Fund all health services fully and equally: mental, physical, dental, vision, hearing, disability aids, etc regardless of cause
Fund ALL our health services equally, and equitably, regardless of the part of the body or brain they affect, or the cause.
Fund: Mental health care. Adaptive devices, equipment, mobility aids, and health tech. Home adaptation. Hearing aids. Glasses. White canes, wheelchairs, assistance dogs, prosthesis, and other mobility aids. Dental care, checkups, fillings, false teeth, and devices for correcting bite. Fund hearing care, checkups, hearing aids, NZSL courses, and adaptive technology. Fund vision checks, glasses, adaptive daily living skills, white canes, etc. Fund addiction services. Fund eating disorder services (including overeating, and weight loss opperations if indicated by science for treatment of a condition that has evidence behind it, not just medical fatphobia). Fund food programmes for vulnerable people, as indicated by scientific studies. Etc
Fund all disabilities, illnesses, injurites etc based on the needs of the person, their situation and their functionality. Not whether they qualify for ACC, a blind benefit, a disability benefit, etc. Not whether it is caused by a chronic physical or mental illness, or a physical difference or injury.
The idea of the change to Te Whatu Ora was to end the postcode lottery. End the disability and illness lottery.
At the moment, whether or not you get the care you need is a complete lottery dependant on how you got the condition, and whether it is physical, mental, chronic illness, in your eyes, in your ears, or in your mouth, or due to an addiction (which is a documented medical condition, not a moral failing), or due to this kind of trauma but not that kind of trauma. It is rediculous, inhumane, and leads to poor outcomes for so many of our most vulnerable people. It also leads to an incredible burden of disease that is completely and utterly avoidable.
Fund care at every stage, including preventative, and moderate severity, as well as severe.
This would bring us in line with other countries with publicly funded healthcare, and would also bring us closer to meeting our obligations under the UN convention on the rights of people with disabilities
Fund care based on meeting the rights of patients to health and disability care, and then based on what will provide the best outcomes, financial, social, and personal.
At the moment so much money, time, expertise is wasted on covering the costs of the physical conditions that arise from completely ignoring mental health, dentistry, optometry, audiology etc etc.
For example, my $90 white cane is not funded. Neither is the training to use it safely. But if I fall down a set of stairs and break both legs, because I didn't have a white cane to get around with, my hospital stay, operations, etc etc is covered. But replacing the stairs with a ramp isn't. So if I bust both legs again trying to get up the inaccessible stairs with both legs in plaster, the operations to put them back together again are covered.
Not only is the current system against human rights. It is against plain common sense.
Why the contribution is important
The current system is inequitable, and horrific. It causes many many deaths every year, and severely impacts quality of life for many many Kiwis.
If I fall down the stairs and get a Traumatic Brain Injury, that makes me go blind, I get funded technology like a braille display and a screen reader and a white cane, I get the care I need for the best outcome, and an income that is 80percent of my wages. Although this is different if I fall down my stairs, or the stairs at work.
If I am born blind, I do not get accessible technology, or a white cane, and I get a disability benefit, which is about a hundred dollars a week less than the PENSION! But I am elligble for disability support workers.
If I have a chronic illness that means I am bedbound in a dark room with no ability to use my vision, I get no disability support workers, no white cane, no accessible technology, and I am probably not elligible for the disability benefit, only the jobseeker, which is even less again.
All three of these hypothetical people could have the EXACT SAME needs. The EXACT SAME disability from a functional point of view. And VERY DIFFERENT OUTCOMES and qualities of life.
If I have a mental health condition, I get three free therapy sessions. If it is severe I may be seen by a psychiatric service with one therapy form only available, despite the evidence for different therapies for different conditions and people, if I am really ill, I may get shut in a room against my will with a cardboard box for a toilet.
One of my closest friends got extensive care for her physical illness, as they should, for a condition that was impacting quality of life, but not expected to be fatal. For their mental health condition, that had already brought them close to death, they got three free councelling sessions and a weekend's respite. You can guess what they died of.
People shouldn't be dying of treatable, preventable conditions at the rates they are.
