May 3, 2026 • 13 mins
The Health Innovators' Summit takes place in Auckland tomorrow with this year's discussion centring around ideas to create a world-class, high performing health system for New Zealand.
The keynote speaker is one of the world’s foremost health policy experts and author of Which Country Has The World’s Best Health Care?, Dr Ezekiel Emanuel.
He joined Kerre Woodham to chat about the state of New Zealand healthcare and how other countries operate differently.
"New Zealand is exactly where there's a line how rich a country is versus how much it spends on healthcare, and New Zealand's exactly on that line for the per capita GDP," Emanuel said.
LISTEN ABOVE
See omnystudio.com/listener for privacy information.
Listen
Watch
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
You're listening to the Carrywood and Mornings podcast from news
Talks headb.
Speaker 2 (00:11):
As I mentioned earlier, the Health Innovator's Summit, a New
Zealand initiative event an association within i B New Zealand,
takes place in Auckland tomorrow. This year's discussion focuses on
exploring ideas to create a world class, high performing health
system for New Zealand. How long have we been trying
(00:32):
to get one like that? Minister of Health Same and
Brown Associate Health Minister David Seymour will both be speaking
at the event. However, the keynote speaker is one of
the world's foremost health policy experts and author of Which
Country has the World's Best Healthcare? Doctor Ezekiel Emmanuel joins
(00:52):
me now, a very very good morning to you.
Speaker 3 (00:55):
Thank you for having me. I'm here.
Speaker 2 (00:57):
I assume for those who haven't read Which Country has
the World's Best Healthcare? The answer is not New Zealand.
Speaker 4 (01:08):
I actually don't say a single country has the world's
best healthcare. In part, I don't say that because there
are so many different metrics you want to use, and
different countries have different preferences. You know, whether you pay
co pay at the point of hair. There are lots
of countries like Canada that don't have such things.
Speaker 3 (01:29):
Or Italy.
Speaker 4 (01:30):
Whether you get you know how much you're spending of
your budget matters to to people are there waiting lists
and how long the waiting list. So there's not a
single country that's best. And I when I evaluate the countries,
I put three or four of them at the top. Netherlands, Norway, Taiwan,
(01:53):
which has a.
Speaker 3 (01:54):
Very low budget.
Speaker 4 (01:56):
Its hospitals are kind of like graduate dormitories, and it's
real problem is that doctors work. You don't get a
lot of doctors time that they see one hundred patients
a day. Nonetheless, it's very low cost. You can walk
in and order an MRI for yourself and it's pretty
high quality. So yeah, I think the best for New
(02:19):
Zealand to compare themselves to is places like Netherlands and Norway.
Speaker 2 (02:23):
Does size matter in terms of budget or is it
about how it's managed, Because for years I have heard
from those within the hell system that in fact they
do get enough money, but so much of it is wasted.
Speaker 3 (02:37):
I don't know about the wasted.
Speaker 4 (02:40):
New Zealand is exactly where there's a line how rich
a country is versus how much it spends on healthcare,
and New Zealand's exactly on that line for the per
capita GDP. I think you know my assessment, and here
I will have to admit I'm not the world's leading
expert on New Zealand. New Zealand is could suffer pretty well,
(03:04):
spending about half a percent of GDP more on healthcare,
mainly raising wages I think, and giving big bonuses for
achieving optimal care. But I think some of it is
how hard the doctors work, how hard, and also other aspects.
(03:28):
I'll give you one example. In the United States, we've
moved a.
Speaker 3 (03:33):
Lot of surgery out of the hospital to what.
Speaker 4 (03:35):
Are called ambulatory surgery centers, which are much cheaper to operate,
where people can come in and within twenty four hours
go home and do a lot of the follow up
care at home. We've done this even for hip replacements,
knee replacements, and that's very different than New Zealand, which
has basically none of that. So I think that's a
(03:56):
kind of innovation that would be necessary. I'd say another
innovation that I would think would be both cost savings
and reduce position frustration and complaints about administrative burden would
be more ambient.
