Winston Peters' prostate exam idea a flawed anti-election bribe

Jenesa Jeram
15 September, 2017

For discerning voters who were getting worried about the splashing of taxpayers' cash this election, fear not. While National and Labour have been pulling out all the stops to get swing voters over the line, not all election policies are designed to buy votes.

In an "up yours" to the usual election treats, some parties are going in the opposite direction: taking money away from taxpayers that make 'bad' personal choices.

So what is the opposite of an election bribe?

A prostate exam.

Earlier this week, New Zealand First leader Winston Peters talked about the need to incentivise men to have their prostate checked. Hundreds die from prostate cancer each year, with the "psychological" aspect of the illness keeping men from getting checked, Peters told the NZ Herald. Their lack of action is costly. Peters' use of the term "incentivise" is a pretty cute way of saying that Winston proposes withholding the tax refunds of those who refuse to undergo the procedure. To call the idea a deep invasion of the nanny state would be less cute, but more accurate.

But he failed to mention that there are risks involved in the testing process that patients should be aware of too. This is not akin to activities like forcing people to eat a bowl of salad: there are health costs as well as benefits.

While the exam itself is harmless, broad cancer screening could lead to more risky treatments for harmless tumours. In fact, in 2014 a Ministry of Health publication was criticised by medical professionals for under-emphasising the controversy.

Don't get me wrong, normalising prostate exams where appropriate is a worthy goal. But withholding tax refunds that the taxpayer is entitled to is the wrong way of going about things. It is bribing people with their own money to undergo a medical procedure that health experts are still torn on.

Besides, does Peters really believe receiving a tax refund is a better incentive for getting a check up than concerns about cancer? I'm willing to bet there are some men who couldn't be paid to take the exam, let alone care about a foregone tax refund.

Implementation is also a tricky issue. Peters believes linking IRD data and medical information can be achieved through "computerisation". Conveniently, computerisation was also his answer for how to administer a tourist tax. Maybe I am pessimistic, but I fear that Peters might be overselling the capacities of computerisation.

Is all of this sounding kind of familiar? It should. No other party has yet been plucky enough to make prostates an election issue, but nearly all have their own invasive policies.

The Opportunities Party (TOP) are proposing a junk food tax to address obesity. Junk foods would be taxed, while healthy foods would get "credits" to receive discounts on further healthy foods. It makes my head hurt even thinking about how such a system could be implemented. While Peters' faith is in computerisation, TOP's faith is in scientists to objectively allocate all foods into three groups.

More substantively, if fiscal incentives matter more to people than being healthy, perhaps it is safe to say that not everyone prioritises their health in the same way.

And now the ACT Party, once a stronghold against the nanny state, have announced one of the nanny-est policies of them all. ACT would increase the maximum fine for the parents of kids who persistently wag school from $150 to $500. Forget addressing the complex relationship between poverty and truancy, making poor families poorer was the chosen response.

Will "incentivised" prostate exams be a bottom line for New Zealand First? Probably not.

But considering how distracted people can get with almost daily policy announcements, it might be easy enough to hide these policy sticks among the many carrots this election.

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