New Zealand Healthcare for Non-NZ Residents, International Students

I’ve had another encounter with the medical system and thought I’d share some of the travails of accessing healthcare in New Zealand without the benefit of being on the public system. The international student insurance is for all intents and purposes just extended travel insurance. It doesn’t cover preventative care (even though postgraduate students are here for years and likely to need to access some preventative care) nor is it designed to let you see anyone not at the university health center. The dentist I saw last year recommended this doctor to me because he isn’t a New Zealander and is younger – he said he is more in tune with the latest goings-on in healthcare. Well, that didn’t quite turn out to be true, and doctors are still woefully ignorant about nutrition and how it impacts on health, and it is still ridiculous to expect a stranger to figure out what is ailing you in the brief 10-15 minutes you get. You’ve done hours of research and meanwhile they’re looking at a few numbers on a piece of paper as if that’s all they need. But, after a round of test results, I was able to achieve a somewhat satisfactory outcome after a couple tries.

If you aren’t covered by the public New Zealand healthcare system, here are some of the hassles you will have to go through, and some of the prices I’ve paid:

A visit to the doctor’s office as an international student (non-NZ resident): $95.

They said they were not legally allowed to do any lab work on me there, so I had to drive to one of the Canterbury Southern Community Laboratories (SCL) collection centers for bloodwork. I ended up holding up the line for quite a bit because the poor attendant had to look up in the price list all of the different codes and prices for each lab test that the doctor ordered. (There was no receptionist at the center I went to.)

Bloodwork lab tests: ranged from $7 to $44 each. Most were under $20.

These costs actually seemed pretty reasonable considering they are regular prices without insurance, and the results came back very promptly. I was able to get a printout of everything from the doctor’s office without hassle, too. (In the U.S., they always seemed to balk when I wanted my own copies of my own records!)

I also went in to see the nurse instead of the doctor one time, and that visit was less expensive ($31). You can get away with this type of visit in some instances, so you might want to ask.

The staff was nice, but they were clearly not used to dealing with people not on the public system. They seemed afraid to ask me for the $95 every time, whispering among their coworkers to check that it was really that much before getting payment. A couple newspaper articles recently have detailed some disgruntled seniors who can’t even get on the waitlists for some procedures because there aren’t enough specialists in the country, so that is a bit disconcerting. You’d think these countries would be pushing harder for better nutrition and preventative care to avoid having so much demand on services later in life. But no, their grocery stores are full of cheap soda and sugary treats, and students are guzzling energy drinks and Coke like it’s no problem.

Prescription drugs are reasonably priced as well, around $15-25 for a month’s supply. You can only get a few months of medicine at a time, but I’ve already detailed that in an earlier post.

Rigid Systems

Health

I received a care package from home (yay Chex Mix!), but unfortunately it was intercepted by MedSafe and they confiscated some of the supplements inside because New Zealand's nanny-state health system requires a prescription for them. In the U.S., melatonin is a sleep aid and sold as a supplement. The letter gives you 30 days to get a legitimate prescription from a doctor (and if you have more than a 3-month supply, the doctor has to take anything over 3 months' worth and dole them out to you gradually) or they destroy them. The letter tries to convince you how bad it is to order drugs online because they could be harmful. I really don't like the health care system here. Also just found out that the junky student health insurance they sell us is really only intended as a travel insurance, so that's why it doesn't cover anything. The government discontinued students getting onto the good health insurance in 2011 apparently.

My Presentations

I had my one-year confirmation oral presentation with my supervisors, a moderator from the department, and a friend who wanted to come along. I'm glad she did because then I could complain about it afterward with someone who had been there. It wasn't too bad, but I get frustrated at constantly being told I haven't include this, that, and the other French theorist for some point, and how the paper won't pass if I don't include them. Research has gotten so bogged down in these theory fads; it used to be psychoanalysis, but of course that went out of vogue. Now it's poststructuralism, but that too will pass eventually. It seems to become more about pleasing others than making a good, original contribution to the field that is accessible to not just a minority.

One of my former students invited me to give a lecture to the public downtown for International Parking Day, where people buy a parking spot and protest cities being made for cars instead of people by setting up alternate things in the parking spot (like a living room set or a table with leaflets and hands-on activities). There weren't too many passers-by in the early afternoon, but I still got a chance to practice presenting and time myself on my Digital Humanities presentations. We had some good conversations before and after about education and travel, so it was a nice experience.

Got to meet the cutest white German Shepherd walking by!

 Others' Presentations

There continue to be interesting presentations that fill me up with all kinds of ideas. It's what I am enjoying most about being back in school. One of the Digital Humanities ones was on the shift from product-based capitalism to financial capitalism where people make money off of money and digital things like data. Basically, we're giving away our data for free when we use social media and other apps that harvest our data and sell it to advertisers. It's digital sharecropping and we should be cautious about further enriching the .0001% (Google, Facebook, etc.). Hard to disagree that we're being taken advantage of.

