Health systems

Question 1

4 S’s

Answer 1

Staff, stuff, spaces, systems

Question 2

TWIGS

Answer 2

Technology, workforce, infrastructure, governance, systems

Question 3

Levels of regulation jurisdiction

Answer 3

1. Federal
   - National policies: Medicare, PBS, private health insurance
   - Research funding
   - Direct payments for community-based medical services
2. State
   - Public hospital management, private hosp. licensing
   - Ambulance
   - Health complaints
   - Community-based primary health services
3. Shared/non-government
   - Pharmaceutical regulation, quality control
   - Health workforce, education and training
   - ATSI funding

Question 4

Healthcare insurance in Australia

Answer 4

Government provides public insurance for basic coverage, people can buy private health insurance on top of that

Question 5

2 components of Medicare + eligible if

Answer 5

1. Free public hospital treatment
2. Free/subsidised treatment from anyone with a MEDICARE PROVIDER NUMBER - services that are included are listed on the Medicare Benefits Schedule

• Doctors may either bulk bill (entirely on Medicare), or charge OVER the MBS schedule, and the patient pays the gap

Eligible if:
- Have a permanent visa
- From a country with a reciprocal agreement with Australia

Question 6

Medicare funding

Answer 6

• Medicare levy: up to 2% of taxable income
• Those w/o private insurance pay further 1.5%
• MEDICARE LEVY provides for 25% of the government’s TOTAL HEALTH FUNDING

Question 7

Pharmaceutical Benefits Scheme

Answer 7

• Ensures access to affordable medication
• Ensures regulation of safety and quality of drugs (TGA - NMRA for AUS)
• Co-payment system: government pays approx. 87%, consumer pays the rest
• PBS safety net: after a certain threshold is spent on PBS-listed drugs, government pays higher proportion
• Threshold:
• 1650, 277 concession (2024 figures)

** Once concession holders meet safety net, they pay NOTHING

• Max. you will pay for a single PBS-listed medication
• 31.60, 7.70 concession (2024 figures)

Question 8

3 stages of healthcare delivery

Answer 8

1. Primary
   - First point of contact
   - Usually GP, paramedic
   - Primary ≠ GP but GP ≠ primary
2. Secondary
   - Specialists that patients have been referred to by primary healthcare providers
   - Acute care in the emergency department
3. Tertiary
   - Consultative specialist care within a tertiary referral centre
   - Usually as hospital inpatient

Question 9

Non-state actors + what laws are they subject to

Answer 9

Company, organisation, group of individuals, political party, religious institution

Not subject to international human rights laws

Subject to international humanitarian law

Question 10

ICJ

Answer 10

Settles disputes between nation states

No power over non-state actors

Question 11

ICC

Answer 11

Investigates and punishes crimes against humanity and war crimes

Must:
- join ICC
- ratify Rome statute

Question 12

Universal Declaration of Human Rights: types of rights

Answer 12

Civil and political rights: immediately enforceable

Economic, social and cultural: progressively realised

Question 13

Globalisation effects

Answer 13

• Decrease in maternal mortality
• Increase in immunisation rates
• Decrease in < 5 mortality
• HAS NOT decreased gap between poor and rich

Question 14

Largest cost to healthcare budget

Answer 14

Recurring costs (94%)