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Preventative Healthcare

Preventative Healthcare

Our health system does a pretty good job of keeping us healthy and living longer compared to others around the world, given the amount of money we invest in it. The problem is that our health system is unaffordable; costs are rising faster than we can pay for them. This is due to increasing public expectations, the ageing population, new technology and the rise of chronic disease. Our health system is also unfair; the people that need help the most often don’t get it until it is too late, while much treatment doesn’t make much difference to those that receive it.

Greater focus on prevention

We keep putting the ambulance at the bottom of the cliff, and that approach is starting to catch up with us. If we want an affordable health system, healthy society and flourishing economy in coming years we are going to have to prevent problems before they happen. We are going to have to start building fences at the top of the cliff.

Many of TOP’s policies already released will have a big impact on the underlying issues that determine our health. We will reduce poverty through our Fair Tax Reform and Thriving Families Solution. Our Climate Action Solution and improvements to tenant rights will also ensure people live in warm, dry homes. Our Real Deal Cannabis Reform and Real Action on Alcohol will reduce harm from both these drugs, as well as investing money in drug and alcohol rehab and improving mental health.

However, so far we haven’t acted on society’s biggest killer: junk food. To this end TOP proposes to ban junk food advertising to kids and place a 20% tax on all junk food, based on an improved front of pack labeling system. We estimate the tax would raise around $1b, and the money would be recycled into subsidies for wholesome foods such as fruit and vegetables. We also want local communities to have a greater say over issues in their local area that can impact on their health.

Getting the best bang for the public health buck

If we want to keep living longer, healthier lives, we can’t rely on the health system to deliver that for us. That is particularly the case with the ageing population and growing levels of chronic illnesses like diabetes that make people unwell. Neither establishment party will face up to this reality. National’s focus is making the system more efficient, while Labour wants to throw more money at the problem.

TOP proposes to replicate the independent health sector funder model of Pharmac across the health system. Health funding would go where there was the greatest health benefit – which is usually prevention and primary care. As a result of this reform we expect to see funding for prevention and primary care rise over time. Primary care is central to our health system and people shouldn’t have to think twice about whether they can afford to go to a GP or nurse. This same approach should also extend to dental care.

TOP will encourage hospitals to retire old technologies, find savings and reinvest them in local community services. Through providing better patient information we will see a shift in focus from end of life treatment to providing greater care. To meet the coming demand we will ensure all health industry staff operate at the top of their scope. 

Labour/Greens and National will continue to bicker over the amount of money going into the health system. TOP understands that this is simply arguing over how many ambulances you put at the bottom of the cliff. No matter how much money we have, we can’t meet the coming crisis. We have to do things differently.  

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Page last updated on 11-Sep 2017


When it comes to obesity and diabetes, studies show that exercise is about 20% of the problem. Diet is more like 80%. In fact most people offset exercise with 'treat' food so it ends up having zero benefit for our waistlines. 
You can read more on this issue here.

Our health system bears the costs when poor diet makes us unwell, so the taxpayer has skin in this game. Charging extra on unhealthy food can help pay for those costs, and offering rebates on healthy food makes it easier for people to make healthy eating choices. It's good for our health, as well as our national health budget.

That is up to Pharmac. Currently Pharmac makes funding decisions independently based on the health returns that different drugs provide. Pharmac works better when politicians don't interfere and try and tell them what to do, and we want to keep it like that. In fact, we want that model broadened over our whole health system so that we can be certain we are getting the best return on each dollar invested. 

The future of healthcare isn't more hospitals, it is more prevention. Every dollar we spend on prevention gets four times the benefits we get from a dollar spent on hospitals. We need to care for people in their communities, and keep them out of hospital. 

No matter how much money Labour and National throw at the health system in coming years, we will not be able to meet the demand. In fact there is rationing in the health system already, and this will only grow in the future with an ageing population, increased demand for treatment, chronic disease and new technology. Every health system in the world is struggling, and ours is no exception. 

What we can do to have better health outcomes - live longer healthier lives - is to invest more of our health budget in prevention. That is a much more effective use of our health budget, and it will give us better outcomes than increasing the amount of money we put in. 
At the same time we have to have a conversation about what we can realistically expect from our health system now and in the future. For example should we be investing more in invasive operations that keep people alive for a matter of weeks, or end of life care? TOP proposes citizens' assemblies to investigate these questions.

We will sit down with a panel of nutrition experts and improve the current front of pack labeling scheme so that it has 3 simple ratings based on their nutrient content: 
Green = every day food like fruit and veges
Orange = sometimes food
Red = junk food
We will tax the junk food on a per gram basis so that there is an average price rise of 20%. The revenue will be collected and totaled. To disburse the money collected we will develop a 'Fly Buys' style card that rewards people every time they buy healthy food (rated green).