The Southern Cross Healthy Futures report is a biennial snapshot of New Zealand’s health and wellbeing behaviours. In this article, we’re examining one of New Zealanders’ biggest concerns: the affordability of private healthcare.

With the national economy slowly recovering from the pandemic, many are feeling the pressure of recent high inflation and interest rate hikes. The rising cost of living is constantly in the news cycle, and for good reason. As the bills stack up, more and more Kiwis are finding healthcare – especially private healthcare – unaffordable.

Barriers to healthcare

In Southern Cross’ latest Healthy Futures report, the cost of living is ranked as the foremost concern for nine out of 10 New Zealanders. Healthcare is an important component of the rising cost of living, with not having access to good, affordable healthcare ranked the third top concern for New Zealanders, rising from 9th place in 2022.1

Cost is the biggest barrier to accessing healthcare, with 10 percent of New Zealanders choosing not to seek professional advice and treatment when it’s needed. For young people aged 18 to 29 and Māori, that figure rises to 13 and 14 percent respectively.1 For dental pain, that number more than doubles, with 20 percent of people foregoing care when needed, mostly due to high costs.1,2  Worryingly, an estimated third of New Zealand adults aren’t receiving the healthcare they need.2

There’s also been a 22 percent rise in people seeking help from accident and emergency services over the past nine years.3,4 This corresponds with the finding that fewer people are accessing primary health care through their GPs.1,3,5 These trends likely reflect the rising cost of living as primary care services can be unaffordable, and emergency services are free.3

Perhaps most concerning is the increase in patients presenting at Emergency Services with immediate or potentially life-threatening conditions.2 The advanced stage of patients seeking care at Emergency Services correlates with a marked uptick in wait times across our primary care services, another significant barrier to healthcare.1,5,6 Around one in five adults will not be able to access their GP due to unreasonable wait times. 5

The picture of our healthcare system grows more dire when we consider the ongoing long-term effects of the pandemic on our collective mental and physical health.1 This includes management of long-Covid cases, and mental health crises, especially among our young people.5 With all health needs on the rise, being unable to access healthcare can be a frustrating and stressful experience.2,5 Ironically, the added stress of accessing healthcare may exacerbate health conditions, creating a negative feedback loop.2

The cost of poor health

As healthcare becomes increasingly unaffordable and untimely, it’s ultimately our societies and economies that bear the cost.

As more New Zealanders begin to forgo healthcare, the result is an extra burden on our health system, and a strain on our economy.2,7 Foregoing healthcare means both a delay in treatment, and a reduced quality of life for a longer period of time.2 In turn, treatments may be more expensive as conditions progress without diagnosis and we find ourselves unable or unfit to continue working or studying. These are termed the indirect costs of ill health – costs such as increased time off work and reduced productivity.7,8 In 2010, it was estimated that New Zealand loses between 2.7 and 7.6 percent of its annual GDP through the indirect costs of ill health.7

The impacts on everyday Kiwis

On an individual level, the correlation between ill-health and financial hardship is strong, with research demonstrating that the two are likely in a complex interplay.9,10 With cost of living pressures rising, it’s no wonder that healthcare affordability is top of mind. One survey showed almost 40 percent of New Zealanders worry about the financial aspect of an unexpected and/or significant health event.11

One way that we manage this anxiety is by taking out health insurance policies. By having access to alternate treatment options, New Zealanders alleviate their reliance on our overburdened public system.12

In Aotearoa New Zealand, insurance claims are largely made for elective treatments. Under our strained healthcare system, elective treatments are characterised as anything which is not an emergency.13 This includes procedures such as:

• Joint replacements
• Heart surgery
• Gynaecological treatments
• Cataract removal
• Cancerous tumour removals
• Diagnostic services, like MRI scans and endoscopies
  
  

Although considered elective, the underlying conditions that require such treatment can come with a limited ability to continue work, potentially resulting in a loss of income. Additionally, lengthy wait times contribute to a decreased quality of life for longer. Those who can access it are increasingly turning to health insurance, as research shows wait times can be halved by going through private healthcare.14

In fact, 60 percent of New Zealanders with a policy say they have health insurance for “peace of mind.12 Sadly, though, many of us are having to go without this peace of mind. Fifty-five percent of New Zealanders say they’d take out an insurance policy if they had more money.11 For those of us cancelling a health insurance policy, 55 percent cite cost of living pressures as the reason.12

Reducing the burden

The impacts of unaffordable healthcare for Kiwis roll onto their employers.

