3.2.2 - Australia's health system Flashcards
Medicare
Australia’s universal health insurance scheme giving all Australians, permanent residents, + people from countries with a reciprocal agreement, access to subsidised healthcare.
Medicare benefits scheme
Document that lists the range of services covered + the amount that Medicare will contribute to each.
Medicare safety net
Provides extra financial assistance for those that incur significant out-of-pocket costs for Medicare services.
What medicare covers
- All/some of fees relating to many essential HC services (consultation fees for doc + spec, tests + exams that are needed, most surgical procedures, etc).
- Expenses for public patient in private hospital.
- 75% of schedule fee for treatment for public in private.
What Medicare doesn’t cover
- Most costs associated with private hospital care.
- Most dental examinations + treatments
- Home nursing care/treatment
- Cosmetic/unnecessary procedures
- Ambulance services
- Most allied health services (unless referred to by GP or carried out in public hospital).
Advantages of Medicare
- Choice of doctor for out-of-hospital expenses
- Available for all aus citizens
- Reciprocal agreement between aus + other countries
- Medicare safety net provides extra financial support
Disadvantages of medicare
- No choice of doctor for in-hospital treatments
- Waiting lists
- Doesn’t cover alternative therapies
- Often doesn’t cover full amount of doctor’s visits.
PHI
A type of insurance under which members pay a premium/fee in return for health-related costs not covered by Medicare (optional + in-addition to medicare).
Extras cover
Cover for general treatment to pay for services provided by dentists, physiotherapists, + chiropractors, generally aren’t covered by Medicare (premium increases with each addition).
PHI incentives
- PHI rebate
- Lifetime health cover
- Medicare levy surcharge
- Age-based discount
PHI rebate
Policy holders receive a 30% rebate/refund on their premium in tax returns (extra for those over 65) or can choose to pay a reduced premium in which the gov contributes to remaining costs.
Lifetime health cover
People who take up PHI after the age of 31 pay an extra 2% on their premiums for every year they are over the age of 30 (loading removed after 10 consecutive years).
Medicare Levy Surcharge
People without PHI + earning more than a certain amount p/a ($90,000 or $180,000) have to pay this extra tax which increases with income.
Age-based discount
Insurers have the option of offering young people aged 18-29, a discount of up to 10% for hospital cover, allowing for a 2% reduction in premiums each year that the person is aged under 30 (max 10%)
The PBS
A key component of the Fed Gov’s contribution to Aus’s health system in which the government provides subsidised medication to the community (consumers must make a patient co-paymenet).
