promotion of continuity of care. Non-residents like us, and tourists, can’t enroll. But we can still see the GP for a slightly higher cost.

An interesting thing about GPs here (to me anyways) is that everybody and their mother seems to be one. I know several in my personal life (as opposed to a grand total of zero back home). Also, they’re not exactly up on any proverbial doctor pedestal. Not to say they aren’t respected- they are- but as both a nurse and as a client I find GPs extremely easy to talk to. I’ve never felt rushed or ignored. I haven’t really met any that consider themselves God’s Gift to whatever.

Older Person’s Health

At 65 years old, a person can be assessed by Older Person’s Health (this organization may have a different name outside of Canterbury). This assessment comes via a recommendation by the GP. Once this assessment has been done, the GP can organize (at no cost):

– Rest Home level care
– Respite Care for a few days or weeks (both for patients who feel like they need extra help, but also just for family members who need a loved one looked after because they need a break!!)
– Rehabilitation
– Palliative Care (Hospice)
– Psychiatric evaluation and care
– Walkers, commodes, shower/wall handles, ramps, wheelchairs, etc.
– “Never Alone” alarms (like the commercial, I’ve fallen and I can’t get up!…) to summon an ambulance. I think there is a yearly fee for this, but many people qualify for this to be waived.
– Meals on Wheels
– In-home help for just about everything:

  • Medication management: Forgetful elderly people living alone need not be forced into care because they can’t remember when/what meds to take. Someone can come in 1-3 times every day and administer medications.
  • House cleaning 1-2 hours per week.
  • Grocery shopping, pharmacy trips, etc, 1-2 hours per week.
  • Dressing, showering, teeth cleaning, etc. (ADLs)
  • Wound care, dressing changes, etc.
There is even a free 8 week cooking course called Senior Chef for people over 65 who want to improve their cooking skills and confidence in the kitchen. They are taught easy and healthy recipes and cooking techniques for 1-2 people.

The elderly population is a bit more of my specialty, both here and in personal interest, however let’s not minimize what socialized healthcare can do for other populations:

What else does your tax payer dollar get you in regards to healthcare? (as in… what’s free?)

Maternity:

  • All costs of required tests (ultrasounds, glucose tests, etc.)
  • A midwife who organizes all appointments, meets with you several times, and is available for questions 24/7.
  • All emergency visits and treatments while pregnant (visits to ED or the 24 Hour Surgery for things like PV bleeding, hyperemesis, lack of fetal movement, etc.)
  • Giving birth, unless you book in a fancy shmancy private hospital.
  • Follow up appointments including those for any complications.
Children:
  • After the birth of your child, you will visit or be visited multiple times by a Plunket nurse. They are available by phone for advice 24/7. They make sure you are getting on with things like development, breastfeeding, sleeping, early childhood nutrition, etc. They have endless resources. They have FREE parenting classes, play groups, and can find you things like car seats at very little cost. 
  • All visits to the GP, ED, 24 Hour Surgery, etc. are FREE to all children (NZ or other) under 6 years of age 24/7/365.
ACC (Accident Compensation Corporation):
 
The ACC is funded by “people’s earnings, businesses’ payrolls, petrol and fees from vehicle licensing, as well as Government funding”. The ACC covers the cost to any person, NZ or tourist, who is injured and requires medical care in New Zealand. If you seek care in a private institution, the ACC will pay for a percentage of your care. If you are treated at the public hospital, or if they are too full to take you and you are instructed to go to a private institution, your full hospital bill is covered.
 
Broke your leg in 4 places while snowboarding for the first time? And actually it happened while you were walking to the bathroom and you weren’t even snowboarding? And actually, come to think of it, you were walking backwards, showing off, because you were drunk, and you fell down the stairs and it was definitely your own fault?
 
No worries, ACC’s got your back. (Although they’d probably prefer you sober up and take some pride in yourself, mate.)
 
The cost of follow ups with your GP, prescriptions, etc. are at a reduced cost, with ACC subsidizing a percentage of these bills.
 
The Cost of Prescription Medications:
  • The cost of all subsidized prescription medication is $5. The catch: the medication you need must be subsidized by the government. Some medications are partially subsidized, and some not at all. One of my colleagues recently told me about their patient who was visiting from Europe. They had forgotten a medication at home which was pretty vital. This particular med is not subsidized in New Zealand, and was going to cost the patient $140/month. This was in no way because they were a tourist. They were angry.
  • All subsidized medications for children under 6 are free.
  • Over the counter (OTC) medications such as aspirin, Claritin, etc. are a lot more expensive than in the States. Ibuprofen 60 tablets is going to cost you about $20. But, if you go see your GP, they can write you a script for OTC medications. Viola! $5.
Made it this far? I commend you! Here’s a photo of a recent sunrise…
 
BTW: No portion of this incoherent “guide” is actually a guide to you or anyone else.
Remember what they say about free advice: you get what you pay for!
And, I’m human. So there’s probably some mistakes in here. Feel free to correct me.
 
Other Bits and Pieces that I find interesting:
  • Gum, lozenges, and patches for smoking cessation can be attained for only $5. A pack of cigarettes costs $17.20. And the percentage of smokers is going down – currently at 15%, down from 21% in 2006. I feel like people in NZ understand that they are expected to take responsibility for themselves, and many of them do.
  • The prevalence of Type II Diabetes is 11.0% of the population, right on par with America (10.9%). NZ is ranked 3rd in the world for adult obesity (behind the recently dethroned America at #2, and Mexico #1).
  • Despite having a socialized system, NZ spends much less on healthcare per person than the US.
  • Because of the ACC, there is no litigation surrounding accidents (your trampoline broke my back, now pay me $200,000; that fender-bender gave me whiplash, now I have PTSD and am suing you for $2 million in “pain and suffering”). Because there is no litigation, my car insurance costs $26/month. 
I feel like this may have gotten a bit ramble-y. Let’s blame it on my non-subsidized intake of Benadryl and generic cough medicine. I think it’s time for me to return to killing brain cells with Netflix. Now don’t you wish I just posted about bikes and ducks? 

 

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