Brian Edwards Media

Private medical insurance – the umbrella you can only open when it isn’t raining.

PET scan 2

We had some pretty good news today: the PET scan which Judy had a week ago suggests that her chemotherapy and radiotherapy treatment has dealt to her oesophageal cancer. I say ‘suggests’ because we can’t be absolutely certain. Judy’s brilliant (and lovely) radiation oncologist is pretty sure that what may look like residual cancer on the scan is in fact inflammation resulting from the dilation treatment she’s having to widen her constricted oesophagus. All good.

Not so good is the fact that Southern Cross, to which we have contributed tens of thousands of dollars over the years, won’t pay for the PET scan. They only pay out on one PET scan per claim year, from 1 August to 31 July, and this was Judy’s third  in the current year.

I’ll come back to this, but first a little background.

After my failed attempt to win the Miramar seat for Labour in 1972, I found myself unemployed and seemingly unemployable. Newly elected Prime Minister Norman Kirk, a collector of grievances,  had no interest in assisting his former candidate and the outlook seemed bleak.

To the rescue came the Public Service Association, a haven for failed Labour Party candidates, under the enlightened leadership of then General Secretary Dan Long.  I was given a job as a PSA ‘advisory officer’. My principal task during that period was to write a paper on private medical insurance.

I concluded in this paper that private medical insurance was a social evil since it created a two-tier system in which the rich could afford the very best in medical services and treatment, while the poor queued with their begging bowls for the reluctant largesse of the public health system. Stripped of the hyperbole, I still think that’s more or less still the case. If you can afford private medical insurance, you won’t  wait as long to be treated and you’ll suffer in considerably more comfort than you would in the public system.

Naturally, when I’d accumulated a bob or two, I signed up to Southern Cross, a ‘not for profit’ supplier of medical insurance.

Somewhere in the dark distant past of my PSA job demonising private medical insurance, I remember coming across this sentence: ‘Private medical insurance is the umbrella you can   only open when it isn’t raining.’ I think that’s not only elegant but true.

Private medical insurance is no more generous or humane or socially responsible  than any other sort of insurance. Basically when you need them most, when, metaphorically speaking, it’s not just raining but pissing down, they need and want you least. They express their disinterest by massively increasing your premiums. The rot sets in when you hit 65.

So Judy has oesophageal cancer. Absolutely central to her diagnosis and treatment is the PET scan. The PET scan is the most reliable way of  telling you whether you’ve beaten the cancer, whether it’s still there but restricted to its original site, or whether, in the worst scenario, it has spread to other parts of the body, metastasised. You can only describe this as ‘vital information’.

In the current claim year Judy has had three PET scans. Each PET scan costs roughly $2,500. Southern Cross paid for the first and contributed a generous $95 to the second. The policyholders, Judy and Brian, forked out the rest.

Judy’s third PET scan was roughly a week ago. Its purpose was essentially to tell her whether the cancer has been beaten. I already knew Southern Cross wouldn’t be footing the bill. I’d taken an earlier call from one of their reps. He’d got saccharine sympathy down to a T. But the message was clear: One PET scan only per claim year. We won’t be paying the bill for this one or any more this year. The policyholders, Judy and Brian, will.

The fact of the matter is that Judy is probably going to need PET scans every three to six months to monitor the battle that is going on between her treatment and the cancer. But despite the honey-tongued apologies of their call-centre operator, Southern Cross really doesn’t give a stuff. It’s all about the cash.

What’s more, the policy doesn’t make financial sense . PET scans could save them money by identifying metastasis at an early stage when it can be most easily treated. Cost: $2,500 per scan. That would seem to me more economic than spending a hundred grand or more on late-stage surgery or other treatment.

Well, I can read your mind, or at least some of your minds: This bastard should consider himself lucky that he can afford private medical insurance. And you’re probably right. In a first world country like New Zealand, quality medical treatment should be instantly available to every citizen regardless of income or assets. But we aren’t there yet and I’m buggered if my wife is going to get anything less than the best. I thought Southern Cross would provide that. They don’t.

As I discovered all those years ago, private medical insurance is the  umbrella you can  only open when it isn’t raining – or not pouring down at least.

Finally, to avoid any possible misunderstanding, all of the medical and medical support staff we’ve met on this journey – the doctors, nurses, radiologists, technicians, receptionists, telephonists – have been wonderful and, yes, just plain lovely. Thanks.

