Open mike 18/04/2021

38 comments on “Open mike 18/04/2021 ”

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1. Sabine 1

   18 April 2021 at 7:31 am

   pre-budget nuggets – i hope not.

   https://www.nzherald.co.nz/nz/pregnant-women-may-have-to-pay-for-urgent-doctor-visits-under-plans-for-maternity-shake-up/IDVI57AW6QJ6JQBFQ2VNYXMGNQ/

   Women who are pregnant or recently gave birth would have to pay for urgent visits to doctors or after-hours medical clinics under proposals being considered by the Ministry of Health.

   In a move that has alarmed doctors and patient advocates, health officials are proposing to withdraw public funding for these unscheduled doctor visits — which number about 30,000 a year — and to instead make urgent care the responsibility of a woman's lead maternity carer, typically a midwife.

   At present, GPs, obstetricians and midwives who are not a woman's lead maternity carer can claim public funding for one-off urgent pregnancy or postnatal care. Under the proposed change, this funding would end.

   Oh man, its so good being a pregnant women in NZ. Seriously, the effort that is being put into making pregnancy a safe and affordable event is just a m a z i n g! Not.

   I really hope that this is just a sort of a belated april fools joke. But then i would not be surprised if this government is looking at cutting the services for the most vulnerable. Those tax incentives for superrich and the surplus need to be paid for, and it will be the poorest of this country that will pay for it.
   • Treetop 1.1

     18 April 2021 at 8:29 am

     This cannot go ahead. Expecting the lead maternity carer to ensure that urgent care is managed when there is already a shortage of midwives is irresponsible and will affect the care midwives provide and increase hospital admissions for antenatal and post natal care.
     • Sabine 1.1.1

       18 April 2021 at 9:05 am

       I would not put it past them to go ahead with it. Women in this country are as much a punching bag as in any other country. Why not try to save some pennies on some women needing emergency care after giving birth to a tiny human. Heck if she dies does anyone care? Honestly, these guys could not dissapoint me more.
       • Treetop 1.1.1.1

         18 April 2021 at 10:03 am

         Honestly, these guys could not dissapoint me more.

         Me as well.

         How much worse will it get for those who need the care but have barriers to get the care?
         • ghostwhowalksnz 1.1.1.1.1

           18 April 2021 at 2:12 pm

           The independent midwives are contracted to 24hr /7 day care already.

           Is the issue the midwives will do 'after hours' for more money or dont they want that burden at all. Maybe they could be hospital midwives where the hospital manages the 24 hr requirement.

           I would have thought the after hours part is managed by a group of midwives so that the womans care comes first rather than the can kicked down the road to after hours clinics and GPs.
           • Treetop 1.1.1.1.1.1

             18 April 2021 at 5:35 pm

             30,000 unscheduled doctor visits a year for antenatal and postnatal care. No way could midwives fill the gap.

             As for being contracted to 24/7 care there are regulations which need to be followed for safe practise.

             Some women find it hard to get a lead maternity carer due to the workload of midwives.

             When there is no midwife available the GP/medical service needs to be available at no cost.
             • ghostwhowalksnz …

               18 April 2021 at 7:28 pm

               Nearly 60,000 births last year , so on average 1 unscheduled outside medical visit per 2 births.

               Could you give more background about how midwives 'couldnt handle' that.

               Dont think there is any suggestion that no help would be available for mothers without a midwife. Its about those that do.
               • Treetop …

                 18 April 2021 at 8:11 pm

                 It would depend on what the visit was for and the follow up. A midwife cannot be expected to attend to more than what they are reasonably able to do at the standard required. I would like to see what a lead maternity carer is contracted to do and the average hours they work per week.
                 • ghostwhowalksnz …

                   19 April 2021 at 8:58 am

                   Yes, would be in many cases.

