Why would universal healthcare stop people from still paying for private insurance if they wanted “better” healthcare? (USA)?

Answered Mar 6, 2019

It wouldn’t stop people from buying private insurance.

Here in New Zealand, every citizen and permanent resident can access the public health system. This means that, you can see a specialist, or have procedures, at a public hospital, without paying.

Note that word, “specialist”. If you just go to your regular GP for something minor, or for maintenance medication (blood pressure, etc), there is a fee (although it is subsidised).

One issue that can be either acute or chronic is medications that aren’t fully covered by Pharmac (the NZ government drug subsidy agency). This can include lifetime maintenance medications, with a three-monthly cost that is significantly higher than the basic $5 fee for fully-covered items. And can also include things like astronomically expensive cancer drugs.

Another big problem is waiting lists. Someone with whom I was acquainted had a choice of either paying $290 for a scan the next day privately, or waiting 3 months for “free” examination at a public hospital. Having no money, and no insurance, she waited, and her condition got worse.

Another person with whom I was acquainted spent over a year on a waiting list for a surgery that really improved her life. I suspect that she may have actually been kicked off the waiting list, and been re-added manually by her doctor. The government likes to kick people off, and tell them that they aren’t sick enough, so to make the waiting lists look shorter and more efficient.

There have been cases of, “the squeaky wheel gets the grease”, where it was necessary for patients to personally start hassling their District Health Board, in order to avoid just being lost in the system.

Some people seem to think this is about having some kind of luxury hotel suite. But this is also about getting serious health problems dealt with in a decent timeframe, before they deteriorate, and threaten the person’s lifespan.

What are some of the dark sides of living in New Zealand?

Answered Dec 26, 2018

I’ll preface this by mentioning that, I lived for several years in Los Angeles in the 90s, so I know what an actual developed-country-hellhole is like. And will try to avoid comparisons, and just talk about New Zealand by itself.

In no particular order:

  • Domestic / relationship violence. Involving current, estranged, and former spouses and partners.
  • Child abuse, including violent abuse, sexual abuse, multiple-offender abuse, and homicides.
  • Poor people making more children that they are not prepared (financially or psychologically/behaviourally) to raise properly (see previous item).
  • Mass binge drinking culture. With the accompanying addiction, automobile crashes, violence, health hazards, etc.
  • A significant obesity problem.
  • A significant amount of amphetamine use.
  • Synthetic cannabis substitutes which are more hazardous than the real thing.
  • Criminal gangs sucking in already disadvantaged/impoverished young people, and financed by the aforementioned drugs.
  • Gambling, including the weekly lottery, and also high-velocity “pokie” machines.
  • Suicide. But let’s sweep that under the carpet with a law that prohibits news media from using that word in articles on that sudden death of a young person, without any medical description, and without any crime suspected (hint, hint).
  • Sexual harassment, and cavalier attitudes towards it, in both educational and employment contexts.
  • Economic disparities intertwined with racial/ethnic disparities.
  • An entrenched Treaty grievance industry.
  • Racism.
  • Anti-immigrant attitudes. Which will even be directed towards white, English-speaking immigrants.
  • Clean and green is an advertising slogan. Our level of farming is rather harsh on the environment.
  • Overpriced housing.
  • While the public health system is better than many places, there are serious problems with waiting lists for specialists/hospitals/scans/procedures.
  • Mass problems with public primary and secondary schools.
  • Mass problems with low literacy and numeracy skills.
  • And, of course, everyone’s favourite…
  • Tall Poppy Syndrome. There is something desperately wrong with a society where I, of all people, have been the target of this, repeatedly. And I barely even consider myself to be a functioning adult.

Why do some people say that New Zealand doesn’t have the capacity to be self-sufficient when ends_abruptl on reddit said that New Zealand is self-sufficient in all areas apart from non-essential medicines?

Answered Dec 25, 2018

New Zealand is dependent on other countries in two directions.

