Health insurance – Who is Covered ?

12/07/2019

In an earlier blog, talking about self-funding retirement income, I added insurance to cover medical costs to the ways in which individuals, rather than governments, could contribute to income adequacy. It is estimated that 1.34 million New Zealanders have health insurance – around a third of the population. We have a public health system and ACC, so what part does health insurance play? This is a question especially applicable to older people who often call on health services but who may be living on lower incomes than they previously enjoyed.

Estimating coverage with age

I set off to see how health insurance cover varied by age. And found information from the New Zealand Health Survey[1] and from the 2018 Annual Report of NZ Health Funds (health insurance providers).  These figures should be seen as tentative but give us some idea of coverage.

Health Survey Data – This recorded 35% of adults as having private health insurance, a figure which decreased from 40% in 1996/97. Coverage was highest for the age groups 35 and 64 (41-42%), and lowest for people 75 years and over (16%). And for the total aged 65 plus – 23%. After examining a range of demographic and socio-economic factors, household income was found to have the strongest association with private health insurance coverage.

Health Funds report – Coverage of the population aged 15 plus was 34.4%, similar to the Ministry of Health figure and the figure for 75 plus was the same – 16%. This source has a breakdown for the older population, which allowed me to estimate what percent of each age group was covered from age 60 onwards. As the diagram shows, this fell steadily from 30% at age 65-69 to 17% at age 80-84, 15% at 85-89 and 12% at 90-94.

judith diagram

Why the drop-off by age?

The main issue seems to be cost. There have been many recent media reports of substantial rises in health insurance premiums for older people, often amounting to 20%, based on the presumed higher risk of making claims.  For one couple in their sixties (quoted in a Stuff article by Rob Stock) their annual premium rose from $3,022 to $3,617. As a result, many retired people are opting out of health insurance –

If we ask around our circle of friends, none of them poor, I think we are the only ones with health insurance.

In another Sorted quote, a couple reported that they were paying $4800 a year for hospital/surgery cover, with an excess of $2000.

We are struggling to accept this cost, even though we can afford it. We paid for private health insurance for 20 years, only ever making very small claims. Now in our 70’s, we decided that the cost is not worth it, so we have cancelled it.

Could the costs be evened out?

House, contents and other insurances do not differentiate by age (although we all know about travel insurances), but one way to reduce health insurance costs for older people would be to even out the premiums between the age groups as is done in Australia under the “community rating” scheme. Of course, the young would pay more than they do now, but the old would pay less.[2] Could a government intervene to make the young subsidise health insurance for older people? Community rating is not unknown in New Zealand, ACC does not base levies on people’s ages.  But health insurance is driven by commercial rather than equity goals.

Weighing up the need for health insurance

Medical insurance has its advantages. A quote by an individual, from Sorted.co.nz

You don’t have to wait for public services, and you can select who you want to see if you’ve got a preference for a specialist or a surgeon. The waiting lists are so long, so you are able to have surgery done right away. And you’re not going to be waiting around in pain.

It is a question of weighing up likely risks and the costs of using medical services, where full or part costs have to be paid. We do have the public health system, and ACC for accidents. There are subsidies for GP consultations. Acute treatment and surgery will always be taken care of. But for ‘elective’ procedures, which are not deemed as urgent (and these will include joint replacement surgery and non-urgent screening), that’s where having health insurance can make a difference.

People could self-insure. Instead of paying an insurance company, health costs can be covered if and as they arise, from personal savings. Sorted recommends setting aside three months’ of expenses for an emergency fund. If saving is possible and very high cost procedures are avoided this may be a cheaper alternative to commercial insurance.

There may also be ways of saving on health insurance –

  • Opting for a higher excess
  • Comparing insurance companies for discount rates (e.g. for non-smokers)
  • Reducing the amount of coverage, say $100,000 instead of $300,000 for surgery
  • Skipping comprehensive coverage and choosing ‘hospital-only’ or ‘hospital and specialist’ policies
  • Using workplace-based health insurance plans. Some employers offer health insurance schemes to their staff. These are usually cheaper to join because employers can negotiate better group rates and offer subsidies. And rates are not based on age.

Doing my research for this post, I looked at websites of health insurance companies. They all offered free quotes. But when I put in my particulars – just to see what it might cost – I found that no new clients would be accepted beyond age 75!

 

[1] The New Zealand Health Survey used data collected between 2011 and 2015, covering people in New Zealand who reported having private health insurance, by age, sex, ethnicity, household income and other variables.

