(CHEERING, APPLAUSE) - Hello, Kiwis. I'm Paddy Gower and I have got issues. On the show we investigate issues big and small that are important to all of us. Tonight ` Mitch McCann meets some Kiwis who have travelled to Mexico for life-saving surgery. Why do they have to go so far for help? And Karen investigates PayWave fees ` are they fair? And why do some shops make you pay them, but others don't? Captions by Julie Taylor and Stacey Spary. Captions were made with the support of NZ On Air. www.able.co.nz Copyright Able 2023 Tonight my issue is with hospital waitlists and how they are creating medical refugees. Ordinary Kiwis forced to flee New Zealand to get the operations that they need. They are putting their health at risk, maybe even their lives at risk, and they are raiding their KiwiSaver to do it. They are going overseas to get operations that they should be able to get done here in our public health system. The example we are using tonight is bariatric surgery. We'll find out a lot more about it, but for now, it's stomach stapling surgery that has proven to be one of the best treatments for severe obesity. Now, thousands of people want this. Last year, though, only 294 surgeries were done in our public hospitals. 294. And surgeons have told us there is a five year backlog. To get it done privately here, it would cost you $22,000. But what if I said to you that you can get it done for $13,000 in Mexico with all flights and accommodation paid for and you can take out your KiwiSaver to do it. Well, for an increasing number of Kiwis, this is worth the risk, because there is next to no chance they could ever get it done here. That's why I am calling these people medical refugees and that's why this is an issue for all of us. Now, tonight, I'm lucky to be joined by my old mate and Newshub U.S correspondent Mitch McCann. As always, Karen O'Leary is here, as our community investigator. And our news deskers; Eli Matthewson and Courtney Dawson. (CHEERING, APPLAUSE) Tonight we're gonna meet a woman called Colleen. a regular Kiwi in Rotorua who has ended up a medical refugee. Mitch goes to Mexico with her, but first, let's meet her at home. (TENSE MUSIC) - Tijuana, Mexico, just over the border from the United States. Around 50 million people cross over every year for this vibrant mix of culture, tequila, markets and nightlife. But in recent years, it's become popular for medical tourism, and that's what's attracting Kiwis like Colleen Walters. (REFLECTIVE MUSIC) (WATER SLOSHES) - So, you're gonna fill it up to the bottom of that ring. Like that. Yup. (BLENDER WHIRRS) This is my dinner. It's looking like a nice blend. Mmm. Thank you. - At home in Rotorua, it's mainly milkshakes on the menu for 48-year-old Colleen Walters. - Mm. - She's on liquids to prepare for surgery in just over a week. - It's like mocha. - (CHUCKLES SOFTLY) - I had big plans of having a big feed, eating all the food that I wanted to eat before I started this journey. But I've left it too late, cos now I'm in detox and I don't want to bugger it up. So, yeah. I feel quite sad inside myself. It's like a funeral. Goodbye to a long lost friend. That's what I think. - Food has always been central to Colleen's life, but she admits healthy food hasn't. - Food is a big part of our household. Ooh, yum. And who wants snacks? In my house, I'm the person that's... in control of the food. Who orders the food, who cooks the food. And even though I've got a disability, I try my hardest to do what I can. So I do the shopping for our house. I was brought up with my koro, so I don't know how to cook good meals. I was never taught that. OK. All he had was fish heads, eels, rotten corn... I'm not even blaming my childhood. I didn't know how to cook good nutrition food. I think this shot shows my double chins too much. (LAUGHTER) - That's why I'm going like this. - OK. LAUGHS: You trying to cover your double chin? - Even when she was younger, her weight was on her mind. - I've always been a big girl. So when I was younger and when I got to my teenage years, I always thought I was a big girl. But I don't think so. You know, when I look back at my pictures, I think, 'No. You weren't that big.' But I felt like I was fat. I'd like to say it was genetics, (LAUGHS). But I love my food. I'm a Maori. I love my food, you know? - A graduate of Te Wananga Whare Tapere O Takitimu, Colleen was actively involved in Maori performing arts. But after her husband died in 2014... - I was just doing everything in excess. Too much drinking booze, too much smoking cigarettes, too much party, party, party, too much food. I went to a doctor because my blood pressure was dangerously high, which ended up causing my stroke, which paralysed me down my left side - Colleen was just 43 years old. She could no longer be as active. The more weight she gained, the harder life became. - Cos I lose my balance a lot. So if I fall over, people can't pick me up. You know, I'm just too heavy for that. And that's jolly embarrassing, you know, that I have to bring somebody from Saint John's to come and pick me up off the floor. I wear a personal safety alarm. The alarm has been a saver for me. If I fall over, and then I just have to lay there until somebody can actually pick me up off the ground. - Colleen considered getting weight loss surgery. - I talked to my GP in town. He told me that I wasn't eligible for it. - And paying for surgery herself at a private hospital was beyond her means. - OK. I just thought, I can't afford $22,000. I didn't even have that in my KiwiSaver. - Her only recourse; going overseas. Still thousands of dollars, but almost half the price of surgery here. - Cos I know a lot of people that have got it done. All they've is, "I should have got it done earlier." Those kind of comments make me think I need to do this now. - That's when Colleen applied to access her KiwiSaver funds under a hardship