Automobiles, trucks, and construction and farming vehicles are imported. Along with petroleum to run them. There isn’t sufficient domestic oil production, although there is a large offshore natural gas field.

Wellington’s newest fleet of commuter trains was built in South Korea. The old fleet was built in Hungary. The new double-decker buses were built in China. Auckland’s newest commuter trains were built in Spain.

Electronic items, ranging from mobile phones to hospital equipment are imported.

Pharmaceuticals are imported. And any of them is “essential” to the people whose quality/quantity of life depends on them.

Sure, we could produce all of the food we need, plus more.

That is the other direction of dependence. This country is very heavily oriented to exporting food, particularly dairy and beef. We need the income from this, and therefore, are dependent on other countries as customers.

One of our greatest vulnerability points is the risk of a food production problem.

There was a serious incident a few years ago, involving allegations of botulinum toxin contaminated milk powder being sold to China. That cost a pile of money, and damaged the country’s reputation, even though it apparently turned out to be a false alarm.

If anyone ever finds even a single case of Bovine spongiform encephalopathy (mad cow disease), whole countries may refuse to accept any more beef exports, for an extended time period. The economic impact of even an accusation would be very serious.

There is a problem right now with Mycoplasma bovis (not found here previously), and a mass-culling of dairy cows. The national impact is about reduced production of milk powder for export.

If other countries don’t want to buy our food, we can’t buy their oil, cars, equipment, phones and other consumer goods, etc.

New Zealand is also heavily dependent on other countries to send us tourists bringing cash into the country.

New Zealand educational institutions (of highly variable level and quality) are also heavily dependent on other countries sending us students (who are effectively viewed as tourists).

Why is Auckland a bigger population centre than Wellington?

Answered Dec 25, 2018

The terrain issues (flat vs. hilly) are certainly a big factor. It’s difficult to spread out horizontally in Wellington.

It’s also difficult to spread out vertically. The earthquake risk in Wellington dissuades the construction of high-rise apartment buildings like you can see in Auckland.

I would also suggest a social factor. A critical mass of immigrants. One person immigrates, and settles in a large city. After gaining citizenship, they then sponsor multiple relatives to also come over, and settle in the same local area.

Prospective immigrants from certain countries (China, India, Pacific Islands) may only have really heard of Auckland, and know that there are already large populations of immigrants from their same origin.

There are also certain cultural/ethnic/family issues, based on those origins.

According to the 2013 census, Pacific people have significantly more children than any other ethnic group. So, when you already have a lot of Pacific immigrants settling in one area (i.e. Auckland) they will then drive up the local population further with their high childbirth rate. And their NZ-born children and grandchildren will grow up, and likely continue that high childbirth rate.

Another issue could be the willingness/inclination of certain cultures (already present in Auckland) to have multi-generational households and extended family members crammed into the same run-down, overcrowded house. So they can tolerate an area with a housing shortage and high rents, without being financially driven out of the city.

The higher opportunity level and dynamic atmosphere of “the big city” may also attract people who already live in some other part of New Zealand. And, since Auckland is already the the biggest city, it may be first on the list of choices for many people.

My guess is that, Wellington will eventually become much larger (physically and in population), with a “supercity” extending the official city limits to swallow the areas up to Kapiti, Johnsonville, and Upper and Lower Hutt.

I’ve lived in Wellington previously, but am generally inclined to go to new places (Palmy is the the fifth [and smallest] city that I’ve lived in as an adult).

If I can line up a job there, I would move to Auckland without hesitation. (Yes, I know housing is expensive, but I have low standards).

Why is New Zealand not recycling? Is New Zealand not recyling?

Answered Dec 21

Other commentators have focused on the actions of households. The problem is the ultimate destination of the material.

On the surface, there appears to be plenty of recycling occurring. Cities have recycling bins available, and pick up the contents weekly.

But where does it go?

