Contrary to Key, Govt does target waste

54 comments on “Contrary to Key, Govt does target waste ”

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1. jafapete 1

   13 July 2008 at 12:05 pm

   Is it possible to get a picture of what 1.5 gm of cheddar cheese looks like?
2. Anita 2

   13 July 2008 at 12:08 pm

   Jafapete,

   If cheese is slightly more dense than water it’s about 1/3 of a teaspoon of cheese, I don’t think a picture of it would really work 🙂
3. vto 3

   13 July 2008 at 12:11 pm

   I think your philosophy is all backwards.

   You seem to regard the govt coffers as being of primary importance and that the taxpayers coffers come second.

   Clearly the proper way to view these matters is that the taxpayers private finances are of primary importance and the govt comes second.

   All else stems from this backwards philosophy.
4. Live Free or Die Hard 4

   13 July 2008 at 12:28 pm

   [Tane: And that’s you banned for life. Don’t think you can come on here and smear us, without evidence, and expect to get away with it.]

   [lprent: lived up to the second part of the name anyway]
5. MacDoctor 5

   13 July 2008 at 2:04 pm

   The idea that a government would purposely spend money in a wasteful manner is patently absurd

   And you really crack me up, Steve. 🙂

   Government is inherently wasteful in direct proportion to the level of accountability and transparency in the government. Unfortunately, most governments, and socialist governments in particular, seem to think that bureaucracy is a substitute for accountability and spin is a substitute for transparency. Bureaucracy and spin are both, by definition, extremely wasteful in that they tend to self-generate more bureaucracy and spin.

   I am intimately involved in the health system. I can tell you that most of our extra health dollars are disappearing into the blizzard of paperwork that nurses and doctors and frontline administrators have to cope with. After nine years of a Labour government, I see NO improvement in our health service, no matter what our government spin doctors say.
6. Pascal's bookie 6

   13 July 2008 at 2:17 pm

   vto,

   Why is that so clear?

   If we accept that having a government is a good thing, leaving aside for the moment how large a role we think is appropriate for a government to take, then we are saying that government must be funded, or bad things will happen.

   I think you would agree that if we did not have government at all it would be very difficult for private citizens to accumulate wealth much beyond subsistence level for the most part.

   Those that could, would mostly do so through force. In order to avoid this we have governments that enable the rule of law, which in turn allows markets to develop. If these two things are what allow private individuals to have lives that are something more than nasty, brutish, and short, then gov’t finance is of primary importance, because it is what allows for private wealth to develop.

   So it seems to me that the arguments are about what governments spend money on, and whether or not certain types of spending are facilitating or inhibiting general well being, however we might define that. Modern mixed economy leftists take a broader view of the things that promote growth. They think that gov’t spending on health, welfare, education and the like are just as important in promoting growth as enforcing contract law, catching robbers, and protecting the borders.

   So, therefore, what many on the right see as wasteful backroom quangoism, many on the left see as necessary spending to ensure that gov’t policy is being thought through and implemented in such a way as to be of most benefit.

   That’s not to say that there is no waste. There is always waste. But babies/bathwater etc. The left think that there is in fact a baby in there, and the right often just seem happy to take the risk that there is not.
7. lprent 7

   13 July 2008 at 2:25 pm

   Jafa/anita: Perhaps if you started from the milk required to produce the cheese it’d look more impressive?
8. Anita 8

   13 July 2008 at 2:42 pm

   Perhaps if you started from the milk required to produce the cheese it’d look more impressive?

   Good thinking Batman!

   1.5g of cheese takes 15g of milk, which is exactly one whole tablespoon – still not a very impressive photo though. Less than most people would put into a cup of coffee.

   How about the two tablespoons (30g) of water the cow would need to drink? Still probably not enough, and I feel a segue into the Green campaign about water quality and rivers coming on.

   All this trivia brought to you by the Moo Milk FAQ and a sunny Wellington afternoon.
9. highrestandard 9

   13 July 2008 at 2:42 pm

   Sadly I have to agree with MacDoctor 100%.
10. sean 10

    13 July 2008 at 3:20 pm

    Sorry, but you guys are kidding yourselves if you think we have anything even remotely close to an efficient public sector. I’ve seen it firsthand in one of the major government departments – one IT project there that could’ve been done privately for 2 million took 46 million to implement.