application. - I never, ever thought that I would be able to afford anything like this. Which really, in essence, I can't. You know? I've just taken my livelihood, my retirement fund. Good teamwork, doll. So, I mean, I'm going to live longer, but I've got no money to live on when I get older. - It's a tough compromise. But with publicly funded surgery so difficult to access in Aotearoa, did Colleen really have a choice? - If I had a choice, I would definitely stay here and have it. Because nobody wants to be travelling around with a disability, especially overseas, and spending all that money. I would definitely choose to stay here. (APPLAUSE) - Right. Welcome, Mitch. Our very first, but probably not our last foreign correspondent on Paddy Gower Has Issues. Now, you followed Colleen on her journey. What did you make of her? - Yeah, kia ora, Paddy. Thank you for having me on. And a big thank you to Colleen for sharing her story, such a personal story that she was willing to share. I think it's important, Paddy, to think about what a big decision this was for someone like Colleen. She talked about different things there. She hasn't travelled very much outside of Australasia before. She has paralysis on her left side from her stroke. She has financial pressures. She had to get her KiwiSaver out. So the fact she thought about all those things, Paddy, and still decided to go overseas illustrates, I think, how important this was to her. While doing this story, we uncovered that there are Facebook groups in New Zealand; people are talking about which KiwiSaver providers are more favourable when it comes to granting hardship applications so people can go overseas or get weight loss surgery here as well. In Colleen's case, she changed KiwiSaver providers so she could get her money out, and that's how she funded her trip. - All right. Thank you very much, Mitch. And we'll see you on the rest of the journey later in the program. Now to you, Karen. I can't believe I'm saying this, but you've been out investigating the... financial world... ? - Paddy, look, I really thought it was gonna pay dividends. As dividends are. (LAUGHTER) But the issue that I'm gonna talk to you about tonight, I'm pretty sure it's close to your heart. I've got it on good authority that you are definitely a tapper and gapper. (LAUGHTER) - A tapper... A tapper and gapper? - You use PayWave. You just go` you tap your card, and you're out of the shop. - Yeah. No, no, no. Yeah, yeah. Yeah, I am a tapper and gapper. (LAUGHTER) - Don't worry. You're not alone. I mean, we` Actually, New Zealanders are leading the way when it comes to using PayWave. But my best friend Emma; she's had enough of the whole system. Roll the tape. So, Emma, thanks for meeting with me. Obviously, I need to know; what is your issue? - That when we do pay wave, we have a surcharge, and... I'm pissed. And it turns out every place has a different` a different surcharge rate. - Mm-hm. Yeah. - So, the amount of times I've gone to the dairy` - How many times have you been to the dairy? - I go to the dairy, like, every other day. - So` - And I PayWave. - So you're noticing you're having to pay the surcharge when you just want to be able to use your card in the way that it's meant to be used? - Yes. Lost my credit cards and all my cards, so I had to get a replacement card that doesn't` you just have to do it the old school way. And, I don't know. Just, like, now when I go to the checkout, I just feel the stress. Firstly, remembering my code now. - You mean your pin? - Yeah. My pin. - What is your pin? (LAUGHTER) - I honestly couldn't even tell you. - Have you thought about, like` you could get your pin tattooed on your arm or something like that, so that it's always there when you need it? - Yup. Yup. - I have actually thought about that. - Have you? - No, I have. - No, you have? - My dad suggested it. - Really? - And then he reminded me that we're not allowed tattoos in this household, so... - Well, maybe just like a piece of paper in your wallet. - I could do that. - Four numbers. You know? - Four numbers. - I reckon you could do it. - I reckon I could do it. - So... Thinking of rate; would you be happy if there was just one set rate? What about, say, like, do you have a favourite number? - Eight. - Eight? - Yes. - So if it was 8% across the board` - Yup. - Would you be happy with that, or? - I mean, no. - No. So, Emily, look. I can see you've got an issue and if you've got an issue, I've got an issue. I'm gonna get this bottom of it. Leave it with me. I'm on the job. - OK. If there's two things I love; it's confronting people who are annoy my best friends and little bags of lollies. So, I know exactly where I need to go. (DRAMATIC MUSIC) First question I've got for you is; you have a surcharge for using PayWave. Why is that? Five to six k? - Yeah. - Five to six Karens? I mean, thousand dollars? - Yeah. - That's a lot of cash. - Yeah. - I mean, I mean it's been great to chat to you. Obviously this wasn't really the kind of 'gotcha' moment that I was hoping for, but... do you have lolly bags? - Yeah. Just over there. - Great. (DRAMATIC MUSIC) - So, what Roni is saying makes sense, but then why do some places not have a surcharge for PayWave? (DING!) My mate Tahir's shop doesn't. So I'm here to ask him why. (SHOP BELL RINGS) Hello. Tahir, you don't charge a surcharge. Why not? - Some people object to it. They don't want to pay. Then we have to increase the price. We don't want to do that either. So that's why we let it go. - So, basically, you're paying for me to use PayWave if I use PayWave? - Yes. - Well, how much do you think it costs you? - We had a pretty slow month in April and it cost us nearly $500. - $500? A month? - Yeah. - And that was a quiet month? - No, no. That's a quiet month. - So if my best friend Emma is paying to use PayWave, and Tahir and Roni are paying to use PayWave, who's