Into a big pile.

The reasons are economic.

The material must be transported to a recycling facility. Which may be hundreds of kilometres away. Or may be overseas, such as in China. The cost of transport may be higher than the market value of the material.

What do you do when the Chinese government restricts importation of the material?

Put it in a big pile, right here in New Zealand.

An alternative is sending it to Malaysia. Where they put it in a big pile, and openly burn it.

NZ’s recycling crisis after China ban: ‘This situation is not sustainable’

New Zealand’s plastic stockpile is at 400 tonnes and could be going mouldy

Kiwis’ recycling is piling up in Malaysia and being burnt in secret, environmentalists say

How do we improve education in New Zealand?

Updated Tue

A few points:

The literacy claims here are misleading, because literacy isn’t black-and-white.

Plenty of people are “literate” at only a very basic level. They have very poor vocabularies and poor comprehension. They also choose not to read anything that they don’t absolutely have to, and so never improve their skill. This also leads having a very poor personal knowledge-base.

Many are also completely oblivious to their skill deficiency.

I’ve encountered adults who got personally offended by meeting someone with decent written or spoken language skills, and/or a good knowledge-base obtained by extensive reading.

And no, these aren’t all just English-as-a-second-language immigrants. And they aren’t all economically downtrodden, either.

I’ve also seen people attempting higher education when their skill levels and attitudes meant that they wouldn’t be able to handle high school.

There are serious disparities based on geographic location and socioeconomic status. Schools for children aren’t all equal. Socioeconomic disparities lead to racial/ethnic disparities.

Higher education (and pseudo-higher education) is also multi-tiered.

The eight universities are one level.

The 16 polytechnics are at a lower level, and some have been caught engaging in blatant fraud and providing seriously poor quality courses. I had a very negative experience with a certain polytechnic some years ago, and the difference between there and a university was like night and day.

Poor management at polytechnics has resulted in three separate government financial bailouts this year. Including at one that was supposedly within a month of shutting down, in the middle of a semester, and had it’s entire governing board fired as a condition of the bailout. In another case, a polytechnic was caught for fraud, hit with a financial penalty that it couldn’t pay, and so received forgiveness of said penalty, plus a pile of additional cash.

One reason for the government tolerating (and even rewarding) bad behaviour from polytechnics is geographic. There are people who wouldn’t even go 20 kilometres from Porirua to either of Wellington’s two universities. Thereby giving Porirua’s polytechnic reason for existing (and receiving one of those bailouts).

There are also deep issues with low expectations and low standards, with polytechnics offering courses taught at high school level, and which do not lead to any improvement in the student’s job prospects. Some specialise in scraping the bottom of the barrel to enroll students with remarkably low skill and attitude levels. And lowering the bar, so that their certificates aren’t worth the paper on which they are printed.

I’ve witnessed a totally irrational situation of shoveling in people who had zero chance of success, and also taking people for whom the level and pace were insulting to their high intelligence, and putting them in the same classroom. Guess who got bullied?

Still lower are private training establishments targeting international student cash-cows with low-level, low-quality non-degree courses, which damage the country’s reputation.

Improvements?

One thing would be to teach students, right from primary school, to act civilised. At the aforementioned polytechnic, I saw people in their twenties and even older doing classroom behaviour that I wouldn’t consider acceptable for a ten-year-old. They got away with it in primary and secondary school, and expect to continue. And I’m not just talking about people with disadvantaged socioeconomic backgrounds.

When the classroom disruption is so severe that a tutor stops speaking/teaching, that deprives the good students of the education that they may be paying and sacrificing to obtain.

Kids also need to be taught that, reading is a normal, daily life function, rather than some uncool misery to be avoided.

A huge issue is parenting. Violence at home? Foetal alcohol syndrome leading to behavioural problems? The child coming to school hungry every morning because Mommy spent the food budget on cigarettes? Poor people having children they cannot afford? Middle-class people who coddle their children and instill a sense of entitlement? All of these harm education for those children, and the others around them.