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67 Comments:

  1. Very sorry to hear of Judy’s illness and hope she makes a full and hearty recovery.

  2. My husband who has worked in the public health system all his life maintains we don’t need medical insurance – if we get sick with a serious illness, he says the public system will treat you well and prioritise you. However I hate the thought of a public hospital.

    It’s the hip ops and non urgent surgery which take the time due to waiting lists and he figures we would save the money in premiums and pay for that privately He also saw his parents getting screwed by Southern Cross as they became older with high premiums.

    Sounds like Judy is on a road to recovery, which is fantastic. Sorry to hear she has been unwell. (I remember her from my TV days) Best wishes for a speedy recovery.
    Suzanne

  3. I won’t bite the hand that paid for MY.recent (successful) cancer treatment, Brian, but I think they do have issues with their arbitrary decisions. My recent experience of Southern Cross was excellent because it was straight-forward and relatively open and shut (cut him open, close him up ). It sounds as though their accountants can’t cope with anything that isn’t a one-off. They need to address such issues, not only in the interests of patients but also of common sense.

  4. I haven’t got medical insurance because, while I could just afford the premiums, I couldn’t afford the “extras”.
    The public health system has saved my life twice in the last few years and I have nothing but admiration for the friendly and dedicated staff. Registrars and nurses work twelve hour shifts!
    So Judy always has that to fall back on although I hope she doesn’t have to.
    By the way, isn’t that picture a scan of a brain?

  5. At the risk of being insensitive at a difficult time, I am not sure I agree. It appears that you knew only 1 pet scan would be available under your policy. Your insurance contract had clear terms, to which you signed up “knowingly”. It follows that to call the staff ratbags for adhering to the contract is perhaps a little harsh.

    It is also perhaps unreasonable to expect the company to be interested in anything other than cash. What they provide needs to balance the premiums they charge against the claim rate. That balance is mediated by the terms of their contracts with clients. To go beyond those terms out of generosity of spirit will only result in cross-subsidisation of one class of clients by another and ultimately insolvency for the company since that subsidisation is unlikely to maintain the competitiveness of the company.

    Having said that, I understand your perspective. It’s hard to accept the rules when they don’t apply to one’s own circumstances, especially when it is impossible to predict exactly what one will require at the time the contract is executed.

    Personally I deal with these issues by regarding myself as patient within the public system who occasionally gets treatment elsewhere rather than someone who is cared for in the private system. Where I end up going is a bit of a lottery based on the terms of a contract I cannot hope to understand and whose relevance to me I cannot predict. Lowering one’s expectations that way does seem to help….

    • Silly us! Well actually we took this policy out in 1991. And we didn’t really know then that, 23 years later, one of us would be diagnosed with oesophageal cancer. Otherwise we’d probably have checked the fine print to see if PET scans were included in the cover. Except of course that neither of us had heard of PET scans then and really haven’t heard of them until very recently. And the other problem is that over those 23 years the terms or our policy have been changed numerous times. And neither of us remember reading anything about only being allowed one PET scan a year, though it may have been in there somewhere over those 23 years with all their changes. And we’re glad of course that Southern Cross has covered most of Judy’s treatment, but we think only paying for one of these procedures which probably tell you whether you’re going to live or die, isn’t entirely reasonable. As I say, ‘Silly us!’

      • 5.1.1

        Not to mention that it is somewhat monstrous to quibble when a patient has a life threatening illness. One of the main benefits of insurance is supposed to remove that source of anguish.

        Glad to hear that Judy seems to have beaten it.

      • As you so rightly point out Brian, it will cost them so much more for surgery later should it be required so false economy. Much more sensible to prevent than cure.

        But yes – silly you for not knowing about these things 23 years ago and even sillier you for not having a team of lawyers go through every change to your original contract every time its been changed over those 23 years.

        I wish you both well and Judy a full recovery.

  6. I’m not sure whether the same applies in NZ, but in Australia private health insurers constantly shill for new customers by advertising their willingness to fund a range of “wellness” services including Jenny Craig, Weightwatchers, yoga, pilates, even gym memberships or acupuncture.

    Now I’m not arguing that these services aren’t perfectly wonderful in their own right. But the concept of insurance is surely something to which you turn in an emergency, such as an accident, or for unforeseeable situations, as when you fall ill.

    It was never about opting to join Jenny Craig; that’d be like taking out property insurance and expecting it to pay for repainting your house.

