health care in australia
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HSC PDHPE: Health Care in AustraliaTRANSCRIPT
Health Care in Australia
PDHPE: Core 1
The Role of Health Care
Aims of health care inAustralia
To provide public health services, including hospitals and administration.
To provide quality health facilities and services to meet the needs of all
Australians.
Organised, financed and delivered by both public and private sources.
Emphasis placed on diagnosis and treatment of illness by the medical
profession.
Health care in Australia mostly about clinical diagnosis, treatment and
rehabilitation.
A shift has occurred in the role of health care, from cure to prevention.
Range & Types of Health Facilities & Services Available
Classified in 2 ways:
InstitutionalEg. Hospitals, nursing homes, psychiatric hospitals
Non-InstitutionalAdmin and research, medical services, pharmaceuticals, health professionals - eg. physio, chiro
Responsibility for health facilities & services
Funding for health facilities and services comes primarily from the Australian Government, state/territory and local governments, non-government agencies and individuals
Responsibility for health facilities & services
Commonwealth GovernmentCommonwealth Government• Funding to state/territories• Medicare• Pharmaceuticals Benefit Scheme• Health promotion initiatives• Worksafe• Veterans
State and Territory GovernmentsState and Territory Governments• Delivery of health services including
administering public acute-care hospitals and psychiatric hospitals• Legislation and regulations for private hospitals, nursing homes and health professionals• Management of mental health programs, dental health services, home &community care, family health services, rehabilitation services
Local GovernmentLocal Government• Personal preventative programs (e.g. immunisations)• Environmental &hygiene regulations• Some home care operations and community health centres
Private sectorPrivate sector• Private hospitals• General practioners• Dentists, pharmacists, physios etc• Private sector, NGOS, eg Cancer Council, Diabetes Australia.
Responsibility for health facilities & services
Equity of access to health facilities & services
1. Access in rural and remote areas
2. Language support
3. Bulk-billing through MedicareBulk-billing occurs when a health practitioner directly bills Medicare for the amount payable for a service; the patient does not have to pay.
Health care expenditure vs expenditure on early intervention & prevention
Expenditure has increasedincreased due to:· Increase in population· Inflation especially in the 1980!s· Australia’s wealth ’ has increased in recent times· Medical research and technology· Population is getting older - they require more medical services
In real terms, it has gone up:· More expensive medical treatments· Well informed population, who value screening & preventative measures· Increasing age of the population
Health expenditure comprises recurrent and capital expenditure on hospitals, medical services, dental services, patient transport services, other health practitioner services, community and public health services, medications, aids and appliances, health research and the administrative systems that support these services.
(AIHW, 2007)
At the moment 90 % of the health care dollar goes
not to "health“ but to "illth“… ill people in the hospital and
acute-care sector.
Health care expenditure vs expenditure on early intervention & prevention
Health care expenditure vs expenditure on early intervention & prevention
If we are to cope with the challenges of a greying Australia…. we must also put more money into prevention stopping people needing medical treatment in the first place.
If we are to cope with the challenges of a greying Australia…. we must also put more money into prevention stopping people needing medical treatment in the first place. Much of the burden of
disease and associated costs are preventable, making disease prevention an important approach for improving the public’s health and to control health care costs
Much of the burden of disease and associated costs are preventable, making disease prevention an important approach for improving the public’s health and to control health care costs
DiscussDiscuss: “An Ounce of Prevention is Worth a Pound of Cure”
Impact of emerging new treatments & technologies on health care
There is no question that early detection and subsequent early interventionis proving to be a significant contributor to improving health status
There is no question that early detection and subsequent early interventionis proving to be a significant contributor to improving health status
A natural concern that often accompanies emerging treatments ortechnologies is the associated costs
A natural concern that often accompanies emerging treatments ortechnologies is the associated costs
since the 1980s, advancements havebeen made in the field of medical imaging that greatly enhance the capacityto detect many health concerns, including the presence of cancer.
since the 1980s, advancements havebeen made in the field of medical imaging that greatly enhance the capacityto detect many health concerns, including the presence of cancer.