                   However, Im thinking the privatisation of medical services like midwifery means it seems to be moving into office hours and poor after-hours service. This may especially be apparent for high income areas as they seem to expect and consume health services at high rates.
   • Rosemary McDonald 1.2

     18 April 2021 at 9:04 am

     I suppose it would be unreasonable to ask who exactly came up with this plan? There must be an individual who can claim credit for this brilliant idea?

     Name them I say!

     Let them step forward (or drag them kicking and screaming) into the limelight and explain their reasoning to we lesser mortals. And then we can shower them with the praise thy so richly deserve.

     Seriously though….back in the day (white) women were being encouraged to breed. Supports were put in place, and the great experiment on How Best To Provide Maternity Care really took off. All designed to ensure more little (white) Kiwis walked the land. Healthy happy Mothers had healthy happy babies and the costs were immaterial if the desired outcomes were achieved. And indeed, we did enjoy the lowest infant mortality rate in the world. For a while.

     I wonder what changed?

     Along side this is a worldwide lowering of the birthrate. Great for the planet. Fewer babies.
     • Sabine 1.2.1

       18 April 2021 at 9:07 am

       Ministry of Health, who would be the minister with whom the buck would stop?

       Andrew Little – well, i guess we will hear about some unnamed lowly staffer who will get the blame for this crap when the outrage just gets too loud.

       I think they are trialing social budget cuts to see with what they could get away with.
       • ghostwhowalksnz 1.2.1.1

         18 April 2021 at 2:15 pm

         The MOH is run by its CEO. The ideas arent created in the ministers office. The head office would have hundreds of policy analysts or such

         Why is this fundamental mistake repeated over aaaaaaaaand over for every ministry

         I notice the story doesnt say the mother will be responsible for these costs , but its the midwife. In fact the midwives cannot charge the mothers extra at all.
         Why arent you making this clear Sabine ?
   • Foreign waka 1.3

     18 April 2021 at 9:46 am

     Yep, just keep those dollars rolling for the film crews etc…You know, baby’s are born all the time, no big deal (sarc). I suspect that we slide back into the 1800 with easy by the looks of it.
   • Ed1 1.4

     18 April 2021 at 1:28 pm

     My trust in articles in The Herald is such that I am not prepared to waste money on reading articles behind their paywall. I suspect headlines are often click-bait, and from previous comments it is clear that yet again this article is based on an anonymous source. That does not mean it is not true, but it may well be one of a long list of possibilities for balancing costs , and it may be that it was intended to indicate the extremes necessary for implementation of increased spending elsewhere. I listened to Media Report this morning; this report may well be part of the same media sensationalism that appears to have motivated political reporters to conveniently spread rumours in the hope of destabilising the National Party; there may be a little truth in what they are saying, but reporting rumours, possibly out of context, has been a favourite occupation of some media 'personalities" – who will take pride in bringing down a Government Minister or Opposition Leader or shadow minister without scruple – journalism it is not, but they may think it pays the bills . . .
     • ghostwhowalksnz 1.4.1

       18 April 2021 at 7:31 pm

       Agree with you on that. It seems that some good journalists are required to rev up conflicts and minimise any informed understanding in their stories as the editors want 'impact'.
2. Bazza64 2

   18 April 2021 at 9:31 am

   This is just crazy, can you imagine a low income family already struggling with housing costs then having to think of money if they are worried about their newborn baby’s health ?

   I generally agree with user pays for a lot of services but the first few years of life shouldn’t be subject to cost cutting measures.
   • Foreign waka 2.1

     18 April 2021 at 9:53 am

     Yes, but here comes the budget issue. The money for the Wellbeing budget had to come from somewhere. We cannot afford to have complicated births or dead's. Now, we solved the latter (income too low, malnutrition and if sick an injection), what are we going to do about the former? Someone was musing over a spreadhseet for accountancy and came up with this wonderful idea. So innovative and human. Stunning. Yeah right.
     (sarc)
     • Treetop 2.1.1

       18 April 2021 at 10:40 am

       Someone needs a reality check and to find a new job as they are callous.
   • ghostwhowalksnz 2.2

     18 April 2021 at 1:27 pm

     Isnt the situation that the pre and ante natal services are provided by the 'Lead Maternity Carer ( who is under government contract to do so) but for some reason arent doing so 'after hours'

     From the context it isnt about normal 'infant' care as these are covered by free GP visits and of course Plunket, but while a woman is pregnant and immediately after.

