Doctors are calling for higher family welfare benefits and taking GST off healthy food - with the extra costs funded by raising the retirement pension age.
An editorial by three leading doctors in today's NZ Medical Journal says the country has got its priorities wrong, paying a generous pension to everyone from age 65 while 22 per cent of children are living in poverty, mainly because their parents are on inadequate benefits.
The Medical Association has published a position statement on health equity that proposes taking GST off healthy food, banning cigarettes by 2020, "fair employment" and a "minimum income for healthy living" for everyone - a list taken largely from a British taskforce on health inequities chaired by researcher Sir Michael Marmot.
Sir Michael, president of the British Medical Association until recently, will speak at seminars on health equity in Auckland and Wellington next week. Health Minister Tony Ryall will open the Wellington event.
Governments worldwide are responding to evidence that poorer people suffer more illness and die sooner than richer people.
The gap between rich and poor is wider in New Zealand than in all but seven of the 30 nations in the Organisation for Economic Co-operation and Development (OECD).
The Medical Journal editorial has been written by the head of the Medical Association's health equity subcommittee, Dr Don Simmers, National Heart Foundation medical director Dr Norman Sharpe and the head of Otago University's health inequalities research programme, Dr Tony Blakely.
It says health inequities narrowed slightly in the first few years of this century, but warns that they could widen again with growing obesity and diabetes among poorer groups.
It says "probably the single most important activity to reduce inequalities in health" would be to make New Zealand "essentially smokefree" by 2025, as accepted by the Government in response to the recent Maori Affairs select committee inquiry.
"Achieving this goal, compared to the 2006 smoking rates continuing unabated into the future, might result in five years' gain in life expectancy for Maori, three years for non-Maori, and a two-year reduction in the life expectancy gap," the doctors say.
They also call for "reprioritisation" of spending. "For example, and deliberately off the two main parties' manifestos, by far and away the largest expenditure on welfare benefits in New Zealand is that on superannuation," they say.
"Yet the age of entitlement to government superannuation, 65 years, is the same as that in 1899 when life expectancy was 25 years less.
"As a society, we want to celebrate and protect the success of our superannuation scheme, but not to the point of gross inequity compared to younger (and more brown-faced, to be frank) people.
"Fair go - it is time that the age of entitlement for superannuation is lifted (as it has in other OECD countries) and allow some redistribution to other sections of our society, particularly younger people."
Dr Simmers said New Zealand should also follow other countries in exempting "good food" from GST.
The Labour Party has proposed exempting fresh fruit and vegetables.
Dr Blakely said research should be done to establish a "minimum income for healthy living for different family types" which should be used to set welfare benefits and the minimum wage.
"My strong suspicion is that the current unemployment benefit and sickness benefit are less than the minimum income for healthy living," he said.
Ministry of Social Development research last year found that 22 per cent of children were in families living on less than 60 per cent of the median income after housing costs.
By the same measure, poverty rates were lower for people aged 65 and over - 15 per cent for single people and 5 per cent for couples.
POVERTY BY AGE
Per cent living in households with under half of median income after housing costs (2009)
* Couple aged 65-plus: 5%
* Single aged 65-plus: 15%
* Two parents with children: 13%
* Sole parent with children: 50%
* All children: 22%
Source: Ministry of Social Development.