Myth 1: Primary health care is not important

Fact: PMS is the backbone of the health care system. It is the patient’s first contact with the medical system where preventive measures, diagnosis and treatment of diseases are provided. Through PMS, serious illnesses can be prevented from developing, reducing the need for hospitalization and specialized care.

Myth 2: Family physicians provide only basic medical services

Fact: Family physicians provide a wide range of medical services. They not only treat acute and chronic illnesses, but also provide preventive checkups, immunizations, healthy lifestyle recommendations, and referrals to specialists when needed. Their role goes far beyond just treating symptoms.

Myth 3: Visiting your family doctor is not necessary if there are no visible symptoms

Fact: Regular visits to your family doctor are important even if you have no symptoms. Preventive check-ups can help identify potential problems early, which helps in better treatment and prevention of complications. A healthy lifestyle and regular health check-ups are key to longevity.

Myth 4: Primary health care is ineffective for chronic diseases

Fact: Chronic disease management is a core function of PHC. Family physicians develop individualized treatment plans for patients with chronic conditions such as diabetes, hypertension and asthma. This helps control disease, reduce the risk of complications, and improve patients’ quality of life.

Myth 5: You should go straight to subspecialists for specialized care

Fact: Family physicians can refer you to a subspecialist if necessary. However, in most cases, the initial health assessment and basic treatment can be done by your family physician. This saves time and resources for both the patient and the health care system as a whole.

Myth 6: Vaccination is not part of primary health care

Fact: Immunizations are an important part of PHC. Family physicians and nurses administer vaccinations to prevent a variety of infectious diseases. Vaccines help protect both individual health and public health by preventing disease outbreaks.

Myth 7: PHC does not encompass mental health

Fact: PHC encompasses mental health along with physical health. Family physicians can diagnose and treat a variety of mental health disorders, provide counseling and referrals to mental health professionals when needed. Mental health is an integral part of a person’s overall well-being.

Myth 8: PHC is only available in major cities

Fact: In New Zealand, PHC is available in both urban and rural areas. The government and health facilities are committed to ensuring access to quality primary health care for everyone in the country, regardless of where they live.

Myth 9: PHC is expensive

Fact: In New Zealand, many PHC services are subsidized by the government, making them affordable to the public. There are programs in place to help reduce the cost of health services for different groups of people, including children, retirees, and people on low incomes.

Myth 10: A family doctor cannot help with rare diseases

Fact: Although family physicians are not subspecialists, they have a wide range of knowledge and experience that allows them to recognize rare diseases. When necessary, they refer patients to appropriate specialists for further evaluation and treatment.

Primary health care plays a key role in maintaining a healthy population. Understanding the true nature and function of PHC helps to break down myths and appreciate its importance to everyone in New Zealand. Seeing your family doctor regularly and utilizing available health services can help maintain health and improve quality of life.

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What is the difference between public and private healthcare?

The public healthcare system and the Accident Compensation Corporation (ACC) will provide you with a good level of medical care for urgent care, emergency care, and accidents.

The public health system classifies non-emergency conditions as “elective” treatment, which means you will have to qualify for treatment and (most likely) remain on a waiting list. Common “elective” treatments are hip or knee endoscopy, heart surgery, hysterectomy, cataract removal, cancer tumor removal, and diagnostic services such as endoscopy, laparoscopy, MRI, tonsillectomy, and sleeving.

Private health insurance can provide faster access to private hospitals for many of these procedures, as well as help with payment.

Is it worth having private health insurance?

If you are diagnosed with a non-acute medical condition, you may have a long wait for treatment in the public healthcare system. In private healthcare facilities, the wait is often shorter, but surgeries can be expensive. With private health insurance, you can get treatment faster and get help with expenses so that your quality of life is better and faster.

So, do I need health insurance in New Zealand?

It is a personal choice, but having private health insurance will complement the public services to which you are already entitled.

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• Surgical coverage – for example, surgical treatment for acute illnesses such as cancer;
• Non-surgical coverage – for example, allergy treatment;
• Basic diagnostic tests – covering procedures such as biopsies and mammograms;
• Non-pharmacy coverage – coverage for medicines that are not subsidized by Pharmac (essentially the New Zealand government) for specialty medicines you may need;
• Overseas treatment – coverage if the treatment you need cannot be done in New Zealand (although this is rare).

Your individual needs will help you decide how much cover you need. It is pointless to have GP visits covered if you rarely see a doctor and/or cannot afford it, but at the same time not having enough cover can create stress for you and your family later if your cover is not enough to pay for the treatment you need.

Understanding health insurance exclusions

To help you understand what’s most important, we explain what’s “not covered” and “exclusions” and what the difference is.

