A different kind of health care system

This week I received clear evidence that New Zealand does indeed have a different kind of health care system.Having been here for a year, some differences between the countries have become muted. I don’t struggle to understand kiwi accents, even when returning from a few months in the states. My ear just switches gears. And driving is less challenging. I switch to the left side with only a few goofs – and those are funny now, not scary.

But this week’s letter was a stand-out difference. It came from the Otago District Health Board, and advised me that the DHB had set an appointment for my mammogram – which is free. They’d like me to have a mammogram every other year – for free – until I am 69. So they’d like to see me and squish my breasts on Oct. 3, if that’s alright with me. A map to the hospital was included, as well as a pamphlet on the health benefits of mammograms.

Isn’t that nice of them? As it turns out, I had a mammogram on my latest trip to the states and Larry is still dealing with the multiple bills and notices that flowed from that. It’s covered by Blue Cross, but not free – and certainly no government agency set my appointment! In fact, I had to wait longer for that appointment than I would for my kiwi exam.

It’s nice, but as an American I’m edgy. I wonder how the DHB got my address. And how did they know my age? I suspect that my GP filled out some form online to put me on the mammogram list.

But then I’m reminded of another letter that was waiting for me when I returned in August. This one was from the Electoral Board. It advised me that I was required by law to register as a voter – if I was eligible to vote. So would I please return the enclosed form in the enclosed free envelope to register? As holder of a permanent resident visa I am eligible to vote. So I returned the form and registered to vote. Now I wonder, did the form include my birth date? I think it did. So maybe when I registered to vote I found my way to the mammogram list? I doubt it –

I suspect my GP’s the culprit. I bet she’s required to send names and addresses of everyone who needs a mammogram in to the DHB. Then I saw a commercial advising young women that the Guardasil HPV vaccination is free for them between ages 12 and 19. I wonder if the DHB is setting appointments for them?

My first reaction harkens to Big Brother – “Who’s watching me??” But I soon realize that the question should be “Who’s watching over me?” And this illustrates one more difference in the relationship between individuals and government in this country. Privacy is a lower priority. And expectations are SO benign! In my lifetime the Kiwi government has never killed its own citizens. My 20-something students were shocked when I showed them a slide of Kent State. There is no constitution to constrain government power over individuals. But most kiwis don’t feel they need such constraint. They rely on precedent and expect government to behave in a civilized manner.

Here the government watches over me. OK, I know this is not about love and affection. The DHB expects to save money by giving me a free mammogram – and by giving young women the HPV vaccine. But
Somehow this knowledge makes me feel cared for as I walk home from the office.

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