    Or how about the GUI screen that had 4 fields changed on it and it cost 400k of tax payer money? Enough to fund a decent sized IT project from start to finish for a medium size company. How about my team having 5 highly paid team leaders and a development manager to handle 3 programmers and an analyst? (and them only being able to find 3 days a week of work for me at that).

    There will always be some level of waste or inefficiency whether it is public or private. The issue here is that it is chronic right across the public sector, and has been for the last 6 years or so.
11. J 11

    13 July 2008 at 3:41 pm

    Sean is correct. A couple of friends working in IT roles in the public sector told me about the hiring of business analystsand programmers when there is no work for them, of projects which are started and never finished and lack of cost controls. Empire building seems to be the manager’s main prerogative.

    It’s pity this attitude to non-essential backroom staff isen’t extended to more vital front line services.
12. Gekko 12

    13 July 2008 at 4:04 pm

    “I think you would agree that if we did not have government at all it would be very difficult for private citizens to accumulate wealth much beyond subsistence level for the most part.”

    That’s a rather large assumption that allows the rest of the ‘we must give everything to the govt’ to follow rather easily. Where does that assumption come from?
13. randal 13

    13 July 2008 at 4:15 pm

    gosh it is wonderful that all knowing contributors to the citizens media can accuse the government of monumental waste yet the mainstream meedia who are are no friends of the government cant prove anything. methinks some of the posters here are just piffle boosters for the gnashnull party.
14. vto 14

    13 July 2008 at 4:23 pm

    Pascal’s Bookie, you make a point but it is not that relevant. Any group of humans will naturally form themselves into some sort of organisation with leaders and rules and penalties etc etc. Whether it is the modern state or a lone bunch of hunter gatherers.

    I am not questioning the need for a structure to allow human society to function. I am questioning the rationale that says that structure should have the prominence it does today. And especially that the people should suffer to allow that structure to operate in the manner that only some of the people think it should.

    Quite frankly, it is more important that people should have enough money for food and a decent house than it is that, by way of example, the govt should pay for inter-generational infrastructure with today’s cash. Or that students should have their loan costs paid for by the workers. Etc.
15. ak 15

    13 July 2008 at 5:09 pm

    Macdoctor said:

    I am intimately involved in the health system. I can tell you that most of our extra health dollars are disappearing into the blizzard of paperwork that nurses and doctors and frontline administrators have to cope with.

    Ah good – not the usual Nat/Act waffle, but someone who by his own confident assertions can give us concrete examples of what National/Act might cut.

    At last count Labour has put around an extra $6billion/year into health.

    As you say, you’re intimately connected Mac, and that most of this money is wasted on paperwork.

    So tell us: where exactly is this money wasted?

    As you are so intimately connected with and certain of this waste, (which by your own assertion must total around $5billion or so/year) please rattle off half a dozen or so actual examples of what you would cut/modify/etc to make some savings.

    We’re all ears Mac: no more generalities or slogans please, just concrete examples. Just a few off the top of your head will do for now.
16. MacDoctor 16

    13 July 2008 at 5:55 pm

    AK: Firstly, a substantial portion of the 6 billion is not increased spending, but simple inflation adjustments. But you want examples:

    Scrap all health boards.
    Allow hospitals autonomy but with centralized drug and equipment purchases.
    Digitalize all hospital records and computerize them countrywide on the same system.
    Add an order-entry computerized system to avoid duplicate investigation and minimize drug errors.
    Scrap the HDC
    Seriously streamline ACC claims for minor injuries.
    Restructure funding streams so that patients do not have to wait weeks in hospitals while we find out which government funder is going to pay for their care in the community or nursing home.

    That will do for a start…
17. lprent 17

    13 July 2008 at 6:52 pm

    J:

    A couple of friends working in IT roles in the public sector told me about the hiring of business analystsand programmers when there is no work for them, of projects which are started and never finished and lack of cost controls. Empire building seems to be the manager’s main prerogative.

    And how is that is different from corporate? It isn’t.

