The Dim-Post

August 11, 2014

Gross

Filed under: Politics — danylmc @ 7:03 am

I think there’s a place for ‘election bribes’ in politics. If you’re looking at a bunch of policies you might campaign on because you believe in them, the smart thing to do is pick the ones that will swing a bunch of voters your way. It’s different, I think, from pork-barrel politics in which there are no values or ideas and you’re just picking a group of voters and saying, ‘Hey vote for us and we’ll give you free stuff!’ The latent libertarian in me rises up and seethes ‘That is not your wealth to just give away in exchange for votes.’

Which is what Labour’s new policy of free healthcare for Over 65s amounts to. Here’s a chart I made from a DPMC report on poverty in New Zealand:

hardshipbyage

Labour’s policy is a generous subsidy to the least needy group in the country. It’s also a very large group of people with high health-care needs and giving them ‘free’ access to healthcare is going to cause a huge increase in demand for primary health services. What’s Labour’s plan to increase the supply of GPs?

So why this policy? Because of this chart recently released by the Electoral Commission showing voter enrolment by age, which speaks for itself:

votersbyageAt least the politics behind the policy are interesting. Labour has finally realised that Winston Peters is highly likely to form a government with National after the election, and this is a direct attack on his voter base, pretty much all of whom are elderly former Labour voters. Which is an interesting thing to do: Peters is bobbing up and down around the 5% mark. The loss of a couple thousand voters could be all it takes to drop him below the threshold and see him wiped out.

It’s a variation on National’s ‘three party’ strategy. You don’t need 51% of the votes to win the election, National figured. You just need one more seat than your opponents. So if the Conservatives and New Zealand First wiped each other out National could run the country with 61 seats even though they won less than 50% of the vote.

The arrival of Internet/Mana upset that strategy for National but now I think Labour are trying something similar. It doesn’t matter how much of the overall vote they get. If lots of those votes are wasted and Labour+Greens+Internet/Mana = more seats than National then they’ve won.

 

 

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69 Comments »

  1. This policy is genuinely morally unconscionable. I’m disgusted with Labour.

    This largess is built on the back of the working poor who’ll see their superannuation delayed and taxes rise to pay for it.

    Comment by Oh Busby — August 11, 2014 @ 7:08 am

  2. Does “material hardship” factor in the monetary cost to this 65+ group of them paying their “high health-care needs”? So are they still well off materially AFTER they spend a comparatively high amount on health-care?

    Comment by tangled_up — August 11, 2014 @ 7:53 am

  3. Won’t it incentives Peters’ voters try to get him a seat at the table and keep Labour focussed were they to get over the magic threshold? Or has this given Peters a bargaining chip for his negotiations with National. If you triangulate the possible downsides it = clustrrf**k. Quelle leadership!

    Comment by Lee Clark — August 11, 2014 @ 7:58 am

  4. Utter insanity. There’s not a lot of evidence that the elderly are prone to avoiding going to the doctor for cost reasons when they’re sick, not least because it’s actually quite cheap for them already. There *is* evidence that making general practice visits free makes the lonely and/or batty contingent of the over-65s (a larger number than you might think at first) significantly more inclined to go along basically for a chat every few days (at $80-odd a pop for the state).

    Perhaps this is Labour’s plan to combat loneliness in the older population, but if so, I’d prefer if they didn’t do it by throwing more money at our privately-owned, moderately cartel-like general practice system, and I’d also prefer they did not do it at the detriment of our already-overburdened public health system.

    Comment by Milla — August 11, 2014 @ 8:04 am

  5. Annette King is doing a rather awful job of demonstrating any sort of need here, beyond “wouldn’t it be nice?” And it would be nice, if that money wasn’t being taken from those who need it so much more.

    Comment by Oh Busby — August 11, 2014 @ 8:18 am

  6. I just want to say not all old people are well off, this policy will help my elderly father a lot. He doesn’t go to the doctor when he should because he can’t afford it.

    Comment by Rose — August 11, 2014 @ 8:26 am

  7. Instead of getting all the outraged high Anglican Tories something to splutter to the vicar over Danyl, perhaps you could have ALSO mentioned Labour is extending the free doctors scheme up to thirteen?

    It is a common sense observation that the young and the old are the heaviest users of healthcare, so to make a real difference it makes sense to include them in this scheme.

    Comment by Sanctuary — August 11, 2014 @ 8:32 am

  8. Maybe he didn’t mention the other policy because it is not a wealth transfer from poor to rich, you walnut.

    Comment by Trouble Man — August 11, 2014 @ 8:42 am

  9. No Sanc, National extended free doctors for under thirteens. Labour’s has decided to claiming it too.

    At least have the decency to credit the party responsible.