Peter Singer, who helped start the animal rights movement in the 70s, was in town speaking on effective altruism, utilitarianism, and rationalism. He believes that people should give their money away to charities and places where it will make the most impact, so like to African charities that provide very low-cost mosquito nets to combat malaria. He says saving more people is better than saving fewer, even if that means not helping people in your community because the money will make more of a difference to really impoverished people. He specifically called out things like walk-a-thons that require a lot of people's time that might be better spent working and earning money that could then be given away. But some people do things for the psychological benefit and so aren't being as altruistic as they could be. It was an intriguing talk with some good audience questions afterward.

An Emeritus Professor of Political Science gave a lecture on throwing out the political science canon (Hobbes, Locke, and Rousseau) because it limits people's perspectives and the ability to make new connections. He said there is no reason we need to keep reading these men's works as if they are the only way of looking at political issues and motivations. I had to agree with him, more in the context of my own field (see above on my confirmation) where a handful of theorists now dominate the perspective one can take when critically examining literature. But the only reason he can say this is because he's retired and has the freedom to challenge the canon.

Diane Foreman is one of the most successful women in the Asia-Pacific region, and the university's entrepreneurship program invited her to give a talk on her successful business career. I had just read about her in a magazine my friend gave to me so some of the information was repeated, but it was cool to hear about some of her business experiences and how she thinks of herself as a capitalist feminist. She believes in treating her employees well and incentivizing them to do better, which has been missing in a lot of my former workplaces. She also talked about the issue with selling time, a point raised in the magazine article. Kids are encouraged to grow up and enter the professions: doctor, lawyer, accountant, etc. But the problem with these pathways is that you can only make money by selling your time. You might bill out at $1,000 an hour, but you aren't making money without billable hours. As a business owner, though, you can make money without having to physically be at your business. You aren't at the mercy of needing others to pay you for your time. She said we should be encouraging kids who have the entrepreneurial spirit to become business owners. I would add that we should be teaching basic business and financial skills to everyone, so even those with Art and Science backgrounds can go into business if they desire. 

The second annual university Feminist Society day conference went well, and I learned some interesting things, including some scary facts about how radicalization is affecting kids and women in the Middle East. There are no easy answers.

 Education

My friend recommended a TV show where several Chinese teachers go to a British school and teach the kids in the "Chinese method" for 3 weeks and see if it is more effective than the British method of teaching. He thought I would be against the Chinese method because it is so rigid and involves 10-12 hours of school per day, but I told him that I had a similarly rigid method of teaching at some points in my education and am all for it. I didn't know how many hours Chinese kids go to school though. He said in junior high and onward, they are constantly at school or at home studying; they have very little free time. Everything is geared toward passing exams to get into a good college. [The BBC documentary was called Are Our Kids Tough Enough? I watched it on YouTube, but it has since been removed for copyright complaints from BBC. It might be available elsewhere.]

Speaking of education, the more I learn about the NCEA high school education system here, the more concerned I am for this country. I had to help a student who is constantly being marked down for his bad grammar and punctuation and said he has a tendency to write long sentences that are incorrect; when I asked him if he knew how sentences work (with a subject and verb and stuff like that), he gave me the saddest face and shook his head and said no, he didn't. Where do you even go with that? It's incredibly difficult to try to explain why something is grammatically incorrect if they don't know the parts of speech and how sentences fit together with punctuation. I learned from the Chinese vs. British show that the UK stopped teaching grammar in the 60s, so I assume that carried over to New Zealand as well. I know some schools still do it, but it's probably only the good ones. I'm hoping the U.S. hasn't given up on grammar; I know they were still teaching it when I went through.

When students here try to apply to PhD programs in the U.S., they are completely intimidated by the GRE tests since they don't have to take anything like the SAT or ACT to get into college. If they don't pass their high school classes here, they can wait until they turn 20 and get in without any requirement. And since there are a lot fewer requirements for what they take in high school, the last time they took a math class might have been junior high! I would venture the rate of doing well on those kinds of tests is not very high; they're hard enough for those of us who've been conditioned to the standardized test system!

Spring is finally coming!

Grading, Seminars, and Dentist Appointment

My cat loves his pet bed and the microwavable warmer. I heat it up in the morning before leaving for school and it is still warm when I get back in the evening. I found a New Zealand supplier (pet.co.nz) so I didn't have to wait.

I really enjoyed Jurassic World and all of the science fiction implications. If we have time while in Sydney, I'd like to see it in 3-D IMAX! The ending is pure awesome.

