H&S Week 1 Flashcards
What is a health care system?
- Organisations, people and actions
- Goal is to promote, restore and maintain health
What are the three broad types of healthcare system?
- Welfare system - healthcare is a fundamental right, and therefore free and government funded (like the NHS)
- Market system - people should pay for their healthcare with certain exceptions (like the U)
- Mixed approach
What are the 7 building blocks of an efficient healthcare system?
- Leadership and governance
- Health financing systems
- Health service delivery
- Health workforce
- Health information systems
- Medical Products, Vaccines and Technologies
- People
True or false: each of the 7 building blocks of healthcare systems are connected, but more or less function independently (except in times of strain/crisis)
- False
- Each are connected in complex ways. This complexity can lead to unpredictable downstream effects in response to changes anywhere in the system.
Recall four models of healthcare systems
- Beveridge (NHS; you never get a beverage, too poor)
- Bismarck (marcket-competition)
- Douglas
- Out-of-pocket
Describe the beveridge healthcare model
- Government single payer, free healthcare
- Funded by taxes
- All doctors govt employees, government has strong price control
Describe the bismarck healthcare model
- Compulsory payments paid into sickness fund
- Can be paid into one of many (non-profit) health insurance companies, who compete with one another
- The doctors work privately, and the government can regulate w/ price controls
Describe the douglas healthcare model
- Funded by the government, which is the single payer
- Funding comes from citizen premiums
- Private doctors, but govt has strong pricing power, and can regulate prices accordingly
What are roles of the government in the healthcare sector?
- Making/enforcing laws and regulations for private/public hospitals, and for consumer protection
- Taxation to ensure wealth redistribution
- Delivering care
- Resolving cases of market failure (not abiding by free market principles)
What three levels of government are involved in Australia’s healthcare system?
- Federal
- State
- Local
What are the basic responsibilities of the federal government in the Aus healthcare system?
- Medicare
- PBS
- Regulation
- Research
What are the basic responsibilities of the state government in our healthcare system?
- Manages public hospitals/community-based care (specialists, GP, dental, mental health)
- Preventative (early) and ambulance (late)
What are the basic responsibilities of the local government in our healthcare system?
- Environmental services (waste disposal, water supply etc)
- Public health promotion
What are some areas that are regulated within the Australian Healthcare system?
- Licensing and registration of practitioners
- Operation of hospitals
- Licensing of private hospitals
- Drugs, therapeutic goods/appliances
What are some agencies that oversee healthcare quality in Australia?
- ACSQH
- Australian council of healthcare standards
- RACGP
What are some roles of NGOs in the healthcare system?
- Inform policy formation
- Train healthcare workers
- Advocacy
- Emergency care
- Develop programs
Explain three funding models to finance healthcare
- Taxation: income tax
- Social health insurance: everyone pays
- Private health: people pay private insurers based on their demographics/risk etc
What are five types of PHI?
- Dominant (in absence of govmt)
- Double-cover (for convenience; pay twice)
- Complementary (for gap payments etc)
- Supplementary cover (normal + extras)
- Alternative (to opt out of the system)
What are the three axes of health insurance?
- Who is covered?
- What is covered?
- How much cost is the insurer willing to bear?
What is it called when everyone has 100% free access to healthcare?
Universal Health Coverage (UHC)
How much of the MBS fee does medicare reimburse for community medical care?
- 100% GP
- 85% specialist
(Of course, gaps can be charged on top of this)
What are the three arms of medicare?
- Hospital based care (medicare pays 75% of the MBS fee for consults and services in hospitals)
- Medical care (?% GP and ?% specialist)
- Pharmaceuticals (PBS)
How do medicare safety nets work?
After a patient pays a certain amount in gaps, the government steps in to reduce their out of pocket expenses.
What are the two main reasons that people choose private health insurance?
- Choice (in public, you just get the next doctor who’s free)
- Lower waiting times
How does the government incentivise PHI?
- Tax penalty for high income earners without
- The earlier you get it, the less loading you pay (after age 30)