    I could give you a list of companies that either I have worked in, or where IT friends have worked in where that has happened. Essentially the larger the organization the more likely that is to happen.

    The only ones that (usually) run projects tightly are the smaller companies.

    Now I suppose that these corporates are meant to have a profit motive helping them focus – yeah right! I’ve never seen it on projects for corporates. Bloated organizations that should usually be broken up is my usual opinion.

    But bugger it – they are large for a reason. You have to be large to run large systems like (say) a telecommunications or power network. Or for that matter to run large scale public enterprises like hospitals, schools, power networks, infrastructure planning, court systems, etc.

    If you can give me a method to make bureaucracies and corporates able to be effectively broken up away from the tasks, and I’ll tell you the methods to make software projects more efficient. I have a little list about who I’d fire – but most of them are there to keep the rest of the organisation off the working stiffs backs. But you can’t because it has seldom been achieved, and usually after a National administration has failed politically (eg muldoon).

    It is about this point that I like pointing out that I’m both a working programmer and an MBA who has worked as a manager many times with a strong interest in organizational systems. That diminishes the usual dickhead tirades about how I don’t know what I’m talking about.

    In the meantime I work in small organizations where I can finish projects.
18. lprent 18

    13 July 2008 at 7:02 pm

    MacDoctor:

    The computer systems you’re describing have been tried several times before. Typically they fail because of the separation of the different parts of the health system. This means that the really is no way of mandating the standards and the minimum requirements from the GP’s clinics to the hospitals.

    Perhaps putting the IT software requirements in the hands of the DOH would help. Mandate the required interface protocols (and remove all competing standards from vendor solutions), and put a ERO for any part of the system not conforming to the standard reporting and operating requirements.

    Probably make sure that there is one person or a small committee driving the process and it isn’t a consultative process. You might not like what you get at the end, but it is likely to work.
19. Draco TB 19

    13 July 2008 at 7:18 pm

    And especially that the people should suffer to allow that structure to operate in the manner that only some of the people think it should.

    That’s democracy for you – thankfully it’s the majority that think it should be run the way it is.

    Quite frankly, it is more important that people should have enough money for food and a decent house than it is that, by way of example, the govt should pay for inter-generational infrastructure with today’s cash.

    The best option is, of course, doing both. If the resources are available to do both then borrowing money to do them will just them cost far more than they have to, holding the country back and, effectively, decreasing living standards.
20. Anita 20

    13 July 2008 at 7:34 pm

    lprent writes:

    Perhaps putting the IT software requirements in the hands of the DOH would help. Mandate the required interface protocols (and remove all competing standards from vendor solutions), and put a ERO for any part of the system not conforming to the standard reporting and operating requirements.

    I think that is what NZHIS is up to (with a nice increase in funding for 08-09). It’s a massive programme of work but they seem to be making progress on a quick glance at their most recent newsletter.
21. vto 21

    13 July 2008 at 7:56 pm

    Mr Draco, of course doing both would be great. During Cullen’s tenure however the tendency has been to view the state as of greater importance than the people when it comes to finances. Cullen’s comments over the years show this (too late in the night to dredge up examples).

    And this is wrong. We are not subjects of the state. We need the money ourselves. I added up all the surpluses during Cullen’s time and divided them by the population – our family dipped out on $35,000! $35,000! Holy f&*%k! Imagine the size plasma screen I could buy with that!

    The govt is big enough and ugly enough to look after itself. I suspect we agree on the need for a govt, but imo it has exceeded its reasonable limits. And furthermore that excess does in fact reduce the number of $20 notes in each workers back pocket each and every week. It is a very direct correlation.
22. bill brown 22

    13 July 2008 at 8:01 pm

    Ya know, vto, Cullen doesn’t actually put all that “surplus” money in a vault in the basement and swim in it at night – it goes (or went) to paying of debt and into the Superannuation fund – which it can’t after the tax cuts ’cause their going into your pocket – hope you’ve told your kids to keep a spare room for you in your old age when the pension fund runs out of money.
23. vto 23

    13 July 2008 at 8:04 pm

    oh yes yes of course there are all sorts of things he did with it. I knew that would distract from my point.
24. The Hardworking Kiwi 24

    13 July 2008 at 9:07 pm

    It has always been clear that the cuts Key has been talking about are nothing but hot air. There is no way that so much “waste” can be found that we will be able to give the average person and additional $30 on top of the average $20 Labour have promised.