    Sure you can opt for a lower premium and not have those options. But I doubt somehow that the $24 a week – which seems to be what “young singles” are charged for one of these “bells and whistles” policies – covers pilates, yoga, and the gym.

    Older people – who’ve often held medical insurance for many years and thus paid many thousands of dollars, as Brian and Judy have – are, I suspect, subsidising these perks so that the insurers can expand their market share. And then, when those “young singles” transition to “old marrieds”, start cutting their entitlements to even necessary and lifesaving services (like PET scans).

    I would have hoped that an insurer would have seen a market and moved to fill it, but that doesn’t seem to have happened. All of them offer these “extras”. So much as I’m loathe to suggest it, perhaps it’s time for “light handed regulation” to become a little firmer.

  7. The difference between the private insurance system and the public health service is that you can generally trust the public service, whereas you’ve discovered what many Americans have discovered about their expensive private insurance schemes when they need them.

    Not that the public system is perfect. I paid out of my own pocket for grommet surgery for my son because the public funding for that has apparently been gutted (I guess it is more important to give cheap prescriptions to old people than it is to make sure toddlers can hear).

    • 7.1

      I was nodding in agreement as I read your comment until came to the last part in brackets. As one of the “old people”, I regard that as a cheap shot. I don’t get cheap prescriptions.

      • 7.1.1

        Subsidized medicines are $5, are they not? And those over 60 consume most healthcare resources, do they not?

        I wasn’t trying to be rude. Just pointing out that children who can’t hear seem to be a low priority for this government, yet tacking a dollar or two onto a prescription charge seems to be a political hot potato.

        • 7.1.1.1

          Actually (depending on how you calculate what constitutes health expenditure) it can be shown that children as an age group consume more public funds for health care than older people – although that may be changing now that old people (of whom I am far too rapidly becoming one) have the bad taste to live longer (ironically largely due to preventative medicine through the public health system). The ‘old people use up scarce health resources’ mantra is all part of the assault on universal pensions which has become a central part of base line Right wing policy over the last couple of decades. Most of it is based on fallicies of this sort. I have never taken out private health insurance and never will. It’s not only a rort but as you rightly suggest Brian, it creates a two tier health system. But then we have never had a purely public health system here since the doctors of that day refused to implement the health provisions of the 1938 Social Security Act i.e. went on strike against the welfare state. And it has never included e.g. dental work, unlike some other welfare states such as the UK or France

        • 7.1.1.2

          Everyone pays $5 per prescription item do they not? Why demonise old people.

          • Yep.

            We are not old, but that applies to us.

            We are grateful for the taxpayers substantial contribution, and begrudge no one.

          • 7.1.1.2.2

            1) I’m not demonising old people about medicine. I’m just stating a fact. If I want to demonize old people, I will remark upon their poor driving skills and general lack of road awareness.

            2) Everyone pays $5 for a prescription, but older people tend to have far more prescriptions than younger people and those are for more expensive medicines, so the overall subsidy is much greater.

            • 7.1.1.2.2.1

              1) You’re not demonising older people about medicine but you are (unfairly) about driving.
              2) So what would you do about it? If nothing, why are you commenting if not to demonise?

    • Um, I would take issue with “you can generally trust the public service”.

      Government policies can change in response to fiscal circumstances and changing public expectation. Examples are the national super surcharge in 1984, the rentention of the national super surcharge in 1991, decrease of benefit levels the same year, changes in ACC coverage under Nick Smith’s regime a few years ago. Also, there is the matter of competence, etc. Remember that we get up in arms when government departments pay higher than market rates for managers and CEOs? OK, well, that means the best people will likely work elsewhere…

      Can I suggest that those of us who reached maturity after that 4th Labour Government see things differently en masse than did the Depression and baby boomer generations who grew up under the supposed “safety net” of the 1938 Social Security Act.

      Whatever you think about the 1984-90 reforms, we have reached an equilibrium of opinion – Kiwis vote to retain market efficiencies, BUT are still deeply committed to health, education and social welfare being amongst the core functions of government.

      So Government is a stop gap against life’s troubles, but it is never foolproof. It is an offer of false and dengerous hope to say and try to make it otherwise. Doesn’t mean you don’t try and get the best out of them, nor neglect budgets. But as politicians have pointed out, we could devote the entire tax take (including with higher rates) to health care…and people will suffer and die of preventable and treatable conditions.

