Back in 2018 I argued that Labour’s cornerstone policies – Fees Free tertiary, KiwiBuild, and the Families Package – were really for the middle class rather than the poor. They follow a theme continued from Helen Clark’s time in power, where interest-free student loans, Working for Families, and KiwiSaver all achieved similar outcomes.
The Government’s latest announcement on cancer is no different.
Government Cancer Plan
The Government’s action plan on cancer sensibly focuses on prevention and early detection, and maintains the independence of PHARMAC. Prevention and early detection are the most cost-effective approach for our health system and also help the poor the most. All in all, it looks like a better package than the one put forward by the opposition National Party, which (as usual) focussed on treatment and was cynically willing to tinker with PHARMAC’s priorities.
But the bigger questions overhanging this announcement are: why focus on cancer? And: if the DHB model has failed on this issue, why should we believe it is working elsewhere?
Harsh Reality of Health Priorities
Why do our politicians focus on cancer, but not on diabetes? We still have third-world diseases like rheumatic fever in this country – diseases that could easily be prevented and eliminated with greater effort.
How did they let herd immunity get so low that we’ve had an outbreak of measles?
Why are they so quick to forget about the one in five children hospitalised with respiratory illness that could’ve been avoided if they lived in warm, dry homes? We have young children who may never live a full life, or whose lives are cut short due to misplaced priorities.
All these other diseases deserve at least as much attention as cancer, if not more. But there are two big differences at play.
Firstly, the harsh reality is that other diseases mostly afflict poor families, who often don’t vote. It is hard to ignore the fact that cancer is a concern of the elderly middle class, who vote and buy newspapers. These are the people that National and Labour are really battling over for votes. The poor don’t vote, or if they do, they already vote Labour.
And secondly, Big Pharma doesn’t have a ready cure for the other diseases.They don’t have an industry behind them like cancer does. There are no big businesses working to ensure their voices are heard and the issues stay in the media.
Newsroom’s Laura Walters looked at the influence of Big Pharma on the cancer debate in The Detail podcast. Cancer advocates have already responded to the Government plan saying it doesn’t contain enough money. But the fact is there will never be enough money to do everything we want to do in the health sector.
If we want our health dollars to help everyone live longer, we need to be very careful about how we spend them. We need to think smarter about how we approach this issue, figure out what works effectively, and not be subject to the whims of pharmaceutical companies. This is exactly why we have PHARMAC: to stand up to these companies. We need to give PHARMAC a break.
For a long time now, health budgets have been allocated on the basis of who yells the loudest. This usually ends up being the elderly, more-educated part of the population. This focus on cancer is simply the latest iteration of a long-standing problem.
How Do We Get the Money Where It is Needed the Most?
Cancer treatment is far from perfect in this country. I lost two of my beloved grandparents to cancer. It was heartbreaking watching them suffer lingering deaths. Maybe my Nana’s death could have been prevented if the cancer had been detected earlier. Who knows?
What I do know is that there are plenty of people who suffer more than my friends and family, and get less help from the health system. We could do a lot more to prevent health problems than we do now and this would mean longer lives for everyone, especially the poor. The problems are much broader than simply cancer: they are systemic. This is why TOP proposes a complete reform of the health system, rather than the piecemeal tinkering put forward by both the Government and National. From the interim report released on 3 September 2019, it looks like Heather Simpson agrees that the DHB model has failed and complete reform is needed.
Our health system decides priorities every day. PHARMAC is one of many organisations making tough decisions so that all New Zealanders get access to proven, safe, and cost-effective medicine. Cancer does need attention – but in a smart, transparent, and sustainable way that doesn’t sink our health system and leave more kids behind.
Geoff Simmons is the Leader of TOP
I read TOP’s ‘complete’ health reform document and I wasn’t impressed. Why not address the fact that we have a 2 tiered health system – surely the biggest indication of prioritizing the middle class over everyone else.
It is also an indication that the concerns of the private wealth accumulation is an integral part of the health system and any government policy has to be constrained by the needs of a profitable private health sector.
If government policy becomes effective at delivering robust health outcomes this will have negative impact on the returns delivered to private health insurance companies and hospitals.
Given the propensity of NZ middle class to reject anything that requires higher taxes or spending money on ‘people who don’t deserve it’ the chances of genuine health reform are negligible.
Middle NZ has no problem stumping up several thousand dollars a year for private health insurance – about 40% of the population – to ensure that they can get access to health care over and above their neighbors, friends and wider family who are unable to afford it.
How about concentrating on both cancer and diabetes and not one at the expense of the other and while we are at it, obesity which is apparently not allowed to be mentioned in our woke centric worlds.
