Somewhere, somehow we have become conditioned to the idea of health funding being capped.
We complain often that the healthcare budget is not big enough, but do not ask why it should be capped in the first place. Medical procedures are not something people undergo for fun. Surely everyone who needs medical treatment should get it as soon as possible?
A capped budget, no matter how large, means that healthcare providers cannot provide health care based on the actual medical needs of the people in their area. Services must be rationed, and people miss out.
Rationing is supposedly based on the people with the greatest need getting services first. This just means that people must wait until they are seriously debilitated before they get corrective surgery, or make do with sub-optimum treatment such as only one cataract removed when they have cataracts in both eyes.
Why do we not insist that the government, instead of apportioning set amounts of money to our district health boards, simply picks up the tab?
Likewise, Pharmac should have an uncapped budget. Pharmac should be able to purchase any proven medication that New Zealanders need, regardless of the cost. A capped budget for Pharmac means that some medications are unavailable to New Zealanders not because they don’t work, but because Pharmac cannot afford to buy them.
We do not need to put up with outdated medication or long waiting lists. The role of District Health Boards is to provide all the services needed to keep the people in their district as healthy as possible. They know how to do this, but they can’t because the government will not fund services based on actual need.
Uncapped funding is not unmonitored funding. An uncapped budget is not an opportunity for inefficiency or excess. Big organizations, private or public, seem to have a propensity for top heavy management, high salaries for their senior staff, and ‘vanity’ projects. Caps may be needed on capital expenditure and administration costs. Other rules may need to be implemented such as a lowest-paid to highest-paid staff salary ratio. Nor should any services be contracted out to private providers. There is no need for taxpayers’ money to fund corporate profit.
Needs-based healthcare may be more expensive – then again, it may not. Not providing timely healthcare has its own costs in other areas such as benefits for people who have to give up work while they are waiting to get their surgery.
Regardless, an uncapped healthcare budget is something we should insist on simply because it is the right thing to do. People should not miss out on medications and medical procedures because they can’t afford to buy privately, or can’t drum up enough political pressure to be pushed up the waiting list.
Let’s have decent healthcare for everyone. To hell with the budget.