Australia's health system Flashcards
What is Australia’s universal healthcare scheme?
Medicare
Medicare
Australia’s universal health scheme. Medicare gives all Australian’s, permanent residents and people from countries with reciprocal agreements access to healthcare.
What does Medicare cover?
- $38.75 schedule fee for doctor and specialist consultations
- Treatment and accommodation in public hospitals
- Most surgical procedures
- xrays
- eye tests
- 75% of schedule fee for treatment in private hospitals
What is not covered by Medicare?
- Cosmetic procedures
- Most costs associated with private hospitals (accommodation)
- Ambulance services
- Glasses, hearing aids
- Dental treatments
- Chiropractic services
Patient co-payment
If a doctor charges more than the schedule fee that Medicare covers, then the patient pays the difference.
Bulk-billed
When the doctor only charges the schedule fee, meaning there are no out-of-pocket expenses for the patient.
Medicare Safety Net
Provides extra financial assistance to people who have excessive medical expenses each year.
When an individual or family has contributed a certain amount to Medicare expenses in a calendar year, then Medicare services are cheaper for the rest of the year.
How is Medicare funded?
Medicare Levy
Medicare levy surcharge
General taxation
Medicare levy
An additional 2% tax placed on the taxable income of most taxpayers. Those with low income may be exempt from paying it.
Medicare levy surcharge
An extra tax that people without Private Health Insurance earning more than a certain amount have to pay. It increases as income increases.
It aims to encourage people to take out Private Health Insurance
Advantages of Medicare
- Available to all Australian citizens
- Reciprocal agreement between Australia and other countries, allowing Australians to access healthcare in selected countries
Disadvantages of Medicare
- No choice of doctor for in-hospital treatments
- Waiting list for many treatments
Pharmaceutical Benefits Scheme (PBS)
Provides life-saving and essential medicine to people at a subsidised rate, in which people provide a co-payment towards the medication.
There are over 5000 medicines listed, reviewed 3 times a year.
PBS safety net
Protection for individuals and families from large expenses for PBS-listed medicines. Once a specific amount has been spent within 1 calendar year, the cost reduces to $6.60.
National Disability Benefits Scheme (NDIS)
Provides services and support for people with permanent, significant disabilities and their families and carers, assisting them to live an ordinary life. It is funded by the federal and state governments.
Eligibility for NDIS
- must be under 65
- must live in Australia and be an Australian citizen, or hold a permanent visa
- have an impairment that is permanent, reduced capacity for social and economic participation, and require assistance from other people.
Private health insurance
Pays for health-related costs not covered by Medicare. It is an optional form of health insurance that can be purchased in addition to Medicare.
What does Private health insurance cover?
Depending on the tier the buyer chooses, it covers
- Private hospital cover
- General treatment cover (dental, physiotherapy, chiropractic)
- or both
Incentives to take out Private Health Insurance
Private Health Insurance rebate
- Policy holders receive a rebate of 25% if individuals earn 90k or under and families earn 180k or under.
Over 65s get extra 4% and over 70s get extra 8%.
Medicare levy surcharge
- An extra tax that people without Private Health Insurance earning more than a certain amount have to pay.
Advantages of Private Health Insurance
- Choice of doctor in public or private hospital
- Shorter waiting time for medical procedures
- Provides various options for buyers
Disadvantages of Private Health Insurance
- Costly in terms of premiums that have to be paid
- Sometimes has a ‘gap’: insurance sometimes doesn’t cover the whole fee and individual must pay difference.
4 key areas of Australia’s health system
Funding - Funding the health system means more people can access and receive treatment as a result of reduced costs.
Sustainability - Health system’s capacity to be responsive to emerging needs and provide continuous care into the future.
Access - Healthcare must be accessible to all SES groups and those living within and outside major cities.
Equity - As Australians have different healthcare needs, the health system must consider these differences if it is to be equitable.
How does Medicare promote health in relation to:
- funding
- sustainability
- access
- equity
Funding - Funds service fee
Sustainability - Preserves funds for the most necessary services
Access - Provides access to people of all SES backgrounds
Equity - Provides additional support through Medicare Safety Net.
How does PBS promote health and wellbeing in relation to:
- funding
- sustainability
- access
- equity
Funding - essential medicines are subsidised
Sustainability - Continuously reviews PBS-listed medicines, meaning that those who will benefit the most are prioritised
Access - Subsidises medicines, enabling people to access required medication.
Equity - Protects low-income individuals and families from large expenses through PBS Safety Net.
How does NDIS promote health and wellbeing in relation to:
- funding
- sustainability
- access
- equity
Funding - Provides funding for assistive technology such as wheelchairs and bed rails.
Sustainability - Each participants receives an individualised plan, meaning only necessary funds are spent on each person.
Access - Enables people with life-long disabilities access to healthcare
Equity - Individualised plans ensures those with greater needs receive greater assistance.
How does Private Health Insurance promote health and wellbeing in relation to:
- funding
- sustainability
- access
- equity
Funding - Provides funding for private hospitals
Sustainability - Incentives allows more people to be treated through private health system. reducing strain on public health system.
Access - PHI rebate increases access to private health insurance for those on lower incomes.
Equity - Low incomers receive greater financial assistance through PHI rebate (25%).
