Healthcare free at the point of need

In the 1990s I lived in New Zealand for a while.  Whilst there, I had a health insurance policy through my company (and the same policy was available to all the employees, including those working machines on the factory floor).  It was a Southern Cross Ultracare scheme.  Southern Cross had less extensive schemes for those whose companies paid (or who themselves paid) less.  This was the top scheme.

My Southern Cross Ultracare policy enabled me to take my voucher and present it at a Southern Cross clinic, to receive treatment without parting with cash.  If I attended another health clinic I claimed back from Southern Cross (and for larger amounts I could arrange to have Southern Cross pay directly).  Here were a few features of my experience:

• I never waited more than 15 minutes to see a doctor
• The clinics were always spotless; The staff were always courteous; The doctors took the notion of informed consent very seriously, and explained things very clearly so that I could understand and take decisions.
• I never waited more than two weeks to see a specialist.  I never waited more than a few weeks for an operation.  (As it happened, I needed both of these.)
• I was entitled to $400 per year of dental care (this was 13 years ago, and that was sufficient that I never parted with cash, despite my poor teeth)
• I had my short sight laser corrected without parting with any cash

Why have I given you this list and told you this tale?  Because it illustrates that under insurance-based health care, there is the very real possibility of having comprehensive healthcare that is totally free at the point of need (I never had to pay at the time I was treated).  It has become fashionable, even in Conservative circles, to suggest that insurance-based solutions cannot cater for the needs of the less-well-off.  This is simply a falsehood.  It does not necessarily follow that an insurance-based system is the best form of public healthcare, or even that it is superior to the type of system we have now.  But wouldn't you, and many others, like the opportunity to provide the public health insurer with the incremental costs of providing a service like that I have described, rather than the service you currently receive from the NHS?

Comments

[comstock]

"Southern Cross had less extensive schemes for those whose companies paid (or who themselves paid) less. This was the top scheme."

So you were lucky in that respect. Others would have been enjoying a lesser standard of care.

Of course it's good that your employer offered the premium scheme to all its employees right down to the lowest grade, but other low paid New Zealanders would be less fortunate. Not to mention those without a permanent employer (temps) or the low paid self employed.

New Zealand can do want it wants- but for the UK I'm for the NHS.

[Andrew Lilico]

But, cornstock, what you are criticizing is not an insurance-basis for the system, but the fact that the insurance of the less well off is paid for by companies, voluntarily. But why couldn't the insurance policies of the less well off be paid for by the State?

[comstock]

Because taxpayers money would be subsidising the profits of greedy insurance companies?

And because I'm not convinced that state insurance would be as good as the top tier you experenced. I'd wager the state would only pay for basic care....

[Adam-]

There is of course the obvious risk of people being deemed or becoming "insurance write-offs" when their health isn't up to standard for whatever reason. I assume you're advocating the insure-all-employees-for-lump-sum arrangement, which allows for speading the "risk" across all employees.

It's important to note the limits of private health insurance. The private sector will inevitably be interested only in the profitable stuff. I can't blame them: any profit-making operation must drop loss-making perts of the business. The worry is these companies will cherry-pick the best bits and leave the rubbish for the NHS to deal with.

This is particularly so with emergency medical care, which in the UK certainly, is decidedly lacking. Private companies are happy to take your (or your employer's) cash for a knee operation, but if you get knocked down in the street you'll find yourself in the nearest NHS A&E for sure.

Of course, there is no reason for interfering if an individual company wants to pay additional insurance for a private health insurance as an employee perk, as well as National Insurances. Such a scheme will lift an enormous load off the NHS. But it's no replacement for it, nor any case for a substantial cut in National Insurance.

[Andrew Lilico]

I'm not advocating anything in particular here. In other places I've advocated a system in which the NHS become a state insurance company, and we have the possibility of purchasing more and less expensive insurance policies, with a compulsory minimum level prescribed each year by the Secretary of State, and the State funding the compulsory minimum level for the less well off.

Note (and this is very important), I say a *minimum* level, not a *minimal* level. I'm not suggesting that the compulsory minimum be an emergency-only service or something like that. I would imagine that the compulsory minimum would be a policy delivering about the level of healthcare we have now.