      A few years ago our family was stung (in our opinion) by a bad and arbitrary ACC decision. It spurred us on to try and ensure we were NEVER palced in the position where a government bureacrat could ever endanger our livelihood. We are nowhere naer that yet, but we are working hard on it…

      Last year, in a critical health emergency for our family the public system was great. It wasn’t gold-plated, but it did (and continues) to do the job. I don’t begrudge that we didn’t have to use the private health insurance we also pay for (taken out at a time when the non-NZ citizens in our household were not permanent residents). It is there as a back stop, merely improving the chances of coverage in the case of emergency. The premium paid is “peace of mind” (I’ve worked occasionally on the fringes of the insurance industry!).

      But the best “insurance” for every undividual is financial independence, so that “money doesn’t matter”.

      I am glad to hear Judy’s condition seems to be improving.

      • 7.2.1

        “But the best “insurance” for every individual is financial independence, so that “money doesn’t matter”.”

        That’s never going to work except for a very few people. Even if we had medical savings accounts, there would still need to be insurance for catastrophic incidents.

        And your own experience with the health system backs up my point. You can generally trust the public system to do the job (soft generalisation).

        Kiwis vote to retain market efficiencies, BUT are still deeply committed to health, education and social welfare being amongst the core functions of government.

        They aren’t really alternatives, since the main reason we have government provision of those goods is that it is more efficient than the market (which most people don’t know because public discourse has been overrun by market fundamentalism). Check out what Americans pay for health care as a % of GDP and then do the same for Canada.

        • What are the raesons for the American/Canadian health anomaly? I’d be guessing duplication of services and/or advertising budgets.

          Um, I’m not sure about “government provision of those goods is that it is more efficient than the market”. With government industries there are often a lot more hidden costs to the consumer, including opportunity costs, loss of competitive/innovative incentive, etc. Sorry to talk “market fundamentalism”

          What I would willingly concede is that government provision seems best to ensure everyone receives adequate (soft generalistion) coverage. The market does a good job of providing items such as luxury cars or pay-TV. However, I don’t consider those necessities, so it doesn’t trouble me many will miss out due to the cost.

          However, I’m more than happy to pay taxes to ensure they receive adequate heath, education and social welfare coverage.

          • 7.2.1.1.1

            Um, I’m not sure about “government provision of those goods is that it is more efficient than the market”. With government industries there are often a lot more hidden costs to the consumer, including opportunity costs, loss of competitive/innovative incentive, etc.

            Sure, but as an alternative to market failure, which is endemic in risk pooling systems such as health insurance, it’s better overall. That’s why we are compelled to pay for the fire brigade, the police, the army, etc. The underlying rationale for healthcare is similar. It’s cheaper and more effective to get the government to do it, so we do.

            We have better health care than Americans and we pay a lot less, we don’t tend to get smashed with co-payments, and we don’t have medical bankruptcies as a norm. You can buy more coverage here if you want more (you can’t do that in Canada), so it’s not a bad deal. Public health care is a massively good deal for almost all New Zealanders, not just poor people (for one, it makes it less likely that you have to suffer the knock on effects of other people, such as your employees, living without medical care).

        • ““But the best “insurance” for every individual is financial independence, so that “money doesn’t matter”.”

          That’s never going to work except for a very few people.”

          You may be right, you may be wrong. Nevertheless, it is a worthwhile goal to strive for, as long as you do it ethically, and you are generous in deed and spirit to others along the way and especially if and when you attain it.

          • 7.2.1.2.1

            I would disagree. Even if we could afford to have our own security guards, it’s just much cheaper and more efficient to risk pool with other people.

  8. I am really sorry to hear of Judy’s health problems and hope she has beaten them, I remember her fondly from her tv times
    Health insurance has always seemed like a gamble to me played with dice loaded by the Companies, it would be interesting to add up your premiums payed against claims payed out
    One scan a year is madness
    I am surprised that as a good socialist ( what I had perceived as your position) you would buy into this scam
    While I as a capitalist have gone the other way, being prepared to fund any extras over those provided by the state with my own funds
    So far I am winning

    • Curious thing this concept of the ‘good socialist’. It seems to imply a life of self-denial – sackcloth and ashes, that sort of thing. I live in a rather nice house in Herne Bay, just round the corner from David Cunliffe who has recently been vilified for living in a rather nice house himself. Another ‘champagne socialist’. But here’s how I see it. As a good socialist I’m in favour of progressive tax regimes. If I earn more than someone else, I’m happy to pay more tax and I don’t complain about it. I’m also in favour of a capital gains tax. Wealth and socialism need not be mutually exclusive. What’s unacceptable is when there’s a yawning gap between rich and poor. That’s where we’re heading at the moment under a National led government.

