Free market efficiency in health – not

Written By: - Date published: 7:05 am, March 15th, 2017 - 37 comments
Categories: capitalism, health, socialism, us politics - Tags: , , , , ,

Health care in the USA is very much in the news at the moment. That country likes to consider themselves the self appointed leaders of free market capitalism, but it’s well known that their market based health system is a train wreck compared to many state run systems. This piece (from a couple of economists) makes the point again:

Improving U.S. Healthcare and Coverage

As economists, we are genuinely partial to market-based solutions that allow individuals to make tradeoffs between quality and price, while competition pushes suppliers to contain costs. But, in the case of health care, we are skeptical that such a solution can be made workable. This leads us to propose a gradual lowering of the age at which people become eligible for Medicare, while promoting supplier competition.

Before getting to the details of our proposal, we begin with striking evidence of the inefficiency of the U.S. health care system. The following chart (from OurWorldInData.org) displays life expectancy at birth on the vertical axis against real health expenditure per capita on the horizontal axis. The point is that the U.S. line in red lies well below the cost-performance frontier established by a range of advanced economies (and some emerging economies, too). Put differently, the United States spends more per person but gets less for its money.

It really doesn’t matter how you measure U.S. health care outlays, you will come away with the same conclusion: the U.S. system is extremely inefficient compared to that of other countries.

Looking around the world, the healthcare delivery systems that have advanced longevity most at lowest cost—those at the top left of the first plot […] tend to be universal and with a substantial government role that establishes a statutory standard of insurance. At one end of this spectrum, Britain’s National Health Service is both the sole payer and provider—analogous to the workings of the U.S. Veterans Administration. Other systems offer a combination of statutory and private components: in the case of Germany, the former is several times larger than the latter. Our view is that the provision of universal care in the United States will require that the government assume a larger role than it has thus far.

The data behind that main graph, and a discussion of some possible explanations, can be found at OurWorldInData.org. Most of the countries that outperform the USA have state run / universal health care. Of those that do not, it would be interesting to know what legislative frameworks constrain private provision.

The idea of free market efficiency is not nearly as powerful or universal as its (often fanatical) proponents would have us believe. The sorry state of the USA’s health system is yet another compelling example of its limitations.

37 comments on “Free market efficiency in health – not ”

  1. Andre 1

    Fundamentally the US model adds enormous administrative cost with the insurance model. There’s all the administration overhead, marketing, and profit on the insurance side. But it may be even worse for the administrative inefficiencies it imposes on the healthcare providers even just for routine stuff let alone the time sucked up if there is a dispute with insurers.

    • Andre 1.1

      There’s always voices in the US calling for single payer, even among conservatives. Here’s one that seems to have Trump’s ear, at least sometimes.

      http://www.vox.com/policy-and-politics/2017/3/14/14923784/christopher-ruddy-medicaid

      I’m really disappointed at how many US pollies missed their opportunity when Trump said “who knew healthcare was so complicated”. They should have been shouting “wanna make it simpler and cheaper? Go single payer. Medicare for all”

      • aerobubble 1.1.1

        14? million just lost access to healthcare, Trump delivered, he’s making it better, more inefficient more restricted. Trumps American dream.

        • Andre 1.1.1.1

          Has something just happened? Don’t see it on any news websites. As far as I know, the state of play is Ryan has shown his bill, the Congressional Budget Office has said it’s a steaming pile, more and more Repugs in the House and Senate are turning and saying they won’t vote for it when it comes up.

    • Sacha 1.2

      And the NZ govt wants to apply the same approach to privatising our social services. What could possibly go wrong?

      • Andre 1.2.1

        I’m more worried about how the US model is steadily creeping into health in NZ, stealthily under the radar. The big steps proposed for other services seem to spark more publicity and opposition.

        • Michael 1.2.1.1

          I agree. Labour must defend the public health system robustly, even if that means telling the people they will have to pay for it through progressive taxation.

      • Draco T Bastard 1.2.2

        Of course they do – the US healthcare system generates massive profits for the bludging shareholders.

        • AmaKiwi 1.2.2.1

          Draco, you’re spot on.

          Follow the money.

          Obama Care had to make huge compromises to be enacted. Add together the lobby bribes of the insurance companies, drug companies, and private hospital industry and you have mountains of money buying the legislators.

          “Sad”

          No. Criminal bribery.

  2. AsleepWhileWalking 2

    I heard that there is plenty of money but it is grossly misallocated. I was then given examples of outrageous G&A expenses.

  3. Bill 3

    NZ – an equal opportunity to receive a diagnosis (maybe). An equal opportunity to go on a waiting list…and then there are the outcomes.

    Private health insurance? Sorted.
    No private health insurance? How’s that wait feeling?

    I could bang on about this, but will limit myself to one instance about two people I know requiring hip replacements. One person, insured, done in a jiffy. The other, whose condition is more marked, but who has no insurance, has been waiting for yonks while their condition and general well being has deteriorated.

    At the moment they struggle to venture beyond the door and their body is fucking out because of the physical stresses and strains associated with compensating for the knackered hip joint. (I won’t go into any suspected opiate addiction resulting from the time spent waiting…waiting….waiting.)

    Still. Another six months and apparently the operation will finally be done…and any secondary complications may or may not iron themselves out after that. Or not.

    Healthcare should be about equal outcomes, not equal fucking opportunity.

    Wouldn’t it be nice if everyone with private health insurance just cashed in or up or whatever as a mark of solidarity and as a way to insist that this bullshit direction of travel for healthcare in NZ is not. fucking. acceptable…hm?

    Yup. I know. Not happening. Every person with private health insurance will have a reason for marking themselves out as a exception…

    • Draco T Bastard 3.1

      Wouldn’t it be nice if everyone with private health insurance just cashed in or up or whatever as a mark of solidarity and as a way to insist that this bullshit direction of travel for healthcare in NZ is not.

