Reform of the New Zealand healthcare system

New Zealand's healthcare reform has come in two waves. In 1983, Area Health Boards assumed responsibility for purchasing and providing all secondary healthcare; but a parallel, centralized system of primary healthcare benefits persisted, frustrating attempts to integrate services. In 1991, a new government reorganized public hospitals into "Crown health enterprises," and planned to introduce user fees, competition with the private sector and a list of core benefits. Over the following few years, some of these attempts progressed slowly or were abandoned altogether. They are also attempts to shift risk and expenditure, rather than design a more fair and efficient healthcare system.