making all this money? The trail leads to one place. (DRAMATIC MUSIC) I want to talk to the manager, please. (LAUGHTER, APPLAUSE) - Wow. - Yeah. So, Paddy, obviously, if you tap and gap and there's no surcharge, you know who's having to pay for that. It's the retailer, the shop owner. So basically, consumers and small businesses are getting stung by PayWave. - Yeah. And I saw you charging to that bank there. - I did. - I hope you went full Karen in there. Did you go full, Karen? (LAUGHTER) - You're just gonna have to wait and see. Yep. - Oh, we will wait and see. We will. Because coming up ` seeking PayWave justice, Karen confronts a bank, goes undercover and makes one of the biggest mistakes of her life. And Mitch is in Tijuana with Colleen as she gambles everything for the surgery that she hopes will change her life. (CHEERING, APPLAUSE) Tom and Jill really blew the budget on their kitchen renovation. Jack and Penny Kaboodled their kitchen. They designed it themselves and it saved them heaps, so they can even afford to enjoy it. Kaboodle. Your kitchen, your way, for less. (CHEERING, APPLAUSE) Nau mai, hoki mai. Welcome back, Kiwis. Now, pretty soon we're heading to Tijuana, Mexico, where Mitch is with Colleen as she heads in for surgery. But right now, it's time to head to my very own trusted news source. Straight from the horse's mouths, Eli and Courtney catch me up with this week's New Zealand Has Issues. (CHEERING, APPLAUSE) - Kia ora, Paddy. National have come out fighting this week. They've been talking about gangs and shockingly, they aren't taking a positive stance. - No, they aren't. Their new policy means judges will enforce longer sentences on anyone who belongs to a gang. But are there facts to back it up? - What evidence have you got that putting gang members in jail for longer works? - What I have is an evidence that I want New Zealanders to feel safe. (LAUGHTER) - They say women are too emotional for politics and yet here this man is, literally setting policy based on his feelings. - They're also planning to ban the wearing of gang patches. They can ban gang patches, but they'll never be able to stop me spelling 'blood' with my hands. It took me months to learn! - Ooh... - Well done, Eli. - Next stop; gangster. Gangster. - And here we go; C for Courtney. Labour's new police minister, Ginny Anderson, did notice one flaw. - Christopher Luxon has embarrassed himself by making a gang's announcement that is already law. - Hm. Pretty impressive. Luxon has become the first candidate to ever achieve his election promises before Election Day. - Very impressive. I mean, he really is a visionary. Other national policies include outlawing murder and giving women the vote. (LAUGHTER) - I don't support it. It's been a tough month for Labour, though, with multiple demotions sackings and scandals. And National MP. Erica Stanford summed it up perfectly. - The ministers serve at the pleasure of the Prime Minister and actually, of late, the Prime Minister has not been placed in a... pleasurable position, Certainly by Michael. - Well, um... (LAUGHS) - That's a weird turn of phrase. - We've never quite gone that far. (LAUGHTER) - I think the only position of pleasure Chris Hipkins has ever been in is underneath Jacinda. - Ooh. (AUDIENCE MURMURS, LAUGHS) Hierarchy. Hierarchy. - It seems pretty kinky, but remember, not that long ago, one of our prime ministers had a pretty public three-way. (LAUGHTER) Which brings us, of course, to the sports news. The new All Black Squad was revealed this week and six brand new All Blacks have been named. So if you're unsure, check your emails. It could be you! - It could even be you, Eli. It could even be you. - Their coach, Ian Foster, seemed really confident in the team. - We're going in and, um... you know, I guess in many ways, not many people are rating us around the world. But wow, what a great spot to be in. (LAUGHTER) - And just a heads up to budding sports journos; always do your research before the interview. - Your second World Cup first as head coach; what are the excitement levels like ahead of a big year? - Oh, extremely excited, you know. It's actually my third World Cup. Just to let you know. (LAUGHTER) - 'Just to let you know' is such a nice way of saying, '(BLEEP) you.' (LAUGHTER) - Mm-hm. He did those first two as assistant coach, though, which is just as good as being a real coach. It's just like how being a comedy newsreader is the same as being a bona fide journalist. Isn't that right? Back to you, bona fide. (CHEERING, APPLAUSE) - Both of you have graduated from the Paddy Gower School of Journalism, which is the best in the world. So thank you so much for your hard work. Now, before we head back to Tijuana, a bit more about this bariatric surgery. There are a few sorts, but the main one that Colleen is having is called a gastric sleeve. They just go in through a few small incisions and remove about 80% of the stomach, leaving a tube-shaped stomach about the size and shape of a banana, which they staple closed. And that's what Colleen has gone all the way to Tijuana to do. (TENSE MUSIC) - So, Colleen has arrived at the hotel here in Tijuana. Her surgery is tomorrow. Hey, Colleen. How are you? - Morena. - (LAUGHS) Nice to see you. - Nice to see you too, Mitch. - How's everything going? - Good. Thank you, mate. - How are you feeling? A little bit nervous? - A little bit nervous. So, surgery tomorrow... - Hopefully it'll give you a new life, right? - I can guarantee it will. My current weight is 144kg. - Mm-hm. - So, before my stroke, I was only 80kgs, which is what I'd love to get down to. - How much do you know about the procedure that you're getting tomorrow? - Um... I just know that it's... I'm not quite sure what the words are for it. I know I looked about enough to... know that I'm going to be OK, I think. - Are you looking forward to meeting the doctor? - Yes. I need to