     The question is whats happening with 'midwives and obstetricians' who are supposed to be on call for these women but arent, to the extent of 30,000 occurences per year.

     Heres the background
     “Your lead maternity carer will care for you while you are pregnant, during labour and birth and for 4–6 weeks after your baby is born. All maternity care is free unless you choose a specialist doctor.”
     “Your care provider (or their backup) will be available 24 hours a day, 7 days a week for urgent care. If you have an urgent concern, contact your care provider immediately, whatever the time of day. ”

     24 hours a day 7 days a week! My take is that many lead carers are telling their patient to go to an after hours clinic rather than care themselves for the woman.
     https://www.health.govt.nz/your-health/pregnancy-and-kids/services-and-support-during-pregnancy/maternity-care
     • Sabine 2.2.1

       18 April 2021 at 1:33 pm

       there is a bit of a shortage of midwives, https://www.stuff.co.nz/national/health/124275511/midwife-shortage-and-more-babies-creates-perfect-storm-for-wellington-hospital-maternity-ward

       also a bit of a shortage of nurses and specialists staff i see here

       https://www.rnz.co.nz/news/national/439623/operations-postponed-due-to-nursing-shortage-at-waitemata-dhb

       we are crowdfunding for beds at Starship Hospital.

       https://www.newshub.co.nz/home/new-zealand/2021/04/starship-hospital-launches-15m-fundraising-campaign-as-it-faces-critical-shortage-of-icu-beds.html

       Maybe it is just systematic underfunding of everything that is the problem. One .govt after the other our health system is left underfunded and understaffed.
       • ghostwhowalksnz 2.2.1.1

         18 April 2021 at 1:46 pm

         And the 24 hour , 7 days per week for care before and 4-6 weeks after birth ?

         Is it the neo liberal model of self employed midwives who get 'chosen' by the mother and then effectively shut out 'after hours' ( except the actual birth of course)
3. Pat 3

   18 April 2021 at 9:58 am

   "Equally important, NASA avoided overreliance on the private sector. Had the agency outsourced its governance role, it would have been vulnerable to what its then head of procurement called “brochuremanship”: when the private-sector party dictates what is “best.” Because NASA had developed internal expertise, it knew as much as the contractors did about technology, and thus was well equipped to negotiate and manage its contracts."

   https://www.interest.co.nz/opinion/109994/mariana-mazzucato-calls-return-mission-oriented-public-sector-procurement-and

   Sound familiar?…..after almost 4 decades of 'small government' (small enough to drown in a bath) by design we are reaping what we have sown.
4. Sabine 4

   18 April 2021 at 12:42 pm

   https://www.stuff.co.nz/national/politics/opinion/300279006/our-health-system-is-under-stress–things-must-change

   When we were re-elected with a clear mandate for change, our Government made three promises – to keep New Zealanders safe from COVID-19, to accelerate our economic recovery and to lay the foundations for a better future.

   On Wednesday, I will announce the future shape and structure of our health and disability system. The changes are bold, but will allow us to build a modern, efficient, effective and innovative health system that works for everyone, no matter where you live or who you are.

   oh boy. I can't wait for wednesday!
   • Foreign waka 4.1

     18 April 2021 at 1:10 pm

     lol, yes every baby will now get the opportunity to be born at the road side as these can be found everywhere. There is no access issue.
     • Incognito 4.1.1

       18 April 2021 at 6:05 pm

       Nothing wrong with home births unless you want to give birth in a car in the driveway.
   • Incognito 4.2

     18 April 2021 at 6:03 pm

     What you gonna do about it?
     • Sabine 4.2.1

       18 April 2021 at 6:42 pm

       I wait till wednesday to read about the amazing changes coming our way.
       • woodart 4.2.1.1

         18 April 2021 at 6:49 pm

         going on your past posts, whatever the gov does wont please you, and you will go into, yet another rant, without suggesting any other solutions. So, why wait, start ranting now. give yourself a three day headstart.
         • Sabine 4.2.1.1.1

           19 April 2021 at 5:24 am

           woodart, dear, maybe don't go by my rant but rather read the article. Or is that like so many things in the 'too hard basket'?