    How long will it take for New Zealanders to realise that National will have to slash funding in order to pay for their ridiculous, unnecessary tax cuts?
25. ak 25

    13 July 2008 at 9:08 pm

    Thanks Mac, back from the Simpsons, let’s see watcha got:

    Sooo…. top of your list is scrap all Health boards. Ignoring the loss of democratic input (thought righties were fans of this), this would save….what? Generously assuming around half a mill per board, about 10 mill. (Heck, quintuple the estimate if you like – $50mill)

    2nd on list: allow hospitals autonomy. Meaningless generalisation with no detail. No national standards or targets at all? Yep, that’d work.

    3rd: Digitalise records…etc. As dealt with above by Lynn and Anita, extensive efforts already made and ongoing. Another woofy generalisation with no detail.

    4th: Scrap the HDC. Saving….?? Yep bugger those crips eh. Nice, Mac

    5th and 6th: “seriously streamline…”, “restructure funding streams…” I specifically asked for no generalisations but here we go again, no details, no concrete savings, nothing.

    So thanks Mac, but that’s a big failure to provide anything remotely approaching a concrete measure that would save anything like the “most” of the extra $6bill spend that you claimed to have “intimate” knowledge of the “waste” thereof.

    As suspected, you’re just spouting National/Act propaganda – and worse, lying like a flatfish about having evidence to back up your claims.

    The fact is, National has largely backed the status quo in Health (see their own discussion document): as in every other significant aspect of Labour’s stewardship, they have conceded Labour’s stellar performance by accepting their policies in toto.

    And Labour has excelled: the Commonwealth Fund, the hugely respected authority on the matter, found our health system to be the second-best in the world last year – at a third of the price per head of the US system. Here ya go Mac: read it and weep for your sorry little “NZ Sucks” effort.
    http://www.commonwealthfund.org/usr_doc/1027_Davis_mirror_mirror_
26. MacDoctor 26

    13 July 2008 at 10:14 pm

    AK: You are seriously weird. You do not appear to be able to debate anything without becoming abusive. If you think I am just spouting National/ACT propaganda then you have a deeply distorted view of the world.

    1. Democratic input to health boards is an illusion. Your mate Cunliffe has shown us that.

    2. While hospitals are dictated to by government fiat, expect no improvement in health services EVER

    3. There have been effective computerized systems available for years. I still cannot access a patient’s latest medicine list or his medical record unless he is attached to the DHB. There is no reason for this bullshit.

    4. HDC – so far, no improvement in medical services in this country but costs several hundred million a year to run, in terms of lost productivity and doctors covering their asses with unnecessary investigations and procedures.

    5. ACC – paperwork is still onerous and almost entirely unnecessary. 90% of ACC claims result in no resultant disability and minimal time off work.

    6. What don’t you understand about funding streams? I have patients sitting in my ward for weeks while some dim bureaucrat decides whether they are elderly health, ACC or disability. All this money comes from the government. The real question is who gives a stuff which funding stream is used? Yet people sit in expensive hospital beds because someone has to fill in mounds of paperwork and shovel it around several committees for approval.

    And by the way, Mr AK, the reason why we still have a functioning health system has absolutely squat to do with the labour government and everything to do with the dedicated doctors and nurses and paramedical workers who provide patient care in trying circumstances.
27. Kevyn 27

    13 July 2008 at 10:35 pm

    “looking first at where resources can be moved around so new policies can be funded from the existing funds, ie. provide more services for the same amount of tax.”

    er…no. It is robbing Peter to pay Paul. Need resources for noisy exhaust blitzes? Take it from booze buses.

    It isn’t providing more services, it is providing different services. When he says government I assume he means cabinet. Do they consult with their advisors before making these budget changes? Or get Treasury to analyse the economic impact? The shift of resources from booze buses to noisy exhausts definitely was made against the advice of the National Road Safety Committee.

    Going through the budget line by line wont identify any waste whatsoever.

