Australian Health Care System Flashcards
wk 6
When was Medibank
1975
What makes you eligible for medicare?
Australian citizen
NZ citizen
permanent resident (or applied)
temporary and covered by ministerial order
citizen of Norfolk, Cocos, Christmas or Lord Howe Island
How do Australian’s indirectly pay for health care?
taxes and Medicae levy / medicar levy surcharge
How do Australians pay for health care directly?
Co-payment for health care services
Co-payment for PBS
Over-the-counter and non-subsiseds care
What is the medicare levy and how much is it?
Medicare Levy - Paid by all people with a taxable income
2% of taxable income
What is the Medicare Levy Surcharge?
If your income is above a threshold and you (and dependants) don’t have appropriate level of health insurance must pay a surcharge.
Additional 1-1.5%
What is the purpose of Medicare Levy Surcharge
Encourage people to take out appropriate PRIVATE health insurance
Use private system to reduce demand on public Medicare system
What is a schedule fee?
Fee for a given service set by the Government
What is a recommended fee?
Guide for doctors with suggested fees set by the AMA
What is bulk billing?
Doctor accepts the Medicare benefit as the full payment
What are out of pocket costs
he difference between Medicare benefit and what clinician charges you.
What can medicare pay for
Full schedule fee for GP services
85% of schedule fee for out-of-hospital services
75% schedule fee for in-hospital services
What is PBS and when was it established?
Started in June 1948
Commonwealth subsides medicines on Schedule so Australians have access to medication at an affordable price.
What is the PBS Copayment and why does it exist?
Patient contribution to control volume and expenditure
When was a concessional category for PBS copayments established?
1983
When was safety net arrangements for PBS established and Who does it protect?
1986
protects those who are chronically ill from large medical costs
How much the general beneficiaries co-payment?
$31.60
How much is the concessional beneficiaries co-payment?
$7.70
Where/What MAY private health insurance cover cost of treatment for/as
as a PRIVATE patient in a private OR public hospital.
What can Private Health Insurance cover?
Dental care, optical care and ambulance transport (in some states)
Describe public health care.
Administered by government and funds raised by taxes
everyone shares risk/burden
free/low cost
long waiting lists
Describe Private Health Care
Individuals pay to obtain private health insurance
indfiual in fund must weigh risk of sickness and needing health care vs cost of policy
premiums can be high
more timley care and choose doctor
What is Lifetime health Cover Policy and what it it’s aim?
Government initaitive that aims to encourage people to purchase private patient hospital; health insurance earlier and maintain it.
What are the Private Health Insurance reforms?
Four cover classifications: Gold, silver, bronze and basic
Provide statements
Aged based discounts for 18-29year olds
Travel and accommodation benefits for rural
Strengthening powers of Private Health Insurance Ombudsman
What are the main responsibilities of the National government?
medicare
PBS
health insurance
What is the major responsibility of state and territory governments?
hospitals - particularly public
What is the main responsibility of local governments?
monitoring health safety and risks in local area
what are the 11 countries that we have a reciprocal health care agreement with?
NZ, UK, Ireland, Sweden, Netherlands, Finland, Italy, Belgium, Malta, Slovenia and Norway
What is the difference between Gap cost and out-of-pocket costs?
Gap cost Medicare benefit vs schedule fee
Out-of-pocket cost= Medicare benefit vs what doctor charges
