<P> The health care system of New Zealand has undergone significant changes throughout the past several decades . From an essentially fully public system in the early 20th century, reforms have introduced market and health insurance elements primarily in the last three decades, creating a mixed public - private system for delivering healthcare . </P> <Ul> <Li> The Accident Compensation Corporation covers the costs of treatment for cases deemed' accidents', including medical misadventure, for all people legally in New Zealand (including tourists). The costs are recovered via levies on employers, employees, petrol and vehicle registration, and contributions from the general tax pool . </Li> <Li> The relatively extensive and high - quality system of public hospitals treats citizens or permanent residents free of charge and is managed by District Health Boards . However, costly or difficult operations often require long waiting list delays unless the treatment is medically urgent . Because of this, a secondary market of health insurance organisations exists which fund operations and treatments for their members privately . Southern Cross Health Insurance, a non-profit organisation, is the largest of these at about 60% of the health insurance market and covering almost a quarter of all New Zealanders in 2007, even operating its own chain of hospitals . </Li> <Li> Primary care (non-specialist doctors / family doctors) and medications on the list of the New Zealand government agency PHARMAC require co-payments, but are subsidised, especially for patients with community health services cards or high user health cards . </Li> <Li> Emergency services are primarily provided by St John New Zealand charity (as well as Wellington Free Ambulance in the Wellington Region), supported with a mix of private (donated) and public (subsidy) funds . </Li> </Ul>

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