On the importance of the public health system

Yesterday we had a long chat with an insurance salesman. Well, I did more so than The Man - both because my list of "issues" is way longer but also because I am more outspoken.

Technically he is a "financial advisor", I think. He specialises in life/disability/trauma insurance and he wanted to review the insurance conditions me and The Man have, so he could see if he could offer us a better deal.

As part of the "sales pitch" he made several comments which I felt were important to counter-argue. We didn't end up debating - he just made the comments about the way he sees the world, and I then made comments about how I see the world.

(To give you a bit of a background: me and The Man have no debts other than our mortgage, and we have insurances to cover all our main assets (home, car, contents). We have life insurance for $86,000 each. Thinking behind it is, in case one of us dies the other has enough money to keep going for approximately 2 years - a breathing time, so to speak, to figure out how life will continue afterwards. We also have trauma insurance for The Man: if he comes down with some serious illness/disability, we get a payout of $86,000. But we don't have trauma insurance for me - due to several pre-existing conditions (epilepsy, PCOS, underactive thyroid, gestational diabetes etc) my trauma insurance would have simply been so expensive that we didn't think it was worth paying.)

So yesterday when that insurance salesman was looking at our existing covers, he asked us about "things that are important to us". The Man said family - it's what keeps him going. I said my life and health - without those, I don't have a way of effectively interacting with the world. The insurance salesman smiled - it's basically the same thing me and The Man are talking about, just a different side of it.

He described to us various "bad scenarios" of what would happen if me or The Man came down with x, y and z. Think typical insurance pitches ;) - cancer, stroke, heart attack. What if they came consecutively? First cancer and then after the cancer is gone, a heart attack. A stroke. The grislier the better ;) Would we want to get treatment quickly through a private insurance? Or would we want to wait, possibly months, until the public system starts treating us? Waiting lists are long, he said, in the public system. Private practices treat quickly.

He said that in any medical school, there are people who are the top of the class, and there are others who are the bottom of the class. Top of the class go to private practices - that's where the best doctors are. Public hospital is not a first pick for someone who is really good at what they do.

...and that's where I raised my hand and said, look, I disagree.

Firstly, I have safeguards in place for the variety of medical professionals I deal with. I rarely come to a doctor's appointment and want to just hear what the doctor says. Usually, I have pre-researched the condition and have my own ideas I want to check and discuss, and so simply relying on what the doctor says is not really how we do things in this house.

And secondly: great doctors don't just go for private practices. Even Southland hospital in Invercargill, it has some top-notch practitioners; some who've come down from Auckland, and you know why? Because they can't afford to live there any more. Our orthopedic surgeon, for one - a young, talented, hardworking man. I heard about him in Christchurch already, as we were preparing for our move down South to Invercargill. He came for the same reason as us, to restore balance to his life: not spend time in traffic jams, have money aside for travelling, have time.

On another hand, I've also been seen by a private practice neurologist, an experience I wasn't overly impressed with, especially in hindsight; which is all just to say that people are different, doctors are different. There are awesome experiences in public hospitals, just as there are awesome experiences in private practices. Sh*t ones can also happen in either.

I said to him that living in New Zealand, the insurance priorities are very different than if I were living in, say, US. New Zealand has public accident insurance (ACC), it has a public health system, a social welfare system. I understand people having private health insurance on the side to make sure that if something happens, they get treatment quickly when it matters the most - a former co-worker had cancer and had quick treatment BECAUSE she had private health insurance who paid for it - but I also understand the need behind a public health system because otherwise, it will become like the United States where only people who are already privileged have the most access to health services which then makes them even more privileged and continues the cycle of inequality, deepening the differences and ingraining the prejudices.

Same with the welfare system. The insurance salesman said that if he meets with someone who answers his questions with "yeah, nah, I'll be alright" then he simply closes his laptop, thanks them and leaves.

I thought to myself: that's exactly why the social welfare system is important. People who don't have good financial skills are unlikely to have sufficient savings or insurance to allow them the "buffer" when the going gets tough. And you can't just leave them to it, because if someone is in genuine deprivation they are going to resort to criminal activity, if need be, if they cannot get their basic needs met otherwise. Expecting all families to bring up their children in a way that those children have good financial management skills is unrealistic - it just doesn't happen. Some families don't have those skills, and they have very little to pass on to begin with. That's where education comes in, and taking SOME social (=communal) responsibility for personal success.

I am not a communist - personal freedom and incentives are an important part of success. Humans as species are territorial and competitive, and it's part of nature that is important to acknowledge and work with. But it's not all personal freedom and incentives either - otherwise there'd be people knocking others on their heads just to get them out of competition. (Which, sometimes, some people, do.) The balance is somewhere in-between.


The older I am getting, the less apologetic I am becoming about my opinions. It's partly intentional - an intense personal conviction that I have a place in the world, and a right to be here.

Voicing my opinion on the topic of public health feels like I am speaking out "on behalf" of it. Kind of like standing up in defence of someone who cannot do it themselves. Kind of like that insurance salesman has the right to voice his opinions on the importance of private health insurance because of the problems within the public health system, I have the right to speak up in defence of it. If people gradually move onto private insurances it gradually drives a degradation of the public system, causing a systematic inequality already described in the current American society. I do not want to ban private insurance, or limit its availability. It's a right.

But I do want to speak up on the importance of the public system. Public education. Public health. The cornerstones of a human society.

1 comment:

  1. I agree, there are some amazing doctors and specialists in the public system, some of whom also have private practices. I am however glad I have private insurance as it meant I could choose my specialist when I got the endometriosis diagnosis rather than hoping that the public system would have someone available who specialized in it. Often the public system doesn't have the resources for that sort of thing and they go for the cheaper treatment option even if it isn't the better option.
    Wouldn't it be great though if no one needed extra insurance, if there was enough funding for the best possible care for all health problems, and enough for all kids to get an education that let them be the best they can be. My kids are lucky that they have educated parents who are capable of fighting for them when needed, I feel for the kids who don't have that though.