Nat health policy: more money for rich, fewer for poor

Written By: - Date published: 2:11 pm, September 10th, 2008 - 60 comments
Categories: health, national - Tags: ,

Jim Anderton is releasing elements of National’s health policy at Question Time:

– Pharmac’s independent decisions could be overruled by politicians.
– Private health insurance would be subsidised by the taxpayer.
– No more money for public health

National’s Jonathan Coleman also reportedly said that he doesn’t think GP fees are high enough.

60 comments on “Nat health policy: more money for rich, fewer for poor ”

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  1. Brett Dale 1
    10 September 2008 at 2:28 pm

    Anderton doesn’t know what he is talking about. Do you really think National is going to give no money to public health???

    Surly Pharmac’s independent decisions could be overruled by politicians, is a good thing? I’m sure a lot of cancer patients would appreciate this.

    [brett. you’re either too stupid or too stoned. no more does not equal none. SP]

  2. bill brown 2
    10 September 2008 at 2:34 pm

    I think what he means is:

    no more money for health

    as in the opposite of

    no fewer money for health.

  3. Lew 3
    10 September 2008 at 2:37 pm

    I hereby dub the purposeful use of the wrong reductive adjective for the purpose of satire, ridicule or denigration `fewering’.

    As in: `Steve, I like the way you fewered that headline.

    L

  4. Matthew Pilott 4
    10 September 2008 at 2:46 pm

    Brett, are you seriously asking that an independent and science-based orianisation be vetoed by politicians?

    So you’re a pork-barrel man. Interesting, hadn’t picked it. Either that or you don’t know what you’re talking about.

  5. Brett Dale 5
    10 September 2008 at 3:10 pm

    Im asking a group of so called experts who turn down funding for certain drugs that may help cancer patients, should have to answer to someone.

  6. Jeeves 6
    10 September 2008 at 3:16 pm

    The fact that National can tell which policies are going to be leaked does tend to affirm the idea that they were in one batch that was either leaked or left somewhere – so it’s probably not an ongoing pattern of leaks as you have previously suggested.

  7. Patrick 7
    10 September 2008 at 3:21 pm

    So who should they have to answer to? Politicians who will not actually look at scientific evidence and will instead be influence by highly emotive constituents and media pressure?

  8. Matthew Pilott 8
    10 September 2008 at 3:22 pm

    You’re asking that science answer to emotion. Maybe another level of bureaucracy in there too?

    They are answerable at present, I seem to recall a certain review into funding a certain drug, which was rejected a second time. Unless you think they’re doing it out of spite. I may sound glib, but I’m happy that they can make such decisions without having to answer to politicians – it takes lobby groups, pressure from multinational pharmaceutical companies and hysterics of the ill-informed out of the picture.

    In all honesty, Brett, I’d have thought this was an area we’d agree on!

    Natinal are saying the science gets it wrong, we should spend taxpayers dollars on drugs not proven to be of benefit, because there’s pressure on politicians to ‘do something’. I wonder which pharmaceutical companies donate to National, given they’d pull a stunt like this.

    It’s actually a sick and disgusting pandering to the electorate from National, it’s weak, pathetic and wrong. Just shows how low they’ll go.

  9. higherstandard 9
    10 September 2008 at 3:27 pm

    MP

    “National are saying the science gets it wrong, we should spend taxpayers dollars on drugs not proven to be of benefit, because there’s pressure on politicians to ‘do something’.

    Eh what – can you explain ?

    “I wonder which pharmaceutical companies donate to National, given they’d pull a stunt like this.”

    The multinational pharma companies couldn’t give a flying about NZ.

  10. mondograss 10
    10 September 2008 at 3:32 pm

    Can someone post Colemans exact comments? Really keen to read exactly what he had to say on doctors fees.

  11. killinginthenameof 11
    10 September 2008 at 3:32 pm

    Brett Dale
    September 10, 2008 at 3:10 pm
    Im asking a group of so called experts who turn down funding for certain drugs that may help cancer patients, should have to answer to someone.

    Operating a limited health budget (what ever the limit) in an industry where there is potential for an unlimited amount to be spent on drugs and treatments is never going to please everyone. Surely those cancer patients should have to answer to the sufferers of what ever illness it is that the funding for their cancer drugs will be taken away from?

    Ministerial veto on Pharmac decisions is indefensible.

  12. killinginthenameof 12
    10 September 2008 at 3:35 pm

    “mondograss
    September 10, 2008 at 3:32 pm
    Can someone post Colemans exact comments? Really keen to read exactly what he had to say on doctors fees.”