      I know you didn’t really define a ‘good socialist’ in the way I’ve described at all. The term just got me thinking.

      Thanks (to you and other commenters) for your good wishes for Judy.

      • 8.1.1

        “…David Cunliffe who has recently been vilified for living in a rather nice house himself.”

        I think you’ll find you’re mistaken, BE. That’s not what he was “vilified” for. He was “vilified” for the hypocrisy of criticising others for living in “rather nice” houses while himself living in a house very much “nicer” than most people can afford.

        • Yes, Randon Punter, BUT he apologised for that, which is a sign of TRUE a leader taking responsibility, unlike John Key who…

          Question: When “true socialists” live under an allegedly unfair tax regime that supposedly increases the gap between rich and poor, are they then obligated to do their bit by giving the monetary difference to charity, or volunteering their time in kind to alleviate the plight of the poor?

          Regular readers of this blog know Brian and Judy donate their time to the City Mission on Christmas Day (and good on them for it – and not in a way to sing their own praises, I might add), so I’m not talking of particualr individuals. Instead I’m referring to the “class” of rich socialists. But if that is the case, what makes them REALLY any different in deed from philanthropic tories other than the what they opine and how they vote ?

          Or is giving to a charity like, say, working in a charter school, and simply entrenching the injustice by filling in a gap that Government should be addressing? Instead, the time and money is best devoted to getting Labour, Greens, or Mana elected?

          • 8.1.1.1.1

            Given that “socialism” (although nobody I know is demanding the public ownership of all means of production) is in part motivated by the inadequacies of charity compared to collective action, while charity is personally virtuous, it’s not really helping much in the long run, and is not and never will be good enough unless there is some sort of radical economic change that eliminates poverty.

          • Kimbo!

            Brian and Judy donate their time to the City Mission on Christmas Day (and good on them for it – and not in a way to sing their own praises, I might add)….etc

            As laudible as the act is, of COURSE they sang their own praises! How else would you and I know about it unless we were there too? Brian and Judy did a great act of public duty (along with my wife – I couldn’t be bothered, and she didn’t skite about it) but of course they weren’t shy in telling us all what they’d done for the community. How else would we discover what fine folk they are? And good on them too – the world needs more selfless folk.

        • Well yes, I know that. And that was an error on his part – the pot calling the (much bigger) kettle black. But this was really all about a Labour leader living in an expensive house in a posh suburb like Herne Bay. A gotcha moment really.

  9. So if you get one PET scan a year, I take it you can’t claim the previous years where you didn’t take them up on the offer.

    I hope the next scans are clear indicators of your wife’s radiant recovery and I’m glad she has such good support.

  10. Hmmm, I think you take it right.

  11. Wishing Judy a full recovery. My wife had a similar situation happen to her many years ago. A similar if not identical policy left us with little or no cover from southern cross despite her having contributed for many years. My only thought was thank goodness we have a “public health system”. It disappoints me that the public system didn’t cover the scans. The private health insurers take the cream from the system and leave the public system to pick up the unprofitable pieces. Its time for a greater investigation into the true advantages/disadvantages of insurance.

    • In this context I should probably make it absolutely clear that it is not my opinion that, from a medical treatment point of view, the public health system is in any way inferior to the private health system. It isn’t.

  12. Best wishes for Judy’s recovery.

  13. I am very sorry to hear about Judy’s cancer. When you’ve appeared on the Panel I’ve followed your updates about Judy treatment progress—always striking a fine balance between privacy and openness—closely. So I’m very pleased she’s doing well. Relatively speaking (the treatment sounds….owie).

    Six months after I arrived here I needed emergency surgery (double spinal fusion in my neck). From the time my GP referred me to a specialist to my surgery was less than 10 days. Entirely through the public system. Care in the hospital was overall very good, with the exception of one nurse in one post-surgical ward. Outcome was excellent a year later.

    As a Canadian I look at the medical insurance context in New Zealand with despair—and Judy’s story and mine underscore why. I’ve also lived in Australia and the US and I have seen the corrosive effects of “choice” through two tiered care. I’ve seen physicians forced to provide care in private sections of hospitals to maintain their privileges. And I’ve seen growing queues for non-emergency care and preventative care for those who are either unable to get private cover (often because of existing conditions) or give up waiting in queue.