    Comment by Oh Busby — August 11, 2014 @ 9:03 am

  10. A walnut! Oh yeah? Well I not fall that hoary old chestnut.

    Comment by Sanctuary — August 11, 2014 @ 9:03 am

  11. @Oh Busby, your offensively colonial name means your are talking to the hand.

    Comment by Sanctuary — August 11, 2014 @ 9:04 am

  12. Early primary healthcare is one of the cheapest forms of medical intervention, compared with waiting till people are really ill and need hospital/specialist treatment.

    The way to deal with wealthy older people getting more than their fare share of services vs tax is to levy increased taxes on capital, not limit services.

    Comment by richdrich — August 11, 2014 @ 9:05 am

  13. Don’t agree with your criticisms. DC has said that they want to ideally all health care made free, so it makes sense to start with the most needy age cohort. Huge numbers of seniors have nosavings and a re struggling so this will make a big difference and hopefully reduce hospital admissions too.

    Comment by Louis M — August 11, 2014 @ 9:05 am

  14. Some interesting intergenerational outrage Danyl. The push for primary healthcare should be welcomed fully, particuarly for older and younger people. Its a wealth transfer this comfortable middle class person doesn’t mind paying for

    Comment by max — August 11, 2014 @ 9:10 am

  15. This is one of those large election promises that parties make, knowing that they won’t ever have to implement it. Firstly, they’ll be in coalition with the fiscally neutral Greens, who will veto it. They want an eventual socialised healthcare model, but this is well down the list of health spending priorities.

    Secondly, the NZMA ain’t nuttin ta fuck wit, and they are about as opposed to this as any professional body could be. They’re a very powerful group, and mobilise to protect their turf. They were opposed to giving free (fully state-funded) healthcare to young children, are opposed to giving free healthcare to pre-teens, and are opposed to giving free healthcare to under 18s. You can bet that they will be opposed to giving free healthcare to New Zealand’s largest and sickest demographic group.

    Comment by George — August 11, 2014 @ 9:15 am

  16. Why are NZMA opposed George? Doesn’t it benefit them to have more customers, regardless of who pays?

    Comment by lucyjh — August 11, 2014 @ 9:26 am

  17. @George: “Secondly, the NZMA [...] are about as opposed to this as any professional body could be.”

    Did you happen to interpret this stance from yesterday’s NZMA press release which begins: The New Zealand Medical Association (NZMA) welcomes the public health focus in the Labour Party health policies released today. “The priorities set out in these policies are the same areas the NZMA has been advocating for over the past years,” says NZMA Chair Dr Mark Peterson. ?

    Comment by izogi — August 11, 2014 @ 9:27 am

  18. izogi, that’s a different take than I expected, so I’ll admit that I was wrong.

    The release, in full, since you’ve selected the most positive part.


    The NZMA also welcomes the proposed increases to funding, particularly the increased primary care subsidies. “But we note that, while the amount of the increase is significant, appropriate targeting is still an issue,” says Dr Peterson.

    “The proposals are for fully funded care for children under 13 and adults over 65, but this still leaves out a significant proportion of those in need. There are also no details around the extension of Very Low Cost Access funding. It’s still worrying that this subsidy may continue to be targeted by post code rather – rather than by need. This needs to be clarified.”

    Dr Peterson believes the extension to the Care Plus programme is positive, as is the extra care for pregnant women. “This may be a chance to improve the integration of services in maternity care—something we’ve been waiting for for some years.”

    However Dr Peterson notes that, while the Labour Party has acknowledged that it needs to talk with general practice about how these increased subsidies should be introduced, fully subsidised care has been promised to other groups without that sort of discussion. “General Practitioners are private businesses, not state employees and need to be able to set appropriate fees. For visits to be free to patients, General Practice needs to agree that the subsidy is sufficient to cover the significant costs associated with running a Practice,” he says.

    Obviously, there is an element of negotiation with the current government here over capitation. This is a promise of further engagement, rather than acceptance.

    Comment by George — August 11, 2014 @ 9:40 am

  19. “General Practitioners are private businesses, not state employees and need to be able to set appropriate fees…”

    An oversight of the first Labour government that needs to be put right.

    Comment by Sanctuary — August 11, 2014 @ 9:41 am

  20. “Doesn’t it benefit them to have more customers, regardless of who pays?”

    Depends on who gets to set the prices.

    “What’s Labour’s plan to increase the supply of GPs?”

    questions questions its about free access Comrades! A very wise committee has come up with this policy.