Speaker 3 (04:11):
AI in the.
Speaker 4 (04:13):
Office room that can transcribe a note, that can make
orders and things like that. Those have been found physicians
certainly in the United States love them and by you know,
the burnout rate when when physicians use them really goes
down ex Actually, so those are some of the yeah,
(04:34):
because the machine is doing more of the of the
grunt work as we call it in the United States,
And those are some of the innovations I think that
would go well and they wouldn't really raise the costs.
Speaker 3 (04:46):
In some cases, they would actually reduce the costs.
Speaker 4 (04:50):
And then I think there's other AI innovations that that
New Zealand could lead on. But I you know, again
my assessment, and I want to you know, hesitate to
be definitive, is that New Zealand hasn't leaned into a
lot of things like AI, and I think being more
(05:10):
aggressive in some areas could actually both save money, increase
access and in pre satisfaction.
Speaker 2 (05:19):
Yes, that's an interesting point you make too, because when
you look at I mean I know a number of
surgeons who in New Zealand who work in our hospitals
here both private and public, and they will use their downtime,
a portion of their downtime to go to the Pacific
Islands and perform surgeries there and far more rudimentary and
basic kind of surroundings. But the surgery is the same
(05:43):
and it's just as successful and the outcomes are just
as good. They just don't have the bells and whistles
that they have back at home, either for the patient
or for the doctor.
Speaker 4 (05:53):
Yes, you know, I mean the Indians are famous for
these sort of assembly line operating rooms where you often
get operated on by nanda for example.
Speaker 3 (06:06):
Just cataract surgery. Yeah, you know, look, let's be clear.
Well I'll let me just raise two.
Speaker 4 (06:14):
Cataract surgery is not as you might say here in
New Zealand with rocket labs around.
Speaker 3 (06:20):
It's not rocket science.
Speaker 4 (06:21):
Yeah, and good people with good whose hands are very
good and they can do that, and they don't have
to be doctors. They can be overseen by doctors, and
they really do assembly lines. They also they also have
a sort of assembly line for coronary bypass graphs. So
I think there's a lot of innovation like that that
(06:42):
you can do. You know, as you say, it doesn't
have all the bells and whistles, but it's very effective
and gets to the same results. You know, I was
in Mozambique a decade ago and they had seamstresses doing circumcisions.
Speaker 3 (06:58):
On young males because to prevent AIDS.
Speaker 4 (07:01):
And you know, they got you know, a week or
two weeks of training and that was it, and they
were doing a fine job with very low infection rates
and things like that. So you know, there are other
ways of doing things than we then were used to
in developing country. I can tell you that in the
United States heart some heart catheterizations are done by physician assistance,
(07:25):
not by the physicians.
Speaker 2 (07:27):
So you know, yeah, interesting, Like we were seeing a
number of New Zealanders heading over to Thailand and you're
on those medical tours. Are you seeing that in other
countries as well?
Speaker 4 (07:41):
Yeah, look, yes, you do see some medical tourism. Let
me just say, I got to think about ten or
fifteen years ago, there was a big flurry o medical tourism.
We're going to save a lot of money that way,
forget it. There can be some medical tourism. A few
people will go overseas for medical procedures. It's not going
to solve the underlying healthcare. It's just some issues, you know.
(08:03):
I think New Zealand we have to distinguish two big issues.
Speaker 3 (08:06):
There are three big issues I think in New Zealand.
Speaker 4 (08:09):
One is a sort of financial issue, how you structure
the system.
Speaker 3 (08:15):
One is workforce.
Speaker 4 (08:17):
And here my sense is that New Zealand doesn't have
too few doctors. I think there's got to be some
change again, as I said, increase pay for increased work
and more assessment of outcomes.
Speaker 3 (08:34):
And I think that's very important.
Speaker 4 (08:36):
And then there's obviously a big complaint about waiting times.
Let me just give you a secret. Every place, every
country complains about waiting times.
Speaker 3 (08:46):
Okay, this is not unique to New Zealand.