    Those who have pointed out the similarities between big government and big business are on the right track. When directors and executives have to rely on written reports instead of being able to look and listen themselves their decision making becomes GIGO.
28. Tane 28

    13 July 2008 at 10:36 pm

    Ak, just riffing off your last comment. Anyone else notice there were three episodes of the simpsons tonight?
29. Steve Pierson 29

    13 July 2008 at 10:52 pm

    Sure did. Gold. It’s cause My Name Is Earl is over.
30. ak 30

    13 July 2008 at 11:55 pm

    Macdoctor: Ah yes… the old you’re seriously weird and then the attack – I’m abusive – in the same sentence yet! Just like the years of vicious anti-Clark tory abuse followed by claims of Labour “smears”. Pathetic.

    Your “points”: none address my question – all unfounded, unsubstantiated, anecdotal slogans, diversions and bulldust with not a single concrete suggestion or “smoking gun” to suggest in even the tiniest way how improvements could be made. And all total diversions from my polite request for concrete evidence of the waste of $5billion.

    e.g.: ACC paperwork is “unnecessary” – yet not a single suggestion of which process could be eliminated or even modified. Provide real proof or shut up.
    And I have patients sitting in my ward for weeks while some dim bureaucrat decides whether they are elderly health, ACC or disability
    Just a big fat lie. Provide evidence and identify or apologise to the “dim-witted bureaucrats” you cowardly malign behind your anonymity.

    The rest is spin and obfuscation, as you well know, but more to the point; not a single answer in two comments to my simple request for real, concrete evidence of the “waste” of “most” of the extra $6billion that Labour has put into our health system since National’s disastrous privatisation experiments of the 1990s.
    Nor any answer to the FACT that we have on of the best health systems in the world as measured by international experts on the subject.

    Big fat failure Macdoc: your assertions of immense waste remain totally unfounded and utterly refuted by the evidence. The single accurate observation you make refers to the calibre of our health professionals: it’s just inexcusably disgusting that you choose to denigrate an entire cohort of similarly essential, dedicated and hard-working people for the purposes of cheap political point-scoring.

    I shouldn’t be surprised: demonisation of entire segments of society has been the classic tory modus operandi for generations. I guess “health bureaucrats” will just have to join the list of jews, irish, blacks, catholics, poofters, pommie unionists, uppity women, commos, yellow peril, and feminazis that inexorably paints those desperate to cling to archaic power structures into their rapidly-shrinking and increasingly bitter and isolated corners.
31. Kevyn 31

    14 July 2008 at 12:11 am

    When our hopitals had “managers” Labour jumped up and down complaining that we had too many managers and not enough workers. Now that our hospials have “bureacrats” National is jumping up and down complaining that we have “too many bureacrats” and not enough workers. Both parties are complaining about the same people – the charge nurses, receptionists, radiographers, IT engineers, specialist medical consultants and everybody else who provides the doctors and ward nurses with the means to do their job.

    ReCaptcha: leaders sponging
32. vto 32

    14 July 2008 at 8:36 am

    The Hardworking Kiwi said “There is no way that so much “waste’ can be found that we will be able to give the average person and additional $30 on top of the average $20 Labour have promised.”

    You see, this is the classic give-away of the mindset that is backwards. It is not in fact the govts money to give. But the mindset is that it is actually the govts money to give. The mindset is that we all work for the over-arching state and the state deems how much we should be given after the govt is happy. This mindset is Cullen thru and thru.

    The Hardworking Kiwi – your mindset and philosophy is all backwards, just as I pointed out up the top. You are proof of my point.

    What should in fact be stated, and by the average NZer not the govt, is: “There is no way that we can afford to give another $30 to the govt, we need it to pay for food and our homes”. Or: “We can no longer afford to give to the govt that extra $30 that we started to give a few years ago through the blah blah tax/levy/etc, you (the govt) will now have to do without it. We have more important places for that $30 to be spent.”

    The philosophy is backwards.
33. RedLogix 33

    14 July 2008 at 8:57 am

    vto.

    I restrict myself to one sermon per month; usually on a Sunday evening:

    http://www.thestandard.org.nz/?p=2487#comment-70522

    It is you who has your philosophy pinned on backwards, facing inwards, self-centered and life denying.