meet the doctor. (LAUGHS) - Yeah. - He's the one chopping into me, y'know? I'd love to meet him. - Yeah. So, what did it cost you overall to come here? - $16,500. And that's including flights and accommodation for myself and a carer. - Yeah. And what would it have cost you to do this at home? - $22,000 it would have cost me over there. (TENSE MUSIC) - You know, what do you think about the health system that you find yourself coming all the way over here to get something done that people get done in New Zealand? - I really think the government needs to take a really good look at it. Because, you know, you've got people taking leave from their jobs, taking leave from the families, you know, leaving their kids at home just to get this done. Cos they're all here by themselves, you know. - Do you see any risks with the surgery tomorrow? - Uh... No, because I'm positive about the outcome of everything that's happening. - Yeah. - It's gonna be great. - Did you decide to take out medical insurance coming here? - Um, I didn't. No, I did not. Only because I was still in that same mindset about being positive, nothing's gonna happen. I know that's naive, you know. Because coming over on the plane, you know, I was thinking, 'Oh, I can't afford for anything to happen to me.' 'If I get stuck over there, I've got no money to bring myself home.' (TENSE MUSIC) - Colleen travelled to Tijuana as part of a package tour she found on Facebook with a company called Trim Up. We've just leave the hotel and we're off to meet Kirsten Leonard now. Now, Kirsten's from Christchurch, but she owns the company that's brought these New Zealanders here, including Colleen, for this trip. Kirsten started her medical tourism business after her own surgery here in Tijuana. What made you think, 'I'm gonna bring other New Zealanders across'? - Well, to be honest, it was... when we had the surgery, when I had the surgery, just walking up and down the corridor thinking, 'Look, more people would come over here if they came in a group.' - And how has it gone since then? How many people have come over? - Well, I lost count at 150 people. - You've brought more than 150 people over? - Yeah, absolutely. - Obviously, you get paid somehow coming here. How does that work? - I'm a package price. So, I'm like, if you went on a tour to Europe, you would pay a package price for the guide. So I'm` I'm the guide. - So, the patients go into the hospital and then, what's your role? - Day of hospital is I'm at the hospital from the moment we get there until the last person is out of surgery and that they're comfortable. - Kirsten has seen medical tourism grow exponentially since her own procedure. In reality, how risky is it to come here and have this done? - No riskier than having it done in New Zealand. You're still gonna be prone to a blood clot if you have it in New Zealand. You're still prone to having a blood clot if you have it over here. - And have there been many complications here? Has anything gone really wrong? - There's been complications, but they don't tend to show up until they get back to New Zealand. So we're quite lucky in that respect. - Colleen has been in Mexico for two days now. - COLLEEN: Hopefully everything's OK. - And her operation is about to get underway. (INDISTINCT CHATTER) (CHEERING, APPLAUSE) - Paddy, this is pretty bleak. So I think maybe it's time to find out if there's anything you've actually got no issues with. - Well, surprise, surprise, Eli; there is stuff out there that I've got no issues with. (CHEERING, APPLAUSE) And this week, I've got no issues with the recession. Yes. You are gonna have to hear me out on this one. And sticking with our theme of tonight, our economy is overweight. Partly because we gorged ourselves on government cash during Covid and we all got a disease called inflation. Now, the symptoms of this cruel disease are easily recognisable in just four simple words ` the cost of living. Every time we buy something, it hurts. And to ease people's pain, the government fed us with petrol subsidies and cost of living payments, but that has just made the economy fatter. The Reserve Bank tried to put us on a diet, but like all diets, it didn't really work, and we now need the economic version of bariatric surgery. Now, you might think that I am making way too many medical analogies right now, but here comes another one. When it comes to inflation, I hate it. I want the economic doctors to cut us open, tear out half our stomach, chuck it in the biohazard bin and staple and put a sleeve around what's left. That is what a recession will do. And luckily we are healthy enough to stand it. We've got low unemployment right now. There are hardly any mortgagee sales out there. And you have to remember that recession is an emotive word and politicians like to weaponize it. Don't let them scare you. Economies do grow and contract. Now, obviously, I don't want to see anybody lose their jobs and I don't want to see businesses struggle. But if we don't have the recession now, then we will have it later and it will be worse then, because inflation will be embedded and much worse. That's why I have no issues with the recession. (CHEERING, APPLAUSE) All right. Coming up ` it is crunch time for Colleen, and Mitch is with her when Dr Cabrera has finished her surgery in Tijuana. And Karen gets way too much information about PayWave and it makes her do something that she will later regret. (CHEERING, APPLAUSE) There are many things that make a house a home. But your house won't feel like home unless it's healthy. There's always something that you can do to make your house healthier. You can put in a heating unit, right down to draught stoppers. It's definitely worth doing something even if you just do one thing at a time. Come to Bunnings, have a chat with somebody and we'll help you out and get it sorted. Where you find a competitor's lower price on the