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Health Care in
Australia
PDHPE: Core 1
The Role of Health Care
Aims of health care in
Australia
To provide public health services, including
hospitals and admini...
Range & Types of Health Facilities &
Services Available
Classified in 2 ways:
Institutional
Eg. Hospitals, nursing homes, ...
Responsibility for health facilities & services
Funding for health facilities and services comes primarily from the
Austra...
Responsibility for health facilities & services
Commonwealth GovernmentCommonwealth Government
• Funding to state/territor...
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 t...
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 wea...
Health expenditure comprises recurrent and capital expenditure on hospitals,
medical services, dental services, patient tr...
Health care expenditure vs expenditure
on early intervention & prevention
If we are to cope with the
challenges of a greyi...
Impact of emerging new treatments &
technologies on health care
There is no question that early detection
and subsequent e...
Health Insurance: Medicare & Private
Health care is essentially providedprovided in Australia in one of three ways:
1.thro...
What is health insurance?What is health insurance?
Health Insurance: Medicare & Private
Private Health InsurancePublic hea...
Medicare: Public Health
Medicare, a government funded health system paid through
taxes and a Medicare levy on incomes (1.5% + a further 1% for
sin...
Medicare & the PBS
The Pharmaceutical Benefits Scheme (PBS) was introduced by the
Commonwealth Government in 1986. This sc...
Medicare & Bulk Billing
Bulk Billing – is when the practitioner bills Medicare
directly, accepting the Medicare benefits a...
The Medicare Safety Net
The Medicare Safety Net provides families and
individuals with financial assistance for high out-o...
Private Health Insurance
Advantages
· Payment of the gap
· Doctor of choice
· Hospital of choice
· Accommodation of choice...
Private Health Insurance
There are two types of private
health insurance cover.
HospitalHospital
Cover covers your costs a...
Private Health Insurance
Private Health Insurance
Ancillary cover helps with the cost of services such as
physiotherapy, dental treatment and optom...
Private Health Insurance & ‘The Gap’
The Gap – Many people with private health insurance are
concerned about the gap. The ...
Health Insurance: Private
GovernmentGovernment
incentives toincentives to
take outtake out
Private HealthPrivate Health
In...
The Federal Gov’t 30% Rebate
A 30 per cent government rebate
is offered on private health
insurance
premiums
The Medicare Levy Surcharge
A 1.5%Medicare levy is collected from all income earners who
earn above a minimum amount in Au...
Lifetime Health Cover (Rating)
A lifetime rating, which becomes applicable after the age
of 30 years, was introduced. The ...
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Health care in australia

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Health care in australia

  1. 1. Health Care in Australia PDHPE: Core 1
  2. 2. The Role of Health Care Aims of health care in Australia 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.
  3. 3. Range & Types of Health Facilities & Services Available Classified in 2 ways: Institutional Eg. Hospitals, nursing homes, psychiatric hospitals Non-Institutional Admin and research, medical services, pharmaceuticals, health professionals - eg. physio, chiro
  4. 4. 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
  5. 5. 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.
  6. 6. Responsibility for health facilities & services
  7. 7. Equity of access to health facilities & services 1. Access in rural and remote areas 2. Language support 3. Bulk-billing through Medicare Bulk-billing occurs when a health practitioner directly bills Medicare for the amount payable for a service; the patient does not have to pay.
  8. 8. Health care expenditure vs expenditure on early intervention & prevention
  9. 9. 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
  10. 10. 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
  11. 11. 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”
  12. 12. Impact of emerging new treatments & technologies on health care There is no question that early detection and subsequent early intervention is proving to be a significant contributor to improving health status There is no question that early detection and subsequent early intervention is proving to be a significant contributor to improving health status A natural concern that often accompanies emerging treatments or technologies is the associated costs A natural concern that often accompanies emerging treatments or technologies is the associated costs since the 1980s, advancements have been made in the field of medical imaging that greatly enhance the capacity to detect many health concerns, including the presence of cancer. since the 1980s, advancements have been made in the field of medical imaging that greatly enhance the capacity to detect many health concerns, including the presence of cancer.
  13. 13. Health Insurance: Medicare & Private Health care is essentially providedprovided in Australia in one of three ways: 1.through the public health care system 2.through private health insurance 3.through out-of-pocket expenses paid for by the individual directly Health fundingfunding is a complexcomplex issue. Currently, the financing of health care in Australia comes from 3 main sources: 1. the Medicare levy 2. general taxes paid to various levels of government 3. payments for private sector services.
  14. 14. What is health insurance?What is health insurance? Health Insurance: Medicare & Private Private Health InsurancePublic health insurance Eg. Medicare Eg. HCF, MBF, Medibank Private etc… https://www.youtube.com/watch?v=7uRFFoTpVRw
  15. 15. Medicare: Public Health
  16. 16. 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
  17. 17. 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
  18. 18. Medicare & Bulk Billing Bulk Billing – is when the practitioner bills Medicare directly, accepting the Medicare benefits as full payments for the service.
  19. 19. 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.
  20. 20. 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)
  21. 21. Private Health Insurance There are two types of private health insurance cover. HospitalHospital 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
  22. 22. Private Health Insurance
  23. 23. 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.
  24. 24. 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.
  25. 25. Health Insurance: Private GovernmentGovernment incentives toincentives to take outtake out Private HealthPrivate Health InsuranceInsurance 30% rebate Medicare Levy Surcharge Lifetime Rating (Lifetime Health Cover)
  26. 26. The Federal Gov’t 30% Rebate A 30 per cent government rebate is offered on private health insurance premiums
  27. 27. 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.
  28. 28. 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%).

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