Is health a basic human right or a commodity? Travelling the difficult road towards equity of outcomes

From 1938, Aotearoa New Zealand health policy committed to providing free universal access to secondary healthcare. This approach initially worked for all citizens except Māori and Pacific peoples, who had different unmet needs. From the 1980s, as a neoliberal agenda spread, it became clear that action was needed to protect the population from the scourge of health as a commodity. Those who could afford to buy healthcare already had better social determinants of health; however, ultimately inadequate legal processes failed to protect many people from the damage to our healthcare systems. The focus should have been on the ultimate goal of universal equity of health outcomes. To rebalance, we define health as a collective and individual legal right. The required laws to thus refresh the social contract should: i) bind rights and responsibilities of government and governed and protect all citizens; and ii) be enshrined against future whims of politicians. We suggest ways forward, including: i) open physician advocacy, starting with the medical colleges; ii) honouring the right of New Zealanders, individually and collectively, to health; iii) adhering to relevant international agreements and national laws; and iv) advancing a codified constitutional legal structure for Aotearoa New Zealand.