Health Insurance: Medicare & Private
Health care is essentially provided provided in Australia in one of three ways:
1.through the public health care system2.through private health insurance3.through out-of-pocket expenses paid for by the individual directly
Health funding funding is a complex complex issue. Currently, the financing of health care in Australia
comes from 3 main sources: 1. the Medicare levy2. general taxes paid to various levels of government3. payments for private sector services.
What is health insurance?What is health insurance?
Health Insurance: Medicare & Private
Private Health Insurance Public health insurance
Eg. Medicare Eg. HCF, MBF, Medibank Private etc…
https://www.youtube.com/watch?v=7uRFFoTpVRw
Medicare: Public Health
Medicare, a government funded health system paid through taxes and a Medicare levy on incomes (1.5% + a further 1% for singles earning over approx $70 000 and couple earning over approx $140 000 who don’t have private cover)
Advantages· Affordable to all the pop’n· Equity in health care· Ease of access to the pop’n· Universality of coverage· Possibility of bulk billing· Special benefits for family
Disadvantages· Compulsory levy even if you don’t use it· No choice of doctor· No choice of hospital· Waiting time for selective surgery· Shared accommodation· The gap
Medicare & the PBS
The Pharmaceutical Benefits Scheme (PBS) was introduced by the Commonwealth Government in 1986. This scheme subsidises most prescription medicines bought at pharmacies in Australia. The major aim of the PBS is to allow all individuals, regardless of socio-economic status, access to necessary prescription medication.
Concession card holders (for example, holders of Pensioner Health Benefit cards) can purchase PBS medicines for a lesser amount—known as the concessional rate (approximately $5). General patients should pay no more than about $32 for each item. Once an individual, or family, has paid a set amount they are issued with a Safety Net Card. This enables the holder access to prescribed medicines free of charge, or at the concessional rate, for the remainder of the calendar year.
http://www.pbs.gov.au/pbs/home
https://www.youtube.com/watch?v=KKIsg3rX3V4
Medicare & Bulk Billing
Bulk Billing – is when the practitioner bills Medicare directly, accepting the Medicare benefits as full payments for the service.
The Medicare Safety Net
The Medicare Safety Net provides families and individuals with financial assistance for high out-of-pocket costs for out-of-hospital Medicare Benefits Schedule (MBS) services. Once you meet a Medicare Safety Net threshold, you may be eligible for additional Medicare benefits for out-of-hospital MBS services for the rest of the calendar year.
Private Health Insurance
Advantages· Payment of the gap· Doctor of choice· Hospital of choice· Accommodation of choice· Payment of ancillary services – chiro, physio etc…· Coverage for travel insurance and other benefits
Disadvantages· cost of services· already paying for health cover (Medicare)
Private Health Insurance
There are two types of private health insurance cover.
Hospital Hospital Cover covers your costs as an in-patient in a hospital
Ancillary (or extras)Ancillary (or extras)Cover is for the cost of other health services such as dental, optical, physiotherapy and a range of other therapies.
Private Health Insurance
Private Health Insurance
Private Health Insurance
Ancillary cover helps with the cost of services such as physiotherapy, dental treatment and optometry. Some funds offer packaged products that cover both hospital and ancillary services.
Private Health Insurance & ‘The Gap’
The Gap – Many people with private health insurance are concerned about the gap. The gap is the difference between what a health fund pays and what a particular medical service costs, which you must pay out of your own pocket.
Health Insurance: Private
Government Government incentives to incentives to take out take out Private Private Health Health InsuranceInsurance
30% rebate
Medicare Levy Surcharge
Lifetime Rating (Lifetime Health Cover)
The Federal Gov’t 30% Rebate
A 30 per cent government rebate is offered on private health insurancepremiums
The Medicare Levy Surcharge
A 1.5%Medicare levy is collected from all income earners who earn above a minimum amount in Australia.
An additional levy of 1% is imposed on high-income earners who :a) choose not to take out private health insurance or, b) do not have an appropriate level of private health insurance hospital cover.
Lifetime Health Cover (Rating)
A lifetime rating, which becomes applicable after the age of 30 years, was introduced. The government imposes a 2 per cent surcharge for each year a person does not take out private health insurance after the age of 30 years.
So, if a person waits until the age of 60 years to take out private health insurance, they can expect to pay a surcharge of 60 per cent on top of their annual premium each year (i.e. 2% °— 30 years = 60%).