           And considering the times and the fact that we are crowdfunding for ICU beds for Starship Hospital, you too should maybe listen to your heart and ask yourself if you maybe too have a rant among all that sweet molasses in your heart.
5. Ad 5

   18 April 2021 at 4:16 pm

   Big congratulations to Lydia Ko for her win today in Honolulu. Great to see her in winning form again.

   https://www.stuff.co.nz/sport/women-in-sport/124875338/lydia-ko-storms-to-first-lpga-tour-victory-in-three-years-with-dominant-performance-in-honolulu
6. KSaysHi 6

   18 April 2021 at 8:26 pm

   Glen Greenwald interviewed. Hope it makes somebodies Sunday night
   • Incognito 6.1

     18 April 2021 at 8:58 pm

     I’m sure it will. What is the interview about? Why should we watch it if we’re not already Greenwald devotees and disciples? Who’s doing the interview?
     • lprent 6.1.1

       18 April 2021 at 10:23 pm

       That was my response reading the comment as well. Greenwald has done some really useful journalism – the the second Iraq War, NSA / Snowden.

       But he seems to have drifted into using dubious sources, supposition and innuendo for quite some time. The last dozen oe so times I read his stuff there hasn't been a keenelnof anything worthwhile or even interesting unless you like Brazilian politics.

       So yeah, a bare link is worthless.
       • Morrissey 6.1.1.1

         19 April 2021 at 8:54 am

         But he seems to have drifted into using dubious sources, supposition and innuendo for quite some time.

         To back up that remarkable claim, could you supply some evidence please?
7. Pat 7

   18 April 2021 at 8:52 pm

   Consider the following.

   Central banks across the OECD have an inflation target of 2% (there has been some flexibility i.e. a range such as 1-3% but the medium term target is consistently around the 2% across those economies)

   If interest is to be paid there needs to be growth (inflation) and that growth needs to occur within the financial system…i.e. credit (debt) so the inflation target of 2% is a credit growth target.

   2% is the approximate operating margin of the private banking sector.

   The inflation target is aligned with the profit margin of the banking sector.

   Inflation targeting was introduced alongside the deregulation of the banking system .
   • greywarshark 7.1

     19 April 2021 at 12:47 pm

     To my slow mind it seems as if the 2% inflation norm enables the banks to be ensured of their profitability with low interest being paid to depositors, and good returns generally on business lending; certainty is great. And seeing the CPI inflation is worked on a model that leaves the major part of dealing in housing out of CPI concerns, the banks can go gang-busters on house dealing – better than drugs I imagine, and legitimate. Whoope!

     But then I am just a simple citizen and cleverer people know that the system is far more complex, with aspects and levers all prevailing that I know nothing about.
     • Pat 7.1.1

       19 April 2021 at 12:55 pm

       CPI inflation is widely considered a poor measure of inflation….but if credit growth is the real (unnamed) inflation target then CPI is simply window dressing
       • greywarshark 7.1.1.1

         19 April 2021 at 1:18 pm

         CPI as window dressing – that's the feeling that I get. A useful system that can be controlled and referred to in praiseworthy terms as a measure of good control of the economy and, I think the idea is, to also refer to the whole country's state. Which would be a Great Big Lie, but hey the CPI is within range, so Good On Us all is sweet and this wine is a good vintage, or have a nice craft beer whatever, to celebrate.

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