Speaker 4 (08:48):
And by the way, you don't have it worse than
many other countries, including many countries as rich, if not richer.
And so I think I think, you know, figuring out what.
Speaker 3 (09:03):
How to address that problem.
Speaker 4 (09:05):
Part of that, I do think is more money, more
money for to pay to work harder and longer, and
you're probably more surgeons who really want to operate and
get them to operate. You know, there's a relationship in
medicine which is called the volume quality out relationship, which
(09:29):
is the more you do of something like, the more
hip replacements you do, the higher your quality. Yeah, and
the reason is you've become much more skilled at it.
It becomes automatic sort of. You know, you know exactly
what you're doing, your team knows exactly what you're doing.
And I think, you know, getting up to that level
is very very important, both to improve the quality of
(09:50):
care and also obviously to get rid of backlogs.
Speaker 2 (09:55):
How much responsibility does a population have to prevent themselves
from getting into hospital in the first place.
Speaker 4 (10:07):
All of us, I think, you know, I've just written
a wellness book. There are many wellness things we can do.
There are six main wellness things that we can do.
As far as I can tell, New Zealand's pretty good
on a lot of the wellness things, eating, well, exercising,
social interaction. And so I think that's that's clearly important,
(10:30):
clearly has to be part of the equation. But also,
let's face it, as a population ages, things begin to
go bad.
Speaker 3 (10:38):
You know, the body is not meant to live forever.
Speaker 4 (10:42):
You know, the hips go, you get heart problems, you
get lung problems. You know, the body does wear out
and that will lead to needing more healthcare, and that's
inevitable as populations in highly developed countries age.
Speaker 3 (11:02):
It's true everywhere, it's not just true in the unit.
Speaker 4 (11:06):
And I think you know a lot of places are
looking into well, how can we improve healthy aging.
Speaker 3 (11:11):
They're you know, key things.
Speaker 4 (11:13):
You've got to increase the social relationships and social interaction.
Speaker 3 (11:17):
Among the elderly. You have to make sure they.
Speaker 4 (11:20):
Exercise and get out and do physical things to stay healthy,
keep their mind sharp, and again, you know, take up
hobbies and other things. So there's a way of thinking
about it, and I'd say most countries are just at
the early stages of sort of systematically thinking about those
(11:42):
things in a policy relevant way. But they're important, but
they're not going to solve the healthcare spending crisis in
large part because you know, we're having more old people
so and you know, in the United States we have
eleven thousand people turn sixty five every day every day,
(12:03):
so you know, health care costs are going to inevitably
go up.
Speaker 2 (12:10):
Sorry, I've didn't got one more question, and we're up
against the ads Clark Medical Insurance. Does that play a
role in a successful health system?
Speaker 3 (12:22):
I think yes.
Speaker 4 (12:23):
I think you want a base social insurance model that
everyone gets to. And then people who value healthcare, value
you know, short waiting times they can buy private insurance,
they should that private insurance should not compromise undermine the
social insurance that we're all entitled to.
Speaker 3 (12:43):
I think that's the way you want to think.
Speaker 4 (12:45):
You want it to augment, not to supplant, and I
think that's the way to think about it.
Speaker 2 (12:51):
Lovely, very very nice to talk to you. Thank you
so much for your time, and I hope you enjoy
your time here, and good luck tomorrow. Doctor Ezekiel Emmanuel,
who is an American health policy expert and the keynote
speaker at Health Innovators Summit.
Speaker 1 (13:04):
For more from Kerry Wood Mornings, listen live to news
Talks at b from nine am weekdays, or follow the
podcast on iHeartRadio
You're listening to the Carrywood and Mornings podcast from news
Talks headb.
