Replace tax-funded healthcare with 'social insurance' for health equity, experts say

Embargoed until: Publicly released: 2026-08-14 00:01

New Zealand

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Private healthcare is undermining Aotearoa's public system, say the authors of a NZ Medical Journal Viewpoint article. The private sector now provides necessary care that isn't just an 'extra', they write, and takes funds and workers from the public system, worsening inequity between those who can and can't pay. They argue that replacing the 'unethical' dual system with a model like ACC, where workers pay a health levy from their income, would reduce the public-private system gap. This 'social insurance' model has many advantages, they say: access to care wouldn't depend on ability to pay, and health spending wouldn't be competing for tax money.

News release

From: New Zealand Medical Journal (NZMJ)

This paper describes the ethical concerns raised by “creeping privatisation” in New Zealand’s healthcare system and proposes an alternative to the current dual public–private arrangement. It challenges the argument made by some ethicists that dual or “two-tier” health systems are ethically permissible and preferable from the point of view of justice, arguing that the private sector undermines and erodes the public sector, creating significant concerns for health equity, social solidarity and long-term sustainability. It examines a social insurance funding model for healthcare as a plausible alternative to the current tax-funded model used in New Zealand, with advantages in addressing the ethical challenges of a growing gap between the public and private “tiers”.

Journal/
conference: New Zealand Medical Journal

Organisation/s: University of Otago, Bond University

Funder: N/A

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