    Maybe give britishamerican tabbacco a call, ask to speak to someone he was at the corprate box with, maybe they can fill you in?

  13. higherstandard 13
    10 September 2008 at 3:36 pm

    Brett

    In defence of the “so called experts” on PTAC and their subcommittees and other medical advisors to PHARMAC – on many occasions they have vociferously called for certain medications to be funded or access criteria for those medications to be changed however PHARMAC has chosen to ignore those recommendations almost always because of the cost to the pharmaceutical schedule which their performance is measured against.

    There have been occasions where PHARMAC has also received specialist advice which was not to their liking and then stacked another advisory group with members whose views were more malleable.

    Personally I would like to see PHARMAC adopt a policy that if a medication meets certain specific criteria it is automatically funded alongside their current modus operandi which is more about cost containment, cost cutting and delaying decisions to fund new medications.

  14. Steve Pierson 14
    10 September 2008 at 3:36 pm

    mondograss. anderton tabled the report. so i guess that can be accessed somehow. i’ll find out.

  15. Brett Dale 15
    10 September 2008 at 3:36 pm

    I dont think cancer patients should have to answer to anyone.

  17. mondograss 17
    10 September 2008 at 3:38 pm

    Thanks Steve, appreciate it.

  18. higherstandard 18
    10 September 2008 at 3:39 pm

    KITNO

    So just theoretically if PHARMAC were approached about funding a pandemic vaccine and told the potential manufacturer where to go the Minister of Health shouldn’t be able to veto that decision ?

  19. Matthew Pilott 19
    10 September 2008 at 3:39 pm

    HS – National want Pharmac’s decisions to be vetoed by politicians, according to this post. Unless a politician has a better scientific understanding of a drug than Pharmac, you can probably guess when those vetos would occur.

    Pharmac might not be perfect, but I’d want them making the calls over National, or Labour, or the Greens, or Act, or the Progressives, or NZF, or the Maori Party, or Dunne and all the people who lobby those parties in order to elicit a decision that is not best practive (apart from best practice to get votes, which is what National appear to have gone with).

    “The multinational pharma companies couldn’t give a flying about NZ.”

    Russel Norman seemed to have a different view, that Pharmac was a major stumbling block to an FTA because of the discounts it can get.

  20. Draco TB 20
    10 September 2008 at 3:39 pm

    BD:

    Surly Pharmac’s independent decisions could be overruled by politicians, is a good thing?

    Using this logic would it also be good to have the independence of the Reserve Bank overruled by the politicians?

    HS:

    The multinational pharma companies couldn’t give a flying about NZ.

    Are you saying that companies, specifically put together to make a profit, don’t want millions of dollars per year in profit?

  21. higherstandard 21
    10 September 2008 at 3:46 pm

    Draco

    The multinational Pharma companies have been declining in NZ for years.

    There entire NZ business would be smaller than a city in Europe or the US and most would be shrinking annually.

    Clearly they want to make profits to return dividends to shareholders and to fund their operations and R&D but the vast amount of those profits are not and will never be generated in NZ – so no they’re not really interested in NZ.

  22. Dom 22
    10 September 2008 at 3:46 pm

    I wonder if National are giving a nod to the Herceptin lobby with the Ministerial override issue. That lobby has gotten a lot of press. Of course, if you fund that Pharmac would have to cut back other drugs, indeed possibly other cancer drugs…

    But don’t we already know what National will do in health – fewerer bureaucrats?

  23. killinginthenameof 23
    10 September 2008 at 3:49 pm

    Well if your saying that they deserve a less cost effective drug at the expense of another drug for someone else, I think they shoudl have to answer to someone.

    higherstandard

    The multinational pharma companies couldn’t give a flying about NZ.

    Except that NZ is one of two countries that allow direct to consumer advertising of drugs, something they would desperatly love to have in every country.

  24. higherstandard 24
    10 September 2008 at 3:50 pm

    Dom by lobby do you mean women with HER2 positive breast cancer and the NZ Oncologists ?

  25. higherstandard 25
    10 September 2008 at 3:53 pm

    kitno

    I would hardly say that we have multitudinous DTC of Rx medicines in NZ and I’m not quite sure what point you’re trying to make ?

  26. Idiot/Savant 26
    10 September 2008 at 3:56 pm

    I wonder which pharmaceutical companies donate to National, given they’d pull a stunt like this.

