KEY POINTS:
Back in the 1970s when health insurance took off in a big way, my worry was that if the articulate and the middle-class deserted the public health system, then where would the champions - and political clout - be for it in the years to come? Eventually I weakened, becoming one of the 1.4 million New Zealanders who now pay increasingly large fees to a private health insurer.
Some of my friends had more resolve than myself and claim the public system is fine. Hopefully it is, but as I reach that stage in life where my parts are starting to show their age and I hear the horror stories about public sector waiting lists, I rather value the security of knowing that if my plumbing needs an overhaul or that suspicious growth on my nose needs removing, I have some choice over the whens and wheres and whats.
That said, I don't get grumpy about continuing to pay taxes to support the alternative public services. Call it additional insurance for times of emergency.
What does royally hack me off, though, is news that Auckland's district health boards are plotting to penalise me and the third of Aucklanders who are privately insured, every time I elect to pee in a private specialist's bottle rather than in one provided at a public hospital.
They're saying that when my private specialist sends me for a lab test it's a discretionary act of self-indulgence for which I have to pay, but if I'm required to do the same test at the behest of a public hospital-based specialist, that would be a necessary - and thus free - procedure.
As usual, it's all about money. A report to the district health boards says referrals from private practice are estimated at approximately 8 per cent of all referrals and if public funding ceased, "a saving of more than $2.5 million will be achieved".
It's as though private patients are not taxpayers as well. The paper carefully ducks the question of what would happen if private patients, to avoid this new impost, "elect to wait for publicly funded treatment". Note the word "wait". The report writer says this is one of the "potential impacts that we do not know the sizes of". No doubt they're gambling on most victims absorbing the extra charges. But where's the equity in that?
Why should laboratory services suddenly become an added expense to those who are already saving the public system more than $600 million a year. That's the cost of the 150,000 procedures carried out in the private system each year, says Southern Cross Healthcare chief executive Dr Ian McPherson. More operations, he adds, than the entire public system does.
Auckland's medical bureaucrats and politicians should consider the consequences if we all started turning up at their hospital doors seeking public specialist treatment instead. The fact is, the public health system would collapse.
Of course the Auckland DHBs would not have contemplated this nonsense if then health minister, one-time veterinary surgeon, Pete Hodgson didn't encourage Hutt Valley and Wellington DHBs to try it out in February 2006. A report to these boards claimed "the principal objective ... was to redirect the available funding to better uses".
It "corrected a longstanding anomaly in which private laboratory tests had been funded but other private diagnostic procedures such as x-rays, ultra-sounds or MRIs were not". Of course another way of looking at it would be to regard the non-payment of the "other diagnostic procedures" as the anomaly.
In the year to October 2007, the Wellington boards squeezed $1.62 million out of 43,566 insured taxpayers. This year, the South Island DHBs picked up on the scent and began sniffing around its privately sick, with Otago and Southland deciding to charge, Nelson and Marlborough deciding it wasn't worth the bother, and the others playing wait and see.
Now it's Aucklanders' turn to be "consulted". With an election looming and a third of voters about to learn how greedy the system thinks they are, it's amazing the Government hasn't squashed Dr Hodgson's folly long ago.
