Healthcare system reforms

Healthcare reforms

private health insurance rebate

public screening and/or vaccination programs

Pharmaceutical benefits

What is the impact of health expenditure on australia’s healthcare system?

Australia’s health expenditure plays a crucial role in shaping the wellbeing of current and future populations

effective spending influences healthcare quality access, long term sustainability and how health srvices address immediate needs while preparing for future challenged

Healthcare vs prevention

• most health ufnding is directed toward treatment rather than prevention despite chronic disease accounting for nearly half of preventable hospitalisation

• highlights that investingin rpevention such asobesity reduction and tobacco control could save billions in costs and improve long term health

• without shift toward preventative measures, future generations willf ace increased disease burden and healthcse costs

What ist htreatening the sustainability of Australia’s health system?

Rising demand, particularly from an ageing population

disparities in access persist, with rural, remote, indigenous populations experiencing poorer health outcomes

How does Australia provide safe, accessible and effective healthcare services that meet physical and mental needs of Australians?

• treatment

• prevention

• education

• research

• policy

• access

How does the healthcare system offer Treatment?

System provides treatment for various conditions such as mental health, dental and ocmmunity health

How does the healthcare system offer Prevention?

offer preventative service sincluding immunisation and breast care screening

How does the healthcare system offer Eductation?

the system provides health promotions and education prgorams

How does the healthcare system offer research?

system funds research and statistical organsiations that look into and publish info on health issues

How does the healthcare system offer Policy?

The system develops national health policy and regulates private health insurance

How does the healthcare system offer access?

The system provides universal access to quality health care

What is the australian healthcare system?

The Australian healthcare system is a publicly funded, mixed system that provides access to healthcare services for all Australian citizens.

• It is designed to ensure people can access necessary medical services while managing costs.

• The system comprises various components that work together to deliver healthcare services through the combined efforts of the public and private sectors.

Why do we need reform in australias healthcare systme

• Rising healthcare costs risng

• aging populataion

• increase in chronic conditions (obesity, diabetes, cardiovascular)

• rural access barriers challenged efficiency and equity of system

• reform necessary to alleviate financial strain on both individual and government, while also improving long term health outcomes across all demographics

What is the goal of the reforms?

Improve access to essential health services

• Reduce health inequities across regions and populations

• Minimise costs for individuals and the healthcare system

• Promote preventative health strategies

• Improve early detection and treatment of disease

What is private haelth insurance rebate? What is it’s goal?

The private health insurance rebate is a government subsidy that reduces the cost of private health insurance premiums

income tested, meaning lower income earners receive a higher rebate

goal is to encourage australian’s who can afford to do so to take out private health insurance, thereby reducing pressure on public system

Why was the rebate introduced?

public hospital system was becoming overcrowded with long wait times for elective surgeries and treatment

rebate introduced to incentivise higher income earners to use private hospitals thereby easing load on public facilities reducing government healthcare expenditure and increasing access for low income earners as the system was already readily available

How does the rebate system work?

individuals and famileis who hold eligible hospital or extras cover can claim the rebate as

• reduction in premiums through insurers (pay less for cost of insurance)

• rebate rangess from 0 and 24.6% depending on income and age

• rebate applies to hospitals, general treatments and ambulance p0olicies.

What is screening?

identifying diseases or conditions at an early stage, often before symptoms appear, allowing for early intervention and prevention of progression.

What is the goal of screening?

to detect health issues early when they are more treatable, improving the chances of successful treatment and reducing the burden of disease.

What are the key features of screening?

Early detection

Targeted testing

Timely intervention

What is early detection?

Identifies health conditions such as cancer, heart disease, and diabetes early, allowing for more effective treatment and better outcomes.

What is targeted testing?

screening programs are typically targeted at specific populations, such as individuals over 50 for bowel cancer, or women for breast and cervical cancer.

What is timely intervention?

Early detection can lead to earlier treatment, which prevents the condition from advancing to a more severe stage, ultimately reducing long-term health impacts.

What are the screenings included in the program?

Breast Cancer (BreastScreen Australia)

Cervical Cancer (National Cervical Screening Program)

Bowel Cancer (National Bowel Cancer Screening Program):

what is Breast Cancer (BreastScreen Australia)?

Offers mammograms to women aged 50–74 to detect early signs of breast cancer.

what is Cervical Cancer (National Cervical Screening Program)

: Offers pap smears (or HPV tests) for women aged 25–74 to detect early signs of cervical cancer

What is Bowel Cancer (National Bowel Cancer Screening Program

): Offers free screening for bowel cancer to people aged 50–74, utilising a home test kit.

What are the benefits of screening in secondary prevention?