    The money you are whining about paying as taxes was NOT wholly your own in the first place. All wealth is conditional on the efforts of others around you. The more wealth you accumulate, the more you are in debt to those others.
34. higherstandard 34

    14 July 2008 at 9:06 am

    AK

    No the commonwealth fund did not find that we had the second best health system in the world, to extrapolate this publication to get that as a take home message is incorrect.

    Do we have a good health system on a worldwide basis – certainly, but I find your attack on Macdoctor both unwarranted and reflective of a similar response that medical professionals receive from the Ministry of Health and governments of all ilks whenever we raise concerns.

    If you sit down and talk to any medical professional in primary or secondary care they will tell you there is waste in the system as there is in all health systems around the world.

    There has been significant increases in backroom staff in hospitals and the Ministry over a number of years and Kevyn these are not in the areas you allude to, we all very happy to have these people in the system as they are critical to it functioning – indeed often we do not have nearly enough help in these positions.
35. bill brown 35

    14 July 2008 at 9:13 am

    “There is no way that we can afford to give another $30 to the govt, we need it to pay for food and our homes’.

    vto, again, we don’t give this money to “the govt”, the government redistributes that money to society to keep society going.

    “the govt” doesn’t hold onto that money.
36. vto 36

    14 July 2008 at 9:22 am

    RedIllogix

    Thanks for the sermon. I will put it together with all other sermons.

    I acknowledged a similar point that someone made elsewhere – that we are all inter-dependent, that some form of governing structure is both a natural human condition and necessary. etc.

    That is not my point, which is quite specific. Read a little more closely.
37. vto 37

    14 July 2008 at 9:28 am

    Bill Brown, so how did society keep going when people paid no tax to the govt, which was not that long ago?
38. bill brown 38

    14 July 2008 at 9:37 am

    Hey I’m no historian so I can’t give specific examples, but I can’t imagine that the average “man in the street” at that time was better off than I am. And I’m very much just an average man in the street.

    Did they have an extensive road network?
    Did they have hospitals where I could get, like, radiation therapy?
    Did most of their kids NOT get sick and die before they became adults?
    Did they have schools just down the road where you could send your kid – just because?

    Where and when did this nirvana exist?
39. vto 39

    14 July 2008 at 9:49 am

    bill brown, good attempt but not quite there. You referred to keeping society going, not the state of society. You are changing your own question midway through.

    But never mind – perhaps back then there were no plasma screens sure, but apparently there was a hell of a lot less crime!

    Govt does not keep society going, as you claim. That is patently absurd. Society exists and keeps going by the mere existence of a group of people. Govts and other things arise from that, effectively as a subset. And that in fact goes right back to the point I have been trying to make – that the current philosophy is backwards.

    Govt is a subset of society, not the other way around.
40. bill brown 40

    14 July 2008 at 10:06 am

    Thanks vto, I didn’t think that that situation existed. I would have been surprised.

    By the way, I wasn’t attempting anything to be “not quite there” about. I was just interested to hear about a society like ours which didn’t rely on redistributing income.

    Were you speaking to someone else about the plasma screens? Sorry you lost me there.

    I never said that the government keeps society going. I said, and I quote myself:

    “…the government redistributes that money to society to keep society going.”

    And thus I agree that, to quote you:

    “Govt is a subset of society, not the other way around.”
41. mondograss 41

    14 July 2008 at 10:35 am

    There is a perfectly good reason why all patient data is not centralised. It’s called “Privacy”. You know, that thing where people don’t want someone knowing everything about them? Like where a female patient doesn’t want her family GP to know she’s had an abortion etc. So what we have in NZ is the NZHIS, it records patient demographics and key alerts (via the NMWS system) like whether the patient has HIV or an allergy to penicillin, but doesn’t act as a patient record. It’s up to the hospitals and GP’s to keep that record, and to keep it seperate, and if data is needed from one to another then there’s a process to go through. I’m not saying the process couldn’t be electronic and Counties and Waitemata DHB’s are doing some good work on this, but there you go.

