Healthcare system

Medicare

-Australia's universal health care system, designed to provide accessible and affordable health care for all Australians, and to improve the health outcomes for all Australian residents.

 

-Gives all Australians, permanent residents and people from countries with an agreement access to health care that is subsidized by the government.

Medicare levy

-An additional 2% placed on the taxable income of most taxable payers.

Medicare levy surcharge

-The Medicare Levy Surcharge (MLS) is an extra 1 - 1.5% on top of the Medicare Levy for those who do not have private health insurance and who earn above a certain amount

General taxation

What does Medicare cover?

-GP Visits

-Blood tests

-Xray

-Public patients in public hospital

What does Medicare not cover?

-Ambulance service

-Medications

-Physio

-Dental

-Private patient in a private hospital

What are the advantages of Medicare?

-Choice of doctor for out-of-hospital services

-Available to all Australian citizens

-Medicare Safety Net

-Low income earners do not pay Medicare Levy

-Covers tests and examinations, doctors and specialist’s fees, and some procedures such as x-rays and eye tests

What are the disadvantages of Medicare?

-No choice of doctor for in-hospital treatments

-Waiting lists for many treatments

-Does not cover alternative therapies

Private Health Insurance (PHI)

-Is an additional insurance that can be purchased on top of Medicare, where members pay a premium (fee) for health-related costs not covered by Medicare.

-People can also opt for ‘extras’ cover, which can cover services provided by;

• Dentists

• Physiotherapists

• Chiropractors

-Most private health insurance policies consist of hospital cover, or extras cover and ambulance cover

Private Health Insurance Incentives

Lifetime cover:

-Designed to encourage people to take out hospital insurance earlier in life and to maintain their cover. People who are over 30 and do not have hospital cover but decide to take out hospital cover later in life pay a 2% loading on top of the cost of the health insurance for every year they are aged over 30.

 

Government Rebate:

-A rebate from the Australian Government to help cover the cost of their premiums. The private Health Insurance Rebate is income tested.

 

Medicare Levy Surcharge

The advantages and disadvantages of private health insurance

Advantages:

-Enables access to private hospital care

-Choice of doctor while in public or private hospital

 

Disadvantages:

-Costly in terms of the premiums that have to be paid

-Sometimes have a 'gap' which means the insurance doesn't cover the whole fee and the individual must pay the difference

The Pharmaceutical Benefits Scheme (PBS)

-The Pharmaceutical Benefits Scheme (PBS) is a Federal Government-funded scheme that subsidises the cost of a wide range of prescription medications, providing Australians with access to necessary and cost effective medicines at an affordable price.

 

-Medications are more likely to be listed on the schedule if they are lifesaving, life enhancing or disease preventing.

 

-PBS Safety Net - If a person needs a lot of medication in any one year, once the threshold is reached, then the co-payments required are further reduced.