Category Archives: Health

The Pharmac Fiasco

If you don’t understand how things work you make foolish mistakes. To explain how the government got into its cancer drugs muddle, we need to explain first how New Zealand’s pharmaceutical purchasing system works. There is a parallel between Pharmac and the Reserve Bank of New Zealand. The Government sets the monetary policy framework with…
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How Centralised Should Our Health System Be?

The Government says it will give localities more control over healthcare decisions. But how? New Zealand’s political reflex is that any problem can be resolved by further centralisation. Students will be officially banned from having cell phones at school from Term 2. The decision could have been left to individual schools. Each knows a lot…
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Centralisation and the New Zealand Health System

Note written for circulation January 2024 In 2023 the New Zealand Health System was further centralised. As usual, the reasons given for the redisorganisation were unclear, thin and unconvincing. There have been no immediate benefits evident from the new structure; experience suggests that if there are any, they will take time to manifest themselves. Downsides…
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What does the Budget mean for the health sector in the long term?

Kaitiaki Nursing New Zealand May 25, 2022 It was surprising that Finance Minister Grant Robertson, in a pre-Budget speech, said that he thought the current health system was “incredibly inefficient”. Of course there are some inefficiencies in health-care delivery, just as there are in private enterprise: mistakes happen, some treatments could have been managed better…
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Centralising the Public Health System

Centralising the Public Health System The proposed health redisorganisation seeks to markedly centralise the health system. Is this grab for power justified; will it work? The Cabinet paper’s justification of the proposed changes is sevenfold. The first two are about Maori issues. One is constitutional, arguing that the ‘public health system does not meet the…
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Posts on Health Economics on Pundit

The following are various columns on my Pundit website which involve health economics.  What is the Fetal Alcohol Spectrum Disorder? (7 November 2014) The Cost of Demanding More Health Care (10 November, 2014) Prolongation of Life and the Quality of Life (28 November, 2014) Thrive: The Power of Psychological Therapy (November 2, 2015) Are we spending enough…
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BEING A HEALTH ECONOMIST

Wellington School of Medicine Summer School  22 February, 2019. But, first, you may well ask, why should anyone – especially a health practitioner – care about health economics? When I was teaching health economics to sixth-year medical students, I wrote on the board so that it was there during the entire session: EITHER HEALTH PROFESSIONALS…
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Productivity losses associated with Fetal Alcohol Spectrum Disorder in New Zealand

N Z Med J . 2016 Aug 19;129(1440):72-83. A detailed version of paper. With, Larry Burd, Jürgen Rehm, Svetlana Popova Abstract Aim: To estimate the productivity losses due to morbidity and premature mortality of individuals with Fetal Alcohol Spectrum Disorder (FASD) in New Zealand (NZ). Methods: A demographic approach with a counterfactual scenario in which nobody in NZ…
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Productivity Losses due to Morbidity and Premature Mortality of Individuals with Fetal Alcohol Spectrum Disorder in New Zealand

Brian Easton, Larry Burd, Jürgen Rehm, and Svetlana Popova Abstract Aim To estimate the productivity losses due to morbidity and premature mortality of individuals with Fetal Alcohol Spectrum Disorder (FASD) in New Zealand (NZ). Methods A demographic approach with a counterfactual scenario in which nobody in NZ is born with FASD was used. Estimates were…
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Policy by Panic

In too many areas the government is avoiding taking policy decisions. When it has to its panic measures are knee-jerk and quick-fix. Just nine years ago, John Key, then leader of the opposition, spoke to the Auckland branch of the New Zealand Contractors Federation about housing affordability which he described then as a ‘crisis reached…
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Are we spending enough on healthcare?

The government is restraining its spending on healthcare – perhaps by over $2 billion a year. Is that what we really want? A common assumption is that public spending on healthcare rises faster than GDP. There are three reasons behind this assumption. First, an aging population requires more healthcare. The over-65s consume more healthcare resources…
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