While there is clearly pressure on the public health system, and private health insurance helps relieve some of that pressure the amount of cover New Zealanders have isn't particularly high.

The health insurance sectors has always struggled to get engagement with governments on incentives, such as tax breaks, to help encourage people to buy cover.

Bawden says an option would be to have a scheme where people can pay for cover on a regular basis.

While she hasn't developed a hard and fast model for how such as scheme would work it would be like KiwiSaver where people can opt out. 

“Such a scheme must be affordable starting with 1-2% of income. It could be a top-up or a rebate for people over 65. What is important is that it makes provision for health care that the government can’t provide,” she says.

“New Zealand needs the government to have this conversation and it’s one that Accuro won’t abandon. It’s so important that people have choice and this is what private health insurance provides.”

Bawden saysTreasury is giving New Zealand a clear view that current expenditure is unsustainable.

By being aware of the challenge to government to meet the provisions of elective surgery within reasonable timeframes, she sees an urgent need for ongoing dialogue between the government and private health providers.

“It’s essential that discussion takes place,” she says. “The burgeoning cost of health is the elephant in the room and governments haven’t faced up to it.”

She says that when the public health system overflows then private hospitals provide a role in caring for people. That’s where health insurance becomes involved she explains. Without private health insurance, there won’t be private hospitals. It’s as simple as that.