    Comment by Simon — August 11, 2014 @ 9:43 am

  21. It is a common sense observation that the young and the old are the heaviest users of healthcare….

    It might be a common sense observation but without examining the impacts of the policy change, it’s a worthless one.
    As Milla pointed out, the issue is the lack of substantive change to the PHO capitation funding model which currently incentivises visits that can be turned around quickly rather than health outcomes.
    Given that PHOs can effectively choose their patients the people who are most hard to ‘fix’ – the poor and the old – end up competing for the same resources.

    Which is dumb.

    Comment by Gregor W — August 11, 2014 @ 9:43 am

  22. Politicians build a vast public apparatus and then you are surprised when it’s used for blatant pork-barrel politics by politicians? That’s so sweet.

    … all the outraged high Anglican Tories ….

    Nixon has resigned, Bill Sutch has been found not guilty and the aftermath of the Yom Kipper War continues to hamper the bold plans of the Kirk government – and other news from 1974.

    Comment by Tom Hunter — August 11, 2014 @ 9:48 am

  23. …. and kippers are cheap!

    Comment by Tom Hunter — August 11, 2014 @ 9:51 am

  24. Sanc, no need to squirm like prissy little twerp when someone calls you out on an egregious error. Take it like a big boy and keep on trucking – sometimes you make a comment even worth reading.

    Comment by Oh Busby — August 11, 2014 @ 9:55 am

  25. “Firstly, they’ll be in coalition with the fiscally neutral Greens, who will veto it.”

    I don’t know what’s a funnier idea, that the Greens are such fiscal hawks that they will veto government spending on principle, or that they’ll have a veto on all Labour policies as part of the coalition agreement.

    Comment by kalvarnsen — August 11, 2014 @ 9:59 am

  26. ‘This largess is built on the back of the working poor …’ indeed? There is a significant group of elderly poor who are, as things are now, only able to suffer the consequences of their ill-health. I’m sure I heard somewhere that the policy is one amongst a mixture that includes increased high earner taxes and, at last, a capital gains tax, so I guess the moral outrage of some commentaters is a bit faux.

    Comment by paritutu — August 11, 2014 @ 10:01 am

  27. George: “izogi, that’s a different take than I expected, so I’ll admit that I was wrong.”

    I’ll take your word for it about their general tone.

    I did stumble on this June article from NZ Doctor Online, about the current situation. It claims that GPs are currently doing about twice the consultations for what’s been predicted by the government and covered by government funding, except for five and under, and perhaps this goes some way to explaining problems that doctors might be having towards subsidies. I have no idea if it’s a reputable source, and maybe Labour’s proposed budget for this is more accurate, or not.

    The article’s behind a paywall so the link might not work, but apparently not so if you’re referred by Google which is how I found it. If you have trouble clicking the above link then try pasting the URL into a Google Search then click the top result.

    From the article:

    “General practices are funded for about half the number of visits their patients actually make, a comparison of utilisation and funding figures suggests.

    [--snip--]

    “Patients aged six to 17 visit their general practice about four times a year, on average, but attract funding for only 2.7 visits.

    “Annual funding for each patient aged 18 to 44 years covers 2.4 visits. But adults in this age bracket visit a general practice about 5.5 times a year, on average, until they turn 25, when the number creeps up to about 6.5 times a year.

    “Adults in the 45-to-64 age range go to the doctor more than nine times a year, well above the 3.6 visits capitation covers.

    “And, once adults are “elderly”, they are having 16 general practice consultations a year, on average, compared with the seven visits for which practices are funded.

    Comment by izogi — August 11, 2014 @ 10:15 am

  28. It claims that GPs are currently doing about twice the consultations for what’s been predicted by the government and covered by government funding, except for five and under….

    Which is why the sweetspot for PHOs is white, urban, middle class mums with 2.4 kids under 6.
    Every snotty nose attracts a subsidy and can be turned around in less than 10 minutes. Having a good source of hypochondriac mums means that the fixed practice costs can be covered quickly and the correlated (and statistically healther / free of chronic illness) catchment of white, urban, middle class >6 but <65 year olds can be gored at $50-100* a pop.

    For a purely economic analysis, see this.

    *Based on the practice’s assessment of the patient’s ability to pay. It is actually possible to negotiate the cost of your treatment with a GP (not many people know this) as they can’t refuse to treat you if you are in the PHO.

    Comment by Gregor W — August 11, 2014 @ 10:42 am

  29. Spending money for primary health care makes a lot of economic sense because it can prevent a mild illness turning into a serious condition that will require an expensive hospital admission. Most old people are not wealthy and often delay going to the doctor because of the cost. Getting early treatment means savings down the track in hospital spending and rest home subsidies.