      If everyone had health insurance the wait for everyone would be just as long as the public list.

      You see, the pricing system that the market relies upon is actually there to price people out of the market.

      If people weren’t priced out of the market then the demand for doctors and hospitals and nurses would increase and thus wages would have to go up.

      • Draco T Bastard 3.1.1

        The US system and the NZ health insurance system proves that we cannot have an effective market in healthcare. It’s a natural demand monopoly – everyone needs it and a market is about pricing people out of getting that service.

        Healthcare, and many other modern services, isn’t something people should be priced out of getting.

    • AmaKiwi 3.2

      The rich would make sure waiting times disappeared if they did not have the fall back position of going privately.

    • miravox 3.3

      Agree Bill.

      I bang on about similar experiences in chronic care – specifically for conditions that requires ‘tweaking’ of medicine to control pain and progression of disease. I’ve known of public hospital care where the gap between appointments was 9 months. Pay for private care and the gap was the recommended 3 months.

      I’ve no idea how a person is meant to manage knowing that the constant stream of cumulative delays means they are in constant pain that affects all aspects of their lives and with the anxiety and stress of knowing the delay is not just enduring more pain, but also worsening the disease outcome.

  4. Tuppence Shrewsbury 4

    New Zealand still has a market in healthcare. And it’s very advantageous for consumers because of the nature of it. Health care is supplied at low cost by the state that’s pricing model is semi subscription on semi occurrence based, with subscriptions being arranged at a macro level. The othe key part of this is upstream where the state has almost monopsony like control In health. For 90% of health products it is the only purchaser, it is therefore the price setter.

    That’s not to say this is the most efficient model, but it works well with insurance companies having strong competition in the state itself and the state having its short comings compensated for by private medical care.

    It’s an efficient method of providing a public good. Probably why we see it mirrored in education too. If only we could admire it’s benefits and extend to other areas?

    • Draco T Bastard 4.1

      Bollocks – see above.

    • AB 4.2

      “and the state having its short comings compensated for by private medical care”
      That compensation of shortcomings is available only to the few who can afford private insurance.
      As these people also tend to be the powerful/decision-makers, the trend is towards the gradual degradation of the publicly-available services. Mainly because the powerful are happy to take resources off the public sector in order to award themselves the tax cuts with which they can pay their private health insurance premiums

    • Tophat 4.3

      Health is for those that can afford it. Our health system is great until you actually become sick.
      Our doctors only diagnose what their governing dhb can afford.
      Going on a wait list to get on a wait list is a very real issue, but being placed on that initial wait list is real work. Being told that having surgery would be, “contraindicative,” to your health is code for, “we have no money to carry out your surgery.”

      pharmac is great if you need paracetamol ,antibiotics etc but try to get a medicine that is not generic/commonly used, you will pay for it in total yourself.

      Acc is as useless as tits on a bull. All it does is deplete our access to proper accident insurance and reasonable compensation. They will try to break you by denying treatment costs and income compensation, sending you broke, forcing claimants to settle for far less than they deserve.

      While there may be a conscious effort to make going to the GP more affordable, only the looks have changed. It is certainly less expensive to catch flu these days but get truly sick and you’ll find the real costs of illness in NZ.

      • Draco T Bastard 4.3.1

        They will try to break you by denying treatment costs and income compensation, sending you broke, forcing claimants to settle for far less than they deserve.

        That sounds remarkably like the US health insurance industry as reported in Michael Moore’s Sicko.

        ACC, as envisioned and put into practice initially, was great. Neo-liberalism for the last thirty years has screwed it over thoroughly.

  5. Draco T Bastard 5

    That life expectancy chart is out of date: Life Expectancy In U.S. Drops For First Time In Decades, Report Finds

    One of the fundamental ways scientists measure the well-being of a nation is tracking the rate at which its citizens die and how long they can be expected to live.

    So the news out of the federal government Thursday is disturbing: The overall U.S. death rate has increased for the first time in a decade, according to an analysis of the latest data. And that led to a drop in overall life expectancy for the first time since 1993, particularly among people younger than 65.

  6. AmaKiwi 6

    As important as “life expectancy” is “reduced quality of life.”

    A good healthcare system helps people to be productive and self-maintaining until shortly before they die. A bad healthcare system has many people bed-ridden and/or disabled for many years before they die.

    The personal and social cost difference between the two is enormous.

  7. Paul Campbell 7

    When I lived in the US I had “good” health insurance – that meant that the main gatekeeper for me getting extended healthcare (more than a trip to the GP) was the insurance company’s agent on the phone who had to OK everything.

    That meant that every doctor or dentist’s office had at least one person (roughly per doctor in a multi-doctor practice) in the office who’s sole job was arguing with insurance companies about money) – there’s an inefficiency right there – two people (one at each end of the phone) that we just don’t have in our health system.

    The result is that it’s very hard to see a specialist in the US – took me a year of agony to get a gallstones diagnosis in the US, compared with my wife in NZ who took less than a month – on the other hand once I got my diagnosis I was in to hospital within a few days while my wife took close to a year – why? because in the US there are surgeons (and body scanners, etc etc) sitting idle waiting for work, while in NZ we have queues which mean that those expensive, scarce, resources busy all the time. Again far more efficient.

    Of course I’m arguing that queues for healthcare are a good thing – provided they’re not too long or course

    • Phil 7.1

      …in the US there are surgeons (and body scanners, etc etc) sitting idle waiting for work, while in NZ we have queues which mean that those expensive, scarce, resources busy all the time. Again far more efficient.

      There’s something you don’t see every day;
      an argument that spare capacity in critical societal infrastructure is a bad thing.

      *shrugs*

      • Draco T Bastard 7.1.1

        Cars are used, on average, 4% of the time.