    I don’t believe anyone who claims to be a social democrat or progressive who has private health insurance. It’s a conflict of conscience and principle. Besides, IT DOESN’T HELP WHEN YOU REALLY NEED IT ANYWAY.

    • I was with you right up to this final rather judgemental statement:

      “I don’t believe anyone who claims to be a social democrat or progressive who has private health insurance. It’s a conflict of conscience and principle.”

      We wanted the very best for Judy, not just in terms of treatment, which as you say is similar under both systems, but in terms of general care and the small additional comforts that are available in the private hospital environment. I fail to see where conscience comes into it. If we were denying someone else treatment in the public hospital sector or expecting the state to subsidise the treatment, then you might have a point. But that is clearly not the case. Indeed our self-funded choice could be seen as freeing up a public hospital bed.

      One thing I’ve observed in my life is that people who exhibit a holistic, all-encompassing concern for the rest of humanity, sometimes fail in their day to day concern for individuals. I don’t know you and am not of course suggesting that this applies to you. But this collective judgement does rather fail to take into account the individual wishes of two people to pursue what they, rightly or wrongly, believe will provide the best outcome in a difficult and frightening situation.

      • 13.1.1

        Thanks for your reply—been a busy week and only just got back to revisiting the thread. I assumed by posting your (usual) forthright entry you were willing to engage on this topic. Thanks for proving that assertion to be correct. Of course it’s a judgemental statement: taking a strong position on any topic means “judging” those with whom you disagree. I think we can agree on that…

        Back to health insurance in NZ: Why not have a single system where the overall standard of care is better, rather than only for those with more money? BTW there are private rooms in Auckland General: I was in one the night before my own surgery last year. They’re assigned based on clinical need rather than patient affluence. Most “wards” are 4 beds, once you get out of the urgent care section. Can’t say what it’s like in regional NZ hospitals.

        I don’t want anyone—anyone—to have to worry about the cost of required medical care. I want access to be the same for everyone. I also don’t want a bloated system (France) or one that’s focused on drop-in clinics (UK). I have piad more tax to support this and am willing to do so again. Health insurance should remain wholly public except for things not covered by the public system. In NZ, between the main system and ACC that doesn’t leave much. The insurance provides for queue jumping, first and foremost.

        BTW my husband and I aren’t wealthy, but we are much closer to the 1% than the 99%. HIs employer provides him with private cover—he’s decided to accept it. I’ve decided not to accept it for myself. Could certainly afford it, but I find the whole faux system of private health insurance in NZ reprehensible. And would vote NATIONAL if they promised to jettison it.

        But I am pleased Judy’s doing better.

  14. Fantastic news about Judy’s PET scan. I totally agree with the Southern Cross experience, all those years and the one time you need them! Quite reasonably we all expect insurance to be a painless answer at times of greatest need and emotional distress, in fact the opposite is true. The best ray of sunshine out of all this is Judy’s eternally cheerful smile on the streets of Herne Bay, priceless! Kia kaha Judy.

  15. Somehow we have all been convinced that insurance companies in general will be right there behind us when it rains. Its a lovely warm feeling to know you have back up, in return for a sum of money every month.
    In truth they are often not there when you need them and will find technical details to opt out of their promise of support. The people of Christchurch are well aware of this.
    It make me angry , it is so unjust and downright cynical.

    Sorry to hear you and Judy have experienced this cynical behavior on the part of Southern Cross and wish Judy well in her recovery.

  16. Best wishes to Judy who sounds to be on a better path now.

    The whole debate simply shows that insurance is very poor way of dealing with health problems. The USA is that failure writ large. They spend about US$9000 per head of population on health and have had about 40m people with no health cover. About 20-30% of the cost of insurance in the USA is that of vetting and, all too often, disputing claims.

    • I’m not trying to make the case for private insurance at the expense of the public system…yet health professionals I know who have had first-hand experience of the US health system tell me they are at the cutting edge of innovation in medicine, systems, and practice.

      Arguably THAT is one of the benefits you get from their system. They do also have public/charity-funded options. However, the thought of millions of your fellow-citizens not automatically covered is not one I’d like to contemplate…

      • Isn’t the innovation in hospital care in the States over the last decades been driven by war – Second World War, Korean War, Vietnemese War, Iraq War, Afghanistan War. And that is all financed by Government.

