Checking in on NZ's unluckiest patient George as he gives up cafe coffees

George BeforeRemember poor George?  He was described as 'New Zealand's unluckiest patient' and has had nearly every condition, illness and accident under the sun. With no health insurance in place, George's unexpected treatment costs left him in a very difficult position financially (and errrr...physically).

Asset 2Well, George has now decided enough is enough. Feeling rather bitter after burning his tongue on his oat milk latte from his local cafe, he completed some rough calculations on the back of his napkin. George quickly realised the cost of private health cover for him (mid-twenties, male, non-smoker) was close to his weekly cafe coffee spend¹ (around 4 coffees per week). So he's now protected himself with private health insurance and armed himself with an at-home coffee plunger that he isn't afraid to use.

George thinking3x

So George, why get private health insurance when there is a government funded public option in NZ?

George has three key reasons and these are all linked to the fact that public health resources are limited, which makes it hard to ensure everyone gets what they need, when they need it.

Key reason #1

More treatment options and specialists 

In the public system, not all specialist treatments are funded and wait times can be long. Alongside this, George had realised he wouldn’t necessarily get to choose his specialist or where he gets treated if he was using the public health system. George felt a bit of a loss of control as he understands that getting treated in a timely and comfortable manner through private health insurance can impact how quickly recovery happens. 

Luckily, private health insurance with AA Health Insurance allows George access to the nib First Choice Network of trusted providers. If George wants to see a provider who is charging a more premium rate he is still able to see them (although he may experience a gap payment depending on the cost), which offers him more choice and control over his health.


Key reason #2

Reduced wait times

George was painfully aware that having a costly or difficult operation for free in the public system (unless it is medically urgent) usually means going on a wait list, which could significantly impact his quality of life and his condition could worsen while waiting.

George remembered that the number of people waiting more than four months for a specialist appointment in the public health system rose from 12,894 in 2019 to 35,326 in June 2022².  The number of people waiting longer than four months for surgery in June 2022 was 35,264 - which was nearly triple the number there was in December 2019³ 

The private system can help bridge the gap here by offering George more choice for when and where he can receive the treatment he needs. Offering more choice can reduce wait times as resources and capacity are less of an issue for private providers.


Key reason #3

More medicines available

George AfterGeorge appreciates that many medicines in New Zealand are subsidised or funded by the Government, significantly reducing their cost. But, he also understands that after Medsafe approves drugs for use, then it is up to PHARMAC  to decide which of those drugs can be funded in the public system.

Unfortunately, PHARMAC has limited resources and has to operate within a tight budget. That means not all Medsafe-approved medicines get government funding, which can make access to them extremely expensive. For many Kiwis, that means effective or even lifesaving treatment can be out of reach.

George has had the non-PHARMAC Plus option added to his health insurance cover, which helps him cover the cost of some drugs that are Medsafe approved and prescribed under the Medsafe guidelines, but aren’t funded by PHARMAC^.


^Cover limits are paid per person per policy year. Policy terms and conditions, exclusions, and benefit limits apply. For more information on non-PHARMAC Plus, see the non-PHARMAC Plus Policy Wording (PDF, 373 KB).







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