Is anyone listening? Inequality in New Zealand’s fully funded hearing aid scheme

This paper explores the New Zealand Ministry of Health’s (MOH) allocation of funding for the Hearing Aid Funding Scheme (HAFS) and the level of service delivery by public and private sectors. The crux of the paper centres on how the system is funded and in what ways the market structure may be affecting access to health care. The study involved three main sampling strategies with primary data being collected from the District Health Board (DHB) clinics and private providers. This was supported with secondary data of service utilization and claims, which was made available via the MOH. DHB and private provider data was collected online. This study found that the market structure and nature of the NZ hearing industry is consistent with an oligopoly – something, which has been assumed in the past but never formally acknowledged. Publicly funded DHB clinics are restricting access to adult hearing aid referrals, as well as referring rejected patients to private audiology providers for ongoing treatment. The findings were consistent with implementation of co-payment fees through DHB and private audiology providers. These findings indicate that high co-payment fees may be increasing the chance of negative externalities, due to a reduction in access and affordability.