This week’s column in the Nelson Mail looked at health policy in the context of the election. I was interested in what might affect me as a young, disabled woman on welfare. Obviously there was a lot to cover and 900 words isn’t much, so I have expanded here and included all relevant links.

Here’s the column as published. The below version has added quotes, commentary, and links to all the policies and plans I discussed. Most of the additional content is in italics.

Who Cares About Your Health?  

I can’t remember the exact moment I realised that politics has a direct effect on my everyday life.

Maybe it was when subsidised prescription charges went up from $3 to $5, and my medication suddenly became less accessible.

Maybe it was when I read that $232m has been effectively cut from the health budget by the current government.

Maybe it was when the latest welfare reforms came in and I was moved from the now non-existent sickness benefit, to ‘Jobseeker support.’ I qualify for an exemption for looking for work, based on the fact that I have a job my many doctors have testified I am currently too ill to do. Others with chronic illness are not so lucky.

So it’ll come as no surprise that my pet topic in the leadup to September 20 is health. Our leaders are making election promises this area and I’ve been watching with interest.

I’m not ungrateful for the current situation. I get some subsidised GP visits and prescriptions, and I see a range of specialists for free, though the waiting lists are usually the biggest barrier to access.

Thinking of one’s health as a political football might not be comfortable, but it is realistic. It will matter to all of us, at some point in our lives. Health expenditure is 20% of government spend. (Note – this is quoted from the Internet Party health policy).

So if the powers that be are playing games with our wellbeing – how do they score?

LINKS: In my research, I looked at the health policies and/or promises available from:

• National (I couldn’t find full policy, this is key points, halfway down this page, additional links below).
• Labour
• the Green Party
• the Internet Party
• NZFirst
• Mana
• The Maori Party
• Act

I also contacted Labour, the Greens, NZ First, ACT, and the Conservatives directly for more information. They all responded except ACT, but the Conservatives didn’t give me any information, and there isn’t any on their website. 

It’s worth noting that this is a massive playing field, and I couldn’t hope to cover everything. I looked specifically for what will affect me, as a young woman with Ankylosing Spondylitis.

Arthritis is the leading cause of disability in New Zealand. Interesting, then, that I found very little mention of it – no specific policy for helping the half a million people affected, or anything addressing the cost of the 25,440 Kiwis who won’t be able to work this year because of it.

There is some consistency across all parties; promises to reduce wait times, subsidised dental care, and greater ease of access to primary health care. The similarities end there.

Labour has announced their intention to extend the Care Plus package, which assists those with low income to access healthcare. Care Plus currently gives me 8 reduced-cost doctor’s visits a year, which is great, but I go every week or two. Under the extension, I would get 4 free visits, and free prescriptions.

The Green Party are also planning to support those on low incomes. Spokesperson Kevin Hague says they will renegotiate the primary care funding formula to more strongly target funding to people in financial hardship.

Green Party Vision:

• A holistic approach to health and well-being that is focused on promoting positive health and lifestyles, preventing or reducing the risk and costs of illness, respecting personal autonomy, and improving quality of life.
• Free healthcare provided by a well-funded public health system, delivering high quality and safe care, which everyone can access in a timely way.
• Equitable health outcomes, including lifespan and health status, for all.

Hague says the government’s efforts in this area are not keeping up with increasing need. The current Very Low Cost Access scheme is based on location of general practices, and was frozen when National came to office.

“It is very blunt targeting, giving cheap access to wealthier people who live in generally deprived areas, and meaning that poorer people living in less-deprived areas have unaffordable care. Even in some of these practices the heavily subsidised co-payment is essentially unaffordable for many.”

In an email, Kevin reminded me that “we [the Greens] have already announced school nurses in every decile 1-4 school, and free primary care for people up to the age of 18.” He also said “we think VLCA has had its day and instead we have to more steeply target primary care funding. We don’t support Labour’s proposal for free primary care for over 65s (unless they meet our deprivation criteria), and note that to use funding to provide this extra subsidy will mean funding for other health services won’t keep up with increasing need.”

Moving on, the Green’s Disability Issues and Valuing Women policies are very relevant to me.

Disability Issues supports employment and independence, two things I’m focused on achieving. Here’s the summary:

1. Improve employment outcomes for disabled people.  We will increase Job Support and Mainstream funding by $6.8 million and require the public sector to provide leadership in employing people with disabilities.
2. Amend the Broadcasting Act and Telecommunications Act to require targets for phasing in captioning for all broadcast and on-demand TV. We will set a target of 100 percent captioning for Television New Zealand (TV1 and TV2) by 2017 and TV3 by 2020.
3. Support disabled people into home ownership.  We will extend the Green Party Home for Life Progressive Ownership package to disabled people who are first home buyers.
4. Invest up to $3.5 million into the Total Mobility scheme.  We will increase mobility and access to independent travel for disabled people and undertake a full review, with the view of implementing a nationally consistent and available scheme.

