U3 AOS2 The Australian healthcare system (6)

Question 1

Private health insurance

Answer 1

Private health insurance is a subscription or policy for which a person pays to provide them with different levels of cover. Private health insurance can provide individuals with additional healthcare services to those provided by Medicare in the form of ‘extras’ which are dependent on the level of cover an individual takes out.

Question 2

List 3 advantages of private health insurance

Answer 2

It helps the government to address the increasing costs of Medicare, if extras or ancillary policies are purchased, an individual can access a wider range of services not covered by Medicare, and it may result in shorter waiting times for some procedures, and can allow patients to select their own doctor in a public or private hospital.

Question 3

List 3 disadvantages of private health insurance

Answer 3

Individuals may feel that they are paying for a service they don’t use, there can be out-of-pocket costs for some services in some policies, and there may be a qualifying or waiting period for some procedures.

Question 4

List all the private health insurance incentive schemes

Answer 4

Private health insurance rebate , medicre levy surcharge, lifetime health cover, and an age based discount.

Question 5

Private health insurance rebate

Answer 5

Australians with private health insurance receive a rebate from the government to help cover the cost of their premiums. Australians who have private health insurance can opt to pay a reduced premium and the government pays the balance, or they can pay the total and claim the rebate via their tax return.

Question 6

Medicare levy surcharge

Answer 6

An incentive that takes 2% of taxable income to assist in covering the cost of Medicare services. An additional surcharge between 1-1.5% in addition to the 2% has been charged for higher-income earners who do not have private hospital health insurance to encourage people to take up private health insurance to reduce the demands on the Medicare system.

Question 7

Lifetime health cover

Answer 7

An incentive for people to continue with private health insurance coverage throughout their lifetime. Anyone who doesn’t have private health insurance with a registered health fund in Australia before 1 July following their 31st birthday and then decides to take out cover later in life, will pay an additional 2% loading on their premium for each year of age over 30 they join (with the maximum loading being 70%).

Question 8

Age-based discount

Answer 8

Individuals aged 18-29 receive a discount on hospital premiums of 2% for each year that a person is aged under 30 when they first purchase eligible hospital cover, up to a maximum of 10 per cent.

Question 9

Explain how private health insurance is funded

Answer 9

Funded by members through the premiums that they pay

Question 10

The National disability insurance scheme (NDIS)

Answer 10

The Commonwealth Government’s new way of providing individualised support for these who are born with, or acquire a permanent or significant disability, their families, and careers. NDIS will fund reasonable and necessary supports and services that relate to a person’s disability to help them achieve their goals through full access to the support they need to improve their quality of life. Eligible NDIS participants (i.e., under 65 years) will receive funding to work towards the goal in your NDIS plan such as improving speech and communication through therapy, or getting and keeping a job.

Question 11

Give 2 examples of things the NDIS will help people with disability do

Answer 11

Access mainstream services and supports, including healthcare, education, public housing, aged care, and the justice system;

Access community services and supports, including sporting clubs, libraries, charities, and community groups;

Question 12

Permanent disability

Answer 12

A persons disability is one that is likely to be lifelong.

Question 13

Significant disability

Answer 13

A disability with a large impact on a persons ability to complete everyday activities.

Question 14

Reasonable support as provided by the NDIS

Answer 14

The support is most appropriately funded or provided through the NDIS.

Question 15

Necessary support as provided by NDIS

Answer 15

Means something a person needs that is related to their disability.

Question 16

Sustainability

Answer 16

Meeting the needs of the present without compromising the ability of future generations to meet their own needs.

Question 17

Prescription Shopping Program (PSP)

Answer 17

Prescription shopping is when a patient unknowingly or knowingly gets more medicine than they medically need by visiting many doctors without telling them about their other consultations.

Question 18

Describe how Medicare promotes health in terms of sustainability

Answer 18

By Medicare only covering essential healthcare services, and not providing services for elective surgery or most allied health services it provides care to what is deemed medically necessary without incurring additional expenses helping the needs of the current generation but also ensuring Australia will be able to support the health needs of future generations financially.

Question 19

Describe how the PBS promotes health in terms of sustainability

Answer 19

Medications that are efficient in treating conditions are added to the PBS which may contribute to reducing the cost of the wider health system by preventing the development of serious conditions and therefore reducing the need for hospital stays or demands on the healthcare system.