    Comment by Karen — August 11, 2014 @ 10:55 am

  30. It would make sense to tie this to the superannuation age, which Labour proposes to raise. You’re much less likely to be able to afford healthcare if you are not in paid work; while a lot of 65 year olds will still be in some form of paid work, the number working at 70 must surely be much lower.

    Also, the ‘wealth” of the elderly is tied up in mortgage free homes, so it is not liquid. Most elderly (70%?) have no income except super and they have to budget very carefully. I challenge anyone here to live on it for any length of time, knowing that their circumstances are not going to improve in the future. (When I was a solo parent living and only working part time, living on the taxpayer’s largesse, I knew I would not be living in that poverty for ever, which helped me cope.)

    Primary healthcare should be viewed as an investment – catch health problems early and you save money.

    Comment by MeToo — August 11, 2014 @ 10:56 am

  31. Oops, must proofread before posting next time… too much “living”

    Comment by MeToo — August 11, 2014 @ 10:57 am

  32. Danyl: “Labour’s policy is a generous subsidy to the least needy group in the country.”

    It’s still pretty important (imo) to ensure everyone’s getting appropriate treatment, whether it’s subsidised or not, so that people’s conditions don’t spiral out and become much worse.

    Are there any good sources of info regarding how frequently elderly people don’t visit GPs when they really should be doing so? And if it’s comon, how much of this is because they either can’t afford it, or perceive that they can’t afford it?

    Comment by izogi — August 11, 2014 @ 11:12 am

  33. Your objection seems confused. Private insurance costs skyrocket for things like this, so a lot of people are probably avoiding spending money at the doctors as their incomes will be low, waiting till that cough becomes something bad then getting admitted to hospital and taking up a bed for a week (i.e. the Grandmother of someone I know). As others have said, this move towards more available primary healthcare should be a good thing, I really don’t understand the objection to that. Also, medicare in Australia currently covers 100% of ALL GP visits there. As far as I can tell the sky is still up there.

    Comment by chris — August 11, 2014 @ 11:29 am

  34. chris: “Also, medicare in Australia currently covers 100% of ALL GP visits there.”

    Are you certain about this? Is it all Australia at a Federal level, or only some of the states?

    Up until a year ago, I was living in Melbourne for 2.5 years with dual Aus/NZ citizenship, and fully signed up to Medicare as an Australian. My one 15 minute appointment slot visit to a GP, on Collins Street in Melbourne’s CBD, resulted in an AU$81 fee. This was even after swiping my Medicare card and applying whatever private health insurance I had through Medibank.

    My guess is that there’s some federal subsidisation via Medicare which is meant to cover “necessary” costs theoretically, but that GPs are still allowed to charge whichever extra amounts they need or want to. You can probably get fully subsidised GP visits somewhere out in the burbs if it’s a 3-4 hour commute away from the highest population densities, and run by a GP who’s more focused on their local community than their personal income.

    Comment by izogi — August 11, 2014 @ 11:40 am

  35. MeToo wrote: “Also, the ‘wealth” of the elderly is tied up in mortgage free homes, so it is not liquid. Most elderly (70%?) have no income except super and they have to budget very carefully.”

    wealth tied up in mortgage-free homes is not liquid, but it does mean you have very low accommodation costs in comparison with someone who is renting, so your income goes further.

    Also, a single person on NZ Super gets $349 per week. A single person on the Sickness Benefit gets about $210 per week (both figures based on having a mortgage-free home). Wouldn’t it logically be a higher priority to give the person on the sickness beneft access to free health care?

    Comment by Can of Worms, Opened — August 11, 2014 @ 11:56 am

  36. Seconding (or thirding?) the need to increase the number of GPs before enacting this sort of policy. Many practices have a wait of a day or two for an appointment in winter, and this will only get worse if more people can afford to go, and others who can sort of afford it aren’t getting put off by the ridiculous fees some of them charge.

    Incidentally, keeping GP services private sector wasn’t an ‘oversight’ by the 1st Labour government – they tried very hard to get them into the public sector but the vast majority of GPs refused. While most seem okay with subsidies I’d guess many, perhaps most, would still resist losing their independence to become state employees.

    Coming from a scientist those are not very good graphs – the first one is meaningless without knowing what of the population each group is. What is should be measuring is what percentage of each group is in hardship. As a side note, I would guess that the relatively low needs of the elderly group has something to do with there being relatively few elderly Maori/PI. The second graph divides everyone into five year age groups, except for the over 70s, creating the false impression that there are a lot more of them than is actually the case.

