Restoring New Zealand’s Health
- Gary Moller
- 6 hours ago
- 6 min read
How Private Profit Has Captured the System – And How We Win It Back
New Zealanders pride themselves on fairness. We like to think our health system looks after everyone, rich or poor. And once upon a time, that was largely true. Through the 1950s, 60s and 70s, New Zealand’s public health service was world-leading: universal, efficient and grounded in the idea that every person, regardless of wealth, walked through the same hospital doors and saw the same specialists.
Those days have slipped away.
Today our health system is sick — not because doctors and nurses aren’t doing their best, but because the structure around them has been captured by private interests, insurance companies, outsourcing arrangements and a political class that either doesn’t understand the mess or lacks the backbone to fix it.
And nowhere is the distortion clearer than in the practice of moonlighting.
Moonlighting: The Conceald Engine of Private Health
Let me explain the pattern plainly.
A surgeon works in the public system. There they see everyone: the elderly, the struggling, the complex, the poor. They run the tests, imaging, diagnostics — all funded by the taxpayer.
Inside that public clinic, something happens. The surgeon also works privately. And now a second process begins: identifying who has insurance, who can self-fund, who is “worth” referring to their private rooms.
This creates what I’ve called the two-step extraction process:
public resources identify the high-value patient
private practice harvests the profit
You’d be surprised how many times patients tell me:“My GP sent me to the public clinic and the public clinic sent me to a private surgeon — same specialist, same person, different door.”
This is not a fringe issue. It is the backbone of private health in New Zealand.
The public system screens the patients.The private system selects the easy, profitable ones.The public system is left with the difficult, costly cases.
Add to this that public waiting lists have blown out to the point where tens of thousands of New Zealanders sit in pain for months or years, and you have the perfect pressure cooker. People are told to wait twelve months in the public system — or three weeks privately. It’s no wonder people cave and pay.
But here is the uncomfortable truth:
Private health relies on public waiting lists. Without long waits, the private market would shrivel.
Private hospitals need those queues. They need the frustration. They need the despair. That’s their sales funnel.
A strong, efficient public system is bad for business.
Read this article: https://www.garymoller.com/post/moonlighting-in-medicine-how-private-health-exploits-the-public-system
When Things Go Wrong: The Public Pays Every Time
Private hospitals thrive on straightforward cases: hips, knees, cataracts, hernias, simple ENT and urology. Low-risk, quick turnover, high reward.
But when something goes wrong — and it does — the entire private model collapses. Private surgical centres simply do not have the deep emergency capability of a true hospital. No 24/7 ICU. No fully staffed emergency department. No crash teams. Limited blood support. No advanced resuscitation capability.
Let me tell you a story I will never forget.
A Preventable New Zealand Tragedy
A close friend of mine went into a private hospital to have a mole removed. He was young — in his early thirties — strong, athletic, a gifted rugby player. A father. A husband. A good man with a full life ahead of him.
A procedure that could have been done under local anaesthetic was instead done under general.
The anaesthetist made a mistake. His heart stopped. He needed immediate, advanced resuscitation — the kind that only exists in a fully equipped public hospital.
The private hospital couldn’t provide it.
They tried. They did what they could. But the capability wasn’t there. An ambulance was called. By the time he reached the public hospital, it was too late. His brain had been starved of oxygen.
He spent the rest of his life severely disabled in a rest home before passing away.
And here is the brutal end to the story:
Every cent of emergency care, ICU support, long-term residential care and the lump-sum compensation to his wife and children was paid by the public.All of it.Not one dollar from the private hospital responsible for the failure.
He lost his life.His family lost their future.The public carried the cost.And the private sector walked away untouched.
If this does not illustrate the structural rot, nothing will.
A System That Profits From Sickness
Let’s go deeper.
A for-profit health industry does not thrive on wellbeing. A healthy person — strong, active, nourished, independent — is a liability. They generate nothing.
The profit lies in illness:
chronic disease
long-term medication
repeat surgery
ongoing diagnostic cycles
dependency from cradle to grave
This is the “womb to the tomb” business model.
Once you see this, you understand why prevention is ignored, why nutrition gets lip service, why natural health irritates the establishment, why waiting lists are allowed to balloon, and why moonlighting persists. Sickness pays. Health does not.
It is not a conspiracy. It is a set of incentives — and incentives shape systems.
New Zealand’s Economic and Health Crisis: Two Sides of the Same Coin
Our economy is weakening. Productivity is flat. Costs are rising. Young, talented people are leaving. When an economy falters, the health system falls with it — and vice versa. Health is not a cost. It is the foundation of a functioning nation.
Allow a country’s people to become sick, sedentary, medicated and dependent, and the economy collapses under the weight. The decline in health is a decline in national capacity.
New Zealand cannot afford a health system that profits from illness. We need a public system that builds health, capability and resilience across every person and every family.
But for that, we need leadership.
Why Reform Requires Political Courage (and Why I Doubt We Have It Right Now)
To restore a genuinely public, genuinely fair health system, we need politicians — especially a Minister of Health — who understand these issues deeply and have the guts to act.
The reforms required are not tinkering. They are structural.
And if I’m honest, I’m sceptical of the current crop of politicians. Most do not understand the frontline. Many are captured by consultants, lobbyists, and the bureaucracy. Few have the background or the courage to challenge private interests.
But that doesn’t mean it can’t be done.
It simply means we must demand more from those who claim to represent us.
How to Rescue a Sick Health System: Real, Practical Solutions
These reforms are grounded in simple logic and public benefit. They are achievable — if the political will exists.
1. End moonlighting in its current form
Public or private — but not both. Choose your lane.
2. Require private hospitals to carry full emergency capability
If they want to use general anaesthetic or perform anything risky, they must provide the same level of emergency care as a public hospital.
3. Stop public clinics feeding private rooms
No more using public assessments as a pipeline for private profit.
4. Ring-fence public specialists’ time
Protect the public workforce from being cannibalised by private lists.
5. Mandatory reporting
Every complication. Every transfer. Every failure. Make it transparent.
6. Levy private surgery to reflect true downstream public costs
If the public system picks up the tab, the private system must pay its share.
7. Invest seriously in prevention
Nutrition, movement, sunlight, resilience — the Freeranger model.A healthy population is cheaper, stronger and more productive than a medicated one.
8. Rebuild primary care
GPs and community clinics must be properly funded and freed from bureaucratic nonsense.
9. Restore national surgical capacity
Clear the waiting lists — and you instantly undercut the private health industry’s entire business model.
This is what real reform looks like.
New Zealand Can Do This
Despite everything, I’m hopeful.
Kiwis are fair-minded people. We don’t like waste. We don’t like injustice. And we don’t like systems where profit comes before people.
We can rebuild a public health system that works for everyone — Maori, Pacific, Asian, Pakeha, male, female, young, old, wealthy, struggling — every person in this country. A system that is robust, honest, functional and fit for the future.
A system that values prevention over dependency.A system that rewards health, not sickness.A system that builds resilience instead of fragility.A system that reflects who we are when we live freely, naturally and with integrity.
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