<aside> 💡 A brief Introduction to the Australian Healthcare system

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1. Compare and contrast the main divisions of responsibility between Federal and State governments.

   

   

   

   1. Shared:
      • Regulation of health workforce
      • Education and training of health professional
      • Regulation of pharmaceuticals and pharmacies
      • Support improvements in safety and quality of health care
      • Funding of public health programs and services
      • Funding of Aboriginal and Torres Strait Islander health services

2. Discuss major trends in health spending.

   • Public Health Care System

     • 1975: Medibank introduced By labor party
       • Covered the whole Australian population with one scheme
       • Funds raised through tax
       • Opposed by the medical profession and opposition (Liberal)
     • 1976-1981: Liberal National party win the federal election and start dismantling Medibank
     • 1983: Labour Party wins federal election and reinstates universal health care
     • Today: bipartisan support for Medicare

   • Australian Health Care System

     • Medicare is Australia's universal health care system introduced in 1984 to provide eligible Australian residents with affordable, accessible and high-quality health care.

   • Australian health expenditure trends:

     • Trending upwards as with international average
     • Growing population
     • Aging population
     • Greater demand/access for service
     • Inflation
     • Newer improved services

   • Health Expenditure

     • International Trend towards increasing health expenditure
       • Aging population
       • Consumer demand for services
       • Greater access to services
       • Provider driven

   • Australian healthcare expenditure

     • 20th highest in world

     

     • %GDP of healthcare increase from 8.7% to 10.3% from 2006-2016

     

     • Healthcare is 19% of 2013 federal budget

     

     

3. In relation to Medicare, be able to apply the following terms and knowledge:

   • Gap amount

     • Difference between schedule fee and medicare benefit

   • Out of Pocket Costs

     • Difference between what the doctor charges you and the medicare benefit

   • The Medicare Levy and how much it is;

     • 2% of taxable income for all taxpayers

   • The schedule fee

     • Fee for service set by government

   • The recommended fee

     • Fees suggested by AMA

   • What bulk-billing is and what it means for patient costs

     • Doctor accepts Medicare as full payment
     • Patient has no out of pocket costs (Gap fee)
     • Incentive for GPS who bulk bill concession card holders, children <16, rural regional and remote areas

   • What the Medicare Safety Net is

     • Financial support for expensive out-of-hospital Medicare benefits schedule (MBS) service if meets a Medicare safety net threshold

   • Patient amount:

     • When doctor charges patient directly for service(s)

   • What the Medicare Levy Surcharge is and its purpose

     • Additional 1-1.5% tax for high income earners without private health insurance
       • Tier 1: 1%
       • Tier 2: 1.25%
       • Tier 3: 1.5%
     • Encourages high income earners to get PHI
     • Reduces burden on government, allows medicare to cover for those who cannot afford PHI
     • Higher income earners pay both levy and surcharge

   • Rebate/partial refund towards cost of taking PHI : families and individuals that pay private health insurance premiums are eligible for the Private Health Insurance Rebate from the federal government

     • Rebate is tiered according to income and age group
     • Increased income means less rebate and after a certain threshold, no rebate is given at all
     • High income, tier 3 no rebate regardless of age
     • Elderly 65+ get 30.3-34.6% rebate if low taxable income

   • Private Health Insurance Reforms

     • Private hospital cover must have 1 of 4 classifications - gold, silver, bronze, basic
     • Discounts
     • Higher excess in exchange for lower premiums
     • Travel and accommodation benefits

   • Lifetime Health Cover Policy

     • Government initiative designed to encourage you to purchase and maintain private patient hospital insurance cover earlier in life
     • 2% extra on insurance policy every year after 30 for which a policy hasn't been taken out

     

     

4. Given cases, identify ways medical services are paid for.

   1. How is healthcare funded?
   2. Medicare eligibility:
   3. Medicare safety net
   4. Medicare Benefits AS A PRIVATE PATIENT

5. In relation to the Pharmaceutical Benefits Scheme (PBS), be able to discuss:

6. Explain what the Reciprocal Health Care Agreement is and identify eligible countries.

7. Briefly discuss some challenges to the health care system, using examples.