Chapter 10 flashcards for SAC

General practitioner

A doctor who has a wide range of skills and knowledge and looks after most of the people in the community.

Allied heath services

Health professionals outside the medical, dental, and nursing professions.

These include: Counselling, nutrition, chiropractic, optometry, pharmacy

Private health insurance

An insurance policy that helps pay for some of the costs associated with allied health services and for the costs not covered by Medicare.

Alternative health services

Healthcare that can be used instead of or alongside traditional health services.

These include: Massage therapy, yoga, and pilates

Three key aspects of Australia’s healthcare system

Medicare, Pharmaceutical Benefits Scheme (PBS), National Disability Insurance Scheme (NDIS). Medicare and PBS is aimed to increase access to healthcare for all Australians, while the NDIS is aimed at improving the lives of Australians with permanent and significant disability.

Medicare

What is medicare: Medicare is Australia’s universal health insurance scheme. It helps Australians access affordable healthcare by covering or subsidising the cost of many medical services, such as doctor visits, medical tests, mental health care, some dental services for children, and public hospital treatment.

In hospital expenses (covered by medicare)

Costs for treatment and accomodation in a public hospital.

Schedule fee: The amount that medicare contributes toward certain consultations and treatments. The government decides what each item is worth and that what medicare pays.

Out of hospital expenses (covered by medicare)

Costs for services such as doctors, specialists tests and x-rays.

Patient co payment: The payment made by the consumer for health products or services in addition to the amount paid by the government. For out of hospital expenses.

Medicare safety net:

Ensures the people who require frequent services covered by medicare, such as doctor’s visits and tests, receive additional financial support.

What is not covered by medicare:

Medicare does not cover some health services, including most dental care, glasses, hearing aids, ambulance services, home nursing, alternative therapies, and cosmetic surgery.

Bulk billing

When the doctor or specialist charges only the schedule fee. The payment is claimed directly from medicare, so there are no out-of-pocket expenses for the patient.

Advantages and disadvantages of medicare:

Medicare has both advantages and disadvantages. It helps young people access affordable healthcare, improves health and wellbeing, and increases health literacy. Disadvantages include medicare making it harder for young people to access certain health services and information.

How is medicare funded

Medicare is funded through three main sources: general taxation, the Medicare levy (a 2% tax paid by most taxpayers), and the Medicare levy surcharge, which is an extra 1-1.5% tax for higher-income earners without private hospital insurance. These funds help pay for Australia's public healthcare system.

Pharmaceutical Benefits Scheme (PBS) and PBS Safety Net

The Pharmaceutical Benefits Scheme (PBS) helps make medicines more affordable by subsidising the cost of many prescription medicines. Patients pay a reduced amount, while the government covers the remaining cost. The PBS Safety Net provides extra financial support for individuals and families who spend a lot on PBS medicines each year.

National Disability Insurance Scheme (NDIS)

The National Disability Insurance Scheme (NDIS) provides funding and support for eligible Australians with a permanent and significant disability. It helps participants live more independently and improve their health and wellbeing by providing services such as personal care, transport, assistive technology, mobility equipment, and educational support.

Community services supporting youth health and wellbeing

Doctors and hospitals, Sports or recreational clubs, headspace, places of worship, volunteer organisations.

Health Services

All services associated with the diagnosis and treatment of disease or the promotion of health and wellbeing.

Factors affecting access to health

Cost, confidentiality, schedule/ time constraints, geographic location, complicated system and health literacy, cultural factors

Digital media

Any form of media that uses electronic devices for distribution. A wide variety of content that can be easily viewed, modified and distributed to a wide range of electronic devices.

Digital media for health and wellbeing

Internet search engines, mobile apps and general health and wellbeing websites, technology-based patient consultations, symptom checkers.

Health Complaints Commisioner (HCC)

Complaints that may be made: Access to services, Quality/Safety, Care/Attention  Respect/Dignity, Communication, Decisions, Privacy, Access to Health Information 

Process of complaint: Complaint is lodged→ Complaint is assesed and is either referred or declines→ There is either a early resolution/ Formal resolution/ investigation→Complaint and outcome is recorded.

Outcome: Explanation, Apology, treatment, records, refund/ compensation.