Speaker 2 (00:11):
As I mentioned earlier, the Health Innovator's Summit, a New
Zealand initiative event an association within i B New Zealand,
takes place in Auckland tomorrow. This year's discussion focuses on
exploring ideas to create a world class, high performing health
system for New Zealand. How long have we been trying
(00:32):
to get one like that? Minister of Health Same and
Brown Associate Health Minister David Seymour will both be speaking
at the event. However, the keynote speaker is one of
the world's foremost health policy experts and author of Which
Country has the World's Best Healthcare? Doctor Ezekiel Emmanuel joins
(00:52):
me now, a very very good morning to you.
Speaker 3 (00:55):
Thank you for having me. I'm here.
Speaker 2 (00:57):
I assume for those who haven't read Which Country has
the World's Best Healthcare? The answer is not New Zealand.
Speaker 4 (01:08):
I actually don't say a single country has the world's
best healthcare. In part, I don't say that because there
are so many different metrics you want to use, and
different countries have different preferences. You know, whether you pay
co pay at the point of hair. There are lots
of countries like Canada that don't have such things.
Speaker 3 (01:29):
Or Italy.
Speaker 4 (01:30):
Whether you get you know how much you're spending of
your budget matters to to people are there waiting lists
and how long the waiting list. So there's not a
single country that's best. And I when I evaluate the countries,
I put three or four of them at the top. Netherlands, Norway, Taiwan,
(01:53):
which has a.
Speaker 3 (01:54):
Very low budget.
Speaker 4 (01:56):
Its hospitals are kind of like graduate dormitories, and it's
real problem is that doctors work. You don't get a
lot of doctors time that they see one hundred patients
a day. Nonetheless, it's very low cost. You can walk
in and order an MRI for yourself and it's pretty
high quality. So yeah, I think the best for New
(02:19):
Zealand to compare themselves to is places like Netherlands and Norway.
Speaker 2 (02:23):
Does size matter in terms of budget or is it
about how it's managed, Because for years I have heard
from those within the hell system that in fact they
do get enough money, but so much of it is wasted.
Speaker 3 (02:37):
I don't know about the wasted.
Speaker 4 (02:40):
New Zealand is exactly where there's a line how rich
a country is versus how much it spends on healthcare,
and New Zealand's exactly on that line for the per
capita GDP. I think you know my assessment, and here
I will have to admit I'm not the world's leading
expert on New Zealand. New Zealand is could suffer pretty well,
(03:04):
spending about half a percent of GDP more on healthcare,
mainly raising wages I think, and giving big bonuses for
achieving optimal care. But I think some of it is
how hard the doctors work, how hard, and also other aspects.
(03:28):
I'll give you one example. In the United States, we've
moved a.
Speaker 3 (03:33):
Lot of surgery out of the hospital to what.
Speaker 4 (03:35):
Are called ambulatory surgery centers, which are much cheaper to operate,
where people can come in and within twenty four hours
go home and do a lot of the follow up
care at home. We've done this even for hip replacements,
knee replacements, and that's very different than New Zealand, which
has basically none of that. So I think that's a
(03:56):
kind of innovation that would be necessary. I'd say another
innovation that I would think would be both cost savings
and reduce position frustration and complaints about administrative burden would
be more ambient.
Speaker 3 (04:11):
AI in the.
Speaker 4 (04:13):
Office room that can transcribe a note, that can make
orders and things like that. Those have been found physicians
certainly in the United States love them and by you know,
the burnout rate when when physicians use them really goes
down ex Actually, so those are some of the yeah,
(04:34):
because the machine is doing more of the of the
grunt work as we call it in the United States,
And those are some of the innovations I think that
would go well and they wouldn't really raise the costs.
Speaker 3 (04:46):
In some cases, they would actually reduce the costs.
Speaker 4 (04:50):
And then I think there's other AI innovations that that
New Zealand could lead on. But I you know, again
my assessment, and I want to you know, hesitate to
be definitive, is that New Zealand hasn't leaned into a
lot of things like AI, and I think being more
(05:10):
aggressive in some areas could actually both save money, increase
access and in pre satisfaction.