Quality of life → treating conditions in early stages reduces long term complications + improves overall health and wellbeing

Cost effectiveness → detecting health issues early reduces the need for expensive, extensive trreatments later on

Improved survival rates → early detection of diseases → better treatment outcomes and therefore improved survival

Challenges of screening in secondary prevention

Access → populations may face barriers to accessing screening services including geo location, financial constraints, lack of awareness

False Positives/negatives → False positives may cause unnecessary stress, while false negatives may give individuals a false sense of security.

Public awareness → Ensuring that the public is aware of the importance and availability of screenings is crucial for achieving high participation rates

What is a mammogram?

an X-ray of the breast that helps identify abnormal growths, such as tumours, in the breast tissue.

How often are women in the target age invited for screening?

In two year intervals

How does this incentivse breast screening?

The program provides free mammograms, with services available at a wide range of locations across Australia, including mobile screening units that visit rural and remote areas.

What are the benefits of breast cancer screening?

Reduced Mortality: Early treatment of breast cancer can reduce the risk of death from the disease. Studies have shown that regular screening can lower breast cancer mortality by up to 30%.

Cost-Effective: Early detection of cancer can reduce the overall cost of treatment by preventing the need for more expensive and invasive treatments in later stages.

Non-Invasive: Mammograms are a quick, noninvasive procedure that can help save lives by identifying cancer early

. Early Detection: Screening helps detect breast cancer at an early stage, often before any symptoms arise, improving the chances of successful treatment.

What are the challenges of breast cancer screening?

False Positives and Negatives: Mammograms can sometimes return false positives (suggesting cancer is present when it is not) or false negatives (failing to detect cancer when it is present). Additional tests may be needed to confirm results.

Awareness: Some women may not be aware of the program or may not participate due to fear or lack of information.

Accessibility: While the program is widely available, some women in rural and remote areas may still face barriers to accessing screening services.

What is the screening test for cervical cancer?

The program offers an HPV test (Human Papillomavirus) every 5 years, replacing the previous Pap smear. The HPV test is more effective in detecting early signs of cervical cancer.

• The HPV Test: This test looks for the presence of high-risk strains of HPV, which can cause cervical changes. If HPV is detected, further tests and treatment can prevent the development of cancer.

Benefits of cervical cancer screening

Benefits of cervical cancer screening Free or Low-Cost: The cervical cancer screening test is available at no cost through the Medicare system in Australia for eligible individuals.

Reminder System: The program reminds individuals of their five-year screening schedule, helping to ensure continuous monitoring

. Accessibility: The test can be done at general practitioner (GP) clinics, women's health clinics, and family planning clinics. It can also be self performed if preferred.

Challenges of cervical cancer screening

vaccine and Screening coverage: While screening is effective, coverage may not be high in some communities, especially among younger women or those in remote areas

HPV Vaccine: The availability of the HPV vaccine, which is available for individuals under 26, has further reduced the incidence of cervical cancer, but ongoing screening is still necessary.

Cultural and Socio- economic barriers: Some individuals may encounter barriers to accessing the screening program due to cultural beliefs, financial constraints, or a lac

What is the screening test for bowel cancer?

Screening test: The primary screening method is the fecal occult blood test (FOBT), which detects small amounts of blood in the stool, a potential sign of bowel cancer.

• Test frequency: The test is offered every two years to individuals within the target age group.

What are the benefits of bowel cancer screening

Early Detection: Bowel cancer often doesn’t show symptoms in its early stages. The screening program helps detect early signs of cancer before it develops or spreads.

Improved Survival Rates: When bowel cancer is detected early, treatment is more effective, leading to significantly improved survival rates.

Preventative Potential: The program can also detect precancerous polyps in the bowel, which can be removed before they turn into cancer.

Cost-Effective: Detecting and removing bowel cancer early reduces treatment costs and the need for more complex and expensive procedures.

What are the challeneges of bowel cancer screening?

Awareness and Participation: Some individuals may not be aware of the program or may feel embarrassed or reluctant to complete the test, despite its simplicity and confidentiality.

False Positives: While the FOBT is a valuable screening tool, it can occasionally yield false-positive results, potentially leading to unnecessary follow-up procedures.

Access Issues: While the test is free, some individuals may face barriers to accessing the program, such as language or cultural factors, or a lack of understanding about the importance of regular screening

What is immunisation?

process whereby a person is made immune or resistant to an infectious disease, typically by the administration of a vaccine. Vaccines stimulate the body’s immune system to protect the person against subsequent infection or disease

What type of prevention is vaccines and why?

immunisation is an essential part of primary prevention, aiming to prevent the onset of infectious diseases before they occur.

