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Thinking Outside The Square: A Fresh Approach To Financing

Thinking Outside The Square: A Fresh Approach To Financing Older Peoples’ Healthcare Claire Austin Health Leaders Conference 4 May 2007. We are ageing better and longer. Soon nearly a quarter of the population will be over 65

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Thinking Outside The Square: A Fresh Approach To Financing

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  1. Thinking Outside The Square:A Fresh Approach To Financing Older Peoples’ HealthcareClaire Austin Health Leaders Conference 4 May 2007

  2. We are ageing better and longer • Soon nearly a quarter of the population will be over 65 • Critical that health care in older age is timely – (Taskforce on Positive Ageing) • Public health expenditure per capita: • Age 15-64 $1,190 • Age 65-74 $3,261 • Age 75-84 $6,144

  3. Key Factors That Contribute To Positive Ageing • Having a positive attitude • Being adaptable to life changes • Maintaining autonomy and having the freedom to choose • Staying involved – community, friendships, social contact • Staying active Ageing is Living – Age Concern New Zealand, 2006.

  4. Public Perceptions Health Insurance and Older People • Ageist and discriminatory • No loyalty for investment • Health insurance should be life-long contract • Greedy insurers • Premiums hike when reaching 65 – when you need access to health care the most

  5. Risk Rating and Community Rating Community rating – Australia • All ages in the pool – spreads the cost and risk across all ages • Rebates as incentives to attract younger people • Risk equalisation scheme • Increased rebates for the 65+ and 75+ age groups

  6. Risk Rating and Community Rating • Risk rating – New Zealand • No rebates or incentives • Unable to pool risk beyond age bands • Claims and costs drive up premiums • One in three older people were claiming for surgery annually (major medical) • 75% of premium written in NZ – through not for profit organizations

  7. What Can Reasonably Be Expected From The Health System? • Unlikely a tax funded system will be able to provide full universal cover • Growing pressure upon services internationally • Importance of timely access - impact upon personal, social, health and economic well-being

  8. What could be done differently? Grant or rebate for those over 65 holding health insurance: • Provides timely access to care • Makes health insurance affordable • Costs of claims can be covered • Relief upon the public system • Fiscally neutral to the Government

  9. Opportunities • Look at alternative ways to resource health care insurance rebates for older people, scrap FBT workplace schemes • Public/private collaboration, eg: planning around electives • Use capacity across the whole system • Smarter purchasing across the whole sector (manage costs together) • System wide quality and research – effective, timely, patient-centered care.

  10. www.healthfunds.org.nz

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