    Comment by helenalex — August 11, 2014 @ 11:58 am

  37. From my previous comment — Sorry, I’d read my Aussie GP invoice wrong but have just checked my Medicare account. For a basic GP appointment in 2012, the base cost was AU$81. Australia’s Federal Medicare then covered $36.30 of this, and I was left with a cost of $44.70 that was charged to my EFTPOS card. As I indicated, I’m sure there are some GPs in Australia who will get their costs right down, but I think it’d be presumptious to assume that those clinics will be accessible to many of the people who’d gain the most benefit.

    Comment by izogi — August 11, 2014 @ 12:04 pm

  38. It is curious to see Danyl repeating Matthew Hooton’s attack lines though.

    Comment by Sanctuary — August 11, 2014 @ 12:20 pm

  39. you’re probably right, igozi, I was going off this http://en.wikipedia.org/wiki/Medicare_(Australia) and the recent furore over there at the $7 charge. I’d just assumed it must’ve been fully covered.

    Comment by chris — August 11, 2014 @ 12:27 pm

  40. It is curious to see Danyl repeating Matthew Hooton’s attack lines though.

    Shock! Horror! Two people have the same idea at the same time!
    Has anyone ever told you, sanc, that you drone on like a political Nigel Mansell?.

    Comment by Phil — August 11, 2014 @ 1:13 pm

  41. Looks like someone has fallen for the old bar chart manipulation trick, first dont use base zero, then use 5 yr age groups except for the two groups you want to scare people with, hello 18-24 or 70+.

    So, No the graph DOESNT speak for itself

    Comment by ghostwhowalksnz — August 11, 2014 @ 1:14 pm

  42. “wealth tied up in mortgage-free homes is not liquid, but it does mean you have very low accommodation costs in comparison with someone who is renting, so your income goes further.”

    Yes, and I believe most of the elderly who are in deprivation are those who rent.

    cf super and sickness benefits – that is an argument to raise sickness benefits.

    The thing about super is once you stop work you stop having an opportunity for additional income. Most younger people unemployed or solo parents would not expect to see 20 or thirty years on such low incomes. You can budget them for a while but once the washing machine breaks down? The roof needs replacing because it leaks? $349 a week may look okay, and it does, but only as a short term income.

    Comment by MeToo — August 11, 2014 @ 1:14 pm

  43. izogi, dont you think going to a non bulk funded GP in Collins St wasnt going to cost an arm and a leg ?
    The term to look for is fully bulk funded , which means that they charge Medicare for all the GP cost. A quick check will find a surgery in Richmond. They are likely others.
    As well , I could be wrong on this, but I think its bulk bill OR you pay entire bill up front and get your refund of part charges from medicare. Not both.

    Comment by ghostwhowalksnz — August 11, 2014 @ 1:23 pm

  44. “dont you think going to a non bulk funded GP in Collins St wasnt going to cost an arm and a leg ”

    I take your point about the bulk funded GPs being closer in. I never expected a Collins Street one to be free. It just happened to be the only one I could conveniently get to during a work day—those GPs would have a fairly hopeless business model if nobody had reasons to prefer going to them. I didn’t mind paying extra because I could afford to, but for someone working on low wages for an employer reluctant to be flexible, and there are doubtless plenty of those in the CBD, it could be a big hinderence. If you’re working in the CBD then getting to somewhere like Richmond and back still takes a while, especially if you need to slide an appointment time around public trasport, which would need another 10+ minute margin on each end just to be confident of getting a tram or train, without even taking transport time into account.

    Anyway, that’s Australia. My only intended point was that I don’t think it’s representative to state that Medicare in Australia covers 100% of ALL GP visits, which is what @chris had stated earlier. Maybe it does, as long as you have enough flexibility to fit the system into your life.

    Comment by izogi — August 11, 2014 @ 1:53 pm

  45. “…It is curious to see Danyl repeating Matthew Hooton’s attack lines though.

    Shock! Horror! Two people have the same idea at the same time!
    Has anyone ever told you, sanc, that you drone on like a political Nigel Mansell?…”

    No, it is just you and you are an idiot.

    I am reasonably happy that two people can have the same idea, however I am struck that the person Danyl would happen to share his idea with is a Hooton.

    Comment by Sanctuary — August 11, 2014 @ 2:24 pm

  46. In sure Danyl and Hooton also occasionally share the same craving for bacon and eggs on a Sunday morning as well.
    Would that strike you as odd, Sanc?

    It doesn’t seem at all unusual that two policy wonks would look at a ham-fisted election bribe / Winston-neutering OAP bait scenario and separately conclude that it was precisely what it is.