• Vaccines help to protect individuals and communities from serious diseases, including measles, influenza, polio, and more

. • By vaccinating, we reduce the spread of infections and protect vulnerable populations.

How do immunisations ensure access and equity?

Free influenza vaccines for those aged 65+ and additional vaccines for healthcare workers, pregnant women, and people with certain medical conditions.

• Immunisation rates are crucial for Aboriginal and Torres Strait Islander (ATSI) populations, who often experience higher rates of preventable diseases due to lower vaccination coverage.

What is the national immunisation program?

provides a national schedule of recommended vaccines for all children and adults.

program follows a structured schedule aligned with age and risk groups and is regularly reviewed by expert committees, such as ATAGI.

• By increasing community immunity, the NIP helps to control outbreaks and protect vulnerable populations.

• The program ensures that individuals receive vaccinations at the appropriate ages and intervals to protect against preventable diseases.

have a significantly lower risk of health complications than the actual disease they protect against, meaning that prevention is often better than cure, as it results in less financial strain on the Australian economy and healthcare system.

Who does NIP target?

babies, young children, pregnant women, Aboriginal and Torres Strait Islander people, and older Australians.

vaccines for diseases such as measles, mumps, rubella, HPV, whooping cough, and influenza

What are the benefits of immunisation?

Prevention of Disease: Vaccines prevent the spread of contagious diseases, protecting individuals and communities from outbreaks.

Herd Immunity: When a significant portion of the population is vaccinated, it helps to protect those who cannot be vaccinated, such as individuals with certain medical conditions or infants.

Cost-Effective: Preventing disease through vaccination is far more cost-effective than treating illnesses that could have been avoided

What are the challenges of immunisation?

Vaccine Hesitancy: Misinformation and lack of trust in healthcare systems can lead to lower vaccination rates.

Access to Vaccines: In remote areas, particularly within ATSI communities, access to vaccination services can be limited.

Cultural Sensitivity: Tailored programs, culturally appropriate education, and engagement with local community leaders are essential in addressing barriers and improving vaccination uptake.

Who do screening and vaccinations target?

target groups with a higher disease risk or limited access to healthcare.

For example:

• Aboriginal and Torres Strait Islander peoples have higher rates of chronic disease and lower vaccination coverage, so targeted immunisation efforts are in place.

• People aged 50–74 are more at risk of bowel, breast, and cervical cancers, so screening is provided free in this age group.

• Pregnant women are offered vaccines for influenza and pertussis to protect both themselves and their babies.

By targeting these populations, programs improve equity and ensure those most at risk receive essential services.

How does public screening and immunisation reduce health inequities?

free and accessible services, removing financial barriers that might otherwise prevent early detection or disease prevention.

• These programs are designed to reach people in rural, remote, and disadvantaged communities, improving outcomes for groups who traditionally face poorer health.

• For example, HPV vaccination in schools ensures all young people can access protection before becoming sexually active, regardless of income. Programs like mobile breast screening units and outreach immunisation clinics ensure equitable access across Australia.

What is the PBS

national government program that subsidises the cost of many essential • prescription medicines for Australian residents

What is the purpose of the pbs

to ensure that all Australians, regardless of income or location, have access to the medications they need to manage their health.

How does the PBS work

government pays most of the cost, and consumers pay only a small copayment at the pharmacy.

• Example: A medication that usually costs $120 may only cost a patient around $30 through the PBS.

The PBS significantly reduces out-of-pocket costs for patients by subsidising thousands of prescription medications.

• It reduces financial barriers to treatment, especially for those with chronic illnesses or those who require regular medication.

How does PBS reduce inequities?

ensures that Australians have timely access to safe, effective and affordable medicines.

• The medicines listed on the PBS are reviewed by the Pharmaceutical Benefits Advisory Committee (PBAC), which evaluates their safety, effectiveness, and cost-effectiveness.

• ensures medications are not only accessible but also evidence-based and appropriate for public subsidy.

• It helps prevent people from delaying or skipping treatment due to cost.

Who does PBS support

Low-income families

Older adults and concession card holders

Rural and remote communities (where access can be limited)

By reducing financial stress and enabling consistent treatment, the PBS helps narrow the health gap between different population groups.

Who is eligible for the PBS

All Australian citizens and permanent residents with a valid Medicare card.

• Some visitors from countries with a Reciprocal Health Care Agreement (e.g. UK, NZ, Ireland) can also access PBS medicines.

• People with concession cards (e.g. pensioner, healthcare, DVA cards) receive further discounts.

What is the PBS safety net?

Designed to protect individuals/families from high medicine costs over time.

family/individual reaches the annual threshold in PBS spending:

• General patients receive medications at the concession rate ($7.70).

• Concession card holders get PBS medicines free for the rest of the calendar year