        And after that there is a huge investment in basic and non-basic research in health through the NHI – again government.

    • Nice to hear from you, Dave. And you’re quite right of course about health insurance in the USA. The Republicans had an interesting take on Obamacare – it clearly meant that the old and sick would be quietly euthanised. For all the faults in our health system, we compare pretty favourably with them.

  17. It’s not only medical insurers who will burn you off as you reach your 60s. I’ve been self-employed since about age 38 and for many years since then paid for income protection insurance. Premiums grew modestly until I hit my mid 50s when they suddenly shot up. For coverage of an $80k salary (the maximum they would allow) I was faced with a premium of about $4.5k and a 90-day stand-down period. Of course I bailed out at that point and Asteron achieved their objective: 20 years of premiums with no claim and then burning off a loyal client once they hit the danger years.
    For this type of cover or medical insurance it seems unfair that young healthy people earning good incomes but with no history of loyalty are favoured over older clients, often with long and unblemished records. Time for the actuaries to spread the risk premiums a little more equitably I think.

    • As a matter of interest our joint medical insurance premiums are currently around $700 a month. I’m a Type 2 diabetic, but that, naturally, was excluded from the cover, since I’d been diagnosed with the condition before I joined. I don’t complain about that, but it’s a fact that my lifespan will probably be reduced by up to 7 years by the disease. Cripes, I’m 76, how many more posts will I have time to write?

      • Plenty, one hopes.

        But $700 a month? Jeeeezzzzz…..add to that the portion of whatever your income tax is and God Almighty….and of course the insurance company will find some way of blaming a broken arm on your diabetes.

        Why not shelve your medical insurance? You then get $8400pa to cover your bills if you insist on going private; and as several posters have said, the public system won’t let you die anyway! Not if they can help it.

        But as for your opening 2 tier comment – what’s yachts and we don’t even own a boat, but we sent our kids to Dio because we wanted them to get an elitist education – is there an issue with that? There’s a two tier system everywhere you look – air travel, TV, motoring….so what’s wrong with the upper-end income earners spending their money on private health? Some of our friends have $70k cars but both of ours wouldn’t sell for $5k.

      • 17.1.2

        We were expecting you to keep going well past your centenary, so if you write your last post at 90-something we will have been well-served.

        Seriously though, a well-managed diabetic in the modern era is not likely to die early? My father is a Type-2 diabetic of a similar age to you: I’m hoping he’ll stick around for a while yet.

        • My father was an undiagnosed diabetic and died as a result of a stroke. After falling to the floor of his living room in Houston he insisted that my mother not elicit help and she called my sister who came over with her husband, who convinced my father that he should receive medical help since he wouldn’t deny that to “mom” if the situation involved her health. After some weeks his condition deteriorated and he was taken home to die of starvation in a somewhat vegetative state.
          When visiting my parents in Texas in 1992, I announced to my father that I had noticed a hairline crack running through the brickwork of their house and wondered what it might mean in 10 years time. “I don’t give a shit, I won’t be needing the place in 10 years time,” was his reply.
          The prospects of old age and decrepitude were never attractive to my father and was evident in his attitude such as saying “bugger the doctor” when cautioned by my mother when the desert trolley arrived at restaurants.
          My father worked on well past his retirement for “disposable income” and when he finally retired he negotiated for a lump sum settlement from his employers rather than a yearly salary for availability for his considerable expertise. “I don’t know how long I’ll be around and I want “your old lady” to live in the style she has been accustomed to”, was his explanation for his negotiation.

  18. 18

    My late sister-in-law was in a private hospital in Bangalore, India.

    It was run like a slick money-making scheme with doctors in on the game spooning out dubious medical advice to keep her in one of their beds for the maximum time.

    Like the American system it shocking to see a corporation profiting from misery, illness, and misfortune.

    My late father was with Southern Cross & had a few major battles with cancer in his last years. He was in both the private & public health systems. To be frank, I couldn’t tell the difference between the care that was paid for in premiums over 20 odd years and the care that was paid for in taxes over 53 years.

    I hope all goes well for Judy & yourself.

  19. ” Cripes, I’m 76, how many more posts will I have time to write?”
    Maybe you will need a ghost writer Brian .

  20. 20

    The great news is that Judy is on the mend. The harsh reality is Sthn X being again proven as crassly commercial.