 

[2] Rob Stock article in Stuff, January 27, 2019.

 

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Valuing Carers and Providing Respite

28/06/2019

According to the 2013 census, 430,000 New Zealanders were identified as carers – 10% of the population. Each week, an average carer provides 24 – 36 hours of support, and this unpaid work is estimated to be worth $7 – $17 billion. The latter figure is more than the total health budget. It is not clear how many of these people care for older people or how many are older themselves. But many are, and the numbers are likely to grow as the population ages.

Intensive unpaid caring, especially for someone living in the same dwelling can be stressful and can threaten the health of the carer. Respite care is intended to give carers a break and a rest, for a few hours, a day, overnight or longer, either in or away from the family home. Respite helps the carer ‘recharge’ and gives the person being cared for a break.

Respite care keeps families together, keeps people out of hospital, reduces the use of funded services, delays the degeneration of people’s physical and mental well being and is, as the Carers Alliance asserts, a cost effective and societally just investment.

Respite services are accessed through local Needs Assessment Service Coordination organisations (NASC), who check eligibility and identify needs. The amount of funded respite support is based on assessed needs. There are different types of services; overnight respite is available some aged residential care facilities, or a paid worker may stay with the person needing support[1]. Those who are eligible for Carer Support/respite days, receive a list of local facilities that hold appropriate contracts. The carer can then contact a facility or organisation to discuss options. A certain number of respite days are allocated each year, and cannot be carried over

 

I Choose – a new initiative

This year the Ministry of Health is starting a more flexible type of respite support called I Choose. This will provide cash payments to carers who can use the money to buy any respite support or service, as long as it gives a break from the caring role. I Choose is called a ‘flexible respite budget’. Voucher schemes like this already operate in other countries.

Despite these changes, a new report, Respite In New Zealand: We must do better, prepared by the New Zealand Carers Alliance in association with Alzheimers NZ and IHC, documents significant problems facing the system. While supporting flexible budgets, the report calls for service improvement and innovation across the country. While calling for implementation of the I Choose framework, the report also seeks –

  • A review of how respite services are funded and commissioned. A fragmented funding environment involving multiple organisations and government agencies is creating duplication and confusion. Streamlined policy settings will help to improve the system and reduce waste.
  • Better availability of services – inequalities in DHB investment are leading to variation across the country. Many users are unable to use their full respite allocations.
  • A respite innovation fund for providers to improve respite services.
  • A cross-sector stewardship group tasked with co-ordinating a system-wide response and creating coherent policy.
  • Better quality assurance and monitoring.

 

An article in the New Zealand Medical Journal[2] concludes

If the government wishes to have more people with disabilities or chronic illness living at home, greater resources are needed to adequately support caregivers. At present this important sector of the population is undervalued and under provided for

Stop Press
A statement from the Ministry of Health, 25th June, 2019

I Choose is on hold while the Ministry of Health works on a sustainable implementation plan to ensure that disabled people and their whānau can continue to get the breaks they need.

[1] http://carers.net.nz/information/advice-give-yourself-a-break/

[2] Jorgensen, Diane ; Parsons, Matthew ; Jacobs, Stephen ; Arksey, H: (2010) New Zealand informal caregivers and their unmet needs. New Zealand Medical Journal 123(1317):9-16

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Why train older workers?

14/06/2019

A recent quote from Forbes Magazine –

It’s nuts, but employee training programs tend to ignore older workers. This is bad for business, bad for workers in their 50s and 60s and bad for the (U.S.) economy.

I know I have been writing a lot about workforce ageing and older workers, but I happen to think these are really important issues for the future. I am not alone. The Careers NZ website points out that mature workers – those aged 55 and over – are expected to play an increasingly key role in the economy as the number of young people entering the workforce falls. If current trends continue there will soon be more people leaving the workforce than entering it, leading to labour and skills shortages. Careers NZ concludes – “

 As New Zealand’s population ages and the number of young workers entering the labour market declines, mature workers are increasingly crucial to filling jobs in areas of skill shortage.[1]

And if we are to keep up productivity and encourage economic growth then older workers have to be helped to keep up their skills.

Barriers to retraining

There are plenty of myths and stereotypes about the abilities of older workers that create significant barriers when they seek participation in the workforce and obstruct their access to education and training. These suggest that older workers –

 

  • lack innovation and creativity;
  • cannot learn and adapt to new technology;
  • are prone to absenteeism because of failing health;
  • will not stay as long as younger people; and
  • are not willing or interested in retraining.

