New directions in health and economic management.

It is a striking fact that in New Zealand both the economy and the health system have performed poorly in the post war era. It seems unlikely that this parallel is accidental, although we should be careful not to uncritically accept superficial explanations for it. In particular it does not seem likely that the poor economic record caused a poor health performance. Nor has poor health caused poor economic performance. The most likely explanation of the similarly poor performance of both the health and economic systems is that they have a common political and social foundation which, in both cases, resulted in the systems failing to function properly. Rather than provide a detailed critique of this foundation, we consider how we might reorganise the health system, and by implication the economy, to improve its performance.