Speaker 2 (05:19):
Yes, that's an interesting point you make too, because when
you look at I mean I know a number of
surgeons who in New Zealand who work in our hospitals
here both private and public, and they will use their downtime,
a portion of their downtime to go to the Pacific
Islands and perform surgeries there and far more rudimentary and
basic kind of surroundings. But the surgery is the same
(05:43):
and it's just as successful and the outcomes are just
as good. They just don't have the bells and whistles
that they have back at home, either for the patient
or for the doctor.
Speaker 4 (05:53):
Yes, you know, I mean the Indians are famous for
these sort of assembly line operating rooms where you often
get operated on by nanda for example.
Speaker 3 (06:06):
Just cataract surgery. Yeah, you know, look, let's be clear.
Well I'll let me just raise two.
Speaker 4 (06:14):
Cataract surgery is not as you might say here in
New Zealand with rocket labs around.
Speaker 3 (06:20):
It's not rocket science.
Speaker 4 (06:21):
Yeah, and good people with good whose hands are very
good and they can do that, and they don't have
to be doctors. They can be overseen by doctors, and
they really do assembly lines. They also they also have
a sort of assembly line for coronary bypass graphs. So
I think there's a lot of innovation like that that
(06:42):
you can do. You know, as you say, it doesn't
have all the bells and whistles, but it's very effective
and gets to the same results. You know, I was
in Mozambique a decade ago and they had seamstresses doing circumcisions.
Speaker 3 (06:58):
On young males because to prevent AIDS.
Speaker 4 (07:01):
And you know, they got you know, a week or
two weeks of training and that was it, and they
were doing a fine job with very low infection rates
and things like that. So you know, there are other
ways of doing things than we then were used to
in developing country. I can tell you that in the
United States heart some heart catheterizations are done by physician assistance,
(07:25):
not by the physicians.
Speaker 2 (07:27):
So you know, yeah, interesting, Like we were seeing a
number of New Zealanders heading over to Thailand and you're
on those medical tours. Are you seeing that in other
countries as well?
Speaker 4 (07:41):
Yeah, look, yes, you do see some medical tourism. Let
me just say, I got to think about ten or
fifteen years ago, there was a big flurry o medical tourism.
We're going to save a lot of money that way,
forget it. There can be some medical tourism. A few
people will go overseas for medical procedures. It's not going
to solve the underlying healthcare. It's just some issues, you know.
(08:03):
I think New Zealand we have to distinguish two big issues.
Speaker 3 (08:06):
There are three big issues I think in New Zealand.
Speaker 4 (08:09):
One is a sort of financial issue, how you structure
the system.
Speaker 3 (08:15):
One is workforce.
Speaker 4 (08:17):
And here my sense is that New Zealand doesn't have
too few doctors. I think there's got to be some
change again, as I said, increase pay for increased work
and more assessment of outcomes.
Speaker 3 (08:34):
And I think that's very important.
Speaker 4 (08:36):
And then there's obviously a big complaint about waiting times.
Let me just give you a secret. Every place, every
country complains about waiting times.
Speaker 3 (08:46):
Okay, this is not unique to New Zealand.
Speaker 4 (08:48):
And by the way, you don't have it worse than
many other countries, including many countries as rich, if not richer.
And so I think I think, you know, figuring out what.
Speaker 3 (09:03):
How to address that problem.
Speaker 4 (09:05):
Part of that, I do think is more money, more
money for to pay to work harder and longer, and
you're probably more surgeons who really want to operate and
get them to operate. You know, there's a relationship in
medicine which is called the volume quality out relationship, which
(09:29):
is the more you do of something like, the more
hip replacements you do, the higher your quality. Yeah, and
the reason is you've become much more skilled at it.
It becomes automatic sort of. You know, you know exactly
what you're doing, your team knows exactly what you're doing.
And I think, you know, getting up to that level
is very very important, both to improve the quality of
(09:50):
care and also obviously to get rid of backlogs.
Speaker 2 (09:55):
How much responsibility does a population have to prevent themselves
from getting into hospital in the first place.
Speaker 4 (10:07):
All of us, I think, you know, I've just written
a wellness book. There are many wellness things we can do.