Also our growing Meth and addiction rates which is probably worse an effect on children and society, but again not allowed to be openly tackled because it is a ‘contentious’ issue unlike the warm fuzzy sounding ‘warm dry homes’ which nobody seems to buy into apart from the politicians and woke because you need heating to heat warm dry homes and there are health effects from the over zealous, a little fact not mentioned when we have growing utility poverty and people have heat pumps but choose not to switch them on. Never mind, the construction industry is happy with the profits!
New research is also coming out that having a house too air tight is leading to health issues from build up of carbon monoxide and chemicals like plastics and indoor air pollution is 5x worse in that outdoor air pollution in air tight houses. https://www.bbc.com/news/uk-scotland-36134213
https://www.architectsjournal.co.uk/buildings/airtightness-blamed-for-health-risks-in-homes/10014252.article
No doubt like leaking homes, the more the government interfere in people’s houses, the more problems they are creating that didn’t use to exist and no doubt expensive litigation will follow when people start getting ill from the so called ‘healthy homes’ standards, like the fake Meth standards, set out by industries and committees that are completely useless and impractical and create other risks.
The elephant in the room, is the growing population that has mean’t that health care is now rationed and the government spends less per person than they used to because they again fail to do any risk management and fiscal calculations for their politics like immigration for example.. which has major effects on health care when you can bring an entire family in for free health care, on the basis of one temporary work permit for 2 years in a job paying very low wages or fake, and you do not need private health insurance because the taxpayers subsides that (and the housing) too in most cases.
The solution to addiction and other problems related to illegal drugs like Meth is simple. Stop wasting boatloads of money on wrong-headed and ineffective attempts to prosecute people for using them, making them afraid to seek help when they realize they have a problem, and invest that money in treatment. As Helen Clark says, decriminalize the lot. Given that the entheogenics – currently class A drugs under the NZ Misuse of Drugs Act – have been shown time and again to be not only non-addictive but addiction interrupters, just allowing people to use those instead of more dangerous drugs (like alcohol) would potentially reduce the amount of addiction problems kiwis have with both illegal and legal drugs (alcohol, tobacco, prescription opioids etc).
> No doubt like leaking homes, the more the government interfere in people’s houses
From what I remember, leaky homes were a result of the deregulation of the building and construction industries under the 1990s Bolger government and the resulting regulatory capture by a handful of corporations, including James Hardie and Fletcher Building. More careful regulation to prevent cheap, unsustainable, and profiteering building practices is exactly what’s needed. The healthy homes standard is long overdue and if anyone doesn’t recognize that I’m guessing it’s been a long time since they rented or stayed as a house guest with anyone who does.
” leaky homes were a result of the deregulation of the building and construction industries under the 1990s”
Deregulation is interfering the same way as interfering! For example deregulating RMA zoning which the Labour Party and Greens sort of/kinda supported, is an example of interfering into housing, if they did nothing then the rise of McMansions and pollution and Ihumatao would not be happening. Likewise KiwiBuild, again they are interfering by adding hundreds of thousands of workers into NZ and then paying the construction industry to make the roads and houses for the same people they are letting in! So Kiwis are spending their taxes not on their own kids and health care and creating wealth in NZ, but supporting construction and Ponzi profiteers… cafe and supermarket owners labour costs… etc
The government was completely complicit in leaky buildings in two ways, Rogernomics collapsed the NZ forestry sawmill industry, while the Natz took advantage to self certify and put construction profits first and therefore allowing untreated timber to build homes with, which was imported in from other countries because NZ added value timber had collapsed under Rogernomics.
A builder was telling me, around those times even if you wanted treated timber you could not get it, because you were reliant of overseas exporters and had to take what was given!
Then there is the James Hardie types who lobbied government to allow new types of cladding which in the majority of circumstances did not prove to be weather tight and allowed the above untreated claddings to rot very quickly…
Added to this self certification operating, the stage was set for a dysfunction building industry to flourish.
Fast forward we are still building dangerous buildings aka Grenfell style because the government has not learnt it’s lesson not to trust the construction industry and seems very uninterested in having robust degrees operating in NZ where cheating is not allowed or making any overseas tradespeople certify with NZ qualifications before operating here!
Today’s headlines… in terms of construction competence and our government and councils are in the thick of it as usual with their champions of industry and advisors….
Construction companies Tallwood, Stanley Group in liquidation
https://www.stuff.co.nz/business/115579344/auckland-construction-firm-liquidated
“Stanley is currently serving as a board member of BRANZ while Udale is on the board of the Tāmaki Regeneration Company, owned jointly by the Government and Auckland Council and council-controlled organisation Panuku.”
no your wrong i have many whanau members and friends who have died prematurely and unnecessary from cancer and they received very poor primary level (GP) help , no scan, no referral to see why they had pain etc
Nice perspective Geoff. There will never be enough money to fund every “$1000s per pill” type experimental cancer treatment. The neo liberal–me me me, mine mine mine generation–need some basic existentialism, humans have a limited life span, no one gets out of here alive. Many NZers already have an extra 20 years of life compared to 1940s/50s, but ‘many’ mostly does not include Pacific and Māori people and poor Pākehā, to the extent it does the middle classes.