    Pfizer, for a start (see The Hollow Men, p. 217-218). No word on the others, and unfortunately the EFA set the disclosue threshold too high to uncover their influence.

  27. killinginthenameof 27
    10 September 2008 at 3:56 pm

    “higherstandard
    September 10, 2008 at 3:39 pm
    KITNO

    So just theoretically if PHARMAC were approached about funding a pandemic vaccine and told the potential manufacturer where to go the Minister of Health shouldn’t be able to veto that decision ?”

    If a proper quality adjusted life years was done, and the potential benifit of that vaccine was judged to be less cost effective than other potential drugs and vaccines then no, the Minister of Health shouldn’t be able to veto it. Why do you think they should?

  28. killinginthenameof 28
    10 September 2008 at 4:01 pm

    I would argue that DTC gives NZ the potential to be a more profitable market than our population, livig standards and general level of health would otherwise allow for. You might disagree, and I’m not saying it nessecerily does make NZ more profitable, but I just think its a bit hasty to write off NZ as unimportant.

  29. Draco TB 29
    10 September 2008 at 4:04 pm

    HS:

    Clearly they want to make profits to return dividends to shareholders and to fund their operations and R&D but the vast amount of those profits are not and will never be generated in NZ – so no they’re not really interested in NZ.

    I’m not saying that they’re out to make the vast amount of their profits from NZ but that they will be open to making a profit from sales in NZ. If they can make a profit they will do so even if it is only a small amount – if the directors and CEO didn’t they wouldn’t be doing their jobs. If reasoned decisions by PHARMAC could be overruled by parliament then the pharmaceutical companies could stand to make even more.

  30. Dom 30
    10 September 2008 at 4:07 pm

    higherstandard – ‘lobby’ being shorthand for everyone who has weighed in on Herceptin. They’ve done really well at pushing their case.

  31. randal 31
    10 September 2008 at 4:12 pm

    its the nats all over. tying everything up for themselves so they can get on a first name basis with rich health professionals pandering to nitwits.

  32. Quoth the Raven 32
    10 September 2008 at 4:37 pm

    Jeeves – If they were Key could name them all, but he refuses to. Why? Because he can’t. He doesn’t know becuase they are being leaked. Mallard has asked him to name them all and he won’t.

    Is this actually from leaked policy as well?

  33. Jeeves 33
    10 September 2008 at 4:43 pm

    I was unaware that he had refused to name them all. In fact he has specifically named health and brought forward the release of the health policy. Can you refer me to a relevant link?

  34. higherstandard 34
    10 September 2008 at 4:49 pm

    KITNO

    Similar to the situation with the MeNZB vaccine my view is that there are definitely times when a Ministerial decision has to be made on whether to fund a product and not a decision based on PHARMAC’s view of the effect on their budget which in the case of MeNZb and a pandemic vaccine would be procrastination and a decision based on the fact that the medication does not meet their cost effectiveness goals or fit within their budget.

  35. Darren Rickard 35
    10 September 2008 at 4:58 pm

    “Private health insurance would be subsidised by the taxpayer”.

    That is bollocks Steve. Those paying private health insurance will merely get a tax break for paying for their own health needs.

    At the moment private health is subsidising the failing public hospital “service”. When you have people being treated for strokes in hospital corridors we have a problem-that simply doesn’t happen in an efficient private hospital.

    No wonder people are wanting to fund reliable hospital care directly out of their pockets. They shouldn’t have to pay twice.

    Your other assertions are lies.

    Still no comments on your Prime Ministers and the Labour Party President’s direct involvement in the Glenn Payola scandal.

    Funny that.

    [lprent: Yep – means that none of the writers have found it interesting.
    After all we aren’t Nat’s, who really don’t want the election to be about issues, but rather about side-issues. The only thing I’m interested in that ‘payola’ is to hope it will help get rid of anonymous donations entirely from the political sphere. I consider them to be corrupting. The Nat’s of course are the biggest users. See my post http://www.thestandard.org.nz/?p=2963.%5D

  36. killinginthenameof 36
    10 September 2008 at 4:59 pm

    Funding less cost effective drugs and vaccination is just waste.

    I don’t entirely understand what your saying at the end there (missing some punctuation maybe? its a bit of a bugger not having the edit function at the moment!) but if theres procrastination going on thats for the miniser and adviors to sort out at a staffing and operational level, not interevne in the decisions they are making.

