Labour goes all in on card-based politics
Wednesday, 5 November 2025
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Henry Cooke is deputy political editor at The Post, and writes a column every Wednesday.
OPINION: Lyndon Baines Johnson knew how to handle a political stunt.
The 36th US President was signing a huge bill into law one summer’s day 60 years ago - Medicare, a huge new entitlement to healthcare for all US seniors that to this day is the high water mark of the American welfare state.
But how to make this a bit more exciting than a simple bill signing? He called up former Democratic President Harry Truman, who himself had fought for a similar goal, and issued him the first ever Medicare card. Suddenly, instead of hundreds of pages of complex legislation, the promise was as simple as a bit of card you could put in your wallet - a card that would get you healthcare when you needed it, pure and simple.
Labour leader Chris Hipkins did not stick the landing quite as well as Johnson.
His own “Medicard” had to be rush-announced two days early last week after RNZ was leaked some details of the policy used to pay for it - a very narrow capital gains tax (CGT). It won’t entitle you to all-you-can-eat healthcare, just three free visits to a GP a year, although it will also help you access the rest of the public healthcare system. And many people will probably just use the app instead.
Despite all this, Labour’s push to put something physical into your wallet is a smart one.
A card is a lovely prop. It’s something to hold up to news photographers, not just now but in later election campaigns too. It is not hard to imagine a re-elected Hipkins holding scissors to a Medicard in 2029, warning that James Meager’s National Party would cut it up if elected.
It also makes some practical administrative sense. Few people who aren’t regular users of the healthcare system have their National Health Index number to hand at all times, or know their login to My Health Record. As we all rack our brains trying to remember how many measles shots we have had, a card in your wallet you can use to get onto an app seems handy. Plus there is the stated purpose - a way for you to make clear to any GP in the country that you are due a free appointment.
The card only really works if you make the policy universal, which is also one of the strongest critiques of Labour’s policy. It is certainly hard to argue that $100 spent making sure a rich retiree can see a private GP down the road three times a year is better spent there than it would be making sure that there is a pharmacy in a deprived area handing out subsidised appointments.
Yet without universality it would make more sense to just add the free visits to the already-existing Community Services Card, which has won few votes for governments in the past given its far narrower political appeal. Highly-targeted subsidised bits of healthcare already exist all over the multibillion-dollar system, and win few votes. Universality may be expensive, but it does have a way of making policies stick - we can all go to free public school, get free hospital care, and get superannuation, and it is hard to see that ever really changing.
The fact that the Prime Minister, a billionaire, and an everyday citizen would have the exact same card is kind of the point. It's a little piece of the universal welfare state everyone could hold in their pocket and use at any point in life - not just in their very early or very late years.
Hipkins’ inspiration is probably a bit closer to home than the US. Australia has a “Medicare” card which guarantees access to healthcare, including free GP visits at most doctors.
Prime Minister Anthony Albanese framed much of his successful re-election campaign around this simple little card, repeatedly pulling his own one out of his suit pocket to restate its importance. Labour has even directly stolen a line from Albanese about people only needing their Medicard to visit the doctor, not their credit card.
Which isn’t to say card-based politics doesn’t have some risks. Helen Clark won the election in 1999 with her “pledge card” in tow, but her attempt to repeat the trick in 2005 snowballed into an electoral finance scandal.
The introduction of a card featuring one’s healthcare data will also raise the ire of those extremely worried about the Government creating some kind of “digital ID” for all citizens. All English-language politics is somewhat internationalised now, meaning there are plenty of Kiwis who know all about the digital ID UK Prime Minister Keir Starmer has proposed, one that would be needed for anyone wanting to work in the UK, and will see any moves in that direction as something of a slippery slope.
But the largest risk is the one that took down Labour last term - a failure to deliver. If the GP appointments aren’t actually there when people need them, free or not, then Hipkins will end up just like half of the other bits of card in your wallet - forgotten, frayed, and eventually tossed into the dustbin of history.