AN ANSWER TO OUR HOSPITAL CRISIS

I was interested to read that breast reduction surgery is available from Medicare in Australia. This made the news when women complained they were at the back of the queue, apparently some surgeons viewing it as a cosmetic issue.

That’s nonsense. Overly large breasts are a hellish problem and just as much an impediment to a physically comfortable life and thus needing surgery, as say hip surgery. But offering this operation in New Zealand (outside of the private sector) would be a pipe-dream, due to the appalling shortage of medical professionals here.

Successive New Zealand governments have been grossly negligent in failing to establish a third medical school and now we have a crisis, reflected by the doctors strike in protest at their huge work pressure.

Shane Reti, the Nats Health spokesman has promised to start immediately after the election, establishing a new medical school at Waikato university. ACT have endorsed this. But it will be many years before it starts pushing out doctors.

I have the answer. Pending New Zealand producing sufficient doctors and surgeons it would be a smart move to fly back-log surgery patients to say Thailand, and additionally, overall cheaper, even including airfares and accommodation.

A senior legal friend needing surgery, took his wife with him and had it done in Thailand, altogether at less cost than here. That included airfares and the necessary recuperation period, lying in the sun around the pool, the Thai private hospital essentially being a luxury hotel. Everyone’s a winner.

Cuba has pumped out armies of doctors, far in excess of its own requirements for decades now. This has been a huge boon for people and specially Americans needing surgery, and unwilling or unable to pay the notoriously high American medical fees.

I put this to a senior medical specialist male. He said it’s spot on but an attempt to do it would induce an uproar protest from our surgeons, worried about protecting their patch. They’d carry on about operations going wrong and an inability to follow up, which of course is rubbish and simply protecting their financial interests.

Regardless, the way round that is to relieve the burden on our medical situation and operation backlog by confining the Thai or Filipino ops’ to the more basic treatments.

This proposition is a damn sight more virtuous then the current situation in the west with its medical doctor and surgeon short-fall crises, pillaging the third world’s doctors with higher salaries.

Visit a British public hospital today and its odds on your doctor or surgeon will be Indian or African.

Paul Theroux wrote about this a year or so back. Theroux had been one of Kennedy’s young Peace Corp in the early 1960s. He was sent to Malawi which is why it became the setting for his early comic novels.

He understandably retained a sentiment for the country and reported how a decade or so back they built their first medical school. But every graduate they’d produced has promptly gone off to Britain, lured by significantly higher incomes.

When I read that I realised why when I was last in Malawi, I encountered many young newly graduated British GPs, presumably lured for the adventure after years of study.

It’s important to emphasis that the Thai, Cuban, Philippines, Spanish, Iranian, Turkish and such-like foreign medical fee-earning scenarios is not at the expense of the locals, rather they have deliberately produced surplus medicos as a foreign exchange earner, just as we produce milk, lamb and wool beyond our own requirements.

But typical of communist regimes, Cuba for example, grossly over-did it, so much so it resulting in them actually exporting doctors for optimistic political reasons, to African and Latino states and Venezuela in particular.

I witnessed this excess in the 1990s when following a rather amusing incident I drove a Cuban girlfriend to hospital in Havana to have her leg patched up. A GP could have handled this in 20 minutes but instead, I was invited to come into the operating theatre and witness 8 no less surgeons hover over her.

Afterwards I thanked them and said if they’d like I’d take them to the only decent restaurant then in the city, it only accepting payment in US dollars, this far beyond their means.

They promptly downed tools, told the nurse to cancel that afternoon’s operations and said let’s go now (it was around mid-day). We had a merry afternoon living it up as with the Soviet Union’s collapse, Cuba was then in a desperate situation, particularly with food shortages.

Those of you familiar with my comic novel “Full Circle” will recall how the key character exploited the post-Soviet massive surplus of tour ships Russia had built and were culturally unequipped to operate, in the hope of earning foreign exchange.

I come back to my base proposition though, namely we’re a trading nation and should not confine trade to material goods but extend it to services, such as surgery, where it makes economic sense.

Currently our private medical practitioners run essentially a monopoly and will protest.
We’ve been through that before in the 1980s when Roger Douglas, to all of our benefits, ended the existing monopolies with the anachronistic import licensing markets.

That’s not peculiar to the medical profession, rather practitioners in every activity thrive on thwarted competition.

Over 200 years back Adam Smith recognised this behaviour and it’s why every western country today has strict anti-monopoly laws.

As said, it’s normal human behaviour. I certainly recall my delight back in the late 1960s when Rob Muldoon became Keith Holyoake’s Finance minister. Rob believed in private enterprise but not in the “invisible hand” reality of market economies and wanted to control supply.

About 1970 he announced a ban on all new industrial and commercial buildings. Henceforth developers would need to justify their need to be allowed to be build new ones. It was fantastic for us existing building owners as we watched rents double inside 12 months.

As I’ve said we should sensibly utilise nations promoting price competitive surgery as a foreign exchange earner, just as we do buying cars and computers from abroad because they’re cheaper than us making them here.