        Does this, in your opinion, show good or poor use of scarce resources?

      • greywarshark 7.1.2

        What do you mean course? If I had to wait a long time in pain as you said you did I’d be course, as would befit someone who has often written on a blog with a love of freedom of expression.

        • greywarshark 7.1.2.1

          Probably I mean coarse. And I am not saying provision of health services is a laughing matter. I have a book on the USA lack-of system or rather it’s monetising of health. In a nation devoted to business and making money, there isn’t much that isn’t up for grabs, from principles to your liver, your health and welfare and everything that you need to live.

          And because money is so much the core of the society, if you can get past the Crime 101 stage and become a Master at it, with lots of dosh you will have broken through the picket fence pale. No longer beyond it you will have become one of the in-group too wealthy to be chastised satisfactorily and with a back door for slipping away. And so bent health professionals with money are vindicated by their wealth and hard to charge or change, despite the attempts of those who still have principles of public good.

    • Draco T Bastard 7.2

      Of course I’m arguing that queues for healthcare are a good thing – provided they’re not too long or course

      Yep, having a short queue shows high efficiency and the right amount of resources being put to use. Having either no queue or a long queue shows either poor use of resources or not enough resources respectively.

  8. RedLogix 8

    Watched Michael Moore’s latest film Where to Invade Next? last night. Hilarious, poignant and Moore at his clever best.

    I’ve always maintained the USA is an extraordinarily diverse nation; the ‘Land of the Free’ … you are free to be pretty much anything you damn well please. There are indeed many Americas, so it is wrong to make dogmatic generalisations about the place.

    Having said that Moore skewers right to the heart of all that is wrong with the American Dream.

  9. Adrian 9

    Aussie being a few years ahead is interesting, maybe it is the warmth, that helps longevity but I wonder if they are counting the Aboriginal stats yet, they weren’t for a long time.

  10. greywarshark 10

    Looking up info on Brit economist Douglas Hague I found some interesting bits in his obituary. He was an early adopter of Friedmans freemarket ideas. and helped Margaret Thatcher understand how to adapt these as Prime Minister.

    …During her tenure as Edward Heath’s education minister, contact with Hague was less frequent — but she insisted that they lunch occasionally (at the Epicure restaurant in Soho) because
    “the Department is full of communists and I need to check on issues… with someone whose views are like mine.”

    When she became party leader in 1975, Hague’s time was largely divided between his Manchester post and the Prices Commission in London, but he also served as one of her speechwriters; and during her 1979 campaign he was one of the very few academic economists who publicly supported her.
    After the election was won, an early paper in her Downing Street in-tray was from Hague urging the abolition of exchange controls — which was done within the year.

    Hague was a consultant to the No 10 Policy Unit from 1979 to 1983, advising on employment and other issues at a time when a gallery of economic thinkers were competing for the prime minister’s ear.
    During the painful 1981 recession he argued (and Mrs Thatcher, guided by another of her gurus, Alan Walters, eventually agreed) that interest rates were too high, and the private sector suffering too much, as a result of excessive focus on control of the money supply.

    Towards the end of his Downing Street stint, Hague moved his academic base from Manchester to Templeton College, Oxford — conveniently closer to London — and responded to a Policy Unit call for more sophisticated British management education by creating the Oxford Strategic Leadership Programme, which became internationally recognised as a stepping-stone for high-fliers.
    The prime minister, however, was initially sceptical: “Leadership?” she said to Hague. “You tell people what to do and they do it. That’s leadership!” …

    From 1983 to 1987 he was chairman of the Economic & Social Research Council, and thereafter he was a non-executive director of a variety of business ventures. He continued to write speeches for the prime minister from time to time, and (as a member of Oxford’s Wesley Memorial Church, which she herself had attended as an undergraduate)
    [He}was particularly proud to have provided her in 1988 with words from John Wesley to support a call to the wealthy, who had recently enjoyed tax cuts, to turn to philanthropy: “Get all you can. Save all you can. Give all you can.”

    http://www.telegraph.co.uk/news/obituaries/11444810/Sir-Douglas-Hague-economist-obituary.html

    (But then I wonder, give to whom? The wealthy often become philanthropists giving away works of art. Applying money to ordinary folks is only worthy when it goes to some special group with some disablement. The disablement of poor childhood in all senses, and the effect of funding a micro bank with myriads of small successes, rates less.)

  11. Infused 11

    I think i’d trust the US system more than most others though. Get cancer or something over there, if you are insured, you’re getting treatment within hours.

    • Bob 11.1

      You’d bloody well hope so if you are effectively paying 3 times as much for healthcare as you do in New Zealand!

    • McFlock 11.2

      lol

      “if you are insured”.

      Yup.
      And driving drunk is a really relaxing and chill way to travel, if you don’t have an accident or get pulled over. /sarc

    • joe90 11.3

      if you are insured

      Indeed.
      /

      Mayo Clinic’s chief executive made a startling announcement in a recent speech to employees: The Rochester-based health system will give preference to patients with private insurance over those with lower-paying Medicaid or Medicare coverage, if they seek care at the same time and have comparable conditions.

      […]

      Mayo will always take patients, regardless of payer source, when it has medical expertise that they can’t find elsewhere, said Dr. John Noseworthy, Mayo’s CEO. But when two patients are referred with equivalent conditions, he said the health system should “prioritize” those with private insurance.

      http://www.startribune.com/mayo-to-pick-privately-insured-patients-amid-medicaid-pressures/416185134/

  12. Richard McGrath 12

    If you think the U.S. has a free market health system, frankly you’re deranged. It is massively regulated.

