Ok, I have raved about this in other blog posts. I have had an idea, a general concept, that access to medicine was becoming a problem—a real problem—with one of the four pillars of New Zealand society: Health, Education, Justice, and Social Support.

Now with this latest report, there is a clear indication we’re well behind with Health funding. Education, Justice and Social support all have their challenges, I am sure, but Health is an area I spend a lot of my time working with on behalf of my clients.

Pharmac

This article on the NZ Herald Site (Archive version) states that, as the CEO of Pharmac says, not all medicines are improvements; they can be accessible on the list under different brands or equivalents. At 13%, even considering this statement, there is still going to be a funding gap for potentially life-saving treatments.

Topical now are cancer treatments; this is an area where the growth and visibility of available medicines have been significant. Every week or so there is a story about someone fundraising for their treatment, usually for cancer.

The average time before funding for a medicine is approved is 579 days, for someone waiting on that particular medicine, it could be a lifetime. If it is funded at all, given only 13% are.

Australia

We often compare ourselves to our closest neighbour, an easy, useful measuring stick. Interestingly, in the same report, Australia, which is often seen as better at this than us, is also lagging behind.

The Aussies are better here but not by much. Where they are significantly better is with their health insurance. Here in NZ, 25% of people have medical insurance, while in Australia it is 69%.

Our medical insurance market

What most readers will not know is that of that, 25% insured, about 80% is Southern Cross coverage. What you probably do not realise is Southern Cross covers very little, up to $10,0000, for non-Pharmac-funded treatment. With non-Pharmac bills being bigger, the largest I have seen so far is $134,000; $10k does not go very far.

Of the rest, only 1 provider historically up to 2003 covered non-Pharmac medicines, and from about 2002 until 2011, 1 other did. Since 2011, we added two, then another one in 2013, and in 2014, the fifth medical insurance provider came to this particular party.

Of the 10 medical insurance providers in the market, half will now fund non-Pharmac cancer treatments and the other 4 will fund treatments other than cancer that have non-Pharmac costs. This is up to the policy limits, $200-300,000 per person per year.

Your risk even with insurance

What this means for the majority of people with medical insurance is that their coverage probably won’t help much if there is a shortfall in government subsidies for their treatment.

They will have two very difficult choices, raise the money from other sources or go without the new treatment and manage with the conventional treatment available.

How to fix this

The third is to act now and get your coverage sorted out. Email me, and I will do all the legwork. You just have to decide which plan and option suit you best.

I understand talking about insurance and discussing the options is not everyone’s favourite pastime. You are in luck, it happens to be mine.

Why do I get hot under the collar and beat the table on this?

Every single day, I see people who haven’t had the opportunity to get the right advice, to get access to the treatment they need, and, most of all, to take control of their situation.

The reason I am often too late is that they call me after something happens and not before. Before, lets me provide you with cover with fewer exclusions or limitations; before lets me give you the answers you need.

Before is right now, call me!