It is a challenge to offer more than just a critique of the reporting that is out there. However, I have never seen reference to the New Zealand model of healthcare in any of the articles or books which I have reviewed and which we had the opportunity to experience for a year. Our family was insured under the nationalhealth insurance plan that is available to all citizen's in the country. Also, my husband as a surgical subspecialist, practiced at the public hospital in Rotorua. New Zealand's system has four key components to implement it's health system:
1) A public plan available to every citizen for a very low monthly premium (a family of three cost $37 month);
2) Private insurance to supplement or supercede the national plan;
3) A national fund called "Catastrophic and Accidental Coverage". This is funded through taxes and financially assists those injured through Work (much like our Workmen's Comp), auto accidents, no-fault medical complications, etc;
4) The Medical Council of New Zealand - a volunteer panel of surgeons and physicians charged with reviewing claims of medical malpractice.
This system has it pitfalls, as do most, and here are a few:
1) The waiting list to be seen by an ENT specialist was a year. This means children referred to the public for tubes and tonsils by their pediatrician had a year to wait before seeing the specialist and then another wait before the actual surgery. For many of the children this meant their speech developement was delayed, requiring speech therapy after their tubes were in place, or suffering with chronic tonsilitis and strep and missing lots of school putting them further and further behind. For those that could afford the private insurance, the wait could be bypassed by seeing a physician who also saw privately insured patients.
2) Surprisingly the public hospitals were nicer, facility-wise, than the private hospitals. There are probably multiple reasons why this is so, but it was unexpected.
3) The Accidental & Catastrophic Fund had its share of abuses and fraud, much like our Workmen's Comp system.
But the pros to the system were also very evident:
1) Everyone had access to care;
2) People who had true catastrophic medical circumstances due to accidents or health did not have to try to blame anyone to get access to funds to assist them in a potentially financially devastating event. This "blame game" is what fuels the need for tort reform. You don't have access to financial help unless you have someone to blame for your condition. Even when there is no fault, people are left with impossible financial implications when tragedy strikes, and their only recourse is to try to sue for some monetary assistance - which sympathetic juries will award even if the physician is not at fault. The lawyers of course retain a hefty portion of the awards, and the malpractice insurance industry justifies the huge malpractice premiums charged to doctors. Currently, the US malpractice environment has softened, but projections are that will change as the economy continues to struggle, and people are faced with medical bills in a failing economy.
3) A rotating group of Medical Professional to access claims of malpractice is much more constructive than a group of lawyers fighting for their clients. Although in some states in the US there are Medical Screening Panels, the complaint is still able to go to court despite a finding of "no fault" by the panel, and the findings by the panel are not admissable in court.
Friends in New Zealand - please comment!