Are we in a health crisis? Certainly.
Is it new? No, it’s been brewing for a long time.
What we’re seeing is the end-game of four decades of neoliberal policies feeding on the corpse of civil society. Finally it seems to have played itself out.
We’ve reached a point in time where the common man actually thinks taxes are bad. The same taxes that pay the surgeon who performs his gallbladder surgery, the teacher that educates his children, and the firefighters who protect his home. People have been conditioned to not see taxes for what they are: the means by which citizens fund a functional and democratic society.
We’ve taken money that should have built new schools and hospitals and tripled the numbers of nurses, and instead created one of the only countries in the world where investors can extract profits and rents without paying capital gains taxes.
We wonder why we can’t afford the currently extortionate rent increases. And why our hospitals are 60-year old heaps, unfit for service. Poverty is rampant, while the wealthy have been making out like bandits. We’ve become the land of the untaxed investment property portfolio.
We knew decades ago that a tsunami of old and infirm patients was coming, and now it is wholly upon us. Preparation would have required a vast increase in the number of doctors, nurses, hospital beds, surgical theatres, and GPs. Far from that, we are currently not adequately staffed or resourced to take care of the patient numbers we had 15 years ago, let alone those we currently face. As we enter a period of economic upheaval, social distress, and the breakdown of public health systems, we are in no position to cope.
Last week Tauranga Hospital made news for having gone from 12 patients on the elective surgery waiting list in 2017 to 1,940 patients waiting (and suffering) today. That’s the case throughout New Zealand. Civil society has eroded, infrastructure has been allowed to degrade, and the middle class hollowed out, while the wealthy have done very, very well.
If there is a crisis in healthcare it is not one that is going to be solved by importing a few more foreign nurses. It is going to require us answering the question of why nurses are retiring or leaving in droves, leaving vacancies in the hundreds. It is going to require a re-do of how our society works: how we tax the wealthy, and how we redistribute that wealth (or whether we do at all).
If we don’t confront this we will end up with what I left in the United States many years ago: a fragmented and failing society that pits one race or group against the other, with both sides losing. The only winners in this are the very wealthy. They’ve had a good run of tax avoidance and achieved levels of wealth hoarding that haven’t been seen in New Zealand in 70 years.
In the few years since Covid popped up, the wealth of the very richest billionaires has tripled. Has your wealth tripled since 2019?
Oxfam says New Zealand ranks 136th out of 161 for fair wealth distribution. The top 2 billionaires in New Zealand own more wealth than the bottom 1,500,000 people in our country. To call that obscene and unsustainable is an understatement.
Rebuilding our infrastructure and our social programmes: health, education, and safety, will require a rethinking of what is the purpose of government. Is it to help the rich get richer, or the common citizen to lead a safe and healthy life? The answer to that question will decide whether our healthcare crisis worsens or resolves.
-Gary Payinda is an emergency doctor in Whangarei and past elected member of the Northland District Health Board.
Dr Gary Payinda 