Another issue is the people who go into teaching. I recall back in 2005, a recently-graduated schoolteacher (in her 20s) living next door. I mentioned the Cassini–Huygens landing on Titan, and said that the kids would probably be excited to look up some photos on the internet. This schoolteacher actually said that she didn’t use the internet, for anything.

NCEA has various problems, and I get the impression that it is excessively complex. And can also be “gamed” to show students/cohorts performing better than they really are.

Education is also affected by unplanned (or deliberate) pregnancies, which can totally derail a young (or even not-so-young) person, and can do so permanently. There needs to be proper sex education in high school, with the emphasis on reducing this. I’ve actually encountered women who acted like I should have been having unwanted children while still a student. Or, really, instead of being a student. This is also a huge factor in the disparities between men and women, in terms of advanced academia and science professions.

Children and teenagers or any demographic background should be encouraged to take interest in science fields, and to see this as a viable path for themselves, and towards rewarding jobs.

The requirements for University Entrance were significantly raised in 2014, but some people say they are still much too low.

I have mixed feelings about “discretionary” entrance for over-20-year-olds without University Entrance. I’ve seen it work out very well in a couple of cases. But I’ve also seen people get indiscriminately shoveled into courses when they had no business being in any classroom, anywhere. Just for revenue.

For higher education, Labour’s fees-free scheme (i.e. election bribe) doesn’t seem to have worked to get more people into university. It’s expensive, and may incentivise some people to view it as a year’s vacation. It would have been better arranged as a reward for actually passing academically.

The previous National government was provoked by a perception of wastage, and basically punished everyone involved in higher education, including students. From 2011, there have been restrictions on loan and allowance eligibility and time limits. Which are worse for mature students and for postgraduate students.

I don’t suggest just throwing money at students who aren’t serious. But will say that, one of the biggest stressors and distractions is worrying about keeping a roof over your head for the years it takes to finish a degree. Especially in high-cost cities, like Auckland and Wellington. I have seriously contemplated camping in a public park.

I support cracking down on cheating and plagiarism (e.g. assignment-for-hire businesses). And on international students (and overseas agents) lying to obtain a visa.

Another problem to address is the increased pressure on academic staff to pass students, as part of performance evaluations, which affect not only individuals, but also institutional funding.

Two universities are currently undergoing “reorganisations”, which have provoked negative atmospheres among the staff, and some students. It’s important to consider economic viability, but the bean-counters can go much too far.

There are problems with supply and demand in certain fields. There may be a perceived labour shortage in a certain field, so it is promoted as where the jobs are, but three years later, there is a labour glut of new graduates. Not coincidentally, schoolteaching qualifications have had this cycle around in the past several years.

New Zealand has serious issues with funding and conduct of research, which can limit opportunities for postgraduate students, and also for the value of the degrees. Some people leave the country in order to pursue research and/or academia (i.e. the “brain drain”).

There is also tall poppy syndrome endemic in New Zealand society. I’ve been treated with open contempt by acquaintances upon hearing that I chose to go to university as a mature student in a STEM field, rather than remaining trapped in a low-level, low-skill, low-wage dead end job. As I’ve written before, this is a strongly female-biased pattern, based on a sense of competition and taking things personally.

Some people get negative attitudes like that, while simultaneously feeling entitled to all of the things that are created by, and work done by, highly educated people.

A million Kiwis lack literacy skills, prompting call for review

We are barely functioning, literally

An answer to New Zealand’s illiteracy enigma?

Why has the New Zealand government made it harder for international students to work in New Zealand after they finish studying?

Updated Dec 17

Because they want customers, not immigrants.

A commonly used term is “export education”. This means that, those hordes of foreign students are lured here, pay a pile of money, and then leave. They need to leave, in order to make room for replacement with next year’s cohort. The ultimate outcomes for those students aren’t considered particularly important.