Diabetes and obesity in particular need to be overcome before tiny numbers near end of life get substantial funding. Which is all very well for me to say not having cancer–yet–of course, but really it ticks me off with those that want everything medical imaginable funded, and also Tax Cuts and put the boot into beneficiaries!
Really, enjoy your life while you are here, and do not expect to get bailed out when 50% of the population are struggling with precarious employment, low pay, exploitative rents and crap food.
I was chemically poisoned in a workplace accidental over-exposure to toxic chemicals in 1992 and was almost at deaths door six months later.
This occurred in Canada while on work contact there.
The medical community there and here in NZ had virtually no formal training of the subject of “Chemical exposure to human health” we were told when seeking a specialist to treat me, so I had to fund my own treatments for 5 years without any government help in Canada or NZ so we fall through the cracks here and those who did not get any treatment from chemical exposure will die of cancer.
In Geoff Simmonds article he interestingly asks, “How did they let herd immunity get so low that we’ve had an outbreak of measles”?
That is a good question, as when I went through the five years of chemical poisoning recovery my immune system was monitored every month during that time to see if the treatment was working, and the laboratory specialists had found that the ‘average population that they use as a ‘reference range’ during that five years people’s immunity was becoming lower and lower in white blood cells, lymphocytes which are the ‘fighting cells’ that help us avoid cancer cells taking over our bodies, and also prevents contracting other diseases.
I was treated in two clinics privately in Canada and the USA before being well enough to return to NZ in 1998, where I was referred to a NZ Doctor specialising in private care of ‘chemically poisoned’ patients.
The ‘public health system’ and training of Doctors in NZ is woefully lacking any expertise in chemical poisoning than is the rest of the world, and need is there to catch up to slow cancer deaths needlessly from occurring even today.
Oh bullshit.
Why is there a need to see bias every bloody where?
Some of the most used expressions used on this site are Big Pharmac Neoliberalism and Colonialism. They are used as an excuse for not getting vaccinated or having too many children that cannot be cared for or being overweight smoking etc.
It is time some people looked in the mirror and realize they need to stop blaming and start growing and contributing to this country
> start growing and contributing to this country
I’d love to start growing and contributing some high quality cannabis to this country, for both medicinal and recreational purposes, but if I did this at present, I’m at risk of going to jail. Sometimes the way social systems are organized really do stop people thriving and contributing back to the community. Blaming people for their inability to lift themselves up by their own bootstraps – as if any of us ever achieve anything without “standing on the shoulders of giants” – is the real cop-out.
Love, love, the NZers who grew up under … even the shadow of ’35. After us no magnetic North. Fellow-feeling as our primary principle.
Strange, the generation before us who only saw bureaucratism and the generation before them who believed but didn’t fight for the Welfare State. Rhythms and currents. But never give the powerful an even break, should be the motto of democracy.
> Fees Free tertiary … were really for the middle class rather than the poor.
This is a NatACT talking point and its rubbish. The children of the middle class will get a tertiary education whether or not it is publicly funded. It’s the children of the working class who are denied the opportunity to get that education – even if they have the talent to justify it – when it costs thousands of dollars a year. What’s worse though is the result that has for *society* as a whole. When fees aren’t a barrier, the most talented and hardworking young people in the country, regardless of their background, get uni and tech degrees and become the next generation of professionals and tradespeople. As fees rise, we only get the cream of an increasingly pampered, complacent, and entitled middle class, who don’t have to compete with working class students hungry for success. It also concentrates the benefits of a tertiary level education in the middle class, and drains it from working class communities, which means they lose a lot of the skills and connections they need to advocate for themselves and improve their prospects.
We must stop looking at education as a commodity that individuals buy for their own narrow self-interest. It isn’t. It’s a tool for strengthening the capacity of our people to contribute back to their communities, and to the wider society we all depend on.
+1 “We must stop looking at education as a commodity that individuals buy for their own narrow self-interest. It isn’t. It’s a tool for strengthening the capacity of our people to contribute back to their communities, and to the wider society we all depend on.”
Maybe also the charity should start at home, ak beginning with the local communities who have paid their taxes for generations, not five minutes, or at all.
Appreciate you talking about this, Geoff. Elucidated it to me and couldn’t be beneficial to you. Everything but the lowest 20,30 % who just happen not to vote much. Labour and their focus groups. Send an army into the poor suburbs, sell it.
I agree about the cancer focus.
But Kiwi Build, as originally intended, more houses deals with supply and would reduce rent costs – that helps all.
You misunderstand the importance of a general help to family building
to sustaining support for families in need (once done through universal family benefit)
Do we really want cost barriers to the education and training of those from poor families?
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