Our proud, yet troubled, public health system



I, like many New Zealanders, feel proud and very fortunate to have a universal tax funded healthcare system that means kiwis can largely access healthcare without having to pay for it directly. But the reality is that this care must be paid for by someone and as a country we are currently failing to adequately fund our health system.

Health funding, at 21% of government expenditure, is the second highest category of crown expenses and at over $16B spent in the year ending 30 June 2017 is the equivalent of 6% of New Zealand’s GDP. While this may appear to be a significant investment, New Zealand funds less healthcare per capita than a number of OECD nations including Australia, the United Kingdom, Canada and most of Scandinavia.

Given the finite level of funding available it is unsurprising that District Health Boards (DHBs) and organisations such as Pharmac need to make difficult funding choices to work within the constraints that are presented to them. Recent examples from many DHBs highlight significant infrastructure, equipment failure and budgetary issues, reportedly driven by chronic underfunding.

It’s easy to get lost in the blame game as the previous and current governments attempt to deflect attention across the aisle. The reality is this is a longstanding issue fuelled by the system’s complexity and our prevailing ideology regarding “free healthcare”.

Currently New Zealand has 20 DHBs servicing a population of a little less than 5 million people. I question along with others, whether this number of DHBs is necessary. Most use different systems and processes leading to inconsistencies in treatment at a national level and a poor experience for patients who move between DHBs. Reducing this complexity and centralising more services would go a long way towards improving outcomes and relieving budgetary pressure.

Additionally it is time we as a country acknowledged the greater role the private health sector could play in relieving some of the burden. The private health sector performs particularly well in the area of elective surgery, one where the public system consistently struggles, and is constantly building further capacity to deliver more services.

Private health insurance plays a key role in supporting the wider private health sector and helps avoid the constraints represented by finite government funding. It is a way that those who choose to (and can afford to) can take more responsibility for their own healthcare needs. My parents live within the catchment area for Counties Manukau DHB and I am thankful they have retained their health insurance. If they do require non-emergency healthcare at least they won’t receive their care in buildings of “high concern“.

Picture credit: Unsplash.com

Does private health insurance help or hinder New Zealand’s health system?

Recently I was asked whether private health insurance helps or hinders the public health system and my immediate reaction was “of course it helps the public system by….!”

But putting that initial gut reaction aside, I put myself into the shoes of those working in the public sector and started to question whether we do in fact encourage top surgeons to move out of the public sector. Does the presence of the private sector contribute to further inequities in health outcomes?

It is generally accepted that surgeons are paid more in the private sector than in public, and it could be argued this disparity could be discouraging surgeons from working in the public sector. However, what we are really seeing is that most surgeons working in a private setting also continue to work in the public sector. Arguably the higher pay rates they can command in the private sector subsidises their public earnings, thereby keeping world class surgeons here in this country.

Retaining quality surgeons in both the private and public sectors should be a key priority for maintaining the high standards of healthcare in this country and is a way that private health insurance can support the public health system.

Private health insurance contributes more than a billion dollars to the health sector annually and this money is often used by private sector providers to partially fund the introduction of emerging technologies such as PET scanning, robotically assisted surgeries, and development of facilities to manufacture radioactive isotopes used in diagnostic imaging across both the private and public health sectors.

New Zealand’s two tiered health system does introduce overall inequities where some people are able to afford a wider range of health services than others. However, health insurance can also help to reduce inequitable outcomes by encouraging those who can afford it, to take greater responsibility for their own health needs. By paying for around half of all elective surgical procedures in New Zealand, the private sector frees up public funding to deliver greater benefits to those who cannot afford private health insurance premiums.

Overall the public health system in New Zealand does a fantastic job but does have its limitations, particularly with regards to elective procedures. Private health insurance has a place in complementing public health services by picking up some of the slack in this elective surgery area, helping to fund innovation that benefits all New Zealanders and encourages those who can afford to look after more of their own health needs to do so.

Keeping one eye on the horizon

Providing insurance to one of the most underinsured countries in the world comes with obvious challenges such as the need to educate Kiwis on the benefits of protecting themselves from the unforeseen.

Financial commentators predict that the type of insurance consumers buy in 20 years will be very different to what’s on offer now. At Sovereign, we are preparing ourselves for the future by using the power of technology and data to target new areas of customer demand.