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    Ah-rah, deeSoo-guh-goo-gee-goo-geeGoo-guh fli-goo gee-gooGuh fli-goo, ga-goo-buh-deeOoh, guh-goo-beeOoh-guh-guh-bee-guh-guh-beeFli-goo gee-gooA-fliguh woo-wa mama Lucifer!I’m about ready to move on, how about you?Not from the shooting, that’s bad and we definitely shouldn’t have that. But the rehabilitation of Donald J Trump? The deification of Saint Donald? As the Great Unifier?Gimme a bucket.https://yellowscene.com/2024/04/07/trump-as-jesus/Just to re-iterate, ...
    Nick’s KōreroBy Nick Rockel
    4 days ago
  • June 2024: Earth’s 13th-consecutive warmest month on record

    This is a re-post from Yale Climate Connections by Jeff Masters and Bob Henson June 2024 was Earth’s warmest June since global record-keeping began in 1850 and was the planet’s 13th consecutive warmest month on record, NOAA’s National Centers for Environmental Information, or NCEI, reported July 12. As opposed to being focused in ...
    4 days ago
  • Connecting the dots and filling the gaps in our bike network

    This is a guest post by Shaun Baker on the importance of filling the gaps in our cycling networks. It originally appeared on his blog Multimodal Adventures, and is re-posted here with kind permission. In our towns and cities in Aotearoa New Zealand, there are areas in our cycling networks ...
    Greater AucklandBy Guest Post
    4 days ago
  • Webworm Down Under Photos!

    Hi,I wanted to share a few thoughts and photos from the Webworm popup and Tickled screening we held in Auckland, New Zealand last weekend.In short — it was a blast. I mean, I had a blast and I hope any of you that came also had a blast.An old friend ...
    David FarrierBy David Farrier
    4 days ago
  • The Kākā’s Pick 'n' Mix for Thursday, July 18

    TL;DR: My pick of the top six links elsewhere around housing, climate and poverty in Aotearoa’s political economy in the last day or so to 6:30 am on Thursday, July 18 are:News: Christchurch's sewer systems block further housing developments RNZ’s Niva ChittockAnalysis: Interislander: Treasury, MoT officials' mistrust of KiwiRail led ...
    The KakaBy Bernard Hickey
    4 days ago
  • The Kākā’s Journal of Record for Thursday, July 18

    TL;DR: As of 6:00 am on Thursday, July 18, the top six announcements, speeches, reports and research around housing, climate and poverty in Aotearoa’s political economy in the last day are:Verbatim: Climate Change Minister Simon Watts held a news conference in Auckland to release the Government’s Emissions Reduction Plan, including ...
    The KakaBy Bernard Hickey
    4 days ago
  • The politics of managed retreat

    Climate change deniers are now challenging the Government over a key climate change adaptation policy. That begs the question of whether New Zealand First will then support Government moves to implement processes to deal with a managed retreat for properties in danger of flooding because of sea level rise and ...
    PolitikBy Richard Harman
    4 days ago
  • Some changes are coming

    Warm welcome again to those who are here. The Mountain Tui substack was officially started on the 2nd of July. I wrote about what led me here on this post. Since then, it’s been a learning to navigate the platform, get to meet those in the community, and basically be ...
    Mountain TuiBy Mountain Tui
    5 days ago
  • About fucking time

    The US Supreme Court has been rogue for years, with openly corrupt judges making the law up as they go to suit themselves, their billionaire buyers, and the Republican Party. But now, in the wake of them granting a licence for tyranny, President Biden is actually going to try and ...
    No Right TurnBy Idiot/Savant
    5 days ago
  • Climate Change: False accounting and wishful thinking

    National released their draft 2026-2030 Emissions Reduction Plan today. The plan is required under the Zero Carbon Act, and must set out policies and strategies to meet the relevant emissions budget. Having cancelled all Labour's actually effective climate change policies and crashed the carbon price, National was always going to ...
    No Right TurnBy Idiot/Savant
    5 days ago
  • The Enemies Of Sunshine And Space.

    Our Houses? The Urban Density debate is a horrible combination of intergenerational avarice and envy, fuelled by the grim certainty that none of the generations coming up after them will ever have it as good as the Boomers. To say that this situation rankles among those born after 1965 is to ...
    5 days ago
  • Still the 5 Eyes Achilles Heel?

    The National Cyber Security Centre (NZSC), a unit in the Government Communications Security Bureau (GCSB) dedicated to cyber-security, has released a Review of its response to the 2021 email hacking of NZ members of the Inter-Parliamentary Alliance on China (IPAC, … Continue reading ...
    KiwipoliticoBy Pablo
    5 days ago
  • Britain's Devastating Electoral Slip.

    Slip-Sliding Away: Labour may now enjoy a dominant position in Britain’s political landscape, but only by virtue of not being swallowed by it.THE BRITISH LABOUR PARTY’S “landslide victory” is nothing of the sort. As most people understand the term, a landslide election victory is one in which the incumbent government, or ...
    5 days ago
  • Gordon Campbell on why right wingers think all governments (including their own) are incompetent

    Since open denial of climate change is no longer a viable political option, denial now comes in disguise. The release this week of the coalition government’s ‘draft emissions reductions plan” shows that the Luxon government is refusing to see the need to cut emissions at source. Instead, it proposes to ...
    WerewolfBy lyndon
    5 days ago
  • The Kākā's Chorus for Wednesday, July 17

    TL;DR: The top six things I’ve noted around housing, climate and poverty in Aotearoa’s political economy this morning are:Chris Penk is set to roll back building standards for insulation that had only just been put in place, and which had been estimated to save 40% from power costs, after builders ...
    The KakaBy Bernard Hickey
    5 days ago
  • Open Letter to Pharmac

    All this talk of getting oldIt's getting me down, my loveLike a cat in a bag, waiting to drownThis time I'm coming downAnd I hope you're thinking of meAs you lay down on your sideNow the drugs don't workThey just make you worse but I know I'll see your face ...
    Nick’s KōreroBy Nick Rockel
    5 days ago
  • A blanket of misinformation

