C6: health system Flashcards

1
Q

what is medicare?

A

Australia’s universal health insurance scheme providing Australian citizens + those w reciprocal agreemnt with access to subsidised care

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2
Q

services covered by medicare (remember min. 3)

A
  • eye tests
  • pathology tests
  • doctor + specialist consultations
  • x rays
  • accommodation + treatment in public hospitals
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3
Q

services not covered by medicare (remember min. 3)

A
  • allied health services
  • dental services
  • ambulance fees
  • fees from private hospital
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4
Q

schedule fee

A

the amount that medicare decides as reasonable and contributes towards the cost of health services

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5
Q

Medicare Safety Net

A

provides extra financial assistance by making medicare services cheaper for those w significant out-of-pocket costs over a certain amount for Medicare services –> enables them to keep accessing healthcare

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6
Q

Advantages of medicare

A
  • available to all Aus citizens
  • reciprocal agreement between Australia and other countries allows healthcare access in other certain countries
  • covers cost of treatment in public hospitals
  • medicare safety net provides extra financial assistance for health services once out of pocket expenses over a certain amount
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7
Q

Disadvantages of medicare

A
  • long waiting times
  • no choice of doctor for in-hospital treatments
  • doesn’t cover full amount charged by doctor
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8
Q

How is medicare funded?

A
  • general tax
  • medicare levy: 2% tax
  • medicare levy surcharge: 1 to 1.5% tax
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9
Q

Medicare levy

A

1-1.5% tax on high income earners earning over certain amount and don’t have private health insurance –> this is an incentive to to get private health insurance –> reduces strain on Medicare-funded public health system

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10
Q

PBS

A

provides essential medicines to people who need them, regardless of ability to pay by subsiding medicine but consumers must make a patient co-payment –> enables + increases likelihood people access subsidies medication

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11
Q

PBS Safety Net

A
  • provides financial assistance for people who have significant out of pocket costs from accessing PBS subsidised medication by making them pay lower co-payment –> enable them to have money to get medication
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12
Q

what is NDIS?

A

insurance scheme helpspeople, once they develop an individualised plan, to: access community services, maintain informal support arrangements (support carers/family etc financially/transport to support disabled person), receive necessary funding (eg. to get assistive technology), access mainstream services

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13
Q

eligibility for NDIS

A
  • Australian citizens
  • under 65
  • have permanent condition
  • condition reduces ability to effectively participate in activities without assistance from others/assistive technology
  • affects social and economic participation
  • if likely to require NDIS for rest of life
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14
Q

What is private health insurance?

A
  • insurance scheme where people pay a premium in exchange for payment for reduced health costs for services not covered by Medicare
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15
Q

Private health insurance incentives (+explaination)

A
  • private health insurance rebate: low income people receive rebate on premiums for private health insurance –> increases affordability of private health insurance + raises funds for public health system
  • Lifetime Health cover: people who get private health insurance after 31 pay extra 2% for premiums every year over 30 –> encourages younger people to get private health insurance
  • Medicare levy surcharge: 1-1.5% tax for high income earners w/o private health insurance –> encourages high income earns to get private health insurance
  • Age based discounts offers ages 18-29 2% reduced price of premiums for every year until 30 –> increases younger people to get private health insurance

THE INCENTIVES ENCOURAGE PEOPLE TO GET PRIVATE HEALTH INSURANCE –> RELIEVES BURDEN ON MEDICARE-FUNDED PUBLIC HEALTH SYSTEM

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16
Q

Private health insurance advantages

A
  • access to subsidised private hospital care
  • choice in doctor in hospital
  • shorter waiting times for surgery
  • private health insurance incentives
  • covers services not covered by medicare
17
Q

Private health insurance disadvantages

A
  • premiums are costly –> reduced equity as not everyone can afford it
  • insurance may not cover whole fee and ndividual has out of pocket cost
  • policies can be complex and confusing to understand
18
Q

Health system funding

A

Medicare: medicare funds part/all fees of health services
PBS: essential medicines subsidised by PBS –> providing treatment for many conditions, promoting health outcomes
NDIS: provides funding for resources like assistive technology
Private health insurance: premiums fund private hospitals + federal government funds incentives

19
Q

Health system sustainability

A

Medicare: determines which services are subsided so funds are preserved for most necessary services + provides necessary funds to maintain Australia’s health system
PBS: PBS-subsidised medication is reviewed so that the most needed are kept
NDIS: only necessary funds are spent according to individualised plan so more people can access ndis
Private health insurance: encourages people, especially younger to get it, reducing public system strain, improving health outcomes

20
Q

Health system access

A

Medicare: provides access to all Aus citizens regardless to SES + provides telehealth, increasing healthcare access for rural areas
PBS: provides access to all Aus citizens to subsidised medication + provides access for low SES by them paying a lower co-payments through safety net
NDIS: improves access to health for disabled
Private health insurance: rebate increases access to private health insurance for low SES + increases access to services that would’ve otherwise been to expensive

21
Q

Health system equity

A

Medicare: safety net provides extra financial assistance for low SES + provides mental treatment plans
PBS: safety net protects low SES from large out-of-pocket costs from PBS medication, concessional co-payment provides greater assistance for low SES
NDIS: people with more significant needs receive assistance + those requiring it don’t need to pay more funding towards it
Private health insurance: greater rebate offered for low SES and older individuals + people using insurance don’t have to pay higher premium