A recent digital triumph was our new ‘bank-grade’ hybrid cloud system delivered in a hugely ambitious – and successful – timeframe of just 10 weeks. A visible customer component is our Quick Quote web and mobile tool, which allows advisers to provide quotes instantly using their mobile devices. While it appears straightforward, it’s anything but. It involved building and deploying key enablers – such as a secure virtual data centre in the cloud (Amazon Web Services), a modern integration and business process management suite – and a configurable pricing engine, modern APIs and user interfaces.

Technology team_resellernews

The technology project team (L-R) – Nick Stanhope; Andrew Scott; Patrice de Marigny; Raffaella del Prete; Tony Lees; Linda Nightingale; Richard Beamish. Absent: Corina Elama; Feng Wu; Ross Stephenson; Liviu Elama and Michael Ung.

The new investment will give Sovereign speed, flexibility and choice. It will enable data-led automation, coherent omni-channel customer experience, machine learning and artificial intelligence – all necessities for a modern and customer-centric business. It’s a small step in a much bigger journey toward making insurance more accessible to more people.

We are also using data to increase our understanding of customer risk, behaviours and needs. Recent analysis told us our customers wanted simple and flexible support after an accident. As a result, we launched Accidental Injury Cover this month. This product complements traditional income protection products and ACC by providing our customers with access to an immediate payment they can use however they wish, whether it’s hiring some help at home, taking taxis or having some time off work. This is available as an optional benefit with no underwriting regardless of whether someone is in paid employment or not.

In the last financial year, we paid out around $70 million in health insurance claims, which gave our customers access to the best medical treatment options. Demand for effective and less invasive options continues to grow in the private sector and we are seeing greater capacity as more specialists and medical facilities come online in New Zealand, particularly in the area of cancer care. We’re constantly looking into our claims data to ensure that our products reflect demand.

The ability to respond to, and even anticipate, the needs of our customers means we can make a difference through our product design, provide greater choice and simply improve the user experience.

Our eyes are constantly fixed on the horizon because we are in the business of being there for customers in their time of need – today and tomorrow.

Originally published as Sponsored Content in the NBR. Republished with permission.

Why transparency is a good thing

In recent years we’ve seen a spate of high-profile privacy incidents hit the media. Notorious examples abound: organisations passing on personal information to police and government agencies without reasonable grounds for doing so, huge data breaches (think Ashley Madison or Yahoo!), and instances of employees inappropriately accessing customer records. Intuitively we recognise that if an organisation is unable to assure its customers that their information is safe, people’s trust in it will be eroded.

But where does transparency fit in and what does it mean? If you ever hear a person described as being “transparent”, chances are it isn’t a compliment. When it comes to privacy however, being transparent is definitely a good thing. It’s about being upfront, open and honest regarding what you’re doing with personal information, and being accountable for keeping it secure. For Sovereign, it means ensuring we are responsible custodians of customer data for the duration of the time we hold it.

When I began working here, I quickly came to understand just how sensitive some of the information we hold is – medical records being just one example. Thankfully, I’m happy to report that Sovereign takes its’ obligations to protect your privacy seriously. We know that the relationship we have with you is built on a foundation of trust, so let’s put our cards on the table and be transparent about a few things:

  • Our Privacy Policy outlines how we collect, use, disclose and protect your information;
  • You have the right to request access to a copy of all the information we hold about you;
  • Sovereign has a team which specialises in responding to Privacy Act requests made by individuals, as well as requests for personal information made by the police and other government agencies;
  • We won’t release your personal information to the police or a government agency without your consent unless required by court order or legislation, or we believe there are reasonable grounds for doing so (such as where there is a serious threat to your safety or the safety of others); and
  • If we consider a government agency is asking for more information than necessary, we’ll push back and ask them to explain why before making a decision on the request.

So next time you wonder what we’re doing with the information we hold about you – just ask. We’ll be happy to tell you.

Let us know if there are more privacy and data issues you would like our Privacy Specialist Tony Collins to cover in future blogs.

To my future self…

jake-baileyJake Bailey is currently in remission from Burkitts non-Hodgkins lymphoma, a condition he was diagnosed with in 2015 – his final year of high school. Based on his experience, we asked him to write a letter to his future self and share what he learned during this journey. Here’s what he said.