There are six main wellness things that we can do.
As far as I can tell, New Zealand's pretty good
on a lot of the wellness things, eating, well, exercising,
social interaction. And so I think that's that's clearly important,
(10:30):
clearly has to be part of the equation. But also,
let's face it, as a population ages, things begin to
go bad.
Speaker 3 (10:38):
You know, the body is not meant to live forever.
Speaker 4 (10:42):
You know, the hips go, you get heart problems, you
get lung problems. You know, the body does wear out
and that will lead to needing more healthcare, and that's
inevitable as populations in highly developed countries age.
Speaker 3 (11:02):
It's true everywhere, it's not just true in the unit.
Speaker 4 (11:06):
And I think you know a lot of places are
looking into well, how can we improve healthy aging.
Speaker 3 (11:11):
They're you know, key things.
Speaker 4 (11:13):
You've got to increase the social relationships and social interaction.
Speaker 3 (11:17):
Among the elderly. You have to make sure they.
Speaker 4 (11:20):
Exercise and get out and do physical things to stay healthy,
keep their mind sharp, and again, you know, take up
hobbies and other things. So there's a way of thinking
about it, and I'd say most countries are just at
the early stages of sort of systematically thinking about those
(11:42):
things in a policy relevant way. But they're important, but
they're not going to solve the healthcare spending crisis in
large part because you know, we're having more old people
so and you know, in the United States we have
eleven thousand people turn sixty five every day every day,
(12:03):
so you know, health care costs are going to inevitably
go up.
Speaker 2 (12:10):
Sorry, I've didn't got one more question, and we're up
against the ads Clark Medical Insurance. Does that play a
role in a successful health system?
Speaker 3 (12:22):
I think yes.
Speaker 4 (12:23):
I think you want a base social insurance model that
everyone gets to. And then people who value healthcare, value
you know, short waiting times they can buy private insurance,
they should that private insurance should not compromise undermine the
social insurance that we're all entitled to.
Speaker 3 (12:43):
I think that's the way you want to think.
Speaker 4 (12:45):
You want it to augment, not to supplant, and I
think that's the way to think about it.
Speaker 2 (12:51):
Lovely, very very nice to talk to you. Thank you
so much for your time, and I hope you enjoy
your time here, and good luck tomorrow. Doctor Ezekiel Emmanuel,
who is an American health policy expert and the keynote
speaker at Health Innovators Summit.
Speaker 1 (13:04):
For more from Kerry Wood Mornings, listen live to news
Talks at b from nine am weekdays, or follow the
podcast on iHeartRadio
Popular Podcasts
Las Culturistas with Matt Rogers and Bowen Yang
Ding dong! Join your culture consultants, Matt Rogers and Bowen Yang, on an unforgettable journey into the beating heart of CULTURE. Alongside sizzling special guests, they GET INTO the hottest pop-culture moments of the day and the formative cultural experiences that turned them into Culturistas. Produced by the Big Money Players Network and iHeartRadio.
Bleep! with Ana Navarro
Fear thrives in silence and confusion. Ana Navarro rejects both. Her voice is an antidote to today’s chaos. Her new podcast, Bleep! with Ana Navarro, takes on today’s most pressing issues with the voices most connected to it: decision-makers, political leaders, cultural shapers, and people on the frontlines of the story. The conversations acknowledge the emotions we all feel—despair, sadness, fear— but emerge with knowledge, perspective, and hope. The belief is simple: fearless dialogue can transform fear into courage, and courage into change. When fear dominates the headlines, this show digs deeper. Because information, debate, and conversation don’t just ease fear, they give us power to shape the future.
Hey Jonas!
Hey Jonas! The official Jonas Brothers podcast. Hosted by Kevin, Joe, and Nick Jonas. It’s the Jonas Brothers you know... musicians, actors, and well, yes, brothers. Now, they’re sharing another side of themselves in the playful, intimate, and irreverent way only they can. Spend time with the Jonas Brothers here and stay a little bit longer for deep conversations like never before.