same stocked item, we'll beat it by 15 percent. BUNNINGS WAREHOUSE Lowest Prices are just the beginning. (CHEERING, APPLAUSE) - Welcome back, Kiwis. Now, coming up, Mitch will be there as Colleen wakes up from her surgery in Mexico. But first, last time we caught up with our community investigator Karen O'Leary, you were off to go full Karen, and I can't wait to see this. Hopefully I do see you go full Karen. - Paddy, I don't think you're gonna believe what actually happened. when I went into that Westpac, it was actually` it was pretty shocking. Have a look. So, they didn't actually` they didn't wanna talk to me. (LAUGHTER) - # We don't talk about` - payWave. - # No, no, no, no. - Finally, I found a bank who would sit down with me. Great. So, why are you charging us so much to use payWave? - Oh, I think` Are you sure you've got the right person? - Yeah. I googled 'bank online', and your name` your name... (LAUGHTER) Yeah. I think it came up for a different reason. Yeah, but, hey, look, while I'm here, maybe you could tell me a bit about what Fertility New Zealand does. - We walk alongside all people facing fertility challenges. We do that through providing support, information and advocacy services. - Do you have, like, an EFTPOS machine? - (CHUCKLES) No. - Back to surcharges. I like talking to people called John, and it just so happens the head of the Commerce Commission is called John, and I'm pretty sure he'll know a thing or two about fees and surcharges. I mean, I guess what I wanna know is when Emma uses payWave, how much is Ronnie actually having to pay the bank? Maybe just use your hands to kind of give me an example of what you're talking about, and we'll just add some really cool graphics. It'll look amazing. - To my hands. OK. - Yeah, yeah. - So, the merchant service fee is... is a total amount that the merchant pays to the bank... - Mm-hm. - ...at the time that a card gets used. Most of it is this transfer that's going across to Emma's bank. - Yep. - And a little bit of it is going to Ronnie's bank to pay for their costs of providing him service. And so what the new law did was it said that amount there is too high, so we're gonna push that down. And what that should have done is drag down the merchant service fee with it, and therefore the surcharge comes down. - Mm. But at the moment, you're saying that the moment it should be there, but merchants are keeping it here. - This top bit is a bit sluggish. - How much is the fee if I tap? - 0.7. - OK, what about if I just insert or swipe? - Zero if it's a debit card, but it will be 0.7 if a credit card. - You know when you can just pay with your phone... - That's contactless. That's just like tap` - Oh, that's the same as tapping. - That's tap and go, yeah. - So what happens if I tap a debit card? - If you tap a debit card, you'll pay 0.7. - What if I tap a library card? - They'll probably throw you out of the library. - OK, what about if I tap this table? Should I have to pay for that? - No. Usually, the free one is your EFTPOS card. - Yes. - Or if you've got a Visa debit card or Mastercard debit card and you swipe it. - Swipe it or insert it. - Yeah, that's right. - Are you a tapper or are you an inserter? - I'm definitely an inserter. - OK, great. (BOTH LAUGH) That surcharge you're paying at the till is there because if you don't pay it, the shop will. I wonder if people know this? Lemonade. Lemonade. Come and get your cheap lemonade. I'm just selling lemonade. It's only 50c a cup. - Could we get some lemonade? - We don't have cash. I've only got payWave. Just, like, a $50 surcharge to use. That's OK, eh? - Sorry, what? - CHUCKLES: $50. - payWave. - Yeah, yeah, no. - No, thanks. - Oh, we were told things are more expensive in Auckland. - The thing with the surcharge is, obviously, I have to pay the banks to use payWave. Do you reckon it's fair? - That's kind of expensive. - That's not my issue. I'm not paying 50 bucks. - I think your issue is that you're thirsty. If you swipe or insert your card, then no one has to pay. - So no one pays a surcharge? - No one pays a surcharge at all? - No, the merchant's not paying; the customer's not paying. - Oh, then absolutely. - You're actually drinking the lemonade, but you haven't actually paid for it yet. - OK. Did I just`? Did I just get this right? You went to a sperm bank. - Per se, yes, yeah. Obviously, I made a bit of an error with my research. I feel like I should have an official researcher to help me out with things like that. But I had a lovely chat with Lydia, so I was happy to have been there, actually. Had a great time. And then I made heaps of money at my lemonade stand. - Yeah, well, I'm looking forward to seeing how this turns out. What comes next in this? - Well, look, obviously I've had to think outside the square and come up with my very own solution, and I think you're gonna be shocked and amazed by it. - Yeah, well, considering you went to a sperm bank, I'm quite worried about how it's gonna turn out. But I can't wait to see it. But right now, it's back to weight-loss surgery in New Zealand, and it's time to go behind the issue. New Zealand, we are obese. In 1977, just 10% of us were obese. But by 2017, it was three times that many ` 31%. The third most obese country in the world behind only the United States and Mexico. Now, last time we counted, in 2021, over 34% of us were considered obese. That's one in every three. That's over 1.4 million adults. That's bad. Now, bariatric surgery is not the only way to lose weight, but it has been proven to be one of the best ways. It helps get weight off, and it really helps keep it off. Now, the bonus ` you also reduce a whole range of things, like heart problems, liver disease, high blood pressure, type II diabetes and depression. Basically, it saves people. Now, to get the surgery, the key thing is you need to have a body mass index of over 40 or over 35 if