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The BulletinJune 2, 2023

How a debate over $5 chemist fees descended into a row over ‘gutter politics’


The government suggests National want to take women back to the ’50s – or worse. The opposition says it’s the victim of a smear campaign, writes Catherine McGregor in this excerpt from The Bulletin, The Spinoff’s morning news round-up. To receive The Bulletin in full each weekday, sign up here.

A single gif, and a whole lot of drama

Despite knowing full well that it ran out of steam at least two seasons ago, I can’t seem to give up on the Handmaid’s Tale. Even if you don’t watch it yourself, you probably know it’s set in a totalitarian near-future when women are forced into sexual and religious submission by a fundamentalist ruling class. Not really much like contemporary New Zealand, then. Yet when National confirmed contraceptives won’t be exempt from its plan to reinstate the $5 prescription charge, Labour’s Megan Woods tweeted out a gif from the show in response. It wasn’t just Woods. “The 1950s called and they want their National Party back,” said prime minister Chris Hipkins. National’s Nicola Willis said Labour was “getting down in the gutter”; Christopher Luxon called it a “smear campaign”. “[Labour] see Luxon’s stance on abortion as a weakness with women so they leapt at the chance for another reproductive rights crack,” writes Newshub’s Amelia Wade. “But their hyperbole is an own goal. If Labour’s Handmaid outrage is to be believed, why’s it taken them six years to remove the prescription fee?”

Getting birth control to those who need it

While it plans to bring back the $5 fee, Willis says National also wants to increase access to clinics offering free birth control, and enhance subsidies for long-acting contraceptives such as IUDs. Writing for the NZ Herald (paywalled), Lizzie Marvelly argues that not only should all contraceptives be free of charge, but so should all GP consultations where they’re prescribed. “A return to the unpopular prescription fees will mean a return to an inequitable system,” she writes. “Luxon [has] showed voters – particularly female voters – that he has no problem with a regime that penalises women unfairly.” A widely shared Spinoff article by The Kākā’s Bernard Hickey sets out the economic reasoning for scrapping the $5 charge, which can become prohibitive for low income earners who have a number of regular prescriptions to fill. Removing the charge will generate savings of around $2.65 billion a year in reduced hospital visits, according to data collected by Otago University researchers.

The fairness debate rumbles on

National’s plan to give free prescriptions to only the neediest groups might sound good on paper, but universal policies are cheaper to administer, prevent stigmatisation and enable wider uptake, argues former Labour advisor Clint Smith on The Spinoff. The fairness of the government’s prescription fee cut was debated again in parliament after National’s health spokesperson Shane Reti noted that British and Australian visitors will now get free prescriptions under reciprocal health agreements with New Zealand. Reti compared it to French backpackers getting last year’s cost of living payment, reports the NZ Herald. Another view of the fairness issue comes from community pharmacists, who argued that the free prescriptions offered by the likes of Chemist Warehouse were a threat to their livelihoods. In their view, scrapping the fee will level the playing field and help keep smaller operations in business.

The problem with a two-tier health system

The rule change, set to commence on July 1, represents one of the largest increases to pharmaceutical funding in recent history, the Herald reports. But unlike previous pharma boosts, no new medicines have been funded by Pharmac, meaning many patients will continue to have to pay out of pocket for the treatments they need. The relationship between the private and public health systems is the subject of a thought-provoking piece by bioethics lecturer Elizabeth Fenton, republished on The Spinoff. “Our willingness to accept a second tier of healthcare accessible only to those who can pay depends on the sufficiency of the first tier. The worse the services in the first tier, the weaker the justification for the second tier.”

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