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Speaker 1: Right. Act Party leader David Seymour has done his own

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Speaker 1: State of the Nation's speech. Of course, he's not the

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Speaker 1: leader of the nation. It's his feeling of the state

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Speaker 1: of the nation. And he says we need to stop

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Speaker 1: being so scared of privatization, and he says we need

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Speaker 1: to seriously look at selling government assets that's also known

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Speaker 1: as asset recycling, and changing the way we fund education

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Speaker 1: and health. And here is some of what David had

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Speaker 1: to say.

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Speaker 2: We're now spending six thousand dollars for citizen on healthcare.

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Speaker 2: Almost how many people would give up their right to

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Speaker 2: the public health care system if they got a six

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Speaker 2: thousand dollars contribution to private insurance. Perhaps we should allow

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Speaker 2: people to opt out of the public health care system

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Speaker 2: and take their portion of the funding with them for

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Speaker 2: that sort of scheme.

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Speaker 1: That's David Seymour. So, Doctor Angus Chambers is chair of

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Speaker 1: the General Practices so A General Practice Owners Association and

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Speaker 1: Angus Joysy Now, hello, good afternoon, good idea, a bad idea.

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Speaker 3: Look, there's a lot of work that needs to go

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Speaker 3: into that to make to see whether it is an

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Speaker 3: evidence based kind of policy. We know that it happens

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Speaker 3: around the world transitioning from what we've got to that

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Speaker 3: has got some you know, pitfalls. Maybe there are some pros,

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Speaker 3: but there are some cons as well. So yeah, we'd

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Speaker 3: have to see what it looked like. I wouldn't be

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Speaker 3: completely against it. I think there are some efficiencies in

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Speaker 3: private run organizations, general practice being one of them.

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Speaker 1: Yes, well, private run organizations in New Zealand do seem

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Speaker 1: to be operating at a higher level. Yeah.

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Speaker 3: Look, I mean there is a whole lot of stuff

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Speaker 3: with insurance based systems. There's a whole claim based bureaucracy

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Speaker 3: that needs to come into play. There's the profit element

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Speaker 3: that you know isn't there in the public system. But

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Speaker 3: perhaps efficiency trumps the efficiency gains trumps the losses that

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Speaker 3: you get from profit. So yeah, we're examining. But it's

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Speaker 3: not a completely obvious solution.

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Speaker 1: Here, and it means that health care is not democratically accountable.

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Speaker 3: The way we've got at the moment.

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Speaker 1: You mean, no, under a private system, while we provide

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Speaker 1: the money, we don't have any control over the operation

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Speaker 1: the actual outcomes other than putting in regulations.

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Speaker 3: Indeed, and you know, certainly some insurance based systems there

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Speaker 3: are people who miss out because they're not ensurable, and

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Speaker 3: they're not they haven't got the money to do it.

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Speaker 3: So we have to be very very careful in anything

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Speaker 3: like this, that's for sure.

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Speaker 1: You've mentioned before in your first answer that it's used

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Speaker 1: around the world.

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Speaker 3: It is.

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Speaker 1: It's used in Germany, it's used in France, it's used

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Speaker 1: in Switzerland, and it's also used, of course in the

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Speaker 1: United States of America. So does it work well well?

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Speaker 3: I think if you're looking at the United States of America,

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Speaker 3: it works extremely well for some people who have got

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Speaker 3: all the resources they need, but it works very very

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Speaker 3: poorly for a large part of the population. I think

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Speaker 3: the European models are probably better at looking at but equally,

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Speaker 3: if you look at high performing health systems around the world,

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Speaker 3: some of the Scandinavian countries would be very near the top,

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Speaker 3: if not the top. And they've got a publicly funded

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Speaker 3: health system, so it's not just a linear, if good

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Speaker 3: insurance system you do better.

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Speaker 1: So you're saying the most successful systems in the world

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Speaker 1: are public and they're in Scandinavia, But also remember that

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Speaker 1: they have very high levels of government spending and income.

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Speaker 3: But very high taxes too, very.

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Speaker 1: High taxes where there we go meanwhim, I mean, maybe

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Speaker 1: it doesn't work in America. I can see many people

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Speaker 1: saying that, so we could adopt something more like Germany,

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Speaker 1: France or Switzerland than it could work here.

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Speaker 3: Yeah, look, I think it bears examining. I wouldn't claim

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Speaker 3: to be an expert on that, but you know, if

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Speaker 3: it's successful and delivers a great care across the population,

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Speaker 3: and we don't have significant people missing out on it,

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Speaker 3: but it would take you know, we haven't got a

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Speaker 3: setup for this at the moment. We certainly have got

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Speaker 3: private healthcare delivery, but it doesn't do the whole suite

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Speaker 3: of healthcare. In fact, a private system relies on our

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Speaker 3: public system to the most complex of surgeries and interventions,

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Speaker 3: and if something goes wrong in the private system, it's

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Speaker 3: not uncommon to have to transfer across to the public system.

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Speaker 3: So we don't want to weaken that and lose some

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Speaker 3: of the great healthcare that we do provide in New Zealand.

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Speaker 1: Doctor Angus Chambers, a chair of the General Practices Owners Association.

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Speaker 1: I thank you so much for your time today. Enjoy

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Speaker 1: your weekend.

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