 

All of these can be refuted. The majority of older employees have long and stable periods of employment. If they are more likely to remain loyal to an employer, this should enhance the return on training investment. But if older workers have limited or no access to training then their skills will certainly become obsolete. A vicious circle develops – outdated skills reinforce stereotypes about older workers which gives them low priority for retraining and hence their disadvantage is reinforced. Research shows that many employers, in New Zealand and internationally, see training for older workers as a risk and a poor investment

They told me I wasn’t qualified enough, but then promoted someone younger with no qualification or experience and paid for her training (quote from an older worker in Equal Opportunities Trust research).

Thus, employers who ignore the training needs of older workers contribute to the under-performance and de-motivation which they complain of. They also deprive themselves of reliable and committed human resources, which could be working productively, and which may well stay longer than the younger workers who are targeted for training.

 

I came across another quote from the Australian politician, Hon. Bronwyn Bishop –

The creation of opportunities for mature age workers to undertake retraining and the breaking down of barriers to access retraining are critical issues. The establishment of a culture of continuous learning and re-skilling is essential to maximize the contribution of mature age workers to economic growth (cited in, Access Economics 2001:xv).

In New Zealand there are few opportunities for older workers to retrain and upskill unless their employers see the benefits. The findings here are mixed. In my own work I have come across many open-minded and far-sighted employers (but perhaps these were the ones which were willing for me to interview them!). But other research has shown that very many employers are not prepared for workforce ageing.

Some positive notes

The World Economic Forum has recently published a report – Towards a Reskilling Revolution: A Future of Jobs for All. This does not explicitly focus on ageing or older workers, but it outlines a process help individual workers, companies, and governments to prioritize their actions and investments in the training area. It introduces a new approach to identifying reskilling and job transition opportunities. It concludes that these efforts will not be easy; individuals will need to be supported and incentivised and will need to recognise the benefits of continuous reskilling in the form of rewarding job transition pathways. To prepare for change of the labour market, a wide range of stakeholders— governments, employers, individuals, educational institutions and labour unions, among others—will need to come together, collaborate and pool their resources.

And a headline from early May –

Fonterra, Air NZ and Bunnings are among those promising to double staff training spending – Some of New Zealand’s biggest companies have promised to double the amount of time and money they spend on re-skilling and training by 2025.

This comes from The Prime Minister’s Business Advisory Council and Jacinda Ardern has tasked the State Services Commission to look into which Government departments can do the same. The Prime Minister is quoted as saying –

A key pillar of this Coalition Government’s economic plan is to reform skills and trade training to address long-term labour shortages and productivity gaps in the economy, to make sure we are prepared for ongoing automation and the future of work.

Let’s hope that older workers are given due attention in these initiatives.

 

[1] https://www.careers.govt.nz/job-hunting/whats-happening-in-the-job-market/mature-workers-in-the-labour-market/

 

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How trends and attitudes affect retirement income policy

31/05/2019

I have listed the various ways in which government policy in New Zealand contributes to retirement income adequacy – led by NZ Superannuation and Kiwi Saver, but also including various health benefits, the Accommodation Supplement, Super Gold Card and Winter Energy grants. In my last blog I also looked at ways in which people can supplement their incomes in retirement through self-funding and decumulation. However, there is a third set of factors which influence the retirement income system – social trends and attitudes. These can have an effect on government policy through their electoral power and also influence individual behaviour, by either encouraging or discouraging the take-up of various decumulation options. How might these operate?

Rising expectations

We are often told about how the baby boom generation have higher expectations of their lifestyles and access to services in their later lives, compared to previous generations. In earlier decades there was an assumption that people would have to manage on much reduced incomes in retirement and get used to a lower standard of living. Now the periodicals and websites aimed at older people are full of advertising for cruises and overseas tours and people are encouraged to ask/demand of their doctors the latest remedies and medications (which they may have seen on TV ads or on the internet).  “Make do” seems to have gone out with the World War Two cohort.

Entitlement to government support

A very common response to any suggestion of raising the age for NZ Superannuation is the cry of entitlement. “We have paid taxes for all our lives so now we deserve it.” This attitude has had a strong effect on government policies as elections loom, even though most countries to which NZ compares itself have already raised the pension age or are planning to do this, driven by financial pressures. A strong feeling of entitlement and the expectation that the government must provide, in income and in other areas, can also affect the propensity to save for retirement.

