Medicare

Question 1

What is public health?

Answer 1

The organised response by society ( governments) to protect and promote health and wellbeing, and to prevent illness, injury and disability.

Question 2

What is the Biomedical; Model of health

Examples

Answer 2

The biomedical model focuses on the medical profession and aims to treat the biological aspects of the disease.
It is known as the quick fix approach as it involves the diagnosis, treatment and cure of a condition.

Examples: Blood tests
X-rays
Medication
surgery

Question 3

Old public health

Answer 3

Government actions that focussed on changing the physical environment to prevent the spread of disease, such as providing safe water, sanitation and sewerage disposal, improved nutrition, improved housing conditions and better work conditions.

Question 4

Preventative model (social) of health

Answer 4

The preventative model of health takes the factors of health into consideration and focuses on promoting healthy lifestyles.
It aims at stopping the illness from occurring and for early detection of illnesses.

Examples: 
Sun Smart program
Breast screen program
Healthy eating pyramid.
National bowel cancer screening program

Question 5

What are non-communicable diseases

Examples

Answer 5

Lifestyle diseases are often referred to as non-communicablediseases.
These diseases are defined as diseases linked with the way people live their life.
Non-communicable diseases include
Atherosclerosis, heart disease and stroke; obesity and type 2 diabetes; and diseases associated with smoking and alcohol and drug abuse.

Question 6

What are non-communicable diseases?

Examples

Answer 6

Lifestyle diseases are often referred to as non-communicablediseases.
These diseases are defined as diseases linked with the way people live their life.
Non-communicable diseases include
Atherosclerosis, heart disease and stroke; obesity and type 2 diabetes; and diseases associated with smoking and alcohol and drug abuse.

Question 7

What is Medicare

Answer 7

Medicare is a universal healthcare system that provides medical care to patients via their GP or hospital for little or no cost.

Question 8

What is a schedule fee?

Answer 8

A fee set for a service by the Australian Government

Question 9

What is bulk billing

Answer 9

Means that the doctor accepts the Medicare payment as full payment for the service, so there is no cost to the patient.

Question 10

What is covered/not covered by medicare

Answer 10

COVERED:
Diagnostic tests (x-ray)
Doctor/GP visits
Eye tests
Pathology tests

NOT COVERED:
Cosmetic procedures
Private hospitals costs
Dental examinations
Physiotherapy
Ambulance services

Question 11

What is the Medicare safety net?

Answer 11

An additional rebate scheme introduced by the federal government for the benefit of patients, covering a range of doctors’ visits and tests received out of the hospital. It provides for reimbursement of 100 per cent of the MBS fee for out-of-hospital services once the relevant threshold
has been met.

Question 12

How is Medicare funded?

Answer 12

Medicare is funded by the Federal Government through 3 sources of income:
The Medicare Levy: this is an additional 2 % tax placed on the taxable income of most taxpayers. Low income earners are exempt from Levy.
2. The Medicare levy surcharge: People without private health insurance and earn above a certain amount have to pay an extra 1-1 ½ % tax.
3. General Taxation

Question 13

Advantages and disadvantages of Medicare

Answer 13

ADV:
Choices of doctor for out of pocket hospital services
Available to all Australians
Covers test and examination, doctors fees and some procedures
Covers simple doctor visits or most of it

DISADV:
No choice of doctor for in-hospital treatments
Waiting lists for many treatments
Does not cover alternative therapies
Often does not cover the full amount of doctors visits

Question 14

Pharmaceutical Benefits Scheme

What is it
How is it funded

Answer 14

The PBS was introduced in 1948 (before Medicare
was implemented) as a limited scheme that
provided free medication for pensioners, as well
as making 139 essential medicines free to other
members of the community.

The PBS is funded by the Commonwealth Government taxes.

Question 15

Private Health Insurance

What is it?

Answer 15

Private health insurance is an insurance which members pay a premium fee for payments towards medical health costs NOT covered by Medicare. It provides cover for private hospital costs and optional extras cover is available.
It covers for services such as dentistry, physiotherapy, chiropractor.

