New Zealand has a universal health care system that covers 100% of citizens and all eligible residents. Government funding of health and disability services means that eligible people receive free inpatient and outpatient public hospital services, subsidies on prescription items, and a range of support services for people with disabilities in the community. The responsiveness of the health care system to patient needs compares well internationally as expressed by waiting times for health care appointments and the involvement of patients in care and treatment, with 59% able to see a specialist in <4 weeks and 72% able to see a doctor or nurse the same day or the next day when needed (OECD, 2015). Anyone who has an accident or injury, including visitors, is usually covered by the government personal injury scheme, ACC. This helps to pay for the treatment and rehabilitation costs incurred by the accident.

OECD data (OECD, 2019) report that the spending on health care has doubled in the last 20 years, increasing from NZD1810 per person or 7.47% of GDP in 2000, to NZD4728 or 9.34% of GDP in 2018 (Table 23) (OECD, 2019). The Government spending on healthcare is ~80% of total health expenditure, with the remaining 20% accounted for by private insurance (~7%) and out of pocket expenses (~13%).

Table 23: Total health care spending per capita and as a proportion of GDP for select years 2000-2018 (OECD, 2019)

	Total spend		Government		Private		Out of pocket
	Per capita (NZD)	% GDP	Per capita (NZD)	% GDP	Per capita (NZD)	% GDP	Per capita (NZD)	% GDP
2000	2320	7.47	1810	5.8	153	0.5	356	1.1
2005	3260	8.27	2598	6.6	203	0.5	458	1.2
2010	4483	9.59	3639	7.8	308	0.7	536	1.1
2015	5169	9.33	4083	7.4	395	0.7	690	1.2
2018	5717	9.2	4728	7.4	449	0.7	738	1.2

 

All people are encouraged to enrol with a general practitioner (GP), and they are expected to visit them in the first instance if they are sick and it’s not an emergency. It is free to enrol with a GP practice and the government subsidises the fee for enrolled patients. General practices are private businesses and set their own fees for consultations and other health services. While the fees charged must be within a certain threshold agreed to by district health boards (DHBs) and PHOs, the level of co-payment is determined by the practices. The cost of a visit will be lower if you’re enrolled with the practice because the Government subsidises the fee for enrolled patients. Some general practices join a Very Low-Cost Access (VLCA) programme run by their primary health organisation (PHO). This means they get extra Government funding to keep their fees at low levels for all enrolled patients. Most general practices offer zero fee visits for children aged 13 and under, and most non-VLCA practices offer cheaper visits for Community Services Card holders and their dependants (Ministry of Health, 2019). Hospital and specialist services are free.

References:

Ministry of Health. (2019). Visiting a doctor or nurse. Available from: https://www.health.govt.nz/your-health/services-and-support/health-care-services/visiting-doctor-or-nurse.

OECD. (2015). Government at a Glance 2015: New Zealand. Available from: https://www.oecd.org/gov/New-Zealand.pdf.

OECD. (2019). Health at a Glance. OECD iLibrary. Available from: https://www.oecd-ilibrary.org/docserver/4dd50c09-en.pdf?expires=1590900931&id=id&accname=guest&checksum=BCC881772EE98968D2EB1E3A0E0684C2.