Under the Women’s policy, abortion would be decriminalised and access to contraception increased (though there’s a lot more in it than that and you should definitely go read it because it’s awesome).

I want to talk a little bit more about the Valuing Women policy. I didn’t really want to get too personal in the column, but, basically, motherhood is something that has been on my mind. It’s something I always assumed I would be able to do “one day,” if I wanted to. With my recent diagnosis and much more awareness of my genes, well… it may not be that straight forward.

That means that things like contraception and abortion are even bigger on my list of considerations. (TW here). For example, if I got pregnant now, the likelihood of me being able to have a healthy pregnancy and a healthy baby feels pretty low. I don’t know the actual statistics, but I know how unwell I am. And I know what my genes are. So I want to know that I can prevent that from happening. And if a pregnancy did occur, that I could have the option of doing what is safest. At the moment, that option is still considered a crime in New Zealand.

As I said, I do get access to many services for free under the current government, though funding has been dramatically reduced. I like National’s plan, underway since 2010, to create a centralised database of health information that can be accessed by patients and their providers. This would certainly make care for people like me more streamlined.

“To achieve high-quality health care and improve patient safety, by 2014 New Zealanders will have a core set of personal health information available electronically to them and their treatment providers regardless of the setting as they access health services.” (Vision for the National Health IT Plan). 

Incidentally, this same plan appears to be the only concrete offering from the Internet Party under health – and the government’s already doing it.

The minor parties didn’t make for much interesting reading, mainly because their policies appear to be largely unpublished.

Neither the Mana or Maori party have full health policies available on their websites, but I agreed with the points they did make around the importance of community healthcare.

ACT’s website gives only the briefest mention of health, and they didn’t reply to my enquiries. I couldn’t find anything on the Conservative position, and again, I didn’t get a reply from them in time to include it here.

In a speech in August, Winston Peters said, “there are about 100,000 seriously disabled New Zealanders. In many ways, they have been forgotten by the political system. We’re going to respond to them.”

Note: the speech, on August 10, was “In Pursuit of Economic Nationalism – Putting New Zealand First.” 

“We’re going to work with the advocates for the disabled, and provide as much relief as we can afford, to improve their daily lives and income. This includes accommodation as well. So we’re going to build for them 1000 homes, spread around New Zealand, to provide them with the housing that they desperately need.”

This sounds good – but NZFirst propose doing so by building 1000 homes for people with disabilities. 1000 out of 100,000 isn’t great numbers. I’m lucky enough not to need housing yet, though it may well be in my future. How likely is it I’d be one of the 90,000?

How likely is it I’ll continue to need to see a doctor of some kind every week? How likely is it that my spine might start to fuse because I didn’t get to physio, or I lose my eyesight because the wait times to see an ophthalmologist are too long? These are all possibilities for my condition.

I’ll be thinking about that, and the 1 in 4 other New Zealanders affected by disability, when I step into the voting booth on September 20.

Welfare

I didn’t even try to cover welfare here – it’s an interlinked topic of course. None of the parties have released updated policies around this yet. It’s always a big election topic so my guess is they’re saving it up.

I think we can fairly accurately estimate what those policies might look like. National will continue to focus on getting people off benefits, regardless of whether their circumstances are suitable or not. It’s been one of their top priorities and unfortunately it works for them.

I presume that Labour and the Greens will both be taking a look at welfare reform, especially with the Greens’ announcement on child poverty.

I’d hate to speculate further.

Mental health

I am aware this is another massive facet I didn’t cover. I’ve spoken before about the current government’s cuts to mental health funding, and that stands. They say it is a priority but I can’t see how. What I am acutely aware of is people in my own community suffering because they cannot get help, because wait lists are too long and services are strained.

Some of the parties have released policy in this area, but no specific funding promises as yet I don’t think. With upward of 500 suicides in New Zealand every year, this is another one I’ll be keeping an eye on.

I hope this has been informative. I will be writing more about politics in the next few weeks.

ALL LINKS

• National – key points here. I guess they haven’t announced their health policy yet? Here’s the Health portfolio under Tony Ryall. Here is the National Health IT plan regarding the centralised database.

• Labour main policy. Here is the announcement regarding CarePlus.

• the Green Party main policy. Here is the Disability Policy and the Valuing Women Policy.

• the Internet Party main policy.

• NZFirst main policy

• Mana statement

• The Maori Party statement

• Act statement

• Here is an interesting sum-up of what might happen to health budgets depending on which way the election goes, in NZDoctor.

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