    Two old sayings have been on my mind lately. The first is: “The pen is mightier than the sword”, describing the power of language and communication to help or to harm. The other, which captures the speed with which falsehoods can become ingrained and hard to undo, is: “A lie can ...
    Greater AucklandBy Connor Sharp
    5 days ago
  • The Kākā’s Pick 'n' Mix for Wednesday, July 17

    TL;DR: My pick of the top six links elsewhere around housing, climate and poverty in Aotearoa’s political economy in the last day to 7:00 am on Wednesday, July 17 are:Scoop: Government considers rolling back home insulation standards RNZ’s Eloise GibsonNews: Government plans tree-planting frenzy as report shows NZ no longer ...
    The KakaBy Bernard Hickey
    5 days ago
  • The Kākā’s Journal of Record for Wednesday, July 17

    TL;DR: As of 6:00 am on Wednesday, July 17 , the top six announcements, speeches, reports and research around housing, climate and poverty in Aotearoa’s political economy in the last day were:Simon Watts released the Government’s draft Emissions Reduction Plan (ERP), which included proposed changes to the Emissions Trading Scheme ...
    The KakaBy Bernard Hickey
    5 days ago
  • “Shhhh” – National's 3 Waters is loaded with higher costs and lays a path to ...

    This is a long, possibly technical, but very, very important read. I encourage you to take the time and spread your awareness.IntroductionIn 2022, then Labour Party Prime Minister Jacinda Adern expended significant political capital to protect New Zealand’s water assets from privatisation. She lost that battle, and Labour and the ...
    Mountain TuiBy Mountain Tui
    6 days ago
  • Plugging a video channel: Dr Gilbz

    Dr. Ella Gilbert is a climate scientist and presenter with a PhD in Antarctic climate change, working at the British Antarctic Survey (BAS). Her background is in atmospheric sciences and she's especially interested in the physical mechanisms of climate change, clouds, and almost anything polar. She is passionate about communicating climate ...
    6 days ago
  • Some “scrutiny” again

    Back in 2022, in its Open Government Partnership National Action Plan, the government promised to strengthen scrutiny of Official Information Act exemption clauses in legislation. Since then they've run a secret "consultation" on how to do that, with their preferred outcome being that agencies will consult the Ministry of Justice ...
    No Right TurnBy Idiot/Savant
    6 days ago
  • Crashing New Zealand's health system is not the way to prosperity, Prime Minister

    Another day, and yet another piece of bad news for New Zealand’s health system. Reports have come out that General Practitioners (GP) may have to close doors, or increase patient fees to survive. The so-called ‘capitation’ funding review, which supports GP practices to survive, is under way, and primary care ...
    Mountain TuiBy Mountain Tui
    6 days ago
  • Closer Than You Think: Ageing Boomers, Laurie & Les, Talk Politics.

    Redefining Our Terms: “When an angry majority is demanding change, defending the status-quo is an extremist position.”“WHAT’S THIS?”, asked Laurie, eyeing suspiciously the two glasses of red wine deposited in front of him.“A nice drop of red. I thought you’d be keen to celebrate the French Far-Right’s victory with the ...
    6 days ago
  • Come on Darleen.

    Good morning all, time for a return to things domestic. After elections in the UK and France, Luxon gatecrashing Nato, and the attempted shooting of Trump, it’s probably about time we re-focus on local politics.Unless of course you’re Christopher Luxon and you’re so exhausted from all your schmoozing in Washington ...
    Nick’s KōreroBy Nick Rockel
    6 days ago
  • How the Northwest was lost and may be won

    This is a guest post by Darren Davis. It originally appeared on his excellent blog, Adventures in Transitland, which we encourage you to check out. It is shared by kind permission. The Northwest has always been Auckland’s public transport Cinderella, rarely invited to the public funding ball. How did ...
    Greater AucklandBy Guest Post
    6 days ago
  • The Kākā's Chorus for Tuesday July 16

    Luxon has told a Financial Times’ correspondent he would openly call out China’s spying in future and does not fear economic retaliation from Aotearoa’s largest trading partner.File Photo: Lynn Grieveson / The KākāTL;DR: The top six things I’ve noted around housing, climate and poverty in Aotearoa’s political economy on Tuesday, ...
    The KakaBy Bernard Hickey
    6 days ago
  • The Kākā’s Pick 'n' Mix for Tuesday, July 16

    TL;DR: My pick of the top six links elsewhere around housing, climate and poverty in Aotearoa’s political economy in the last day or so to 6:00 am on Tuesday, July 16 are:PM Christopher Luxon has given a very hawkish interview to the Financial Times-$$$ correspondent in Washington, Demetri Sevastopulu, saying ...
    The KakaBy Bernard Hickey
    6 days ago
  • The Kākā’s Journal of Record for Tuesday, July 16

    Photo by Ryunosuke Kikuno on UnsplashTL;DR: The top six announcements, speeches, reports and research around housing, climate and poverty in Aotearoa’s political economy in the last day to 6:00 am are:BNZ released its Performance of Services Index for June, finding that services sector is at its lowest level of activity ...
    The KakaBy Bernard Hickey
    6 days ago
  • The second crisis; assumption was the mother

    Late on the night of July 16, 1984, while four National Cabinet Ministers were meeting in the Beehive office of Deputy Prime Minister Jim McLay, plotting the ultimate downfall of outgoing Prime Minister Sir Robert Muldoon, another crisis was building up in another part of the capital. The United States ...
    PolitikBy Richard Harman
    6 days ago
  • Can we air condition our way out of extreme heat?