you've got complications like diabetes. Now, here is a BMI chart. The green bit shows the healthy range. And as you can see ` I'm at 24 ` healthy, but I've gotta work pretty bloody hard to stay there, if I'm honest. Now, you have to be nearly off the chart, then, to even be eligible for publicly funded bariatric surgery. There is clearly a massive demand out there for it too ` about 2000 people in New Zealand have this surgery each year, but in a good year only about 500 of those are public. The other 1500 have to pay for it themselves ` 22,000 bucks. Now, remember, only 294 people got the surgery in the public system last year. 294, an all-time low, despite all of the obese people that we've got out there. There is an argument that it is a good investment. Studies say it pays for itself within four years, because we're not paying for the huge costs of things like diabetes and heart disease. That's why people really want it ` in some cases, need it. And that's why we have medical refugees on planes to Mexico, India, Thailand and Turkey right now. Now, I happen to know one of these medical refugees pretty damn well. It's my good friend Lloyd Burr. Lloydie, my brother from another mother. You've had bariatric surgery. What's it done for you, bro? - Well, Paddy, I've told you this before, and I'm stoked I can be here to tell the nation this, but it changed my life. And you asked me to come on your show tonight, and I'm in London ` I'm on holiday ` but I jumped at this chance. I went to a shop, and I bought this. I didn't have to go to Mr Biggs. I didn't have to go to Mr Chunky's. I went and got a normal jacket from a normal shop. That's the kind of dignity that it provides. And I didn't do this on a whim. I went to Turkey and got this done for NZ$5000. I talked to a few people before I did this, though, and they'd spent up to NZ$30,000, sometimes AU$30,000 to get this done. I'd seen the change that it had in their life. It saved me a lot in terms of medication. I don't get gout as much as I used to any more. And it blows my mind that the New Zealand government doesn't actually do this for a lot of people. This is an investment in people. It's bonkers it's not funded more widely, and it's bonkers that people have to go to places like Mexico and Turkey to get this done. - All right, Lloyd, thank you so much and get back to your holiday. And coming up ` Karen's payWave solution is the public service hip-hop song nobody needed or even wanted. Then Mitch is there when Colleen wakes up. And I met the Kiwi doctor who's gutted Colleen had to go so far for help. (CHEERING, APPLAUSE) (CHEERING, APPLAUSE) - Nau mai, hoki mai. Welcome back, and I am really looking forward to Karen using music to solve our problem with payWave fees. But first, it's time to check in with the rest of the planet. So Courtney and Eli, my news deskers, has there been anything going on out there in the world this week? - Good golly, Paddy, you're an absolute hound for the news, but luckily, we're happy to sniff out the good stories for you. It's time for The World Has Issues. - The Church of England has issues with vicars demanding a pay rise to cope with the cost of living crisis. More than 200 clergy and staff have asked for a 9.5% pay rise in their annual salary. They can barely afford to pay for the holy water bill, let alone the power of Christ. (LAUGHTER) Just imagine how much worse things would be if they had to actually pay their fair share of tax. - LAUGHS: Yeah. - Good luck getting a pay rise when your boss is a barefoot communist who wears a bed sheet. (LAUGHTER) - You'll get some Facebook comments about that one. The United Arab Emirates have banned the new animated Spider-Man film due to their stance on LGBT rights. A poster saying 'Support Trans Lives' can be seen very, very briefly in the background of a scene, and that was enough for them to ban it. This is probably the most offensive removal from cinema since they discontinued Tangy Fruits. - Yeah. Bring them back. Bring them back. - Love 'em. I actually was considering travelling to the UAE, but I found out I'm actually not allowed because I'm Dubai-curious. (LAUGHTER) - And now to Colombia, where a police officer was hospitalised after swallowing banknotes to hide his involvement in an extortion plot. The officer was caught on camera swallowing a wad of cash that he had extorted from a businessman in return for not arresting him. When a fellow extortionist told him they needed to increase internal cash flow, this is not what they meant. On the bright side, though, after he passed it, a family of rats in the sewer became extremely rich. (LAUGHTER) - To the USA, where Kourtney Kardashian told her husband, Travis Barker, she's pregnant by holding up a sign at his concert. It is the couple's first child together. Such an adorable announcement. Let's just hope Kourtney didn't turn around and see the three other woman with the same sign. (LAUGHTER) This isn't the first time she's had to use a sign to get Travis a message. Empty the dishwasher, mate. This one's about how they made that baby. And here she is reminding Travis to record his favourite programme. And that's all the news that happened this week. Back to you, Paddy Kardashian. - Well, it could have been worse. You could have said I was pregnant. All right. Back to our main issue with medical refugees. Mitch McCann is in Mexico about to see Colleen as she wakes up from her surgery. - Tijuana, a skyline of hotels and hospitals. Many crossing the border between the United States and Mexico are coming for cheap prescription drugs and medical care. But is this low-cost medical tourism too good to be true? - It was a no brainer. It was only a third of what it was gonna cost me in New Zealand to have the surgery. - Teresa is a helper on the package tour Colleen paid for. She had weight-loss surgery in Tijuana a few years ago. - Purely cos I couldn't