    Comment by Gregor W — August 11, 2014 @ 2:42 pm

  47. If I shared the the same thought as Hooton I would have to spend an hour in the shower with a steelo trying to scrub myself clean, that is all.

    Comment by Sanctuary — August 11, 2014 @ 2:51 pm

  48. You lost me at “I think there’s a place for ‘election bribes’ in politics.”

    Comment by Bill Bennett — August 11, 2014 @ 6:24 pm

  49. It’s a stretch to call Danyl a policy wonk.

    Comment by kalvarnsen — August 11, 2014 @ 7:32 pm

  50. At least Danyl admits he is a closet libertarian. Greens take note.

    Comment by peterlepaysan — August 11, 2014 @ 7:39 pm

  51. “… a generous subsidy to the least needy group in the country.”

    This may be true of many over-65s, but by no means all of them. We’re the cohort who were screwed over in the employment arena by Rogernomics; moreover, many lost their savings in the consequences of the 1987 stockmarket crash. And, because of the previously referred-to employment screwing-over, many of those people never fully recovered financially to where they’d been beforehand.

    Those who have work-related superannuation as well as the Universal Super – or have profited from selling real estate of one sort or another – along with those still able to work, will be managing ok. But for those without such advantages, life is tough. Yes, owning one’s own home is cheaper than renting – until major maintenance is needed. And that’s when the inadequacies of the Universal Super are revealed. It really isn’t enough to live on, and still have a decent quality of life – you know, a car, mobile phone, broadband, heating in the deeps of winter, replacing the whiteware when one needs to. Add to that visits to the GP, never mind the dentist, and a pensioner is really up against it.

    I have a relative who is a longtime citizen of Australia, and a pensioner. The Australian system offers to pensioners GP and other health services which are either free, or orders of magnitude cheaper than they are here. Including dentistry, I believe. We’ve compared notes: this person simply couldn’t afford to live in NZ; not only do they get the generous healthcare, but also discounts, subsidies and financial help with many other living costs. Such luxuries aren’t available here.

    Here’s a thing: a halfway decent society ought to look after its citizens, and it shouldn’t be the case that it’s either this or that group, rather than all groups. Nor should we be targeting: for obvious reasons, it doesn’t bring about equitable outcomes. That many people nowadays see the current state of affairs as unexceptionable illustrates how deeply neoliberalism has permeated the public’s thinking on social issues.

    Comment by D'Esterre — August 12, 2014 @ 12:15 am

  52. “Here’s a thing: a halfway decent society ought to look after its citizens, and it shouldn’t be the case that it’s either this or that group, rather than all groups”

    This is all very well, but I think few would argue that a halfway decent society needs to care for the rich as attentively as the poor.

    Comment by kalvarnsen — August 12, 2014 @ 4:05 am

  53. “This is all very well, but I think few would argue that a halfway decent society needs to care for the rich as attentively as the poor.”

    That feels like a straw man. It’s not about caring for the rich as attentively as the poor, it’s about caring for everyone to a base line. Most rich people will still hold onto comprehensive health insurance as they age so won’t be as much of a burden on the public system – though I accept that a universal GP subsidy could just have affect of meaning health insurers stop covering GP visits thereby transferring the cost to taxpayers.

    I used to buy into all this hate for retirees, costing the younger generation money etc etc, but I think it’s overblown and counterproductive now. We shouldn’t be getting stuck into some class war with the baby boomers (as much as I’d love to), but trying to work out how we can ensure that they’re not the last generation to enjoy a ‘dignified’, state-sponsored retirement.

    Comment by chris — August 12, 2014 @ 9:44 am

  54. “though I accept that a universal GP subsidy could just have affect of meaning health insurers stop covering GP visits thereby transferring the cost to taxpayers.”

    I’d be keen to know how many people actually have private health cover for GP visits. To me iit seems to be getting more into pre-paying for common ongoing costs instead of insuring for stuff that’s expensive and unexpected.

    From my quick check of Southern Cross, it adds quite a lot to your insurance bill (about $5.50/week per person which is maybe 33% more). If you’re seeing a GP frequently enough to actually be benefiting from that, then surely there must be a lot of people out there who are paying for it yet barely taking any advantage of it at all.

    Comment by izogi — August 12, 2014 @ 10:00 am

  55. @MeToo: >”Also, the ‘wealth” of the elderly is tied up in mortgage free homes, so it is not liquid.”

    This is always the refrain. But wealth of these asset-rich income-poor members of the elderly is only tied up in mortgage free homes because they are choosing not to sell or borrow against those homes. Why is it the state’s responsibility to ensure that an elderly person both has an adequate liquid income, and gets to keep a freehold home to ultimately pass on to their progeny?

