Anne Else: Three Cheers For The Nanny State

Since my last column three weeks ago, my husband has turned black and blue. No, like most cliches, that’s wrong – he’s more sort of purple and maroon with little yellow bits.

On his birthday, he found out he needed a pacemaker. They said it would be about five weeks. We were a bit sceptical, to put it mildly. First Wellington Hospital announced it was going to have to close some heart surgery beds for lack of staff, then the junior doctors threatened to strike. We looked at each other and said, “Five weeks? Yeah, right.”

Well, we were wrong. Five weeks and three days after he got the news, he got the pacemaker. His bruises startled the staff – he did tell them that he always bruises badly, though I don’t think they really believed him till they saw for themselves – but otherwise everything went perfectly.

Having an operation is always a scary business. There may be a tiny group of seriously weird people who have operations for fun, and there’s certainly a growing cult of seeking surgery to drag perfectly normal bodies a fraction closer to some mythical ideal image. But for most of us they’re something to be avoided if at all possible.

So my husband and I (pause to wave gloved hand majestically to cheering crowd) were not overjoyed when we both turned out to have the kinds of inherent problems – his irregular heartbeat, my cataract-plus-glaucoma – which, while not life-threatening, urgently required surgical attention. But we were immensely relieved when we received it, promptly, efficiently, supremely skilfully – and completely free. We had to psych ourselves up for the ordeal of “going under the knife”, as our parents used to call it. But we know we’ve been really lucky, and we’re very grateful.

This is not how it might have been. Remember when apparently sane policy makers (including businessmen moonlighting as health consultants) came up with the theory that free hospital care, including operations, was bad? Health care was exactly the same as baked beans, they said, and not having to pay just meant that everyone would rush off to grab as much as they could. So the answer was to copy the USA - turn hospitals into Crown Health Enterprises, charge, and make everyone buy their own health insurance. They conveniently forgot to mention that just as you get to the age where you start to need little luxuries like cataract surgery and pacemakers, you also need a second mortgage to pay the premiums.

They also forgot to mention that although the USA spends twice as much on healthcare as a share of GDP as we do – more than any other nation on earth – millions still have no or minimal healthcare cover, and a major health problem can mean financial ruin. According to Dr Floyd Bloom, president of the American Association for the Advancement of Science (AAAS), the entire system there is now "in imminent danger of collapse".

Fortunately for us and thousands more like us, good sense returned to government and we got our hospitals back. I know the New Zealand healthcare system does have some problems. More pay and better conditions for nurses would go a long way towards fixing many of them. But it’s easy to lose sight of just how well it does work for most people, most of the time.

There’s also a strong focus on the cheapest and most effective kind of healthcare – prevention. On December 10, smoking will be banned from bars and pubs for the first time in this country. One of the loudest protests has come from Winston Peters, who told the Sunday Star-Times it was “just another example of the nanny state”.

Those great brains who tried to do away with free hospital care went on and on about the nanny state too. Like Peters, they said the most important thing was “having a choice”. The tobacco industry pushes the same line, conveniently overlooking the fact that their products are so addictive, they make “choice” a farce. Up till now, the bar and pub staff had no choice – they were forced to smoke too.

The hospital staff who have to deal with the appalling damage routinely done by smoking don’t have any choice either. If you ask them, they will tell you any public health measure that lessens it has their vote. More selfishly, it has mine too. The less smoking there is, the lower the demands it makes on the healthcare system, and the more room there’ll be in it for the rest of us when we need it. Sometimes a nanny state is exactly what the doctor ordered.

- Anne Else is a Wellington writer and social commentator. Her occasional column will typically appear on a Monday. You can subscribe to receive Letter From Elsewhere by email when it appears via the Free My Scoop News-By-Email Service

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