After all, losing a skilled and valued employee, whether in full or partial capacity, impacts a workplace and its workflow tremendously. The costs aren’t just financial, although many of them will be. There’s also the social and emotional cost to colleagues, and the overall impact on a person and organisation’s wellbeing.

Luckily, workplaces can help make “peace of mind” more achievable for their kaimahi (staff). Workplace health insurance schemes can make health insurance – and therefore quality, timely healthcare – affordable for New Zealanders.16 Workplace health insurance schemes have been shown to alleviate stress, which could impact positively on employee performance and morale.15,16 Other positive effects include increased staff loyalty, reduced surgery-related absence, and an improved and desirable workplace culture.14,15,16

Some workplace insurance schemes include options for your whānau, giving New Zealanders even more peace of mind. In Southern Cross’ latest Healthy Futures report, they found 65 percent of New Zealanders were concerned for their family’s or whānau health over their own.1

For more insights on New Zealanders’ health and wellbeing behaviours and needs, you can read the full Healthy Futures Report 2024, available here.

References

1. Kantar and Southern Cross, “Southern Cross Healthy Futures Report 2024”, (Auckland: Southern Cross, 2024).
2. Association of Salaried Medical Specialists, “Anatomy of a health crisis: By the numbers,” (Wellington: Association of Salaried Medical Specialists, 2024).
3. Dr Collin Tukitonga and Grace Shaw, “Why Primary Healthcare should be free,” Newsroom in ‘Health & Science, University of Auckland’, 25 June 2021, https://newsroom.co.nz/2021/06/25/why-primary-health-care-should-be-free/
4. RNZ, “Specialist doctor shortage: more than a third of adults not getting the healthcare they need,” The New Zealand Herald, 03 May 2024,
https://www.nzherald.co.nz/nz/specialist-doctor-shortage-more-than-a-third-of-adults-not-getting-healthcare-they-need/QSRXTN72ENDVTCTJFINZT5LZ6Y/
5. Ministry of Health – Manatū Hauora “Annual Update of Key Results 2022/23: New Zealand Health Survey,” Ministry of Health, 14 December 2023, https://www.health.govt.nz/publication/annual-update-key-results-2022-23-new-zealand-health-survey
6. Maite Irurzun-Lopez, Megan Pledger, Nisa Mohan et al. “‘Closed books’: restrictions to primary healthcare access in Aotearoa New Zealand—reporting results from a survey across general practices.” New Zealand Medical Journal | Te ara tika o te hauora hapori 137 no.1591. (March 2024):11-12.
7. Heather Holt. “The Cost of Ill Health,” New Zealand Treasury, (Wellington: New Zealand Treasury, 2010).
8. Max Rashbrooke. “Lightening the Load – the case for a fully-free public healthcare system,’ Association of Salaried Medical Specialists, (Wellington: Association of Salaried Medical Specialists, 2022). 2.
9. Toi Te Ora Public Health Bay of Plenty & Lakes Districts. “Determinants of Health & Health Equity,” Toi Te Ora, 04 March 2024, https://toiteora.govt.nz/health-topics/determinants-of-health-and-health-equity#:~:text=Income%2C%20employment%2C%20education%20and%20housing,than%20those%20living%20in%20poverty.
10. Ken Judge and Iain Paterson, “Poverty, Income Inequality and Health.” New Zealand Treasury (Wellington: New Zealand Treasury, 2007): 7-8.
11. Financial Services Council New Zealand. “Money and You - Taking Cover.” (Auckland: Financial Services Council NZ, 2022).
12. Financial Services Council New Zealand. “Accessible and Affordable Healthcare.” (Auckland: Financial Services Council NZ, 2024).
13. Financial Services Council New Zealand. “Health Insurance”. Financial Services Council NZ website, Accessed 25 July 2024,https://www.fsc.org.nz/topics/health-insurance
14. Kantar, “Employer benefits of health insurance.” (Auckland, Kantar, 2019).
15. Southern Cross Health Insurance. “Health insurance for business”. Southern Cross Health Insurance website, Accessed 25 July 2024, https://www.southerncross.co.nz/society/business
16. Southern Cross, “Healthy Futures Report: Business edition.” (Auckland, Southern Cross, 2023).