Chai Chuah, until February 2018, was the Director-General of Health and Chief Executive of the New Zealand Ministry of Health. He is a Chartered Accountant, born in Malaysia, educated in Malaysia and New Zealand, and now resides in New Zealand. He has nearly 30 years of operational, strategic, and policy experience in healthcare services and systems. He is the first and only Asian to have held a Chief Executive position in the New Zealand public service. He currently speaks, writes, and provides advice on "Future of Health Systems, Developing Leaders We Need and Better Care for Our Seniors."
Chai's LinkedIn: https://www.linkedin.com/in/chai-%E3%80%82%E4%BB%81%E6%9D%90-chuah-%E8%94%A1-4801855a/
Hanh: [00:07:07] I know how different new Zealand’s health care and elder care system looks compared to the United States. Can you start. By telling us some of the key differences. So our audience is aware.
Chai: [00:07:19] So I will probably spend more time on the New Zealand system and catch prey like the U S system. And if I’m not quite right there, let me know.
Chai: [00:07:30] So the, the New Zealand health system, first of all, in terms of context and New Zealand is a very small country with a very small relative to the U S so New Zealand only has a population of 5 million people. And the land area it’s only 268,000 square meters. Whereas the us is 9,900,000 square meters. So it’s huge compared to New Zealand.
Chai: [00:07:57] So the aging [00:08:00] population using Leland at this point in time is roughly the same. In percentage has to us roughly around 15, 16%. And I think that if I look at projections going out to 2050, I think both our countries hitting towards that 20 to 25% Mark, depending on which source. So, a health system and therefore our aged care system each largely funded by the government.
Chai: [00:08:31] And the New Zealand government funds our healthcare through a public taxation system.
Hanh: [00:10:12] that’s very interesting. Do you believe there are some aspects of aged care in New Zealand? That might be farther ahead. Then the United States. And if so, how would you recommend the elder care workers in the U S to act to get up to date with what’s going on?
Chai: [00:10:29] So putting aside the basis of funding, because I think that that’s a big policy issue, but if I were to look purely at the models of care.
[00:10:37] So I think that the interesting thing with the New Zealand models of care is it’s currently sitting at a huge on the road. No Dylan’s system is not that different from the Australian one. If you were keeping an eye on the Australian system at the moment. Yeah. Going through a major per Royal commission inquiry into the [00:11:00] aged care system.
[00:11:01] And when I read the interim report, it is almost identical to the one I’m seeing in New Zealand. So both Australia and New Zealand are sitting at a turning point now. I think that the thing that I would say to people listen to me for cars is that it is the aspiration and the aspiration of a number of us that the New Zealand models of care starts to move towards much more of a system where sells the things we touched on earlier around.
Hanh: [00:18:49] So let me ask you, can you talk a little bit about the impact of COVID in senior living?
Chai: [00:18:54] So one of the things I’ve been doing is, uh, because I was actually tracked overseas for four months because I was in Malaysia trying to look through my siblings. We should care for mother. So I had the luxury of being away from New Zealand and then she watching and doing a lot of.
Chai: [00:19:13] Reading and listening to what’s happening around the country, around the world, around the impact of COVID on DOP. Now that is as a consistent theme. BRCA what countries you look at, even in New Zealand, those are new, Zealand’s been handled as a model of having managed well, thus far, I think the consistent thing is when it comes to COVID, everybody can recognize is that one of the at-risk groups is the elderly.
Hanh: [00:28:40] So we’re undergoing a generational shift in the world. Aged care. Clients are shifting from the silent generation, the baby boomers. So how do we think this will change?
Hanh: [00:28:53] And what are the biggest challenges will this post?
Chai: [00:28:57] So I think that the big [00:29:00] shift is a swing towards consumers. And I see this one a lot, whenever, even when I was in the job, I keep saying to facial colleagues, I said right now, So you’re dealing with the silent generation. These people are very compliant.
Chai: [00:29:16] They don’t ask questions. And even when things are to suit them, they don’t really complain. They put out a lot and largely because it’s the values of that generation. They did grateful for whatever help we can get, even if it doesn’t quite work there. And I say, when you look at a baby boomers’ generation, and again, it’s those won’t be in 46 to 64.
Hanh: [00:36:01] There’s stuff. That’s why they’re saying stop learning. You’re stuck and have a fixed mindset. You’re not open and you’re not looking ahead because you’re still right here. You’re stuck.
Chai: [00:36:15] Yeah. And there’s always a blame game. It’s always somebody else’s fault.
[00:36:20] So the leadership thing emphasis I put on this stuff is because I see a lot of this stuff right now. And I, I, and I got some good people in there, but I think that them being good actually doesn’t mean they’re good, effective leaders. And the common theme I’m seeing is a failure to keep learning. And also I think is a lack of courage to do the right thing.
Hanh: [00:37:51] I love the fact that you said courage because I think it’s very true because here’s the thing why people don’t talk about this stuff that we, that you and I are talking right now [00:38:00] because it’s very, it’s frowned upon.
Chai: [00:38:36] I think the technology presents an entirely different challenge, which even if you muster that you will struggle to try and cope with the challenges of how do you actually design much better care for seniors right now, because you know, when you can’t get as you and I have at a very [00:39:00] personal level of looking at it, Supporting someone that you can love about who is aging and it has, and is moving along that whole continuum.
[00:39:10] Right? You can realize that actually it’s not an easy decision. Every decision you make is not purely on facts is not purely on money is not purely on facility is not purely on technology.
Hanh: [00:46:57] Is there anything else that you would like to share with the audience?
Chai: [00:47:01] I, I think you had the last question around the public private partnerships in healthcare. I think that the delivery of health care will always be a partnership, not just between the public sector and private sector. But also, with civil society and actually we’ve consumers, it’s always a puncture.
Chai: [00:47:22] I think that the, regardless of what is the sources of funding, whether it’s insurance or taxation, et cetera, when you look at the delivery of services, given our conversation, it is a partnership, not just the private providers or the providers, but it’s actually also with civil society and also among consumer.
Hanh: [00:48:20] I agree about private or public it’s one it’s unified in providing options for the baby boomers. Like you say, purpose, vibrancy, life longevity, and also choices of how they want to live in the later part of their life.
Hanh: [00:48:36] Very true. I really appreciate this opportunity to talk to you. And I’m so glad that we connected. I learned so much and thankful the fact that. A lot of your values and principles align with what I envisioned. So I really appreciate that.
Chai: [00:48:52] So let’s stay in touch and let’s see how we can collectively, so advocate and bring more people into the discussion and into the network.
[00:49:01] Because I think that I’m very excited by it and making connections like this. Okay. And I’ll send you some other people that have connected to them and they will be more, they will be more than happy to get to know your connections and talk to you as well.
Hanh: [00:49:15] Great. I would love that.
Chai: [00:49:17] Yeah. Okay. Real pleasure to talk to you and let’s stay in touch.
Hanh: [00:49:24] Take care. Yep.