    This is a re-post from The Climate Brink by Andrew Dessler Air conditioning was initially a symbol of comfort and wealth, enjoyed by the wealthy in theaters and upscale homes. Over time, as technology advanced and costs decreased, air conditioning became more accessible to the general public. With global warming, though, ...
    7 days ago
  • Review: The Zimiamvian Trilogy, by E.R. Eddison (1935-1958)

    I have reviewed some fairly obscure stuff on this blog. Nineteenth century New Zealand speculative fiction. Forgotten Tolkien adaptations. George MacDonald and William Morris. Last month I took a look at The Worm Ouroboros (1922), by E.R. Eddison, which while not strictly obscure, is also not overly inviting to many ...
    7 days ago
  • Media Link: AVFA on the Trump assassination attempt.

    In this episode of “A View from Afar” Selwyn Manning and I discuss the attempt on Donald Trump’s life and its implications for the US elections. The political darkness grows. ...
    KiwipoliticoBy Pablo
    7 days ago
  • Law & Order: National Party 1, Police 0, Public -1

    What happened?Media is reporting that police have lost in their pay dispute with the Coalition Government.Some of you might remember that the police rejected Labour’s previous offer in September, 2023, possibly looking forward to be taken care of by the self-touted ‘Party of Law and Order’ - National.If you look ...
    Mountain TuiBy Mountain Tui
    7 days ago
  • Gordon Campbell on the Trump shooting and a potential hike in fees for visiting the doctor

    Having watched Donald Trump systematically exploit social grievances, urge people not to accept his election loss and incite his followers to violent insurrection… it is a bit hard to swallow the media descriptions over the past 24 hours of Trump being a “victim” of violence. More like a case of ...
    WerewolfBy lyndon
    1 week ago
  • The Kākā's Chorus for Monday July 15

    The exploitation of workers on the national fibre broadband rollout highlights once again the dark underbelly of our ‘churn and burn’ economy. Photo: Lynn Grieveson / The KākāTL;DR: The top six things I’ve noted around housing, climate and poverty in Aotearoa’s political economy today are:An extraordinary Steve Kilgallon investigation into ...
    The KakaBy Bernard Hickey
    1 week ago
  • The Kākā’s Pick 'n' Mix for Monday, July 15

    Photo by Jessica Loaiza on UnsplashTL;DR: My pick of the top six links elsewhere around housing, climate and poverty in Aotearoa’s political economy in the last three days to 9:00 am on Monday, July 15 are:Investigation: Immigration NZ refused to prosecute an alleged exploiter despite a mountain of evidence - ...
    The KakaBy Bernard Hickey
    1 week ago
  • City Centre Rebuild: How Soon Is Now?

    Patrick Reynolds is deputy chair of the City Centre Advisory Panel and a director of Greater Auckland There is ongoing angst about construction disruption in the city centre. And fair enough: it’s very tough, CRL and other construction has been going on for a very long time. Like the pandemic, ...
    Greater AucklandBy Patrick Reynolds
    1 week ago
  • Peril, dismay, resolution

    This afternoon we rolled into Budapest to bring to a close our ride across Europe. We did 144 km yesterday, severe heat messages coming in from the weather app as we bounced along unformed Hungarian back roads and a road strip strewn with fallen trees from an overnight tornado. Somewhere ...
    More Than A FeildingBy David Slack
    1 week ago
  • Bullet the Blue Sky

    In the locust windComes a rattle and humJacob wrestled the angelAnd the angel was overcomeYou plant a demon seedYou raise a flower of fireWe see them burnin' crossesSee the flames, higher and higherBullet the blue skyBullet the blue skyThe indelible images, the soundtrack of America. Guns, assassinations, where-were-you-when moments attached ...
    Nick’s KōreroBy Nick Rockel
    1 week ago
  • The Kākā’s Journal of Record for Monday, July 15

    TL;DR: The top six announcements, rulings, reports, surveys, statistics and research around housing, climate and poverty in Aotearoa’s political economy in the three days to 6:00 am on Monday, July 23 are:University of Auckland researcher Ryan Greenaway-McGrevy published an analysis of the impact of Auckland's 2016 zoning reforms.BNZ's latest Performance ...
    The KakaBy Bernard Hickey
    1 week ago
  • The Kākā’s diary for the week to July 23 and beyond

    TL;DR: The six key events to watch in Aotearoa-NZ’s political economy in the week to July 23 include:PM Christopher Luxon has returned from a trip to the United States and may hold a post-Cabinet news conference at 4:00 pm today.The BusinessNZ-BNZ PSI survey results for June will be released this ...
    The KakaBy Bernard Hickey
    1 week ago
  • Was The Assassination Attempt Fake?

    Hi,It’s in incredible photo, and we’re going to be talking about it for a long time:Trump, triumphantly raising his hand in the air after being shot. Photo credit: Evan VucciYou can watch what happened on YouTube in real time, as a 20-year-old from Pennsylvania lets off a series of gunshots ...
    David FarrierBy David Farrier
    1 week ago
  • 40 years ago, inside the crisis that made modern NZ

    It had rained all day in Auckland, and the Metro Theatre in Mangere was steamed up inside as more and more people arrived to celebrate what had once seemed impossible. Sir Robert Muldoon had lost the 1984 election. “Piggy” Muldoon was no more. Such was the desire to get rid ...
    PolitikBy Richard Harman
    1 week ago
  • 2024 SkS Weekly Climate Change & Global Warming News Roundup #28

    A listing of 34 news and opinion articles we found interesting and shared on social media during the past week: Sun, July 7, 2024 thru Sat, July 13, 2024. Story of the week It's still early summer in the Northern Hemisphere. The season comes as our first year of 1.5°C warming ...
    1 week ago

  • Minister to speak at Australian Space Forum

    Minister for Space and Science, Innovation and Technology Judith Collins will travel to Adelaide tomorrow for space and science engagements, including speaking at the Australian Space Forum.  While there she will also have meetings and visits with a focus on space, biotechnology and innovation.  “New Zealand has a thriving space ...
    BeehiveBy beehive.govt.nz
    1 hour ago
  • Climate Change Minister to attend climate action meeting in China

