Australian Healthcare System

Public Includes

Public hospital, Medicare, PBS, NDIS

Private Includes

Private hospital, Private health insurance, Medical practitioners in private practic

Medicare is…

Australia’s universal health insurance scheme, managed by the federal government. 

Medicare Provides .. to ..

Subsidised healthcare to all Australian citizens and permanent residents and people from countries with reciprocal agreements.

Medicare ensures . . 

Access to essential medical services at reduced cost.

Medicare covers ..

GP and specialist consultations, x-rays and pathology, minor surgical and therapeutic procedures and 85% of the schedule fee for specialist such as dermatologists and cardiologists.

Bulk Billing

No out-of-pocket costs if the doctor charges only the schedule fee.

Patient Co-Payment 

Patient pays the difference if the doctor charges more than the schedule fee.

Medicare covers (Dental)

Basic

Schedule fee

The amount of money that the government deems appropriate for a particular medical service or procedure.

Patient co-payments

The payment made by the consumer for health products or services in addition to the amount paid by the government.

Bulk-billing

When the doctor charges only the schedule fee so there are no out-of-pocket expenses for the patient.

PBS

Australian Government program that makes essential prescription medicines more affordable for all residents, primarily by subsidising their cost

NDIS

provides services and support for people with permanent, significant disabilities, and their families and carers.

Private health insurance

A type of insurance where members pay a premium (or fee) for health-related costs not covered by Medicare.

Private health insurance rebate

An income tested rebate on premiums for private health insurance.

Lifetime health cover

People who take up private insurance after the age of 31 pay an extra 2% on their premiums each year they are over the age of 30.

Medicare-levy surcharge

People or families that earn a high income pay an extra 2% tax as a Medicare levy surcharge if they do not purchase private health insurance.

Age-based discount

Offers young people aged 18–29 a discount of up to 10 per cent in premiums for each year that the person is aged under 30.

Access

Provides all people with timely access to quality health services based on their needs, not their ability to pay, regardless of where they live in the country.

Equity

Provides more support to individuals and groups that need more support are able to receive it.

Disadvantages of Medicare (3)

• Financial Burden of Aus Gov.

• Long waiting list.

• No option to choose doctor or hospital.

How is Medicare funded

Federal Government raises revenue from taxpayers.