A preference for home ownership

 The desire to own houses has been described as being “ingrained in the national psyche”. It has been seen as the path to responsible citizenship.  In 1950 Prime Minister Holland is reported as saying, “The Government has great faith in the social value of home ownership…it promotes initiative, self-reliance, thrift and other good qualities which go to make up the strength of the nation.”

This may explain the stigma which tends to be associated with renting and perhaps the fact that renting in New Zealand is insecure compared to the situation in European countries.

The report of the recently released report of the Welfare Expert Advisory Group of the Ministry of Social Development promotes home ownership as a way of moving out of poverty. But the rates are falling, from a peak of 74% in 1991 to an estimated 65% now. Falling home ownership rates will have an impact on the adequacy of NZ Superannuation, and rising rental rates (mentioned in my blog of February 2018) are already putting pressure on the Accommodation Supplement.

Attitudes towards inheritance

People are living longer, and later life health and residential care costs are growing. There is some evidence that the wish to leave money to the next generation may be lessening, but it is still strong for many people. While some older people are adopting the SKI principle -spending the kids’ inheritance and taking that cruise/buying a new car – others are depriving themselves in order to leave bequests. And “inheritance impatience” is a motive for the financial abuse of older people – “I am going to inherit, so give it to me now!”

Helping out children in their own lifetimes – for house deposits, tertiary education, or assistance in emergencies – has always been practiced by older people and can be a source of happiness and wellbeing for all concerned. Thinking about increased longevity, those receiving bequests may well be into their 60s themselves and perhaps inheritance can become the next generation’s retirement lump sums.

Extending working life

Most New Zealander now realise that there is no “retirement age” here; no compulsory retirement anymore. There is no work test for NZ Superannuation and employment conditions have become more flexible. More and more people aged 65 plus are in some level of paid employment. What is needed is more adaptation to ageing in the workforce, on the part of both workers and employers. Another trend, which I am researching at present, is increasing numbers of older people starting their own businesses – the possibilities are endless.

All these trends and attitudes have political implications and will resonate with politicians when policy responses to ageing are being considered.

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Decumulation Revisited

17/5/2019

This is the year for another Retirement Income Policy Review, carried out three-yearly by the Commission for Financial Capability (as successor to the Retirement Commission it inherits this requirement). At the end of April, I took part in a “Summit” hosted by the Auckland Retirement Policy and Research Centre which aimed to contribute to this review, which is due to report by the end of this year[1].

The previous 2016 Retirement Income Policy Review report called for more work on decumulation tools and mechanisms, but along with other recommendations of this review, not a lot appears to have been done. About three years ago I posted two pieces on decumulation –looking at what it means in relation to retirement income planning and the options available. I think that the term “decumulation” has become better understood since that time. So perhaps it is time for a revisit.

Especially as one of the terms of reference of the 2019 Retirement Income Policy Review is –

An assessment of decumulation of retirement savings and other assets, including how the Government can ensure New Zealanders make the most of their money in the decumulation stage.

How does decumulation fit into the policy system?

The “running down” or decumulation of savings and assets has always been an option for increasing retirement incomes, assuming people have them and are willing to use them. And whether they have been able to accumulate assets depends on individual life experiences, such as work careers and home ownership, and also on attitudes and expectations.

Many people die with money in the bank. This may reflect an intentional bequest motive, a “rainy day” contingency plan, or inertia. But, as an interviewee once remarked to me “there are no roof racks on hearses”!

There is certainly evidence that many older people need to supplement NZ Superannuation to have a comfortable standard of living. Decumulation (along with continuing in paid work) is a way of achieving this.

There are many ways in which government policy can either facilitate or produce barriers for decumulation. But, up to now it has not come explicitly into the policy sphere, except in the form of income and asset testing for residential care. There have been questions about how additional income from decumulation might affect access to income-tested benefits. We await with interest to see what the review will come up with and what the governmental response will be. One possibility would be to apply asset and income testing to home care services – as is done for residential care.

What are the current decumulation options?