  37. Quoth the Raven 37
    10 September 2008 at 5:30 pm

    Jeeves – Mallard said it on 3news. Their video is incredibly slow so I can’t be bothered finding it, but it’ll be there.

  38. handle 38
    10 September 2008 at 5:40 pm

    Darren, if you want a privatised two-tier health system, move to the United States. Not here, thanks.

  39. Jeeves 39
    10 September 2008 at 5:41 pm

    Ah, so when you said “Mallard has asked him to name them all and he won’t.” you meant “Mallard said he has asked him to name them all and he says he won’t”. Well I don’t take everything Mr Mallard says at face value. He’s only slightly more trustworthy than Winston.

    How do you explain the health policy if National is refusing to name the other policies?

  40. Quoth the Raven 40
    10 September 2008 at 5:52 pm

    Jeeves -This from the NBR, Key said:
    “I’m not going to go through them all, because you don’t know if they’ve got them all, but there is a batch of them together.”

    He’s not going to go through them all because he can’t. We’re just supposed to believe him when he says they’re all from the same batch. Science, health, environment, consvervation, housing and biofuels all from the same batch. Excuse me for this but yeah right.

  41. Jeeves 41
    10 September 2008 at 6:00 pm

    Yeah. That was yesterday. Then today, he presumably realised they did have them all, hence this: http://www.stuff.co.nz/4688063a6160.html
    But then who am I to second guess your amazing power of inference as to what John Key can and cant do.

  42. Quoth the Raven 42
    10 September 2008 at 6:08 pm

    So you think that National’s Science, health, environment, conservation, housing and biofuels policies were all from the same batch and were all left at the same time in a cafe. All of them. Undoubtedly there will be more as well. I personally can’t believe that they were all left in a cafe. Can you?

  43. Draco TB 43
    10 September 2008 at 6:25 pm

    DR:

    At the moment private health is subsidising the failing public hospital “service’.

    Links please.

    PS. If people on private insurance get tax rebates then the government of the day better make damn sure that they don’t use any the public health service.

  44. Jeeves 44
    10 September 2008 at 6:40 pm

    Quoth: Yeah I can believe that. As a National supporter (kind of) I don’t want to believe that anyone can be stupid enough to leave policies lying around. But given that the election is close it seems reasonable that caucus gets a bunch of policies together to review. That someone could leave that batch in a cafe is not the most glowing recommendation for a National MP, but of course its possible. I don’t want to name names, but a look over National’s caucus reveals one or two people who may not always have all the metaphorical lights switched on.

    I know this doesn’t PROVE that the leaks were a mistake, all i’m saying is that its not an unreasonable thing to suggest as some here seem to think. It also exaplains why Key knew they had the health policy.

  45. Quoth the Raven 45
    10 September 2008 at 7:03 pm

    Jeeves – I suppose half a dozen National policies would be so thin they’d be easy to misplace. Key should have known from the beginning they had the health policy. If they were all left at a cafe together as Key claims. So why did he say he didn’t?

  46. toad 46
    10 September 2008 at 7:09 pm

    Never mind the leaks, feel the size of it! The Nats’ health policy is Sicko: Natty-style.

  47. Jeeves 47
    10 September 2008 at 7:43 pm

    Quoth: Probably hoping they didn’t have it… Then later realising they probably did.

    Like, I know we’ve spent ages arguing about this, and I am to blame for that as much as you. But um… where’s Labour’s policy? Are we just presuming more of the same? More of the same what? Are they going to nationalise more assets? Ban more parental control techniques? Allow dogs to marry? (that one’s not serious by the way…more of a dig a a certain Wellington National candiate)

    I am thinking I should start my own blog. Independent right wing. Like Kiwiblog without the National Party line testing and constant refrain about mysterious exotic lovers and desires to see hot Lesbians.

  48. monkey boy 48
    10 September 2008 at 8:17 pm

    did somebody mention lesbians?

    [lprent: monkeys? cheddar cheese? whatever – do you have a point ? At least the TV ad I was watching has a point. ]

  49. Anita 49
    10 September 2008 at 9:08 pm

    Quoth the Raven,

    Key should have known from the beginning they had the health policy. If they were all left at a cafe together as Key claims. So why did he say he didn’t?

    Yesterday National released a couple of policies that they believed Labour had. The fact Labour has something else today proves that National has absolutely no idea what has been leaked.

  50. SPC 50
    10 September 2008 at 10:06 pm

    The theory from the first few leaked papers was that it was someone like Simon Upton (who understands evironment conservation and science)- or some bluegreen who felt really betrayed.

