The next article they had me write was on healthcare in New Zealand, only half the size so not quite as in depth as the last one.
So this week it is the health issue, unfortunately most of my knowledge of health and the treatment of ill health comes from TV shows like House. So on House a person wanders into the ER with an array of symptoms and House and the team do a bunch of random tests, MRI scans and risky surgeries to figure out that the person has some weird form of cancer, or STD or whatever. What you will never see on a show like House is a decent cancer screening program, healthy eating and exercise or practising safe sex stopping people getting diseases in the first place. It just doesn’t make a sexy medical drama.
The problem is the idea that the big flash medical equipment and challenging surgeries is the best form of medicine is embedded in our healthcare system. Personally I think it would be more true to call it the most expensive form of medicine that the average person has access to. Our medical bill as a country is huge, around 18% of the money the government spends goes to the Ministry of Health.
The thing is if we were to put as much effort into stopping people getting sick as we do on all the fancy stuff to make sick people better we could still have a wicked good health care system and save a lot of money as well. Look at something like bringing in home insulation, it is cheap to do and people are much less likely to get sick. But instead of bringing in a decent standard of insulation for all homes in New Zealand we spend our money on medicine, doctors and equipment to treat all the people that get sick.
I feel sort of obliged to bring up the Cuban model of health care. Due to the American blockade and general poverty they had to create a healthcare system on a budget. So they focused really heavily on screening to catch diseases early, public education and disease prevention. It turns out that doing things this way gives them a life expectancy comparable to the best countries in the world, which is really amazing considering the American blockade hasn’t allowed much medicine into the country.
According to the World Health Organisation Cubans only spend 11% of their tax dollars on health care. Of course Cuba has a lot less money to spend than us and they don’t have any money going into private healthcare either so in actual dollar terms they are spending a hell of a lot less than us to get results that are almost as good. Which makes it really obvious that we are wasting a lot of money in making people healthy when stopping people getting sick in the first place is so much better.
Which isn’t to suggest that our healthcare system is bad or that Cuba’s is good, both have strengths and weaknesses. I think it makes sense to look at what is working around the world and try to merge the best of what countries like Cuba do with the best of what we do. If we can get a really good public health system going in New Zealand just think of the money that will free up to buy flash new equipment or maybe we could pay our doctors a salary that is competitive with what the Aussies pay their doctors.
So moral of the story, just because something is sexy and dramatic doesn’t mean it’s the smartest thing to do, at least not in medicine.
