Healthcare experiences in New Zealand

This post on our experiences with healthcare in New Zealand was originally on Facebook. Unfortunately, I can't figure out how to make it available to the world (access control is "Everyone", but that's just everyone on Facebook). Please click there for the full context (pictures and text).

Initially I'm posting the text here. I'll probably push the pictures up too, at some point. Or I might not.


Experiences with Healthcare in NZ

After I posted a link, David asked me,

So how's healthcare down there tigs? Free everything and no pre-existing clause? :)

I started replying but gave up because it was getting long for a comment and FB would reject it. A reply in status would also be too long. Thus the note.

The following is just a narrative of our experiences, it's certainly not complete. I'm sure there are broad areas that we have absolutely no hinanawan about :-).

Not everything is covered by government healthcare. My eyeglasses, for instance, and (I think) dental care, need to be paid for individually or by insurance. There are government hospitals and private hospitals. If you don't like government healthcare because you don't want to wait for that elective surgery, you can go to a private hospital. You might even buy health insurance so that you can experience the private hospital experience (anecdotally, at certain levels of care, you get good wine with your meals :-).

Visits to a general practitioner are subsidized by the government (and, possibly, by the locality also). Currently the nominal cost of an adult's visit to a GP at our health center is around NZ$75 (exchange rate is currently around .70 USD per NZD, although it's been as low as around .52 in the past year or two, I think) for an adult. There are government discounts/subsidies. After those are factored in, I pay NZ$45 to see the doctor.

Timmy's and John's visits are NZ$15. Except when they go to see the doctor for vaccinations. Those are free and performed by nurses (they stick the needles in better than the doctors do :-).

So not all healthcare is *free*, but it's reasonably priced. The fee is a very affordable deductible and a speed bump against people abusing the front-end system (the GPs and nurses who will treat anything that doesn't need specialist care or equipment).

The local clinic has maybe 7-12 doctors on staff (not all at the same time) and the same number or maybe fewer nurses. Doctors visits (and nurse assistance, e.g., for vaccinations) are by appointment although they're always available for emergencies. The local clinic closes at night though, and on weekends. When it's closed emergency cases go to any of the nearby hospitals. There are three or four hospitals within 20 minutes drive. Doctors appointments may have a wait period of a week. You can see the same doctor every time, if you want, but your waits will probably be longer (particularly if the doctor goes on his month-long vacation). You can also just see any available doctor. Your health records are in a centralized system and any doctor in the Wellington area can see your records (no data about how private hospitals interface with that database, they probably have access).

Government healthcare isn't run for profit, so it will never reject you for treatment due to pre-existing conditions. You might need to *wait* for treatment, and the hospitals might not be as flashy as in the U.S. (and certainly there are fewer tests and MRIs and such) but you won't be refused treatment.

A friend at work has a son with leukemia (I think). He's been treated at the Wellington hospital cancer center. He needed some treatment that they couldn't do here, so he now goes to an Auckland cancer center. Next week (I think, I was chatting with my friend on the bus the other day), he goes to Auckland for his bone marrow transplant. If that's anything like sol's giving birth to John, it'll be all free. That he has to go to Auckland means that the family still needs to pay out some large sums, but they can cope since they don't need to pay for the healthcare itself, just the travel to Auckland and lodgings there for the parent who brings the child.

When Sol's mother was here, she had to go to the doctor for prescriptions for her vertigo and high blood pressure. We paid NZ$75 for the doctors visit and the meds were subsidized (in the same range as Philippine prices, *much* cheaper than in the U.S.).

There's a prescription refill service (Sol says it costs NZ$15 for a refill, and it can only be refilled once). So it's possible to get prescription refills cheaply while cutting doctors visits in half. I wouldn't be surprised (but have no data) if the number of refills can be higher than one for things like blood pressure, heart or diabetes meds which the patient is probably going to need for the rest of his life.

When Sol was pregnant with John, we were lucky that a midwife we met at the hospital lived near us. She became Sol's midwife. She'd come to the house on Saturdays to take Sol's blood pressure, weight, and fetal heartbeat monitoring (she brought the doppler device to the house, I got to hear John's heartbeat :-) etc. She arranged for the gestational diabetes tests and told sol what the results were. If there had been a problem, she'd have told sol what adjustments to make.

Sol had a choice of home birth, water birth (I think at the hospital, but I think also possible at home), or hospital birth. Since Sol had Timmy via caesarian section, we decided on the hospital option in case another one was required.

When Sol went into labor, we waited a long while because we (and the doctor) wanted to try for a normal birth first. After sol had tried for the normal birth with no success (the doctor and midwife were very impressed at her efforts), the doctors (with 2 and 3AM phone consultations with a specialist) decided (and we agreed) to go with the C-section.

Sol in the delivery room, being prepped for C-section

The view from the other side, doctors hard at work.

First picture of John

At the maternity ward, John slept beside Sol's bed.


Just like Timmy, John had jaundice. Sol stayed a few extra days at the hospital because John had to undergo UV treatment for the jaundice and they were taking blood samples to monitor improvement.

The maternity ward was our least favorite part of the whole experience. We weren't in a private room (we were spoiled by St Lukes Hospital :-), so John would wake up when the other babies would cry. And there was one baby who cried a lot since he couldn't feed. He figured it out after a while, but it was very stressful the first few days.

They wouldn't let me stay in the hospital overnight, so I couldn't help Sol with picking up John when he needed to be fed at night. That was hard for Sol since she was recovering from the C-section. The nurses and doctors were very good though. And the nurses, particularly, were a huge help to Sol. She'd press the button, they'd come over and help with the baby (for feeding or diaper change).

So it's not all roses. On the other hand, I didn't have to pay multiples of my monthly salary for the C-section (at St Lukes, we paid 3x my monthly salary, I think, and that was with the doctor's fee discounted by half!).

There's also a compulsory (for workers) accident compensation system (www.acc.co.nz). So anyone who has an accident at a workplace is going to get compensation. You don't even have to be working there. We were confused when we got an ACC letter one day. Apparently someone had reported Timmy's accident at school (when he cut his eyelid) and so we were entitled to refunds for any health care costs.

As it happened, Timmy had just the one NZ$15 doctor's visit when the doctor applied glue to the wound. We didn't bother to claim at the ACC. We're hoping to avoid future dealings with the ACC , but if I get carpal tunnel syndrome or similar, I know who to go to. A friend of ours (and his wife) got physical therapy treatments via the ACC. There might also be some situations when eyeglass prescriptions would be refunded by the ACC, but I haven't looked closely enough at that. Maybe with my next lens purchase.

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