    Now it’s hard to say – one thing we know, is that the Fast Forward investment in the primary sector has been butchered to fund subsisdy to private health care etc.

    How anyone can believe National is about investment in anything is beyond me.

  51. Quoth the Raven 51
    10 September 2008 at 10:16 pm

    Thanks Anita. I hadn’t thought of that. I just assumed Labour had it as well.

  52. sean 52
    10 September 2008 at 10:35 pm

    SPC “How anyone can believe National is about investment in anything is beyond me.”

    Thats clearly because you don’t understand it in the least. Thinking outside of the box is something that you socialists just don’t get.

    When over 1 million kiwis are on private health insurance, due to the inadequacies of our failing health system, it is a brilliant move to subsidise it – as opposed to installing thousands more bureaucrats as Labour have done.

    How many extra billion are spent a year on health under Labour, without even a single extra bed (in real terms) being created?

  53. SPC 53
    10 September 2008 at 10:55 pm

    sean

    I understand politics better than you.

    While National does not take money in return for subsidising private schools and health care, they do regard their policy as an investment in party donation fundraising. A million people offered a bribe for donating and voting National.

    How exactly does subsidising the premiums of those covered by private health care actually result in any investment in health? The individuals who can already afford the pulic sector + private health extras simply get a subsidy and spend their money somewhere else. It’s the politics of class self interest.

  54. Draco TB 54
    11 September 2008 at 12:30 am

    sean:

    Thinking outside of the box is something that you socialists just don’t get.

    Um, no. All the thinking out side of the box has come from the socialists. This is why they’re called liberals and free-thinkers. The people of the right are called conservatives because they try and stop those changes from coming about.

  55. Jared 55
    11 September 2008 at 9:03 am

    SPC: The government is about providing services for the taxpayer. No part of that should allow for active discrimination just because “they can afford it”. As equal citizens paying proportionally different tax bills the government should be addressing each and every citizen, not just those in need. A diverse range of citizens fork out for private health insurance, and they should not be penalised just for making that choice, just as parents who pay for private education for their children shouldn’t be penalised. Part of the taxes we pay go towards education and healthcare, and the government should be supporting other initiatives other than strictly public healthcare and education, instead of citizens paying out twice. I think you would be very surprised at just who gets health insurance, and its not just the “rich pricks” you seem to think, although the left seem to criticise their needs when in reality they pay a large proportion of the tax bill.

  56. Ari 56
    11 September 2008 at 3:39 pm

    Um, no. All the thinking out side of the box has come from the socialists. This is why they’re called liberals and free-thinkers. The people of the right are called conservatives because they try and stop those changes from coming about.

    Just a nitpick- generally speaking, the opposite to a liberal is an authoritarian. The opposite to a conservative is a progressive.

    Using “liberal” as synonymous for “left” is very sloppy, as there are plenty of right-wingers interested in liberties.

  57. Phil 57
    11 September 2008 at 6:40 pm

    “as there are plenty of right-wingers interested in liberties.”

    … and plenty of left wingers keen on authoritarianism too

    🙂

  58. Draco TB 58
    11 September 2008 at 7:16 pm

    Using “liberal’ as synonymous for “left’ is very sloppy,

    Especially when the word liberal can have a different meaning dependent upon who you’re talking to. Consider it Poetic License, in context people would figure out what I meant 😛

    and plenty of left wingers keen on authoritarianism too

    Depends on what you call authoritarian I suppose. Plenty of people of the right that I’ve communicated with think that banning incandescent lights is but I consider it just regulating that everyone work with the same info – something that doesn’t, and can’t happen, in a completely free market. These same people were also keen to give the police more power, longer detention without charge and greater airport security for national flights – ie, getting very close to a police state.

  59. SPC 59
    11 September 2008 at 7:43 pm

    Sorry Jared but public health care provides for and includes everyone. If those with private health care were excluded from public health care you might have a point, however they are not. They simply choose to use private care some of the time – a choice made at their convenience, this correctly left for them to afford out of their discretionary income.

    It can be argued that the diversion of medical staff to enable this more available for some system results in a shortage of staff in the public health system. Subsidy would thus result in further erosion of the public system and it being left short of staff and dependent on the private sector charging for services to the public health provider (how much are private health providers donating to National?).

    Some would then say the only way out of that crisis was making health insurance compulsory/charging the public for health care – which would undermine the whole point of private cover – a better service for those prepared to pay for it. Which is why tax subsidy of private health care is problematic.

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