To my future self, I hope you remember…

  • Always remember how lucky you are for every day you receive.
  • Live every day with passion and pride, simply because you are able to.
  • Understand that your life could change beyond recognition in a day. Live accordingly.
  • Never have regrets. Do what you want to do, tell people what they mean to you, achieve as much as you can in the time that you have because you don’t know how long that is.
  • Don’t feel sorry for other people in situations you cannot change, it will achieve nothing. Instead, be grateful for the people in your life and your ability to live a normal life. It seems impossible, but next week you might be fighting to cling onto that life.
  • Take great pleasure in the journey of life instead of fixating on the destination.
  • Treat your body well. Just because other people thrash themselves and are fine doesn’t mean that it’s okay or healthy, or that you’ll be fine as well. If something’s wrong, then don’t take a “she’ll be right” attitude – being tough is about taking care of yourself so you can be strong, not just ignoring your body.
  • Appreciate hospital staff; the doctors, nurses, cleaners, kitchen staff, and the orderlies. These people dedicate their lives to saving others, and that’s an incredibly powerful thing. They go underappreciated so often, and they are the last people who deserve that.
  • Suffering is a building block. Those who go through life without suffering are worse, not better for it, because the blade never gets sharpened.
  • What separates those who succeed from those who fail is not the number of times they get knocked down, but how many times they’re willing to get back up and start again.
  • Some people are broken by misfortune, whilst others choose to grow from it.
  • Happiness is not an objective we seek, it’s a talent we develop.


What is your spirit of death?

Lisa Gunnery, NZ CEO The Hunger Project.

africa-1Imagine a village in one of the most remote areas in Malawi. People in this village have very little and struggle to feed themselves. Most live in mud huts and have no education. History is passed down through word of mouth and is often built around a belief in powerful spirits which can both give and take away in equal measure.

Part of the work in ending hunger is addressing the surrounding and complicating issues that are happening in a community. This can be infrastructure related, like access to fresh water and sanitation, and it can be health related – as in the case of HIV education in Africa which is incredibly important given the remote nature of the rural villages where The Hunger Project works.

A few years ago, when an educator from The Hunger Project was teaching people about HIV in this village he came across a potential stumbling block called “The Spirit of Death”. This spirit came into play whenever a husband died suddenly in the village. The wife had to appease the spirit by performing a ritual which was out of line with the practices for HIV prevention. If the spirit was not appeased, the belief was that a member of the woman’s family would die each day until it was.

For the first time these people understood the impact of HIV and how to prevent it, but they found themselves in a difficult position – they remained afraid of the Spirit. In order to get more information the trainer gently questioned the story behind the Spirit. Was theirs the only village the Spirit came to? Yes. Were there other ways to appease the Spirit? No.

After the questioning process, the villagers met and discussed the situation and much to the surprise and delight of the trainer, came up with a solution which both continued to honour the Spirit but also invoked sense in terms of safe sex practices.

It’s easy to scoff at the idea but the truth is that we let our own “Spirits of Death” stop us from doing what we want to do every day. Whether it’s a cultural or a personal limitation our “Spirits of Death” are always present. We can learn a lesson from the villagers in Malawi. They found a way to honour their tradition but in a way that supported the group rather than hindered them.

Take time to explore your Spirits of Death – what are the self-limiting beliefs that you have and which stop you from achieving what you want? Are they real – or are they a story you have conformed to? Can you rethink the limitation and come up with a way to remove the block? If you aren’t able to let go of the belief – is there another way of honouring it that will bring about a similar outcome but in a more positive way?

We need to talk about suicide

Statistics show 579 people have died by suicide in New Zealand in the 2015/16 year – the highest number of suicides since the Coroner’s Office began keeping records in 2007/08.

Suicide is extremely complex and an area that I certainly don’t profess to understand. But, as a New Zealander who wants our country to thrive, it’s clear that the current situation needs to change.

Although the statistics are overwhelming it’s important to remember that suicide is preventable and as a starting point we must focus on boosting our mental wellbeing, shedding the stigma around mental illness, building supportive communities and providing education.

Youthline CEO Stephen Bell describes the need for communities to be safe and secure for our young people. Mental Health Foundation CEO Shaun Robinson has called for better education where individuals can have courageous conversations and their friends and family are guided on how to respond appropriately.

Many organisations and people are working incredibly hard, often with very limited resources, to reduce suicide levels in New Zealand. In addition to these groups and government, we each have a role to play in changing the current situation.