Grading 30 essays was a huge pain and took me 3 days to complete. The good news is some students did a lot better than last time (not that anything in the class was about improving their writing) and there were fewer instances of plagiarism. However, some students did worse and evidently didn't feel like putting much time into their work. A lot of them clearly struggled with the essay questions, but only a couple sought my help.

Seminars & Conference

I won one of two travel scholarships to one of the Australia conferences I'm going to in a few weeks, so that was great news. They would like to present it to the awardees at the conference banquet as well.

I attended several of the Teaching Week seminars on-campus and learned a lot of good information on diversity, ineffectiveness of the lecture for student engagement and learning, and motivations and profiles of first-year law students. I feel like I'm being stuffed full of information which is all coming together with common themes.

The National Digital Forum held a one-day "barcamp" which is a kind of conference where the people attending decide on the topics they want to see covered, rather than the program being pre-determined. It was an interesting way of organizing. Attendees ranged from library staff, to academics and teachers, to students, to museum and gallery staff. We shared tools and resources, ideas on how to digitize content and why it is so important, ways of helping people learn coding and tech skills, and how to enable partnerships between libraries, museums, and students. I have quickly become a big proponent of Digital Humanities and the importance of turning the critical eye of the humanities to digital content and not letting the small percentage of programmers dominate the tech sector. I am looking forward to the international Digital Humanities conference in one week in Sydney!

Dentist Appointment

We had our first experience with dentistry in New Zealand. Apparently, it is uncommon to have dentists and hygienists work together in the same office. So when you go for a dental checkup and X-rays, this is performed by a dentist in a 15-minute window. To get an actual teeth cleaning, you have to go to a hygienist and pay anywhere from $80-$150 because dental things are not subsidized by the government healthcare system. The dentist said he would really like to have a hygienist in his office, but he has faced resistance from New Zealanders who think that it is a strange concept. 

He was a fairly young guy who has a lot of complaints about the abysmal state of healthcare, especially dentistry, here. He recommended American or British doctors because they will be more thorough and caring (threat of litigation still weighs on American doctors he said). He and his staff were telling me horror stories about their encounters with the healthcare system, like a family member getting metal in an eye that ended up rusting and causing permanent damage, all because the initial doctor said there was nothing in the eye (and the person can't sue in this system). I said they could probably be a millionaire in the U.S.! They also mentioned doctors giving wrong prescriptions and ignoring a woman on the floor in pain who clearly needed emergency medical attention. He was also upset that the government was trying to pretend there were no waiting lists for healthcare by pressuring healthcare providers into essentially hiding their waiting lists. It was all very disappointing to hear.

Not-so-pleasant Aspects

After the two-week trip in the North Island, the time has come for some of the not-so-pleasant aspects of New Zealand. The speeding ticket from the first day of the roadtrip waiting in the mail did not help...

Healthcare

My first experience with the New Zealand healthcare system was not enjoyable. The law only allows pharmacies to dispense 3 months' worth of prescription drugs at a time. You have to go back in for a doctor's appointment every 3 months to get a refill (contraception is the exception - it is every 6 months). For people on a medication for years that does not require close monitoring, this is ridiculous. The international student insurance of course doesn't cover the appointment or the prescriptions, so this could quickly become a signficant cost. Some other students have said that it is sometimes possible to get a cheaper nurse's appointment for refills, but I have not tried this yet. (Also, even over-the-counter drugs from a pharmacist can only be given out in 1-month supply.)

Living

We have found that toilets here don't flush well, regardless of whether or not they are in rich people's houses or nice business establishments. It is nice that most of them have the dual-flush option to save water, but they don't get enough power to actually get the water clean. I finally looked up the difference and found an Australian company trying to show that their way is superior to the North American way: 

"North American toilets most commonly utilize siphon jet technology. Most of the water in the tank is used to create a vacuum or siphon effect in the trapway of the toilet bowl, which then pulls the waste out after the water. [...] Washdown toilets do not use this flushing mechanism. When flushed, the water is released very quickly from the tank and into the bowl through an open rim bowl design" (http://www.caromausa.com/resources/faq.php#a2). 

Sorry, but the washdown toilets just don't do the job. It's not saving water if you have to flush several times. 

Power outlets are not installed in most bathrooms, at least not in older places. If they are, they are in inconvenient locations and not usable for things that need to rest, like electric toothbrush charging stations. I'm not sure where people who use electric appliances (hairdryer, hair curler, etc.) get ready in the mornings. There is also a general lack of power outlets in hallways or rooms; often there is only one or two for a whole room. Power strips are the norm here.