  1. Invest KiwiSaver lump sums, when schemes mature at age 65, and other savings. Use the returns for current income needs and leave the capital for a “rainy-day” or for bequest.
  2. Draw down capital and accumulated interest regularly, based on a target income which you think you need and will need in the future But it may be hard to calculate how to make this last a lifetime as no one knows for sure when they will die.
  3. Purchase a life annuity, providing an income guarantee until death[2]. There is such a scheme in NZ – Lifetime Retirement Income (https://www.lifetimeincome.co.nz/). Depending on how much you invest in this scheme you receive a fortnightly payment insured to continue for the rest of your life. It is possible to make lump sum withdrawals, but this will reduce the income received.
  4. Trade-down to a smaller/less expensive dwelling; or move into a retirement village where greater certainty about housing costs are offset by a significant charge on home equity.
  5. Use a commercial equity release scheme, mainly in the form of reverse mortgages with compounding interest on released capital loans. This option is offered in NZ by Heartland Bank and other banks. The Heartland option guarantees lifetime occupancy of your home; a no negative equity guarantee and there is no requirement to make any repayment until the end of the loan (https://www.heartland.co.nz/reverse-mortgage). Customers can take out lump sums or regular monthly advances from their cash reserve. The interest rate charged on the loan is variable and will change from time to time. At present the rate is 8%. This is applied as compound interest, so over several years the debt will increase accordingly.

[1] In Auckland I did not speak in detail on decumulation, I was outlining the retirement income eco-system which I blogged about late last year. But decumulation did come up.

 

[2] In the UK there was a policy which required a proportion of retirement scheme lump sums be used to purchase annuities (this is now been withdrawn).

 

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Better Later Life – He Oranga Kaumātua

3/5/19

As I foreshadowed in my previous blog, the Seniors’ Minister Tracey Martin released a discussion document in Auckland on 12th April and opened consultation on a new ageing strategy. There is much to admire in this document and very little to disagree with. I am sure,it will stimulate a lot of discussion and comment.

One feature is the extensive use of Te Reo Maori, with the Maori titles of sub-sections coming before the English, for example Te take me whakahou – The case for change. Along with National Programme news, this provides a gentle nudge for all of us to become more familiar with an official language of Aotearoa/New Zealand. Spread throughout are meaningful quotes and sayings in a variety of languages and scripts, such as –

ਚੰਗੀ ਮੈਟ ਚਾਹੋ ਤਾਂ ਬੁੱਢੇ ਨੂੰ ਪੁੱਛਣ ਜਾਓ.

Need a good piece of advice? Consult an old person.

In her introduction, the Minister notes that the document reflects submissions made by many people and groups in 2018 on what a new strategy for an ageing population should cover. She emphasises the need to see beyond the tendency to look at the ageing population only in terms of what it will cost and recognises the role of all, from central and local government to families, whānau and individuals, working together. These holistic views permeate the document, referring to other policy strategies already in place. I believe that the Healthy Ageing Strategy, 2016 will be a valuable source, with its life-course approach.

“I want this strategy to be different, looking more broadly at how people can have better later lives and also recognising the significant contribution older people have made and continue to make to New Zealand.”

Brilliant!  The full document is available at http://superseniors.msd.govt.nz/about-superseniors/ageing-population/better-later-life-report/index.html. Here is a brief outline with my comments.

Another accolade from me is the acknowledgement of difference and diversity throughout, starting with the definitions –

“Older people” is used to mean people aged 65+ but recognises that people
age differently and have different aspirations and needs.”

The next generation of older people, now aged 50-64, is recognised and “older worker” is used to mean people aged 50+ working or seeking work. I was especially pleased to see a clear statement that New Zealand does not have a retirement age. It irritates me intensely when “retirement age” is used in the media and elsewhere, suggesting that retirement is compulsory (or universally expected) at age 65.

After stating its Vision and Guiding Principles (diversity, value, safety), the document sets out five key areas for action-

 

Consistent with the emphasis on diversity, the document frequency calls for wider options for older people – in housing, employment, transport and ways of saving for later life. Forward-looking considerations are noted, calling for reaction. These include the prospect of higher levels of poverty among older people, especially as a result of falling levels of home ownership; higher insurance and rating costs; the need for workforce change with higher participation by older people; higher debt levels among older people; and the effects of climate change. Looking broadly, we need to recognise the need for adjustment to change, which applies to all generations and all areas of life.

After each section -topic by topic – there is a text box “What we want to achieve”, for example –

 

“People have equitable access to the social services they need to support them to live well. “

This is followed by “What needs to happen”. Most of the actions specified are aspirational and general, without details of implementation. This, the document states, will come in an Action Plan to be developed over the next two years (hopefully some action will come sooner). For example –

“Encourage people to stay as fit and healthy as they can throughout their lives.”

