There’s been a lot in the news lately regarding the Supreme Court of the United States and their recent ruling on President Obama’s healthcare law. I know that healthcare reforms in the US are fraught with political tension. I’m not going to get into that here. Instead, I’m going to share my experiences working in the US healthcare system, working in the NZ healthcare system, and being a patient in both.
I grew up in the US healthcare system and many of my family members, myself included, work in it. I’m a nurse, and within my immediate family there are 2 other nurses, 2 in nursing school, 3 doctors, and 2 in medical school. We are very much a medical family. I received my nursing education in the US and spent the first couple of years working as a nurse there.
Moving to New Zealand was a change for me, both personally and professionally. I had my opinions about “socialized medicine” and, to be honest, they weren’t good. I didn’t understand how a system like that could work.Over time, I’ve come to understand and appreciate it. There are more issues at work in the New Zealand system besides laws mandating access to and affordability of healthcare. I can’t find specific numbers, but I believe that in the US, there are a large number of specialist practitioners but not enough family practice providers. Again, I don’t have the numbers to back this up, but I believe the case is reversed here in New Zealand: there are an adequate number of GPs and fewer specialists. As a result, people in New Zealand may have trouble being seen by a speciality care provider and have a longer wait in that regard, but when it comes to seeing a family physician, they are usually able to find one who’s accepting new patients. Furthermore, they aren’t being denied because of lack of health insurance.
My own experience as a patient in the New Zealand system has been good, but limited. My main usage of health services here has been for my pregnancy and the delivery of our son, for his well-child checks and vaccinations, and for immigration medicals and post-pregnancy care and follow-up. Immigration medicals, as you would expect, are not covered by the NZ system and we were required to pay for these out of pocket. However, my maternity care was provided for thanks to the fact that my husband and I are on 2 year working visas. We contribute to the country by paying taxes and, as a result, are able to utilize the healthcare benefits provided to all Kiwi citizens and permanent residents. We do pay high taxes, so I scoff whenever I hear someone ask whether or not New Zealand has “free healthcare”. No, it doesn’t. What it does have is access to that healthcare for all who meet the criteria – citizens, permanent residents, or who are on the correct type of visa.
I’ll give you a few more specifics regarding my personal experiences in the system. I had a midwife and at no point did she issue me a bill for services. All of my pregnancy labs were covered. I had a 20 week ultrasound scan and then another scan at 41 weeks. Both of these cost just over $100. I gave birth in the hospital, and I never received an invoice for that. Afterward – about 2 hours postpartum – we were discharged from the hospital and my husband drove me and our newborn son to an after-care facility. While there, I could have had a shared room at no charge but we decided to pay a few extra hundred dollars for a private room so that my husband could stay with us. During our stay, my son was seen by a paediatrician. This isn’t always done, but my midwife had a small concern and so asked for a consult (it turned out that our son was fine). The paediatrician never billed me for the visit. We were also checked out by 2 different midwives during our stay there, and my own midwife visited to do a check.
We had the option to stay at the after-care facility for several days, but I was ready to get home after less than 24 hours. Another midwife did an in-home visit within 24 hours of my discharge. She did the heel-stick for our son and sent that off. My regular midwife did weekly visits from there on out up till our son was 6 weeks old. At that point, a paediatric nurse took over and visited us at home twice. From then on, I took our son to the nurse’s clinic for his regular checks. I saw a doctor for his vaccinations but again was never issued a bill for these.
My own post-natal doctor’s exams came with a fee. The doctor did an assessment and cervical smear, which were billed at the enrolled patient fee of $65 (had I not been enrolled, i.e., had I not filled out paperwork indicating that I wanted to become a patient of that practice, then the fee would have been higher). I was also charged a $30 nurse fee for an MMR vaccination. I was not billed for the vaccine itself.
The New Zealand system works well. It has its problems. I still struggle to understand it sometimes and there are moments where I balk against some of the restrictions and the very high wait lists for certain procedures, exams, or interventions. However, overall, I’m quite happy with our experiences here and very grateful for the quality and level of care that my family has received.
Jenny is an American from Indiana living abroad in Auckland, New Zealand. An ER nurse, she spends her spare time with her husband and infant son and enjoys photography, travel, and writing about her experiences as an expat. You can read more of her thoughts and opinions at www.practicallyperfectblog.com