Chapter 6 Flashcards
What does Medicare cover
- Consultation fees for GP’s and Specialists
- X-rays
- Pathology tests
- eye tests by optometrists
- Treatment in a public hospital
What does Medicare not cover
- Cosmetics
- Glasses
- Pharmaceuticals
- Ambulance
- Home nursing care
Advantages of Medicare
- Choice of doctor for out-of-hospital services
- Available to all Australian citizens
- Reciporical agreements with other countries
- Medicare safety net
Disadvantages of medicare
- No choice of doctor for in-hospital treatments
- Waiting lists
- Doesn’t cover alterniative therapies
- Gap
How does a new drug enter the PBS
- Drug must be assessed by PBAC (advisory comittee) for effectiveness and cost effectiveness
- Government must agree to fund it
Describe the NDIS
The NDIS is a national insurance scheme that provides services and support for people with permanent, significant disabilities and their families and carers.
How to be eligible for NDIS
- Aged under 65 when applying
- Must live in Australia and be an Australian citizen or hold a permanent visa
- Meet disability requirements
Define private health insurance
PHI is a type of insurance under which members pay a premium in return for payment towards health related costs not covered by medicare.
PHI incentives
- Private Health Insurance Rebate
- Lifetime Health Cover
- Medicare Levy Surcharge
- Age-Based Discount
Private health insurance Rebate
Income tested rebate on premiums
Lifetime Health Cover
People who take out PHI after the age of 31 pay an extra 2 % on premiums for every year over 30
Advantages of PHI
- Choice of doctor in hospital
- Shorter waiting times
- Incentives
- Enables access to private hospital care
- Alternative treatments
Age-based Discount
2% reduction in premiums for each year that the person is aged under 30, up to 10%
Disadvantages of PHI
- Costly
- Gap
- Qualifing periods
- Confusing
Key considerations of a sustainable health system
- Funding and regulation
- Efficient health system and workforce
- Disease prevention and early intervention
- Research and monitoring