Transcript Resources for imgs

Australian Healthcare System
•
•
•
Australia has one of the best health systems
in the world, and the general Australian
population enjoys good health.
The average life expectancy is 81.4 years,
the 11th highest in the world.
Sadly, the status of Aboriginal and Torres
Strait Islander Australians is significantly
worse, with an average life expectancy of
62.4 years. In 2008, the Coalition of
Australian Governments (COAG) committed
to closing the gap in life expectancy by 2031.
•
•
•
The Australian healthcare system is universal. Its
aim is to ensure that all Australians can access
the health services they need regardless of
financial circumstances.
The universal public health system is run and
funded by the Commonwealth, State and
Territory governments and the governments of
each state.
The public health system is also complemented
by a private health sector, which allows
individuals more choices in health care.
The Australian healthcare system can be
divided into three sections:
- Public health sector
-
-
Private health sector
-
-
-
Medicare
PBS
Hospital
General
Patients and the Healthcare system
 The
public health sector accounts for almost
70% of total health expenditure.
 The two major components of the public
health system are:
1) Medicare
2) Pharmaceutical Benefits Scheme

Medicare is Australia’s universal health
insurance scheme. It was introduced in 1984 to
make health care affordable, accessible and of
a high quality.

Medicare provides access to
1)
Medical care in a public hospital without cost
as a public patient
2)
Free or subsidised treatment by medical
practitioners, including specialists
•
Medicare is available to residents of Australia
who:
•
Have Australian or New Zealand citizenship
•
Hold permanent Australian visas
•
Have applied for a permanent visa
•
Medicare is also available to passport
holders from countries with whom Australia
has reciprocal healthcare agreements.
•
People with chronic illness can also receive
Medicare rebates for allied health services
(eg. speech therapy, physiotherapy) under the
Medicare program Allied Health Initiative.

Medicare is run by the Department of Human
Services and funded by the Commonwealth of
Australia.
 Medicare
is financed through the income tax
system. Individuals pay different sums
depending on income levels.
 Normally, the Medicare levy is 1.5% of
taxable income, but it may vary depending
on individual circumstances.
 An additional 1% Medicare levy may be
deducted if the individual does not have
private health insurance.
The Medicare Benefits Schedule (MBS) is a list of
the Medicare services which the Australian
government subsidises. Medicare benefits are
only available for services listed in the MBS.
 MBS is part of the Medicare Benefits Scheme
managed by the Department of Health.
 A medical practitioner can choose to set a higher
fee for their services than the fee listed in the
MBS. However, the Medicare benefit for the
service will be the listed benefit. The difference
between the fee charged by the medical
practitioner and the listed MBS benefit is known
as “the gap”.






The Pharmaceutical Benefits Scheme(PBS)
is an Australian government program that
provides government subsidy for the cost of
medicine for most medical conditions.
PBS is managed by the Department of
Health and administered by the
Department of Human Services.
You must have a PBS prescriber number to
prescribe medicine under the PBS. This is
administered by Medicare.
All Australian residents with a current
Medicare card are eligible for PBS.
Overseas visitors from countries with a
Reciprocal Health Care Agreement (RHCA)
with Australia may also apply to access the
PBS. Currently (as at January 2014), these
countries are the UK, Ireland, New
Zealand, Malta, Italy, Sweden, the
Netherlands, Finland, Norway, Belgium and
Slovenia.
Private health insurance provides patients with access to
additional benefits, including choice of doctor, hospital and
timing of procedure. Private health insurance does not cover in
full the payment required for the majority of treatments, but it
does provide patients with assistance to meet these costs.
There are two main types of private health insurance:
1)
Hospital
Hospital cover provides assistance for in-hospital medical care
and hospital costs such as accommodation fees. Most services
listed under the Medicare Benefits Schedule (MBS) are covered
by private hospital insurance.
2) General (also known as ancillary or extras cover)
General insurance policies help to cover costs of non-medical
health services such as dental, optical and physiotherapy
treatments.
Individuals with private health insurance can choose to be
treated as a private patient in public or private hospitals.
 PrivateHealth.gov.au
is an Australian
Government website that explains how
private health insurance works.
 There is a specific section concerning private
health insurance for overseas visitors.
General
practitioners
(GPs)
Private
sector health
professionals
Communitybased
services
Public
hospitals
Specialists
GPs
-
Patients can choose their own GP
GPs’ fees are covered either fully or partially by Medicare, depending on the GP’s choice of billing.
Public hospitals
Patients can access public hospitals’ emergency departments of their own accord, through
ambulance services or through a doctor’s referral.
Specialists
Patients generally see specialists after referrals from GPs.
Community-based services
There are a range of community-based services in areas such as mental health and family
planning, which can be directly accessed by patients. These are usually administered by each state
or territory’s Department of Health.
Other private sector health professionals
Dentists, physiotherapists and natural therapists are examples of private sector health
professionals.
The fees for their services are usually covered by the patients or subsidised in part or full by
private health insurance.














Australian Government Department of Health
http://www.health.gov.au/
Australian Government Department of Human Services
http://www.humanservices.gov.au/
Medicare (general site)
http://www.humanservices.gov.au/customer/dhs/medicare
Medicare (for health professionals)
http://www.humanservices.gov.au/healthprofessionals/?from=banner
Medicare Benefits Scheme (MBS)
http://www.mbsonline.gov.au/
Pharmaceutical Benefits Scheme (PBS)
http://www.pbs.gov.au/pbs/home
PrivateHealth.gov.au
http://www.privatehealth.gov.au/