These people’s contribution is bringing cash into the country, not staying or working long-term. They are effectively viewed as tourists.

There have been mass abuses:

  • Agents (particularly in China and India) lying to prospective students, and saying whatever will get their money.
  • Fraudulent financial documentation, claiming that the student has the required funds to live on, when they actually do not.
  • Businesses exploiting those financially desperate students. Ranging from restaurants to brothels (which I think may be illegal for people on student visas).
  • I once had a student flatmate from a developing country, whose husband moved here, without a work permit. They eventually moved out, and I had a strong suspicion that they were planning to stay in the country illegally. I’m sure they weren’t the only ones with that idea.
  • Cheating on English language testing, resulting in students who cannot function academically, and whose employment and social situations are poor. I have personally met a couple of these people.
  • Academic misconduct, including students with poor English ability resorting to paying sleazy businesses to write assignments for them.
  • Pressure on teaching staff to maximise the number of passing students. Not for genuine success, but for revenue. This also relates to the National government’s idea to to base university funding partly on pass rates. There are implications that this pressure is more likely to involve international students (e.g. with the obvious language issues, and mismatches of speaking ability compared to writing quality).
  • International students don’t count towards the enrollment caps or subsidies involved with domestic students. Their fees are much higher, incentivising piling them in.
  • A substantial number of low-quality, low-level educational businesses known as “private training establishments”. There have been reports of shenanigans all the way up to students simply laying cash on the owner’s desk, in exchange for a passing grade.

Those private training establishments have serious, systemic issues. They are accredited by the government, generally for low-level courses and “qualifications” that do not result in any credit towards an actual degree. Some is taught at a high school level. This results in little or no benefit to the students, and doesn’t enhance their ability to contribute to NZ society, in terms of employment. They are not creating highly skilled/qualified, in-demand professional workers.

The government has previously tolerated that, specifically because those PTEs exclusively target international student cash cows. Unfortunately, it is starting to kill the goose that lays the golden egg, when those students go back home, and tell all of their friends about the “ghetto education” being sold.

There was an incident several years ago, where a few (probably related) PTEs in Auckland passed about 50 Chinese students with some kind of diploma in business management, which they then used to get into a university, ostensibly to study at degree level. And couldn’t speak a word of English.

There was situation a few years ago, where students who had some type of Indian nursing qualification had taken a course at a polytechnic, that they believed would get them nursing licenses in NZ. But their Indian qualifications were then deemed to be inadequate. They protested in front of Parliament, but had no recourse or compensation.

There was an incident recently, where a PTE had had its accreditation cancelled a year ago, so that the students didn’t receive their certificates from NZQA. Then, a bunch of them moved on to another PTE, where the same thing happened again.

There are also serious quality issues going on at various polytechnics, which are Crown-owned, but have had major accountability issues, but that’s another story.

International students don’t receive NZ government loans or the taxpayer subsidies that apply to domestic students, so there isn’t an investment that you would want to be recovered by having people stay here and pay taxes for a few more decades.

It’s all about pulling money into the country.

Generally, NZ also has serious population issues. Auckland and Wellington both have high housing costs, crowding, and infrastructure problems. The country overall has plenty of empty space, like in the middle of the South Island, but that isn’t where new immigrants (or anyone else) tend to want to go.

There is a strong perception that foreigners (both immigrants and non-resident investors) are largely responsible for the housing problems. There may also be a perception that, people from crowded and poor countries like China and India, will tolerate poor housing conditions and working conditions, thus enabling bad attitudes from landlords and employers, dragging things down for everybody.

There is also social ghettoisation that you can see among international students, while they are studying. The Chinese students huddle together, and the Indian students huddle together. There may be a sense that they simply aren’t interested in ever fully assimilating, and would continue that ghettoised situation if they stayed.

