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This month’s edition of Healthcare Review – OnlineTM considers the role of health insurance in the health care system in New Zealand.
Private health insurance has a significant but changing role in health delivery in New Zealand. While a considerable proportion of New Zealand’s population is covered by private health insurance (37% in 1996/7), the proportion covered has fallen in recent years. Interestingly, however, the proportion of health spending attributable to health insurance is growing.
Recent publicity regarding the federal rebates for private health insurance in Australia has highlighted the very different regulatory regimes operating in New Zealand and Australia. This has prompted consideration of the impact of regulation on the way that private health insurance fits alongside Government funded health care in the highly regulated Australian model and the contrasts between this and the situation in New Zealand.
Philip Davies, Deputy Director-General (Policy), Ministry of Health provides a review of the regulatory environments applying to health insurance in Australia and New Zealand and considers the impact of these environments on services provided in each country. He also reviews the health insurance market in New Zealand and the market structure.
Key players in the market appear to be moving from passive claims paying roles to more active involvement in offering incentives and assistance for policyholders to remain healthy. They are also extending their roles in the broader health sector, for example through IPA management services, integrated care schemes and relationships with service providers. Davies summarises challenges facing the health insurance industry, which he sees as stemming from the ‘twin phenomena of moral hazard and adverse selection’.
Roger Bowie, Chief Executive, Southern Cross Healthcare, also considers the extended roles of health insurance players in the broader health sector. He establishes a picture of what the health insurance future could look like and considers these broader roles as a possible response to this environment.
Bowie provides, by way of background, an outline of the development of the New Zealand health system and of the drivers for the current system. Against that background he elaborates on the health system of today and the roles of the private health insurance industry alongside those of Government and ACC.
