NZIER has released a report to the Health Funds Association, which represents health insurers, on the expanding role of private health insurance in the future of healthcare.

It says New Zealand's health system will face increasing pressure and Kiwi consumers will be asked to increase personal responsibility.

The report, by Michael Bealing and Derek Gill, says there needs to be more honesty and clarity about the future funding of health and disability care and how it can be made fiscally sustainable.

The report draws a parallel with the discussion of retirement income funding and the development of KiwiSaver.

Bealing and Gill suggest a work-based health insurance scheme constructed in a similar way to KiwiSaver needs wider debate.

They say more examination and costing is required but the most promising workplace approach would comprise measures including an ongoing information programme to raise public awareness of the need for private health cover, automatic enrolment in a workplace-subsidised employer plan and a targeted enrolment subsidy.

"A workplace based scheme that nudges people towards greater personal responsibility with features like preferred providers, portability and non-exclusion – adopted in the KiwiSaver scheme – could play an important role in making the New Zealand health system more sustainable."

HFANZ chief executive Roger Styles welcomed the report.

He said there were 600,000 New Zealanders covered by workplace health policies, about half of which were subsidised. "There is a lot of support out there for extending that."