    Comment by Matt — August 12, 2014 @ 3:42 pm

  56. “From my quick check of Southern Cross, it adds quite a lot to your insurance bill (about $5.50/week per person which is maybe 33% more). If you’re seeing a GP frequently enough to actually be benefiting from that, then surely there must be a lot of people out there who are paying for it yet barely taking any advantage of it at all.”

    The “Hospital Only” option costs me $2600pa so its not cheap as you age. I also pay the first $500 cost.

    Back in the day about half the population covered itself with private insurance but its a fact that the State system has improved hugely and the private sector has whittled down to (IIRC) under 30% as a result and because its simply unaffordable on just National Super.

    JC

    Comment by JC — August 12, 2014 @ 4:10 pm

  57. Back in the day about half the population covered itself with private insurance but its a fact that the State system has improved hugely

    I do still know more than a few people who are stuck on waiting lists for non-critical but often painful and difficult things like knee and hip operations, often strugling with the prioritisation process. I currently have private health insurance (with Southern Cross atm) with the idea of covering extremely expensive stuff that’s unexpected, and it’s only hospital cover, but statistically I’m unlikely to need either of those operations for a while if ever, and I’m still in two minds about how useful it is with the public health system.

    In some respects I’m wondering if I should be stashing the money elsewhere so I can put it towards premiums later in life, but then you can hit new complications in the industry, like health insurers refusing to cover you for pre-existing conditions that might have come up before you decided to re-insure. SC already made me ditch a life-time’s earnings of discounts and medical history, simply because I decided to go overseas for more than a year, even though I’d been fully covered by another provider during that time and not claimed. It seems less efficient than the public health model (if it’s done well) and it’s tempting to drop the insurance entirely.

    Comment by izogi — August 12, 2014 @ 4:59 pm

  58. Izogi – an important consideration re private is that if your op goes to shit, you’ll end up in the state system for acute services anyway (though you may be re-transferred for recovery).

    The benefits are really geared towards offsetting risk around dental and the like, or bumping up the list for specialist assessment to get you onto the acute state lists for colonic surgery etc.

    At the end of the day, it’s generally the same surgical crew anyway (for consultant surgeons and aenesthetists at any rate).

    Comment by Gregor W — August 12, 2014 @ 5:37 pm

  59. I’m in an annoying position with southern cross. I’m youngish so my premiums are cheap (~16 a fortnight, including GP visits, I should really change my policy as I go maybe 3 times a year), but I’ve been a customer since 1992 as my parents covered us kids. Due to this lucky happening I have no preexisting conditions on my policy, problem is, I can now never leave southern cross or cancel my coverage. Well played insurers, well played.

    Comment by chris — August 12, 2014 @ 5:52 pm

  60. “and it’s tempting to drop the insurance entirely.”

    I have the same argument with myself every time the bill arrives :( But then I remember a doc back in the 80s at the public hospital telling me that I was at the head of the queue because I was a taxpayer who paid to keep the system going.

    A joke maybe but the point that your utility drops when you get old wasn’t lost on me.

    JC

    Comment by JC — August 12, 2014 @ 7:31 pm

  61. @ Kalvarnsen: “..few would argue that a halfway decent society needs to care for the rich as attentively as the poor.”

    In my view, this comment neatly illustrates the degree to which neoliberalism has permeated people’s thinking, on social issues at least. Before the Rogernomics bulldozer started work on this polity, there wouldn’t have been too many people who thought that way, really. I didn’t suggest that the rich shouldn’t be looked after; I believe that a society ought to look after all of its citizens. If 30-odd years of neoliberalism has taught us anything, it’s that “targeting” – no matter the means used – results in injustices and inequities somewhere in the system.

    Some of you may not be aware of the surcharge – effectively means-testing – which applied to National Super from the mid-80s through to the late 90s. It was politically very unpopular among retirees, who at that stage weren’t the much-reviled baby boomers. Moreover, it affected only a smallish number of wealthy superannuitants. Gordon Campbell (Scoop, May 30, 2012) noted that “… only 10% of wealthy superannuitants had to pay back their super in full, and only a further 13% in part…” This suggests that the “wealthy retiree” may well be a bit of an urban myth; the superannuitants of the 1980s and 90s had been the beneficiaries of the “steady jobs-for-life and almost full employment” world which had preceded Rogernomics. If there weren’t large numbers of rich retirees at that time, in virtue of what should we suppose that there will be now, given the bleak austerity of the economic and employment landscape throughout so much of the last 30 years?