    I’m trying to remember the other things that were suggested for improving the health system, but the other commentators were right, mostly they were vague and unuseful generalisations. The suggestion of a centralised procurement system for medical supplies would be worthwhile but has been done in some areas and on that experience would yield about $1m per DHB per year.
42. ak 42

    14 July 2008 at 11:44 am

    HS: No the commonwealth fund did not find that we had the second best health system in the world, to extrapolate this publication to get that as a take home message is incorrect.

    Most blatant case of calling black white yet seen on this blog. NZ is clearly ranked 2nd overall in table on page one and the extensive analysis following.

    …your attack on Macdoctor…

    Attack? Hardly – I simply asked Macca to supply one skerrick of evidence to back up his ludicrous claim that most of the extra health spend is wasted. Both he and yourself have failed dismally: if exposing blatant lies from purported professionals (one of whom cannot spell navel) and self-proclaimed “insiders” is an attack, then either tidy up your game or brace yourselves for further “ak-attacks”.

    If you sit down and talk to any medical professional in primary or secondary care they will tell you there is waste in the system as there is in all health systems around the world.

    Agreed. Just as there is in any large organisation. But lashing out at entire sectors with baseless and hyperbolic invective is no way to behave – let alone identify problems and improve things.
43. MacDoctor 43

    14 July 2008 at 12:08 pm

    AK: You call me a liar and thats not abusive? You clearly have no clue as to what is happening in the health system. You accuse me of supplying no evidence yet supply absolutely zilch to support your completely baseless viewpoint. Let’s face it – I’m the one with the first-hand knowledge but, of course, I’m just a dumb doctor, what would I know about the health system.

    Your attitude is exactly the same as the dim bureaucrats in my last post. I therefore conclude that you are probably one of those said bureaucrats, so I will stop posting now and go and do something more productive – like bang my head on a brick wall.
44. Draco TB 44

    14 July 2008 at 12:12 pm

    oh yes yes of course there are all sorts of things he did with it. I knew that would distract from my point.

    It didn’t distract from your point – it totally annihilated it.

    What you said was that it was possible to do both anyway but that we should borrow to do the capital investment because it was ‘inter-generational’. I’m pretty sure previous governments have said the same which is why we have 15 to 20% of GDP as government debt. The interest we’re paying on that would almost pay for Nationals tax cuts which is why I said that such borrowing decreases living standards. If we weren’t paying that interest we would be better off both individually and as a country but we are and that dictates higher taxes now. Once we’ve paid them off we can have lower taxes.
45. ak 45

    14 July 2008 at 12:43 pm

    Macca: I will stop posting now and go and do something more productive – like bang my head on a brick wall.

    Excellent therapeutic choice for your condition.
    (But do remember that on remission the resultant claim forms must be double-checked and fully compliant and if there is any damage to that wall the appropriate PCT47s will have to be logged on in the correct field prior to approval by your CAD and entered against both the Risk Register and IPP.)
    Patients, brother 8)
46. higherstandard 46

    14 July 2008 at 2:55 pm

    AK

    Your link is not functioning. As I said previously if the report is the same that has been trumpeted here before as saying that NZ is the second best health system in the world that is an incorrect assumption to take from the report.

    And once again in Macdoctor’s defence you asked her/him for a few examples off the top of her/his head, they were supplied and were all reasonable suggestions which you proceeded to deride and attack leading me to assume as she/he did that you may indeed be one of those dim health bureaucrats that cause us both some dispair.
47. vto 47

    14 July 2008 at 3:49 pm

    Mr Draco, your economics is simplistic. And arguing over that was not the point of my points.
48. ak 48

    14 July 2008 at 8:21 pm

    HS: Sorry about that, here’s the link again, this time including 2007 (where we are now ranked third equal with Australia)

    http://www.commonwealthfund.org/usr_doc/1027_Davis_mirror_mirror_international_update_final.pdf?section=4039

    Oh and yes, it is the same one I have posted here before.

    And the unmissable table showing our overall rating is very clearly displayed on the second page of the executive summary. Not to mention a further table on page 5 (reproduced below)

    Which means that you are knowingly repeating your blatant, barefaced LIE.

    Without a shred of justification.

    I still suspect you are burt

    But I KNOW you are a blatant LIAR

    (and a “doctor” that can’t even spell “navel” or “despair”)

    Pathetic.

