How does the operation of PHARMAC's 'Community Exceptional ...

waiting list for patient priority. The public hospital surgeons were also permitted
to operate in private surgical hospitals and this began what has become known
as the ‘dual system’ for public and private provision of health care in New
Zealand.
The legislation also revised pensions and extended benefits for families,
invalids and the unemployed. The political motivation for the programme was a
desire by Savage’s government to establish an equitable distribution of
resources through taxation which provided New Zealanders, particularly the
poor, with free access to an adequate range of health and social support
services.
The wartime experience of rationing in New Zealand was based on government
issued ‘Ration Books’ which were issued in 1945 during World War II (NZ
History Online, 2012). The ration books ensured there was an equitable and
adequate amount of food, clothing and some household items for families and
workers. Many people were able to circumvent the rationing system by
inventive legal and illegal means. However, there was a motivation by the
government to use ration books to ensure, as far as possible, an equitable and
acceptable distribution of scarce resources to the greatest number of people.
The Post Office allocated the rations according to rules established by
government officials to control consumption. Frugality was considered a virtue
largely because the future was uncertain and if goods or services could be done
without, this was believed to be prudent to assist the war effort. Rationing was
established in the national psyche as a necessary encumbrance citizens were
prepared to tolerate as a contribution towards the greater common good.
Daniels and Sabin, writing in their book Setting Limits Fairly published in 2008,
described the culture in New Zealand of strong community and democratic
values combined with one of the most extensive and oldest (Hornblow, 1997)
social security systems in the world (Daniels, 2008). These authors attribute
the openness of the rationing debate in New Zealand to these historical social
and political factors and the country’s previous World War II experience of
rationing.
Bloomfield (2003) dates the beginnings of the New Zealand experience in
explicit health rationing to the Green and White Paper on Health: Your Health
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