    @ Chris: “We shouldn’t be getting stuck into some class war with the baby boomers (as much as I’d love to)…”

    Indeed. And there you have it. The effect – or perhaps the intention – of neoliberalism is the creation of the environment for a class war, or an intergenerational war, between baby boomers and their children. What’s happening at the macro level that we’re heedless of, while we scrap over diminishing resources? It isn’t boomers’ fault that public health improvements brought about by earlier generations have resulted in the next generation living longer,healthier lives. A fortiori, it wasn’t boomers who inflicted neoliberalism on us in the shape of Rogernomics: those politicians most influential in bringing that about were in fact from the aforementioned earlier generation. Blaming boomers – and keeping the pension at niggardly levels, or even reducing it – won’t solve the problem of child poverty. Or the struggle for survival forced upon those on benefits or the minimum wage.

    If people are looking for someone to blame for our current situation vis a vis national superannuation, Robert Muldoon’s your man. He’s the one who, in the 70s, cancelled the Kirk government’s compulsory superannuation scheme. We’re still living with the consequences of that disastrous decision.

    Comment by D'Esterre — August 12, 2014 @ 11:28 pm

  62. “In my view, this comment neatly illustrates the degree to which neoliberalism has permeated people’s thinkin”

    You’ve got it exactly wrong. Whining about how the rich have rights too and need to given protections and support they don’t need because otherwise it’s discrimination against them is a very important part of neoliberal ideology. The pre-84 policy consensus wasn’t based on the idea that the rich needed as much support from the state as the poor.

    Comment by kalvarnsen — August 13, 2014 @ 5:09 am

  63. @Kal: But it was based on universality. Granted, this was a strategic move to prevent the middle classes complaining about the welfare state, rather than any kind of ideological thing, but still. Means-testing and targetted funding are much more a part of post-1984 policy than 1935-84 policy.

    I don’t think ‘the rich should get support they don’t need’ is part of neoliberal ideology; it’s just something that some neoliberals think/say because they’re hypocrites. The ideology says no one should get anything unless they’re starving right now and can prove it’s not their fault.

    Comment by helenalex — August 13, 2014 @ 8:50 am

  64. “…But it was based on universality. Granted, this was a strategic move…”

    Universality was NOT simply based on pragmatic calculations. To say that is to sell short the beliefs of the those who founded the welfare state. Universality (along with aggressive income redistribution) recognises that in order to get people to support the welfare stae, all citizens must equally benefit and equally see the advantages of egalitarianism. Further, selectivity cost huge amounts of money and governmental effort to adminster, but more importantly to a generation of politicians who had actually felt the harsh sting of the shame of poverty it is stigmatising. People forget that an important humanitarian principle behind the welfare state is that “social security” isn’t just preventing hunger and destitution in a land of plenty but also the noble aim of giving back to people their dignity and pride.

    Comment by Sanctuary — August 13, 2014 @ 9:29 am

  65. Universality was NOT simply based on pragmatic calculations.

    I’m with Sanc on this one. The universality of welfare was highly ideological given the socio-political context of the late 19th-early 20th century.

    It had the fringe benefits of lowering the aggregate transaction costs and nixing middle class whinging (though bearing in mind the notional middle class of the period was miniscule compared to today), but the whole concept was absolutely grounded in the very recent history of rapidly eroding class distinctions, a bloody global conflict and the very real threat of labour-centric economic disruption/militant socialism – so maybe it was pragmatic in the sense that it neutralised a more radical socialist alternative, but this wasn’t driven by middle class concerns relating to equity.

    Comment by Gregor W — August 13, 2014 @ 10:03 am

  66. Giving benefits to the middle class neutralised radicalism? Because if all those middle class people didn’t get their pensions, they’d have become communists?

    Comment by kalvarnsen — August 13, 2014 @ 10:15 am

  67. We older folk have less scope for earning extra money for paying for unexpected doctor visits. When the bank balance is down you are stuck with hard choices as are many on low incomes.

    Comment by xianmac — August 13, 2014 @ 10:23 am

  68. I think you should read my comment again, kalvarnsen.

    Comment by Gregor W — August 13, 2014 @ 10:28 am

  69. @ Kalvarnsen: “Whining about how the rich have rights too and need to given protections and support they don’t need because otherwise it’s discrimination against them is a very important part of neoliberal ideology.”

    Well of course. That’s what I said above, even though it was differently phrased.

    “The pre-84 policy consensus wasn’t based on the idea that the rich needed as much support from the state as the poor.”

    As helenalex points out, pre-1984 policy was based on universality.

    @ helenalex: “The ideology says no one should get anything unless they’re starving right now and can prove it’s not their fault.”

    Ha! Nicely put…

    Comment by D'Esterre — August 13, 2014 @ 6:52 pm


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