    Again with Sthn X … Wife gets new hip. Quote goes to Sthn X who pre approve the procedure. Sthn X then announce a much lower payment limit that reflects their purchasing power (something like: Sthn X pay $12k, Surgeon charges $20k) than the surgeons fee because they ‘purchase’ so many hip replacements they get a favourable rate. The surgeon is mystified as he explains that his charges, and those of his colleagues are the same, irrespective of whether the procedure is undertaken in either public or private health system. The inference is clearly that Sthn X would appear to be blatantly dishonest. QED

    A minor procedure compared to Judy’s, but unfortunately further evidence of Sthn X’s flimsy and convenient value set.

  21. 21

    In reply to
    “Lee Churchman
    April 4th, 2014 at 23:11
    Drive not, so that ye not drive into the back of my car. :)”

    According to insurance companies’ premiums, you should be more worried about being rear-ended by under 25s.
    If they could find the slightest justification for charging over 65s more, I’m sure they would.

    • 21.1

      With apologies to Jasper Carrott: old people aren’t in many auto accidents, but they see thousands. ;)

  22. 22

    My best wishes to Judy for a full and speedy recovery.

    I am one of those people covered in moles and freckles. Several years ago, after some Basel cell carcinomas were removed, I was advised by my doctor that I am at high risk of developing skin cancer and to have regular mole map checks done. Southern Cross refused to cover the cost of this relatively inexpensive biannual check despite the high risk factor and the possibility of a much cheaper treatment regime if any cancer was detected early. They describe mole map checks as ‘cosmetic’. This is, in my opinion, crap. This and the situation Judy finds herself is in should be covered by a compassionate insurer and, I am sure, any competent economist would say it makes good business sense to potentially reduce their long term liability.

    On the advice of my broker I changed health insurers and now have far more comprehensive cover at a better price from an insurer with a top rating.

    Your story, my own and many others I have heard over the years have led me to conclude that whoever decides the policy terms and conditions at Southern Cross has his or her head firmly buried in the sand. I am surprised that they have not sustained a mass exodus of policy holders cancelling to go to other insurers offering far better deals.

    • A 100% public health system is all that is required. Insurance underwritten health is a con. Interesting though the number of right wing supporters I know who want a good public health system along with getting the dangerous juggernaut trucks off the road and the return of rail. Not a lot to ask but is John Key listening. Does he even care.

  23. Don’t get sick; eat healthily, do not smoke, do not drink too much booze, exercise regularly, have good friends and stay mentally alert by seeking mental and sensory stimulation by going to plays and movies and read good books and do the Herald’s Word Wheel and Word Builder.

    • What a boring life that would be. Be sensibly dirty for acquired immunity and with all things that are enjoyable and bad for the health, do in moderation. Above all, don’t be neurotic about your health and have genes that predispose you to longevity.

      • 23.1.1

        I agree with your “Be sensibly dirty” comment. Apparently all parts of our bodies must get a good workout with the exception of our immune systems. Never mind, there are plenty of expensive medicines available now for when we get sick. My concern is that we’re breeding superbugs.
        My Gran used to say, “You’ve got to eat a peck of dirt before you die.”

  24. Best wishes for a full recovery, Judy.

  25. 25

    I am very sorry to learn of Judy’s health problems and wish her well.

    Health insurance is, like many things, a choice to make.

    If someone ‘goes private’ for health care, whether they pay or an insurer pays, there is a saving to the ‘system’.

    Here’s a thought: Health insurance premiums ought to be tax deductible because of the saving to the tax payer funded health system if the insurer pays for what would otherwise be paid for by tax payers.

  26. First of all to you both my best wishes. My husband was diagnosed with oesophageal cancer in December 2011. We did not have private health insurance, but did elect to go private for the initial procedure that identified the cancer. Within five days of that initial procedure we were seen by our public hospital cancer unit and he started chemotherpy within a further 10 days, I might add that this was also over the Xmas/New Year period. Our view is that whilst the public system is stretched, when it comes to stuff that matters, ie. life threatening it kicks in, and kicks in incredibly well. The public system provided two rounds of chemo, one round of radiation, two 8 hour plus surgeries, two intensive care nights, and multiple hospital stays. Never once did we feel we were getting a second class service or that we could get better elsewhere, because believe me we looked. Unfortunately for us the outcome was not positive and Mark died in September last year but that was not because of a second class public health system. Again my very best wishes, and may the PET scans continue to be good.