And, to a significant extent, there is also pervasive xenophobia in NZ society, which actually goes way beyond racism, and will also be directed at white/European, English-speaking immigrants.

Why are immigrants leaving New Zealand?

Updated Nov 24

Someone who was psychologically and practically equipped to move to a new country, may also be psychologically and practically equipped to move again. Also, some people deliberately use NZ as a “back door” to their real destination, Australia, which has greater economic and social opportunities.

However, a big reason could be the incredibly negative social attitudes towards immigrants.

I know I harp on this, but there is a big difference between men and women.

Men say stupid things, like:

“Do you ever think about going back?”

“Huh, huh, huh, I bet you wish you were back there!”

And then they get disappointed if you tell them that you actually have control over your location.

Women are much, much worse.

“You have an accent! Where are you from? Why are you here! You owe me an explanation!”

Incessantly.

Most women in this country take one of exactly two attitudes:

  1. You had better confirm that you are being forced to live in your current location, without any choice. And that you are stuck in the same suburb for the rest of your life.
  2. You had better confirm that you will “go back where you came from”, without any choice. Not just the country, but a town where you lived as a child. Because it is very important to be as small-minded as possible, and to have zero adult control.

It really is that micromanaging. A lot of women get personally offended at the idea that someone could even just relocate to a new city, inside the same country. This also relates to many, many women’s locations being based on an emotional umbilical cord to their mothers, and/or a financial umbilical cord to their breadwinning husband. They totally resent women who assert basic adult independence.

Did I mention the, “You have an accent!” harassment with virtually every woman you meet? Some of them expect you to be impressed by their amazing perceptiveness. Some of them act like they have never met a foreign-born person before.

There are women who will start up a rapid-fire interrogation. Where they reveal nothing about themselves (not even their name). While demanding details about a foreign-born person’s legal/governmental status, work and finances (including taxes), and the arrogantly intrusive, “Why did you come here, so I can decide if your reason satisfies me”. Try working with the public, and total strangers will do this.

Let’s not forget the mass racism. If an immigrant is white/European looking, some people will assume that they automatically share the common bias against Asian people.

A lot of the condescension and hostility towards immigrants is really about tall poppy syndrome, and the resentment of anyone who got off the couch and did anything interesting with their life.

Some women get an indignant, “I never get to go anywhere I want!” attitude, as if the immigrant is perpetrating some kind of personal unfairness against them.

No matter how long an immigrant has lived here, there is an automatic assumption that they are really just on vacation. With confusion and resentment about how someone could be on vacation for years and years.

Generally, the only relief is in more educated situations, such as university environments, which contain many foreign-born people.

Speaking of which, there are people who will direct the, “you have to go back where you can from” attitude towards an immigrant with higher education in a STEM field, including a degree that was heavily subsidised by NZ taxpayers. It’s like they actually think that the “brain drain” is somehow going to help the country.

Some will automatically assume that, a foreign-born university student is here on a student visa which will expire upon graduation (or maybe better yet, dropping out). If she corrects this, and states that she is a permanent resident, some still don’t seem to comprehend the difference, and keep pushing.

I once encountered an induhvidual who claimed that, no employer in NZ will ever hire an immigrant, or even someone who merely moved to a new city within the country. The logic being that, all immigrants “go back where they came from”(to a specific town) for emotional reasons. So there isn’t any point in hiring someone who will be doing that real soon now. However, this is combined with the idea of job discrimination being used to force immigrants to leave. So it’s a circular logic.

I have encountered women who will demand to know if an immigrant’s mother lives in New Zealand, and get offended and demand an explanation if the answer is “no”. One directly stated the intent to harass a middle-aged coworker, every single day, to go home to her mommy.

I have encountered a woman who was a small-time landlord’s wife, and who suggested that, a paying, civilised tenant should move out and go back where they came from.

An OK country. But many, many stupid, small-minded people. And that includes in larger cities, like Wellington.