    “The top-performing and lowest-performing countries have been relatively stable over time (Figure 3). The U.S. ranked lowest in editions of this report released in 2004 and 2006. Last year, Germany led the six nations. This year, U.K. performance improved to first with inclusion of data from the 2006 survey of primary care physicians, reflecting in part the dedicated effort made in the U.K. to implement a health information system that supports physicians’ efforts to provide quality care and a payment system for primary care physicians that rewards high quality.
    Figure 3. Overall Ranking
    AUS
    CAN
    GER
    NZ
    UK
    US
    Overall Ranking (2007 edition)
    3.5
    5
    2
    3.5
    1
    6
    Overall Ranking (2006 edition)
    4
    5
    1
    2
    3
    6
    Overall Ranking (2004 edition)
    2
    4
    n/a
    1
    3
    5
    Health Expenditures per Capita, 2004*
    $2,876
    $3,165
    $3,005
    $2,083
    $2,546
    $6,102
    Note: 1=highest ranking, 6=lowest ranking.
    * Health expenditures per capita figures are adjusted for differences in cost”
49. higherstandard 49

    14 July 2008 at 9:05 pm

    AK

    No AK you are perpetuating the lie that this report as you said earlier today showed NZ to have the second best health system in the world.

    “And Labour has excelled: the Commonwealth Fund, the hugely respected authority on the matter, found our health system to be the second-best in the world last year ”

    Poppycock the report is first and foremost a survey and is of 6 healthcare systems only

    (That the UK is rated number 1 I find laughable as unless it has improved out of sight I find it extraordinary that a survey has found the NHS superior to health services in NZ, Australia and Canada.)

    Which means that you are incorrect in stating that

    “And Labour has excelled: the Commonwealth Fund, the hugely respected authority on the matter, found our health system to be the second-best in the world last year ”

    ‘I still suspect you are burt ‘

    No my name’s John actually

    ‘But I KNOW you are a blatant LIAR’

    I hope I have dissuaded you from that suspicion.

    Good evening
50. killinginthenameof 50

    15 July 2008 at 12:08 am

    far out you guys on the left must feel like your banging your head agaisnt a brick wall trying to exlain to these kiwi blog cast offs. Makes it a bit difficult for every one when crosby\textor–>key makes “personal attacks” this weeks buzz word. How about instead of sitting around calling things personal attacks you do something to disprove them huh?
51. Kevyn 51

    15 July 2008 at 5:04 am

    Bill Brown, the answers to your questions are:

    Did they have an extensive road network? Yes, over 80% of our road network was built before 1900.

    Did they have hospitals where I could get, like, radiation therapy?
    They had hospital but, like, radiation therapy hadn’t been invented.

    Did most of their kids NOT get sick and die before they became adults? Yes, except for the ones that got sick and die because vacines hadn’t been discovered for most life-threatening childhood illnesses.

    Did they have schools just down the road where you could send your kid – just because?

    Yes, just because it wasn’t compulsory. Actually, because they didn’t have school buses half the kids went to boarding schools.

    All of the above were funded by local government or churches until early in the twentieth century, a level of government where local needs can actually be met.

    Where there was central government funding it was for buildings, from revenue from customs duties and land sales. Sales taxes and income taxes came when central government assumed responsibility for health and education.

    So neither of you is strictly correct.
52. higherstandard 52

    15 July 2008 at 8:08 am

    AK

    Are you there.

    Still awaiting some explanation of why I am a liar for taking issue with the conclusion you drew from the report you were trumpeting ?
53. Phil 53

    15 July 2008 at 9:05 am

    I was going to point out the ak that the world contained an awful lot more than six countries, but you beat me to it.

    I don’t know what your experience is, but I’ve heard very good things about the middle eastern countries – especially the oil barons like Saudi Arabia – that they have health systems second-to-none. Then lets not forget some of our Pacific cousins like Japan; the medical technology available there is astonishing
54. higherstandard 54

    15 July 2008 at 9:23 am

    Phil

    Many are magnificent but very expensive and as always outcomes are dependent on the individual skills and competency of the people working there who’s care you are under.

    Variance in care within countries health systems is also fairly high.

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