Our new Minister of Health, Dr Jonathan Coleman, has inherited a portfolio which has averaged expenditure increases of 4.2 per cent per year for the past decade. There will be pressure to continue increasing funding, offset by reductions in education, social programmes, culture, environmental protection, and public housing. This would be a mistake.

Over the next few years more Kiwis will develop chronic diseases such as diabetes, dementia and respiratory disease. The cost of caring for individuals in their last few months of life will continue to grow as long as we focus on adding years to life instead of adding life and dignity to years. It's financially unsustainable.

Left unchanged, spending increases will be driven by greater use of pharmaceuticals, diagnostic, and information technology. Technology companies will make fortunes selling computer apps to monitor behaviour in the mistaken belief that information and feedback are enough to alter complex conditions.

Pharmaceutical companies will push drugs for more people at an earlier age by inferring they reduce the risk of chronic conditions. They will point to studies showing their drugs are more effective and cost efficient than doing nothing or using another medical treatment. But they will fail to compare themselves with public health interventions.

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