People shouldn't be housebound or cut off from society for want of their basic rights, such as a wheelchair or white cane, or a ramp.
I have a thyroid condition, for it I need regular blood tests, and check ins with my doctor, and I take medication every day. My blood tests are completely funded, my doctor can just order them. My medicine is completely funded, it incures the 5-dollar per prescription charge, but I get it back on my disability benefit, or by going to a pharmacy that doesn't charge prescription costs. My doctor diagnosed me with the regular funded screening tests.
I have ADHD. My doctor cannot diagnose ADHD. The secondary mental health system rarely diagnoses ADHD, and you have to be actively dying to get to see them, if you are lucky. I had to pay nearly a thousand dollars to a private phsychiatrist to get diagnosed and medicated. My medicine is funded, but appointments to renew my diagnosis, or refine that medicine are not. Because mental health care is not fully funded in New Zealand.
I have PTSD, OCD, Anxiety, depression, and Autism. I can access 3 councelling sessions a year. No long term therapy. No psychiatrist. No care. But my medicines are funded. If I needed Physical Therapy, it would be partially funded. If I needed hand therapy it would be fully funded. I need psychiatric therapy and it is simply not available.
I have a complicated physical disability. My medical care (neurologist, MRI, meds, etc) is completely covered, but my mobility aids, adaptive technology, and wearable devices are not. I asked for assistance, with the protective goggles I have to wear, at a hospital appointment, they suggested I try etsy. My orientation and mobility training to get around with a white cane was covered by a charity. The white cane I had to buy with my own money.
I have sleep apnea. My screening test was completely funded. My overnight sleep stidy in the hospital was completely funded. The box of the CPAP machine is completely funded. But the mask, hose, harness and tube that connect to the machine and make it work are not funded, and I have to buy them. So the machine that costs many thousands is mine free for as long as I need it, with full support if anything breaks, but the periferal parts, that cost between about $90 and $200 are not funded, so if I can't afford them myself, or my disability allowance is maxed out (which it is), then the barrier to being able to use the diagnosis that took a hospital stay, expensive technology, multiple technicians, nurses, and doctors, etc etc, and resulted in me having permanent loan of a piece of medical kit that cost many thousands of dollars, is a couple of hundred dollars worth of moulded plastic.
All care, assistance, medical and mobility devices etc to live a normal, fullfilling, dignified life, as outlined under the convention on the rights of persons with disabilities must be met.
All additional care and resources should be triaged based on need and outcomes, in the way they are for a lot of physical conditions already. Regardless of what body system(s) is involved (ie parts of the body, eyes, ears, teeth, brain, mental health, etc), and how the injury, illness, or condition was aquired. Or how the device is categorised (ie consumables, tech, mobility aid, medical device, medicine etc etc).
At the moment, if a person who had an accident at work needs a 30,000 dollar device to get to work faster and with less pain, they get it, which they should.
If a person who was born with a disability needs a 3,000 dollar test in the hospital for a physical condition, every year, they get it, but if the test shows they need a 90 dollar piece of quipment that counts as a 'consumable', that has to be replaced once a year, they don't get it.
If a person with a mental health condition needs a course of weekly therapy for six months, to get themselves to a place where they can stop binge eating, and improve their depression, then they can't get that. They can get as many sessions as they need with a non-mental health trained dietician at the hospital. If they need therapy to treat the binge eating, forget it. If they need a gastric band operation because the meds they have to take for the depression they can't get other treatment for, are taking away their sense of being full and it is the best option for that patient. Forget it. But if they then develop diabetes, go blind and become an amputee, then they can have the gastric band operation that could have prevented all this in the first place, the insulin and medical care they need, the disability benefit, etc. But they can't get the guide dog and wheelchair they now need to get around. And it is an illness, so they have to go to the lotteries commission to get a phone they can use. And they still can't get the therapy they needed in the first place to prevent all of this.
Stop the partially funded patchwork nightmare that is healthcare in New Zealand.
by AceTimelord on March 11, 2023 at 05:07AM
Posted by Bware March 25, 2023 at 08:21
There will always be the need to prioritise within the health budget.
But there is so much waste and poor quality spending.
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