Question 20

Describe how private health insurance promotes health in terms of sustainability

Answer 20

Private health insurance is economically sustainable because it helps to meet the healthcare needs of the current generation through placing less burden on the public system.

Question 21

Describe how the NDIS promotes health in terms of sustainability

Answer 21

By introducing and implementing the NDIS over the span of 3 years this ensures its able to be a durable service benefiting, assisting, and promoting the health of those with a disability in this generation but also for future generations during the course of their lives.

Question 22

Describe how Medicare promotes health in terms of access

Answer 22

Medicare allows an individual to be able to select their own doctor for out-of-hospital services, which makes such services more accessible because people will have the ability to select a doctor in their local area and will also be able to select a doctor who meets their social or cultural needs which will help people to feel more comfortable in seeking healthcare.

Question 23

Describe how the PBS promotes health in terms of access

Answer 23

The PBS provides access to medication at local pharmacies which can promote access because individuals are able to get the medication, they need without location acting as a barrier to necessary treatment.

Question 24

Describe how private health insurance promotes health in terms of access

Answer 24

Private health insurance also improves access for patients who rely on the public system as by treating some people in private hospitals, it reduces the waiting times in public hospitals, meaning people can access the treatment they need sooner.

Question 25

Describe how the NDIS promotes health in terms of access

Answer 25

The NDIS aims to ensure that Australians with a disability receive the reasonable and necessary funded support required for them to financially access all the services they need to live their life.

Question 26

Access

Answer 26

Individuals being able to make use of a particular service without barriers such as location, knowledge, time, or costs.

Question 27

Describe how Medicare promotes health in terms of equity

Answer 27

Medicare includes a safety net to protect those who experience higher costs of healthcare, those who have concession cards and big families from large out-of-pocket costs for healthcare services, thus providing extra support to those who need it most.

Question 28

Describe how the PBS promotes health in terms of equity

Answer 28

The PBS also includes a safety net to protect those who suffer chronic illness, those who need many medications or expensive medications, those who have concessions cards and large families from large out-of-pocket costs for PBS medications, thus providing extra support to those who need it most.

Question 29

Describe how private health insurance promotes health in terms of equity

Answer 29

The Medicare levy surcharge protects those who earn less from paying a levy if they cannot afford private health insurance meaning that higher income earners are encouraged to take out private health insurance, which reduces the burden on the public hospital system, meaning that those who cannot afford private health insurance have better access to the public hospital system.

Question 30

Describe how the NDIS promotes health in terms of equity

Answer 30

Through ensuring that people with a disability and their carers receive full access to the support they need, the NDIS promotes equity because more resources are being provided to support those who need help the most.

Question 31

Building healthy public policy

Answer 31

Relates directly to decisions made by governments and organisations in relation to laws and policies that directly affect health (e.g., health sector, workplace and school policies, local councils such as recreation and housing and transport). Examples of these policies includes healthier environments (i.e., banning smoking), influence behaviour (e.g., compulsory wearing of seat belts), and removing the GST (i.e., tax) on unprocessed foods.

Question 32

Create supportive environments

Answer 32

A supportive environment is one that promotes health and assists people in making healthy lifestyle choices. It aims to provide a healthy physical environment through providing shaded areas in schools and investing in sustainable energy production. It aims to provide a healthy social environment through supporting smokers to quit and aiding in a fulfilling social life.

Question 33

Strengthen community actions

Answer 33

This action area is centred around the community working together to achieve a common goal. The more people working together towards a common goal, the greater the chance of success. Communities work together to identify and set health priorities, and plan and implement strategies to achieve better health. For example, the government immunisations scheme, results in higher immunisation rates.

Question 34

Develop personal skills

Answer 34

Education is a key aspect of this priority area. People gain knowledge and skills necessary to make decisions that will affect their health. People who have knowledge and life skills have greater control over their lives and choices to enhance health. For example, talking to people to resolve conflict rather than using violence.

Question 35

Reorient health services

Answer 35

Movement away from the biomedical model to one that promotes health and prevents ill health. Includes all members of the community (e.g., doctors, hospitals, individuals, community groups, health professionals, government departments). For example, healthy eating to reduce impact of cardiovascular disease (CVD).

A health system that reflects the Social Model of Health must therefore address all the determinants of health, not just disease. This requires a shift towards health promotion. Doctors take on a role of educator or provide preventative health care messages not just curative care.