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The public system — Health insurance can bridge the gap

05 Jul 2022

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In New Zealand, we’re lucky to have a two-tiered health system that gives everyone options. The public system, funded by general taxation, means that all Kiwis can get medical help and care when they need it, for free. Private healthcare is also available, providing prompt, quality care for people who have private health insurance.

That insurance is paid for by individuals or by their employers, who want to help protect their people from the unexpected. So why go private, when there is a government funded public option?

There are a few key reasons, mostly linked to the fact that the resources available to the public system are finite, making it hard to ensure everyone gets what they need, when they need it. Private health insurance overcomes these hurdles in a number of ways.

1. More treatment options and specialists

In the public system, not all specialist treatment is funded and wait times can be long. You also don’t necessarily get to choose your specialist or where and when you get treated.

For you or your employees, this takes away a lot of control. It also impacts on how easy it is to see a specialist, how timely and comfortable treatment is, and can impact how quickly recovery happens.

Luckily, private health insurance with nib allows members access to our First Choice Network of trusted providers. If you or your employee want to see a provider who is charging outside of the efficient market price you are still able to see them, offering more choice and control over your health.

You may experience a gap payment depending on the cost. Our online tool makes it easy to search for providers in New Zealand, with a badge next to the providers who are in the First Choice Network. Plus, you will be advised as soon as a request for pre-approval has been submitted.

2. Reduced wait times

Unless it is medically urgent, having a costly or difficult operation for free in the public system usually means going on a waiting list. If it is medically urgent, it pushes other operations down the waitlist, due to limited resources and capacity. So if you or your employees are on a wait list, there’s no guarantee of when you will be seen to.

The number of people waiting more than four months for a specialist appointment in the public health system has doubled, and the number of people waiting longer than four months for treatment has more than trebled, from just over 8,000 in February 2020 to nearly 27,000 in March 2022.

If you or your employees need treatment, you’d want it to be quick, reducing the wait time, pain and time away from work and regular life. The private system can help bridge the gap here by offering members more choice for when and where they can receive the treatment they need. Offering more choice can reduce wait times due to resources and capacity being less of an issue for private providers.

3. More available medicines

Many medicines in New Zealand are subsidised or funded by the Government, significantly reducing their cost. Medsafe approves drugs for use, then PHARMAC decides which of those drugs can be funded in the public system.

Unfortunately, PHARMAC has limited resources and has to operate within a tight budget. That means not all Medsafe-approved medicines get government funding, which can make access to them extremely expensive. For many Kiwis, that means effective or even lifesaving treatment can be out of reach.

nib also offers an add-on option for non-PHARMAC drugs which can be added to your Premier Health Business Base Cover and gives you access to Medsafe approved drugs that are not funded by PHARMAC.* If this option is selected as part of a new group plan for 15 or more employees, we cover qualifying pre-existing conditions, no medical questions asked.**

Give your people options

While we’re lucky to have public health in New Zealand, a great way to get you and your employees prompt and comprehensive medical care is with private health insurance. It gives you and your employees more control over your health, what medicines you have access to and where you receive treatment. It can also shorten your wait times significantly depending on the treatment you need.

Private health insurance also provides other benefits, depending on your needs and how you customise the cover for you and your employees. For example, nib covers all pre-existing conditions without waiting periods if 15 or more employees are insured. This means employees who have an ongoing medical condition can have their health needs met without worrying about the cost, plus gain more control over who treats them, when and where**.

As an employer, you may be in a position to invest in your employee's health and wellbeing through a paid for or subsidised group plan. At nib, we have a range of cost-effective options available for you to cover your employees and also their families if desired. To find out more about what might work for your workplace, contact [email protected].

*Drugs must be Medsafe approved and prescribed under Medsafe guidelines. Please see policy wording for more details. Terms, conditions and exclusions apply. **Terms, conditions and general exclusions apply. Please read the policy wording or contact [email protected] to find out more