get the surgery done in New Zealand. I didn't make all the criteria. - So you were ineligible in New Zealand? - Yeah. - Publicly? - Yeah, publicly. My doctor was one who said that trying to get it on the New Zealand dime was never going to happen. - Have you managed to benefit from the surgery? - I lost 30 kilos, which I've managed to keep off now for three and a half years. - Should New Zealanders have to come all this way to get the surgery? - No. No, we shouldn't. It should be available in New Zealand for everyone without being made to feel like you're a failure. - We've been given access to film on a surgical ward at one of Tijuana's private hospitals. And we're about to meet a surgeon who performs weight-loss surgery on New Zealand patients. I want to ask him about the quality of care and how safe it really is. How many patients have you seen since you've been doing bariatric surgery? - Well, from 13 years now, I calculate around 8000, probably a little bit more. - You've perform surgery on 8000 patients? - Yes, I think. Gastroenterology. - All different. - Yes, all different. - (CHUCKLES) Doctor, how risky is it coming here for surgery? Is it safe to come here? - Yes, it is very safe to come here. - What should people be looking for? - Well, they have to look for the experience of the doctor, that the credentials ` that is the most important. - So what you're telling me is that surgery in Tijuana can be safe, but it's important to do your research. - Exactly. You have to do your research, because not all the doctors are qualified, and not all doctors have the experience. - Why is it so cheap for people to come here compared to other countries like New Zealand? - The economy in general, that all services are not as expensive, because all the salaries in general are low. - Well, Colleen has been in hospital for over a day now. We know she's had her surgery; we just don't know how it went. Hello. - Hola. - Hola. (LAUGHS) How are you? - Good, thank you. - Nice to see you. How are you feeling? - Oh, a little bit tired, you know. - Yeah. - But feeling really good, actually. - How did everything go? - Um... Well, all the post-op tests came back really good. - Yeah. What do you make of this whole experience that you've had here? - It's definitely one that I don't regret doing. You know? - You don't regret it? - No, not at all, yeah. - Yeah. In less than 24 hours, Colleen will be discharged. - There's so many things that I need to get out and do, and there's too many things I need to do and too many people that love me for me to just sit back and not do anything. You know? Just got to be positive about life. - Yeah. - Yeah. (APPLAUSE) - OK, Mitch, well, it looks like you and Colleen really connected over there. - Yeah, look, Paddy, I had a lot to do with Colleen while she was in Mexico. We spent a lot of time together. I'd spoken to her on the phone before she came over. And, look, I really got on with her. I really liked her. She was a caring person ` really positive, as you saw in that story. So I'm glad that everything went well for her there. Tijuana ` now, I have to tell you about this Mexican city, because I went all the way to do the story. I knew it had been called Mecca for medical tourism before, but I didn't quite realise how much the city is thriving on the medical industry. As soon as you drive in, there are signs and billboards everywhere around what procedures you can get. There are hospitals and pharmacies seemingly on every corner of that city. And in the hotel I was staying at, I think there would have been dozens of people there for medical tourism for surgery. - All right, Mitch, thank you very much. Fantastic investigation. And we talked to Colleen just yesterday. And apart from a bit of a sore puku, she says she's doing just fine. Now, Karen, have you been able to help Emma with these payWave fees? - Well, look, Paddy, mean I think you can see how this is. It's a very complicated issue. And I think, basically, it comes back to people like you and I just taking that extra time to insert or swipe your card. But what I have done as well is create somewhat of a public awareness campaign and a music video that goes along with it. And I think it's gonna change the whole of New Zealand. Emma, look, I've got some good news, and I've got some bad news. It's mostly bad news. - OK. - So, those surcharges that you're paying, the shops have to charge that, because otherwise the banks are gonna take the money from them. But I'm not sure if you know, if you have an EFTPOS card or a debit card and you swipe it, insert it, just spend that time to push the buttons, then the shop doesn't have to pay that money. - I think I'm just gonna have to get the habit back in of remembering my PIN code. - Yeah, cos the banks really just want you to tap and gap, basically, cos then they're making the money. - Right. - So, Emma, your issue has inspired me. So my plan is I'm gonna start a campaign, a public campaign, to help small businesses get rid of being squeezed by those merchant service fees. Are you happy with that? - I like that. That sounds great. - I'm on the job. - Thank you. - See you soon. (RADIO STATIC HISSES) (LAUGHTER) (CHEERING, APPLAUSE) Thank you. - Wow. - Yeah. - Wow. Wow, wow, wow. - Thank you. I know. Obviously, the music video speaks for itself. - It certainly does. - But I'm also` The good thing is that just this week, John and his mates at the Commerce Commission have come out saying that they're gonna do an investigation into banks' profits. So, basically... - That's you, you reckon? - Well, yeah, I was talking to John just the other week. So, again, good result for me. - Yeah. Another massive result for Karen O'Leary. Now, coming up ` what's wrong in New Zealand that desperate people go to Mexico for medical help? I met the Kiwi doctor who is not afraid to tell me. (CHEERING, APPLAUSE) (CHEERING, APPLAUSE) - Welcome