This is my recent column in the New Zealand Herald, which is published in the digital “Premium” edition every Thursday…
Psychotherapist Kyle MacDonald on why he’s chosen not to take out health insurance.
When it comes to the politics of health, it seems impossible to separate it from money, whether it be the recent debate about funding cancer drugs, doctors’ salaries, the cost of hospital renovations or the financial performance of our District Health Boards.
But should it be?
In the lead in to the last election there was a rare televised debate between the Health Minister Jonathan Coleman, and then Labour Health spokesperson, David Clarke. The interviewer asked them both, at the end of the interview if they had health insurance, and both said yes.
I recall being deeply disappointed by this.
At an individual level, having health insurance is a rational choice to make – at the same time as it undermines the very basis of our public health system – a system meant to cater to us all equally.
Fortunately we are a long way from the corporatised disaster that is the American health system, but nonetheless the existence of the need for health insurance, and with it privatised health care, is the thin end of the wedge that enables discrimination between those that can afford to access health care, when and where it is needed, and those that can’t.
Now of course, at this point I run the risk of being labelled a complete hypocrite, as my income is largely due to the privatised mental health system. But, as I’ve detailed elsewhere , that is the reality of mental health care in New Zealand, and I wish it wasn’t – as do many of my colleagues.
It is also that time of year, where talk of the District Health Board budget’s come up in the news once more, and it frustrates me so deeply that we have the same conversation every year – that DHB’s are “in deficit” and need to work harder to stay within their budgets.
DHB’s are not “in deficit”. They are underfunded, because our health system is underfunded. If they blow their budget providing health care to the people they serve, then they need to be given more money to ensure they can provide those services. It is that simple.
I see the ongoing issue with framing this as a problem of budget management as political sleight of hand: it points towards the problem being the way that District Health Boards manage their finances, as opposed to the real problem: how successive governments consistently underfund health.
You might argue with the simplicity of this, but you can’t argue with the ethics. If we have the ability to treat a health condition, we should. Money should never come into it. Your personal financial situation should never determine your ability to access health care, for you or your family.
Access to good quality health care is a human right, not a financial decision.
And yet, a large portion of the electorate will continue to vote for tax cuts. No doubt many of the same people will still happily pay a premium on health insurance to protect their own health needs, yet complain abut paying – relatively – much less into the funding pool that pays for our national health system: via taxes.
And in case you’re wondering, I don’t have health insurance. Never have, and never will. For me that isn’t a financial decision, it’s an ethical one.