    Climate Change Minister Simon Watts will travel to China on Saturday to attend the Ministerial on Climate Action meeting held in Wuhan.  “Attending the Ministerial on Climate Action is an opportunity to advocate for New Zealand climate priorities and engage with our key partners on climate action,” Mr Watts says. ...
    BeehiveBy beehive.govt.nz
    3 hours ago
  • Oceans and Fisheries Minister to Solomons

    Oceans and Fisheries Minister Shane Jones is travelling to the Solomon Islands tomorrow for meetings with his counterparts from around the Pacific supporting collective management of the region’s fisheries. The 23rd Pacific Islands Forum Fisheries Committee and the 5th Regional Fisheries Ministers’ Meeting in Honiara from 23 to 26 July ...
    BeehiveBy beehive.govt.nz
    2 days ago
  • Government launches Military Style Academy Pilot

    The Government today launched the Military Style Academy Pilot at Te Au rere a te Tonga Youth Justice residence in Palmerston North, an important part of the Government’s plan to crackdown on youth crime and getting youth offenders back on track, Minister for Children, Karen Chhour said today. “On the ...
    BeehiveBy beehive.govt.nz
    2 days ago
  • Nine priority bridge replacements to get underway

    The Government has welcomed news the NZ Transport Agency (NZTA) has begun work to replace nine priority bridges across the country to ensure our state highway network remains resilient, reliable, and efficient for road users, Transport Minister Simeon Brown says.“Increasing productivity and economic growth is a key priority for the ...
    BeehiveBy beehive.govt.nz
    2 days ago
  • Update on global IT outage

    Acting Prime Minister David Seymour has been in contact throughout the evening with senior officials who have coordinated a whole of government response to the global IT outage and can provide an update. The Department of the Prime Minister and Cabinet has designated the National Emergency Management Agency as the ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • New Zealand, Japan renew Pacific partnership

    New Zealand and Japan will continue to step up their shared engagement with the Pacific, Foreign Minister Winston Peters says.    “New Zealand and Japan have a strong, shared interest in a free, open and stable Pacific Islands region,” Mr Peters says.    “We are pleased to be finding more ways ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • New infrastructure energises BOP forestry towns

    New developments in the heart of North Island forestry country will reinvigorate their communities and boost economic development, Regional Development Minister Shane Jones says. Mr Jones visited Kaingaroa and Kawerau in Bay of Plenty today to open a landmark community centre in the former and a new connecting road in ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • 'Pacific Futures'

    President Adeang, fellow Ministers, honourable Diet Member Horii, Ambassadors, distinguished guests.    Minasama, konnichiwa, and good afternoon, everyone.    Distinguished guests, it’s a pleasure to be here with you today to talk about New Zealand’s foreign policy reset, the reasons for it, the values that underpin it, and how it ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • Delivering 24 hour pothole repairs

    Kiwis and freight operators will benefit from the Coalition Government delivering on its commitment to introduce targets that will ensure a greater number of potholes on our state highways are identified and fixed within 24 hours, Transport Minister Simeon Brown says.  “Increasing productivity to help rebuild our economy is a key ...
    BeehiveBy beehive.govt.nz
    3 days ago
  • Peer Support Specialists rolled out in hospitals

    Five hospitals have been selected to trial a new mental health and addiction peer support service in their emergency departments as part of the Government’s commitment to increase access to mental health and addiction support for New Zealanders, says Mental Health Minister Matt Doocey.  “Peer Support Specialists in EDs will ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • Consultation opens for the Emissions Reduction Plan

    The Government’s draft Emissions Reduction Plan shows we can stay within the limits of the first two emissions budgets while growing the economy, Climate Change Minister Simon Watts says. “This draft Emissions Reduction Plan shows that with effective climate change policies we can both grow the economy and deliver our ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • Benefit stats highlight need for welfare reset

    The coalition Government is providing extra support for job seekers to ensure as many Kiwis as possible are in work or preparing for work, Social Development and Employment Minister Louise Upston says. “While today’s quarterly data showing a rise in the number of people on Jobseeker benefits has been long ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • School attendance continues to increase

    Provisional school attendance data for Term 2 2024 released today has shown more students are back in class compared to last year, with 53.1 per cent of students regularly attending, compared with 47 per cent in Term 2 2023, Associate Education Minister David Seymour says. “The Government has prioritised student ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • $22.7m of West Coast resilience projects underway

    Transport Minister Simeon Brown has welcomed news of progress being made by the NZ Transport Agency (NZTA) on the first of several crucial resilience projects underway on the South Island’s West Coast.“State highways across the West Coast are critical lifelines for communities throughout the region, including for freight and tourism. ...
    BeehiveBy beehive.govt.nz
    4 days ago
  • Migrant school leavers to get part-time work rights

    The coalition Government is providing migrant school leavers with greater opportunities, by increasing access to part-time work rights for those awaiting the outcome of a family residence application, Immigration Minister Erica Stanford has announced.  “Many young people who are part of a family residence application process are unable to work. ...
    BeehiveBy beehive.govt.nz
    5 days ago
  • Funding to support use of NZ Sign Language

    Seven projects have received government funding totalling nearly $250,000 to maintain and promote the use of New Zealand Sign Language (NZSL). Initiatives that received an NZSL Board Community Grants this year include camps that support the use of NZSL through physical and sensory activities, and clubs where Deaf people and ...
    BeehiveBy beehive.govt.nz
    5 days ago
  • Inflation data shows progress in economic recovery

