Editorial: Super not the only fiscal elephant in the room

Why not try to develop some strategies to improve the nation's health? Photo / 123RF

If there's one sure thing about the coming election campaign, it's that voters will be bombarded with statistics about the cost of New Zealand Superannuation. Depending on who's talking, the numbers will aim to prove that Super is: a) an unsustainable and unfair burden on future taxpayers; or b) an entirely affordable gesture of support to our deserving senior citizens.

Meanwhile, expect much less noise about another expense which is bigger, growing just as inevitably, and promises to keep outstripping the cost of Super - healthcare.

Without getting bogged down in the statistical swamp, it's worth noting that Treasury projections have the cost of healthcare, as a percentage of economic activity, rising into the far-distant future, remaining ahead of the (also rising) cost of Superannuation.

Or, to quote from a 2013 Treasury report: "Since 1950, New Zealand's real per capita GDP has increased by 144 per cent, while real per capita government spending on healthcare has increased by 412 per cent. We think this trend will continue." While some politicians will debate the finer points of Superannuation policy, suggesting permutations of age limits, indexation, eligibility criteria and other esoterica, they have much less to say about reining in the cost of health.

That may be because, while Superannuation costs are seen as something we can control, rising health spending is regarded as the inevitable result of an ageing population. Or it may just be that politicians know there are no votes to be won by suggesting rationing access to healthcare.

Meanwhile, the cost of health keeps rising.

To some extent, as more of us get older, spending more on health may be something we just have to learn to accept. But the rising cost of healthcare isn't just about an ageing population: new treatments, which in turn create greater expectations, and rising healthcare salaries are also adding to the expense.

Given the huge amounts of money involved, anything that limits those future cost increases is worth considering. Achieving that goal is likely to involve a mix of strategies. Changing the way healthcare is provided, and by whom, may be part of the answer. It may be that the state has to encourage - or require - people to pay more for their own care. There may have to be greater discipline about which novel treatments get funding. And encouraging the use of health insurance may also have a role.

There may also be a case for spending more now, to save later. Better co-ordination of treatment for people with chronic conditions is one area where such investment could yield long-term dividends - financially, as well as in health.

And given that many long-term illnesses are a result of lifestyle, why not put "nanny state" objections aside for a moment and try to develop some strategies to improve the nation's health?

Meanwhile, when the politicians start throwing numbers around, the rest of us should remember that Super isn't the only fiscal elephant in the room.