I think I've already mentioned the absurdity of the sub-standard housing and lack of central heating, but now that colder weather is here again (52 degrees F in the house this morning), it is very frustrating. Just using the heat pump for a little bit in the morning and evening and heating blankets has shot the electricity bill up a lot. It will easily be over $300 a month for electricity this winter. Also, I downloaded the manual for the heat pump which is technically an air conditioner to try to figure out how the timer works so the kitchen won't be an ice box in the morning. I had to laugh out loud:

"Heating Performance: The air conditioner operates on the heat-pump principle, absorbing heat from outdoor air and transferring that heat indoors. As a result, the operating performance is reduced as outdoor air temperature drops. If you feel that insufficient heating performance is being produced, we recommend you use this air conditioner in conjunction with another kind of heating appliance."

So...the main source of heating in most New Zealand houses is not really designed to work well when it's cold outside. Great... Guess it's good I have three space heaters, three heating blankets...

Part of the reason we study at school is because most of the buildings are heated (who knows how much that costs). But it is unclear who is in charge of the heating. Sometimes if the weather outside warms up, it actually becoems too hot in the room and students start opening windows to get a breeze. Having heaters on and windows open is so wasteful. 

We started using our clothes dryer and discovered that because it doesn't have a vent on the back, all of the moisture in the clothes shoots out through the front vent and soaks the laundry room floor in front of it. I'm not sure who designed it this way or why there isn't at least a warning that you will have a puddle to contend with when you use the appliance.

"Morning tea" is basically snack-time at 11:00am, and last week I went to one as part of a staff meeting. As in the past, there were napkins but no paper plates or utensils for eating some of the food. All of the food is not finger food, and yet they still do not provide a non-messy way of eating them. This has happened with fruit before, but this time there were full sponge cake and carrot cake pieces. I picked up a piece of the chocolate and raspberry sponge cake with my bare hand and it oozed raspberry jam and whipped cream all over. I put it in a napkin to hold it, but this still involved sacrificing one hand to become entirely messy. I cannot understand how anyone thinks this kind of food can be eaten without a plate and fork. 

Education

I know a lot of U.S. college teachers still take attendance in their classes and count it as part of your grade. Here, taking attendance is not the norm (although I've heard some teachers do it). Sometimes lecture halls are full; other times they are visibly missing most of the students. My tutorial attendance has been steadily dropping and I know I have neither carrot nor stick to hold over them. Fewer students are actually completing the weekly reading as well, making it difficult to have discussions when no one has read. The whole system seems to be based on the ideal notion that students are there to learn, rather than complete the assignments, pass the classes, and earn a degree that can then help them get a job. There are some good students, of course, but you have to wonder what the rest of them are doing with their time since most classes don't have homework and just have a couple essays or tests for the entire grade. 

I also just finished grading their first round of essays and encountered an astonishingly high number of grammar and punctuation errors. From asking around the staff and other postgrads, I have learned that the New Zealand education system is not very good and if you don't go to a good school or have a good English teacher, you probably won't learn grammar or how to write an essay.  

Another interesting thing is that the school allows time clashes, so a student can be enrolled in two classes that have lectures at the same time and not go to one of them but complete the assignments and get credit for it. Some of my students are unable to attend my tutorials because of time clashes. There are also three-week-long study breaks with exams at the end. We never had that long to study for our exams; plus, we had homework throughout the semester! I believe these breaks are a legacy of the British system.

General 

D learned in one of his law classes that there has been boilerplate language regarding acts of God (like earthquakes) in mortgage agreements for decades, and people signed them without any consideration that their homes could be repossessed and demolished by the bank if it deemed earthquake damage irreparable. So technically, if a homeowner didn't have earthquake insurance, they wouldn't be entitled to receive any compensation in the event of an earthquake. Yet because the 2010 and 2011 earthquakes caused so much damage to the city as a whole, public pressure ended up turning against the enforcement of these clauses. The situation raises interesting questions about whether it's fair to the people who prepared and bought earthquake insurance that people who didn't pay for it ended up getting bailed out because of the disaster. Four years later, people are still waiting for insurance claims to be settled and a couple houses in our neighborhood are in the process of being demolished. 

Also, earthquakes are getting to be a pretty common occurence for me here, though I am still scared when they happen. We experienced our first one while at school on April 24th. Since we were several floors up, the shaking was gentle. It lasted for about 20 seconds.

A lot of roads are poorly marked. In the U.S. there are Botts' Dots and reflective markers so you can clearly see the lanes. In the dark, it is hard to tell where lanes are, and it is dangerous when it's raining and you can't see where you're supposed to be driving. In construction areas especially, you sometimes have to guess where the lane dividers are. 

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I think that is the bulk of it for now. It will be interesting to compare Australia in a few months with New Zealand and the U.S. It should hopefully be a bit warmer there!