back, Kiwis. So is this medical tourism too good to be true? Is it safe? And what is so wrong with our system here that people are forced to do this? Well, I went to Middlemore Hospital to ask one of the country's top surgeons ` what is going on? My first question to you is what would you say to someone like Colleen who's heading or headed off to Mexico to get this operation done? - I don't know much about Colleen, but in general, I think it's not a very good idea. I understand why people do it. And the biggest reason for that is probably the lack of accessibility of that kind of surgery in New Zealand. - What could go wrong with getting bariatric surgery over in Mexico? - Well, probably the worst-case scenario is a leak. So a surgeon over there, typically they do what's called a laparoscopic sleeve gastrectomy, where you remove most of the stomach, and it's got a little staple line along the edge of the stomach. And sometimes that doesn't heal well ` only in about 1% of people. I'm not sure what the contingencies are for people who have a complication, and all surgeons have complications. It doesn't matter how good you are and how flash your hospital is, and, you know, you're there, and you have a leak, then what do you do? And where do you go? And who's gonna look after you? I have colleagues who've had to deal with that ` people arriving back from Mexico or India or Thailand with severe life-threatening complications from bariatric surgery that's been done overseas. Some of them have been lucky to make it back. - Wow. That's a real worry for Kiwis that are going there. - I mean, that's only a worry for one in 100, but that's about what it is. If you're that one in 100, you're in trouble. - Life-threatening trouble? - Life threatening trouble. - Let's talk about the people who are doing it, because they are desperate if they're gonna do something like this. - Yeah, no, totally acknowledge that. - So... - They're people that we would love to help here. - So why aren't you helping them here? - (LAUGHS) I'm the surgeon; I can do one patient at a time, Paddy, you know, so here at Middlemore Hospital, we do more bariatric surgery in the public hospital system than any other public hospital in New Zealand. We're doing our best. We've been smashed by COVID. We haven't been able to do much at all in the last three years. We're working hard to get going again and get up to about 150 cases a year. We get 600 referrals a year, roughly ` probably more, even, than that. And we just don't have the resource to do it. Like, we've got six surgeons that do bariatric surgery here. All them do other types of surgery as well. It's a chronically underfunded and underappreciated part of medicine. Like, it's got the stigma around it. It's related to obesity. People who are obese are stigmatised. And it's kind of... I've had the feeling in the health care system it's been a sort of, oh, it's nice to do a bit of bariatric surgery, but it's the first thing that goes under the bus when the going gets tough. - And that's on a very strict criteria that Kiwis are saying they can't meet as well. So there's way more beyond that. - Yeah, well, that's just` it's basically rationing. Like, we know that the 600 people, most of them would benefit from bariatric surgery, but they... we only can provide 150. So we dream up all of these barriers for people to kind of meet the target that we can achieve. - So those barriers that people are talking to us about, which they say are really impossible to meet in some cases, these, in your words, are sort of being dreamt up or invented because` - It's a form of rationing. But I mean, like, it's something that we have to do. Like, if I wanted to do 600 bariatric cases a year, I couldn't, because there's no` the infrastructure isn't there in terms of people and theatres and nurses and hospitals and beds. - Yeah. So you need more funding. - Yeah. And healthcare in New Zealand has been chronically underfunded, and then it's been smashed by COVID. Those are the two biggest things, right? So it was on its knees before COVID, and now it's, like... crawling. (APPLAUSE) - So we got a response from Te Whatu Ora, and the eligibility criteria that we've been talking about all night has been in place since 2011, but there are no plans to change it. Any review of it has been deferred because of the current pressure on the system. Now, Te Whatu Ora also say that the government has put in $118 million of extra funding to address the surgical waitlist, but that's gotta cover all surgery. Now, thanks tonight to Mitch for his amazing investigation, to Karen, for her ongoing incredible mahi, and, of course, to our news desk. And tonight, my issue was with wait lists that create medical refugees. And for me, it goes like this ` you just heard a top surgeon tell the truth. Our health system dreams up the criteria that are stopping people from getting bariatric surgery because our health system is beyond broken. So if you're at home now waiting to get a knee operation, a hip operation, a cataract operation, but you don't meet the criteria, you'll no doubt be wondering if those have been dreamt up too. Now, on this show, I like to turn issues into solutions where I can. Sadly, tonight we have been shown a potential solution for our waiting lists, but it's going overseas and becoming a medical refugee. This is not a solution I particularly like. It's totally unregulated for starters, but it is a solution all the same, considering that these patients are driven by desperation. But, honestly, what the hell is going on if this is a solution? The real solution, we all know, is a better health system, one that can take a long-term view rather than being short-sighted and driven by desperation. Good luck to us with this. I'm Paddy Gower. Those were my issues, and I'm gonna miss you. (CHEERING, APPLAUSE) www.able.co.nz Copyright Able 2023