title: Funding New Zealand's public healthcare system: time for an honest appraisal and public debate.
abstract: Successive New Zealand governments have claimed that the cost of funding the country's public healthcare services is excessive and unsustainable. We contest that these claims are based on a misrepresentation of healthcare spending. Using data from the New Zealand Treasury and the Organisation for Economic Cooperation and Development (OECD), we show how government spending as a whole is low compared with most other OECD countries and is falling as a proportion of GDP. New Zealand has a modest level of health spending overall, but government health spending is also falling as a proportion of GDP. Together, the data indicate the New Zealand Government can afford to spend more on healthcare. We identify compelling reasons why it should do so, including forecast growing health need, signs of increasing unmet need, and the fact that if health needs are not met the costs still have to be borne by the economy. The evidence further suggests it is economically and socially beneficial to meet health needs through a public health system. An honest appraisal and public debate is needed to determine more appropriate levels of healthcare spending.
authors.affiliation: Director of Policy and Research, Association of Salaried Medical Specialists, PO Box 10763, Wellington 6143, New Zealand. lk@asms.org.nz.
authors.forename: Lyndon
authors.initials: L
authors.lastname: Keene
authors.forename: Philip
authors.initials: P
authors.lastname: Bagshaw
authors.forename: M Gary
authors.initials: MG
authors.lastname: Nicholls
authors.forename: Bill
authors.initials: B
authors.lastname: Rosenberg
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Frampton
authors.forename: Ian
authors.initials: I
authors.lastname: Powell
mesh_terms: D005380:Financing, Government; D059066:Gross Domestic Product; D005102:Health Expenditures / Q000639:trends; D006301:Health Services Needs and Demand; D061889:Healthcare Financing; D006801:Humans; D009520:New Zealand; D011157:Population Dynamics; D019472:Universal Health Insurance / Q000191:economics*