• Most policies do not cover specific standard treatments such as dental care and physiotherapy – these are known as “not covered”. Below are a few examples, but it is important to check the policy you are purchasing to find out exactly what is not covered. Standard treatments that fall under “not covered” are different from “exclusions”;
• “Exclusions” are claims for medical treatment related to or caused by certain diseases or conditions that are not covered by your health insurance. Examples of exclusions include claims for dementia care, pregnancy complications, and organ transplants.

Examples of items that (usually) fall under “not covered” (unless your policy specifically allows it):

• Consultations with a general practitioner;
• Dental care;
• Optical care (i.e. contact lenses and/or glasses);
• Related treatment, such as physiotherapy, chiropractic care or osteopathy;
• Acupuncture, traditional Chinese medicine and therapeutic massage;
• Speech therapy;
• Any mental health treatment.

Examples of items that (usually) fall under the “exclusions”:

• Chronic diseases;
• Cosmetic care / procedures;
• Dementia;
• Fat transplantation and liposuction;
• Sex reassignment surgery;
• HIV/AIDS and any medical condition resulting from it;
• Infertility or assisted reproduction (IVF);
• Disease caused or contributed to by drug or substance abuse;
• Organ transplantation, transfusion of autologous blood/blood products;
• Self-inflicted illness or injury;
• Unapproved medical services.

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Early diagnosis and treatment

Regular visits to your family doctor help detect conditions early, which increases the chances of successful treatment.

Preventing complications

Effective chronic disease management reduces the risk of complications and hospitalizations.

Reducing health care costs

Prevention and early diagnosis of diseases help reduce the cost of treatment in the long term.

Improved quality of life

Ongoing medical support and advice on living a healthy lifestyle helps to improve overall health and quality of life.

How do I get primary health care in New Zealand?

Everyone in New Zealand is entitled to primary health care services. To use these services, you need to:

Register with a family doctor (GP)

Find a medical practice near you and register with a GP. This can be done online or by visiting the clinic in person.

Use online resources

Use online platforms to find doctors, book appointments and get medical advice.

Go to a pharmacy

Many pharmacies provide primary care services, including drug counseling and immunizations.

Visit the dentist

Regular checkups with a dentist are important for maintaining oral health and preventing disease.

Understanding the basics of primary care and actively utilizing available services can help you and your loved ones maintain good health and prevent serious illnesses. Don’t neglect your regular dental visits and take charge of your health.

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What is primary health care?

Primary health care includes a wide range of services provided on an outpatient basis. It includes prevention, diagnosis, treatment and management of chronic conditions. The main providers of PHC are family physicians (GPs), nurses, pharmacists, dentists and other health professionals who provide community-based care.

Primary health care services

Primary health care covers various aspects of health including, but not limited to, the following:

Disease prevention and health promotion

• Immunization;
• Screening programs to detect early signs of disease;
• Counseling on nutrition, physical activity and avoidance of unhealthy habits.

Diagnosis and treatment

• Initial examination and treatment of acute and chronic diseases;
• Referrals to specialists when necessary;
• Laboratory tests and analyses.

Chronic disease management

• Health management of patients with diabetes, hypertension, asthma and other chronic diseases;
• Support and education for patients to improve self-management of their health care.

Rehabilitation and support after injuries and surgeries

• Assistance in recovery from surgical procedures;
• Physical therapy and recovery counseling.

Mental Health

• Counseling and support for patients with depression, anxiety disorders, and other mental health conditions;
• Referrals to mental health professionals.

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At the hospital, the patient will be seen by a practice nurse. If the patient’s condition is serious and life-threatening, he or she will be referred to a doctor immediately. In other cases, the patient will have to wait in a “waiting list” to see a doctor. The waiting time can be several hours, especially on weekends.

You can also contact Healthpoint’s 24-hour telephone counseling service.

HealthPoint is a toll-free phone line that is open 24/7. You can get advice about your health and medical care in New Zealand. Qualified nurses are available to help you determine if you need to see a doctor, find a clinic, or answer health-related questions.

How to know where to go if you are in pain

The Your Location Doctor website schematically summarizes the levels of care.

GP / Pharmacy

If you have a cold or other illness, you can go to consult your GP family doctor or go to the pharmacy if you have a mild illness.

Accident & Medical Clinic (Urgent Care Clinic)

For urgent health problems when you cannot see your family doctor. For example, if you break your arm or get a deep cut.

Hospital. Urgent care hospital

If you are seriously ill and need to be hospitalized and there is a life-threatening condition, you should go to an emergency room by calling 111.

ACC Accident Insurance

All people in New Zealand, regardless of visa type, age and occupation, or time spent in the country, are insured with Accident Compensation Corporation (ACC). This organization covers all accidents, from road accidents and workplace injuries, to skiing injuries, accidental falls and more.

If an accident does occur, the medical staff at the hospital offers to fill out the necessary form. ACC allows you to pay not only for medical treatment and recovery expenses, but also includes payment for home and work assistance, as well as disability benefits.

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