    Today’s Consumer Price Index data which has inflation at 3.3 per cent for the year to July 2024, shows we are turning our economy around and winning the fight against rampant inflation, Finance Minister Nicola Willis says.  “While today’s data will be welcome news for Kiwis, I know many New ...
    BeehiveBy beehive.govt.nz
    5 days ago
  • Experts to advise Minister on Oranga Tamariki

    The Oranga Tamariki Ministerial Advisory Board has been re-established by the Minister for Children, Karen Chhour. “I look forward to working with the new board to continue to ensure Oranga Tamariki and the care and protection system, are entirely child centric,” Minister Chhour says. “The board will provide independent advice ...
    BeehiveBy beehive.govt.nz
    6 days ago
  • Expectations set for improved medicines access

    Associate Health Minister David Seymour says he has set clear expectations for Pharmac around delivering the medicines and medical technology that Kiwis need.  “For many New Zealanders, funding for pharmaceuticals is life or death, or the difference between a life of pain and suffering or living freely. New cancer medicines ...
    BeehiveBy beehive.govt.nz
    6 days ago
  • Regional Development Minister to host summits

    Regional Development Minister Shane Jones will hold a series of nationwide summits to discuss regional priorities, aspirations and opportunities, with the first kicking off in Nelson on August 12. The 15 summits will facilitate conversations about progressing regional economic growth and opportunities to drive productivity, prosperity and resilience through the ...
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    6 days ago
  • Government delivers new school for Rolleston

    The Coalition Government is addressing growing demands on Canterbury’s school network, by delivering a new primary school in Rolleston, Education Minister Erica Stanford says. Within Budget 24’s $400 million investment into school property growth, construction will begin on a new primary school (years 1-8) in Selwyn, Canterbury.  Rolleston South Primary ...
    BeehiveBy beehive.govt.nz
    6 days ago
  • New speed camera signs to improve safety

    The Government is welcoming the rollout of new speed camera signs for fixed speed cameras to encourage drivers to check their speeds, improving road safety and avoiding costly speeding tickets, Transport Minister Simeon Brown says. “Providing Kiwis with an opportunity to check their speed and slow down in high crash areas ...
    BeehiveBy beehive.govt.nz
    6 days ago
  • NZ, Korea strengthen relationship

    New Zealand and the Republic of Korea continue to strengthen their relationship, Foreign Minister Winston Peters says.   “New Zealand and Korea have a long history – from New Zealand soldiers fighting in the Korean War, through to our strong cooperation today as partners supporting the international rules-based order.    ...
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    7 days ago
  • Investing for future growth in tourism and hospitality

    The Government is moving forward with recommendations from the Tourism Data Leadership Group, beginning with establishing a Tourism Data Partnership Fund says Tourism and Hospitality Minister Matt Doocey. “The Tourism Data Partnership Fund is funded through the International Visitor Conservation and Tourism Levy (IVL) and will provide up to $400,000 ...
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    1 week ago
  • 4000 more job seekers to get case managers

    A new over-the-phone employment case management service will see thousands more job seekers under the age of 25 supported to find work, Social Development and Employment Minister Louise Upston has announced. “MSD case managers provide valuable support to help people into work, but less than a third of those receiving ...
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    1 week ago
  • Trade Minister to attend G7 meeting in Italy

    Trade Minister Todd McClay will attend the Group of Seven (G7) Trade Ministers meeting in Reggio Calabria, Italy next week. This is the first time New Zealand has been invited to join the event, which will be attended by some of the world’s largest economies and many of New Zealand’s ...
    BeehiveBy beehive.govt.nz
    1 week ago
  • Ministers reveal consequences for unruly Kāinga Ora tenants

    Ministers are pleased to see Kāinga Ora taking a stronger approach to managing unruly, threatening or abusive tenants, Housing Minister Chris Bishop and Associate Housing Minister Tama Potaka say.    “For far too long, a small number of Kāinga Ora tenants have ridden roughshod over their neighbours because, under Kāinga ...
    BeehiveBy beehive.govt.nz
    1 week ago
  • Prime Minister wraps up US visit in California

    Prime Minister Christopher Luxon has finished a successful four-day visit to the United States with meetings in California on his final day focusing on innovation and investment.  “It has been fantastic to be in San Francisco today seeing first-hand the deepening links between New Zealand and California. “New Zealand company, EV Maritime, ...
    BeehiveBy beehive.govt.nz
    1 week ago
  • Prime Minister leads Indo-Pacific Four at NATO

    Prime Minister Christopher Luxon today chaired a meeting of the Indo-Pacific Four (IP4) countries – Australia, Japan, the Republic of Korea and New Zealand. The IP4 met in the context of NATO’s Summit in Washington DC hosted by President Biden. “Prosperity is only possible with security,” Mr Luxon says. “We need ...
    BeehiveBy beehive.govt.nz
    1 week ago
  • District Court judges appointed

    Attorney-General Hon Judith Collins today announced the appointment of three new District Court Judges.   The appointees, who will take up their roles in July and August at the Manukau, Rotorua and Invercargill courts, are:   Matthew Nathan Judge Nathan was admitted to bar in New Zealand in 2021, having previously been ...
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    1 week ago
  • Urgent review into Wairoa flood response begins

    Environment Minister, Penny Simmonds today announced the terms of reference for a rapid review into the Wairoa flood response. “The Wairoa community has raised significant concerns about the management of the Wairoa River bar and the impact this had on flooding of properties in the district,” says Ms Simmonds. “The Government ...
    BeehiveBy beehive.govt.nz
    1 week ago
  • NZDF’s Red Sea deployment extended

    New Zealand has extended its contribution to the US-led coalition working to uphold maritime security in the Red Sea, Defence Minister Judith Collins and Foreign Minister Winston Peters announced today. “The decision to extend this deployment is reflective of the continued need to partner and act in line with New ...
    BeehiveBy beehive.govt.nz
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  • Government provides support to tackle tax debt and compliance

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