I talked to Youthline and the Mental Health Foundation to find out what we can do (as individuals) right now to make a difference:

  1. Build the Five Ways of Wellbeing into your day so that you are taking care of yourself and the people around you. This helps to improve resilience when things get tough.
  2. Check in with friends, family, and workmates regularly – support your community.
  3. Encourage your workplace to consider educating employees so they can deal with suicide-threat situations appropriately. Training offered by Youthline helps ensure staff can direct people to trained services.

As a country, we’ve managed to turn around some terrible statistics before. In 1987, our road toll was 795. In 2014, it was 293.  Serious injuries have fallen by 40% over the last 30 years despite growing car use and population growth.

In 30 years I hope we look back and see a similar change for our suicide statistics. I’m not saying suicide is an easy thing to solve but change is driven by an acceptance and awareness that things can’t continue the way they are.

There is also an opportunity for the government to play a greater role in providing access to treatment options. According to a report by the Royal Australian & New Zealand College of Psychiatrists, the economic cost to New Zealand of mental illness is about $12b annually – about 20% greater than the cost of injury claims to ACC ($10b).

Equally, an opportunity exists for insurers to better understand and manage mental health claims. At Sovereign, we recognise that claimants on disability income claims need more than just financial support. That’s why we spend considerable effort supporting customers with their recovery.  For example, we offer claimants access to a dedicated case manager to help co-ordinate private psychological support, occupational therapy, vocational re-training and return to work support.  However, we recognise more must be done to help Kiwis before they need to claim.

Let’s start talking about what role we can all play in turning these statistics around.

Note: This article was prepared in collaboration with The Mental Health Foundation and Youthline.

For more information about suicide prevention see www.mentalhealth.org.nz/suicideprevention

If you or someone you know is in need of support phone:

Lifeline – 0800 543 354
Suicide Crisis Helpline – 0508 828 865 (0508 TAUTOKO)
Depression Helpline – 0800 111 757 to talk to a trained counsellor
Samaritans – 0800 726 666
Youthline – 0800 376 633. Text 234 free between 8am and midnight, or email: talk@youthline.co.nz
Healthline – 0800 611 116

Diversity and inclusion are non-negotiable

Diversity and inclusion

Sharron-Moana Botica, Chief Customer Officer

If you want a business that attracts and retains top talent then a diversity strategy has to be your number one priority.

Over the last ten years, Sovereign has become a multi-cultural business that reflects the country we serve. If you take a walk through our offices you will see representatives from more than 50 ethnic backgrounds.

Diversity of thought benefits our customers, makes us more innovative as a business and helps us to develop new products.

The way things have been done previously are not the way they need to be in the future.

We understand that this journey will never end – there is always more we can do. Recently, we started the process of integrating the “MX” salutation and “X” gender reference into both our customer and people systems. These designations refer to individuals who either don’t identify as being of a particular gender, or for people who don’t want to be identified by gender.

As Sovereign’s LGBTI executive sponsor, and an ally of the Rainbow community, understanding what it means to be intersex was important to me. I didn’t fully realise what it meant until viewing this video, which was passed to me by a member of the Rainbow community at Sovereign. Watching this video really struck a chord.  It was obvious how challenging and difficult life could be through a lack of inclusion.

So we set about making these changes happen. Introducing the “MX” salutation was easy enough but including the “X” designation in our customer system was a little harder – the main reason being that insurance premiums are calculated in part by gender.

We worked with key stakeholders to help them understand why these changes mattered and the positive impact it would make to our business. We also connected with influencers across the company who could help us explain why these changes were relevant for different departments.

Finally, once the changes were made, we used the communication channels available to us to let people know these options were now available to them.

For anyone attempting a similar change I would recommend the following actions:

  • Bring all the people (or departments) that are impacted together.
  • Start the conversation with a view as to why it is important to do this.
  • Don’t get dragged down to why it can’t happen.
  • Understand responses and work out a plan on how to resolve them.
  • Focus on the end result.

The value of these changes is that we are making a difference to people who were previously excluded. This has made many people proud to be part of Sovereign.

Even ten years ago, there would not have been the sliver of an opportunity for an insurance company to consider gender X. It is a sign of how much we have evolved, and the value of ongoing diversity and inclusion activity, that we have been able to challenge history.

We are in the process of updating our systems and collateral that has gender sections, changes that will take time but importantly the changes are underway.

It is also a sign of Sovereign’s transformation – the way things have been done previously are not the way they need to be in the future.

I’m happy to answer any questions about Sovereign’s diversity strategy – so feel free to fire away in the comments below.