 

“Build recognition of the importance of cultural diversity in the design and provision of social services. “

As I read the document, I mentally applied ticks of approval many of the statements, perhaps because they reflected my own propensities and the outcomes of my research, especially in the areas of employment and housing. I very much applaud the points on p.26, headed “Paid work and Business Owners”, about providing opportunities for upskilling and for older entrepreneurship. In housing, the emphasis is on remaining in the community, which will have numerous advantages –

“Ageing in the community safely and independently can improve older people’s physical and mental health and wellbeing, and social connectedness. It also reduces the chances and period of time that older people are in residential care services.”

Just a few requests – I would like to see more about prevention in a discussion of elder abuse. Only a very brief mention under safety (p.39). I think there should be more emphasis on walking and pedestrian safety. Also, when showing figures for employment of older people, there should be a breakdown by age, 65 plus is not enough.

Submission are due by June 3 – only a month away. I had better get on with mine!

 

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A good year for policy?

Judith Davey
18/4/19

A new strategy for an ageing population
In the April edition of the SuperSeniors Newsletter, the Minister for Seniors, Tracey Martin, talks about the new draft strategy for an ageing population. – Better Later Life – He Oranga Kaumatua 2019 to 2034. This was released in draft in Auckland on 12 April and now consultation will begin.

I found several things interesting about this announcement. The “Positive Ageing” title of the previous strategy has been dropped. In fact “strategy” does not appear in the new title. It has a 15-year time frame. The five major themes are announced – financial security, health, housing, safety, and social connections and the way our communities are physically built so that they are accessible to all people. The emphasis on diversity and difference should be applauded. But how do we react to the phrase – “Better Later Life 2019-2034 is a new way forward and will help inform how we look after our older people for the next 15 years and beyond”? I am looking forward to studying the full text and will be encouraging submissions. These will be reviewed, and the new strategy finalised and launched later this year. Then implementation will begin, so there is plenty to do.

Well being as the focus for the 2019 Budget
On Thursday 30th May, the Minister of Finance, Grant Robertson will deliver the government’s 2019 Budget. This has been heralded as the first “Wellbeing Budget “in the world. What does it mean for New Zealand? And, especially for older New Zealanders?

The idea builds on the Living Standards Framework (LSF) designed by Treasury, developed over many years and informed by public feedback from surveys and submissions; also consultation with local and overseas experts, drawing on the work of the Organisation for Economic Co-operation and Development (OECD). This framework contains a wide range of “wellbeing indicators” from rates of unemployment/employment to housing conditions and environmental quality and will track how they vary over time, between different population groups, and by regions. No single set of indicators can capture absolutely everything that matters for every person, family, whānau and community, so the “dashboard” will be regularly updated.

In December 2018, the Minister’s Budget Policy Statement was published, foreshadowing the main priorities for the 2019 Budget. He said the Government wanted to look beyond a purely economic and fiscal viewpoint and traditional economic measures – such as Gross Domestic Product (GDP) – to a wider set of indicators of wellbeing when deciding on the government’s investment and funding decisions. So, it will produce the baseline for strategies which look to the future, embedding wellbeing in public policy. The stated priorities are;

  • transitioning to a sustainable and low-emissions economy;
  • boosting innovation, and social and economic opportunities in a digital age;
  • lifting Māori and Pacific incomes, skills and opportunities;
  • reducing child poverty, improving child wellbeing and addressing family violence;
  • supporting mental wellbeing, with a special focus on under 24-year-olds.

Quite a few objectives bound up in those statements!

The idea is that indictors will be measured to show progress (or otherwise) towards these objectives, which are all relevant and topical issues, and hard to disagree with. But there is bound to be criticism from sections of the community whose interests appear to have been left out or who think that other issues should be given prominence – perhaps “looking after our older people” which is a priority I noted above, by another part of government.

There is agreement that the ultimate goal of public policy is to improve wellbeing for all citizens. The wellbeing approach to policy is intended to “identify the actions we believe will make the greatest contribution to improving the intergenerational wellbeing of New Zealanders”. But, as Professor Arthur Grimes said in his commentary, “the proof of the pudding will be in the eating. The question will be whether it will lead to substantive change, or is it just cosmetic?”

We already know, from Statistics New Zealand’s General Social Survey (GSS), that older people score highly on this agency’s measures of wellbeing. People 65 plus have the highest scores for overall life satisfaction and feelings that life is worthwhile, according to GSS data. People 75 plus have the lowest rates for feeling lonely. We still await the 2018 GSS results, which we will have to put against the LSF findings. It is looking to be an interesting year for policy, and we need to keep our eyes and ears primed.

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