The NZ Health strategy contains a number of worthy goals and objectives, including the focus on technology and smart systems. However the degree to which we can deliver on future health outcomes will likely be significantly constrained by available funding, which is insufficient to meet all present needs, let alone potential future healthcare demands.

Yet with public funding accounting for 80% of total health spending, the NZ health system is, by international standards, dangerously over-reliant on taxation funding. The NZ Health strategy omits consideration of arguably the biggest strategic issue in health – the unsustainability of public funding and the need to grow alternatives to tax funding. Official forecasts are dire, with public health spending under present policy settings projected to soar by $10 billion in today’s dollars – a bigger fiscal headache than the rising costs of NZ Superannuation.

There is a need for a strategy to broaden healthcare’s dependence on tax funding and help grow alternative funding mechanisms over time. Growing the overall funding pot will not just reduce pressure on the public purse, but will help lift overall health outcomes and reduce the level of unmet need in the future. With 86% of people agreeing they would likely pay a greater share of their healthcare costs in the future, it is time to start planning what that might look like.