Healthcare in New Zealand

This article needs to be updated. The reason given is: Needs to be updated to reflect recent changes to the healthcare system (Introduction of Health NZ and the Māori Health Authority). Please help update this article to reflect recent events or newly available information. (November 2022)

The healthcare system of New Zealand has undergone significant changes throughout the past several decades. From an essentially fully public system based on the Social Security Act 1938, reforms have introduced market and health insurance elements primarily since the 1980s, creating a mixed public-private system for delivering healthcare.^[1][2]

• The Accident Compensation Corporation covers the costs of treatment for cases deemed 'accidents', including medical misadventure, for all people in New Zealand (legally or otherwise^[3]). The costs are recovered via levies on employers, employees, petrol and vehicle registration, and contributions from the general tax pool.
• The relatively extensive and high-quality system of public hospitals treats citizens or permanent residents free of charge and is managed by district health boards. However, costly or difficult operations often require long waiting list delays unless the treatment is medically urgent.^[4] Because of this, a secondary market of health insurance organisations exists which fund operations and treatments for their members privately. Southern Cross Health Insurance, a non-profit organisation, is the largest of these at about 60% of the health insurance market and covering almost a quarter of all New Zealanders in 2007, even operating its own chain of hospitals.^[5]
• Primary care (non-specialist doctors / family doctors) and medications on the list of the New Zealand government agency PHARMAC require co-payments, but are subsidised, especially for patients with community health services cards or high user health cards.
• Emergency services are primarily provided by St John New Zealand charity (as well as Wellington Free Ambulance in the Wellington Region), supported with a mix of private (donated) and public (subsidy) funds.
• New Zealand has one of the highest nurse turnover rates.^[6] Not all nurses leave the profession but rather continuously switch organisations. Not all the impact of nurses leaving is negative, but when it is it can cause reduced continuity of care, disruption of services, and a drop in overall productivity.

In 2012, New Zealand spent 8.7% of GDP on healthcare, or US$3,929 per capita. Of that, approximately 77% was government expenditure.^[7] In a 2010 study, New Zealand was shown to have the lowest level of medication use in 14 developed countries (i.e. used least medicines overall), and also spent the lowest amount on healthcare amongst the same list of countries, with US$2510 ($3460) per capita, compared to the United States at US$7290.^[8][9]