Question 16

Private Health Insurance

How is it funded?

Answer 16

PHI is generally funded by members through the premiums they pay. The cost of private hospital treatment is covered by Medicare (which pays 75% of the schedule fee), private health insurance companies (which pay the gap between what Medicare pays and the balance of the schedule fee) and individuals (who pay the different between what the hospital charges and the schedule fee as an out-of-pocket expense.

Question 17

Private Health Insurance

What is covered by it

Answer 17

Private health insurance cover is generally divided into hospital cover, general treatment cover (also known as ancillary or extras cover) and ambulance cover.
General treatment policies cover treatments outside of hospital such as dental, optical, physiotherapy or pharmacy

Question 18

How is PHI different to Medicare

Answer 18

The main differences are that Medicare only covers the cost of your treatment as a public patient and a set range of non-hospital health services. Private health insurance can give you more choice about the type of health services used and more coverage for different types of services.

Question 19

What the three key PHI incentive schemes.

Answer 19

Private health insurance rebate
Medicare levy surcharge
Lifetime health insurance cover

Question 20

NDIS stands for

Answer 20

National: The NDIS is being introduced progressively across all states and territories.
Disability: The NDIS provides support to eligible people with intellectual, physical, sensory, cognitive and psychosocial disability. Early intervention supports can also be provided for eligible people with disability or children with developmental delay.
Insurance: The NDIS gives all Australians peace of mind if they, their child or loved one is born with or acquires a permanent and significant disability, they will get the support they need.
Scheme: The NDIS is not a welfare system. The NDIS is designed to help people get the support they need so their skills and independence improve over time.

Question 21

What does the NDIS do

Answer 21

They provide all people with disability with information and connections to services in their communities such as doctors, sporting clubs, support groups, libraries and schools, as well as information about what support is provided by each state and territory government.

Question 22

Who is eligible for the NDIS

Answer 22

People aged between 7-65, an Australian resident, often need support from a person because of a permanent or significant disability, use special equipment because of the permanent or significant disability, and need support now to reduce future needs.

Question 23

How is the NDIS funded

Answer 23

The NDIS is funded across all levels of government with the Federal government providing the 3 year roll out costs and 53% of the running costs in 2019-2020.

Question 24

Australian Charter of Healthcare rights

A
S
R
P
I
P
G

Answer 24

They have the right to:
ACCESS - healthcare services and treatment
SAFETY - Receive safe and high quality health care that meets national standards and to be cared for in an environment that is and makes them feel safe
RESPECT - Be treated as an individual (dignity and respect) and have their culture, identity, beliefs and choices recognised
PARTNERSHIP - Ask questions and be involved in open and honest communication
INFORMATION - Clear info about their condition, risks, benefits, tests/treatments, given assistance when needed, access to health information etc
PRIVACY - Have their personal privacy respected, kept confidential and secure
GIVE FEEDBACK - Provide feedback or make a complaint without it affecting you, have concerns addressed

Question 25

Responsibilities by consumers of healthcare

Answer 25

• attending any scheduled appointments or cancelling/rescheduling providers when they can’t attend
• providing honest and accurate info about their health
• sharing any change of circumstance with their service provider in order to reduce any risk to their health
• informing health professionals if they decide at any time to change or stop treatment
• being respectful of healthcare staff and other people using services
• taking an active part in their healthcare decisions
• asking questions if they are unsure about anything
• speaking up if and when they are unhappy

Question 26

Options for consumer complaint redress

Answer 26

• The Victorian Ombudsman
• Australian Health Practitioner Regulation Agency
• Health Complaints Commissioner, Victoria

Question 27

Factors that can impact the knowledge an individual has in relation to health services.

Answer 27

Age, language barriers, SES and educational levels

Question 28

A wide range of health services are available in Victoria to meet the health needs of individuals.
These include:

Answer 28

traditional medical or health services, community health centres, online services, telephone counselling services, mental health services, preventative health services and many other local programs