Australias Health System

What are the 2 main components of Australias health system?

Public sector and private sector

What is the public sector made up of?

• Public hospitals

• Medicare

• PBS

• NDIS

What is the private sector made up of?

• Private health insurance

• Private hospitals

• Medical practitioners in private practice

What is Medicare?

Australias universal health insurance scheme

Aims to make sure all Australians are able to access basic healthcare that is subsidised by the government

Who can access Medicare?

• All Australian permanent residents

• Those people from countries with a reciprocal agreement

Services covered by Medicare

General practitioner consultation fees, treatment and accomodation as a public patient in a public hospital, eye tests, x-rays, blood tests

Services not covered by Medicare

Most dental examinations and treatments, accommodation costs in a private hospitals, alternative therapies, ambulance services

Bulk billing

Service providers choose to charge the patient no more than the scheduled fee because they get paid directly from the government for their services, therefore bulk billing services is basically free

Scheduled fee

The amount the government, via Medicare, contributes towards costs of treatments and services.

Patient co-payments or out of pocket expenses

When the service provider chooses to charge more than the schedule fee for their service, the patient will have to pay the difference.

Medicare safety net

When an individual or family has reached a set amount of out of pocket medical costs, medicare makes their services cheaper

Advantages of Medicare

• Available to all Australian citizens

• Safety net provides financial support

• Choice of doctor for out of hospital services

Disadvantages of Medicare

• Does not cover alternative therapies

• Waiting lists for many treatments

• No choice of doctor for in hospital treatments

How is Medicare funded?

General taxation, Medicare levy, Medicare levy surcharge

General taxation

Medicare levy and levy surcharge cannot meet the costs of medicare so the additional costs are through general tax revenue

Medicare levy

Most tax payers in Australia pay an additional 2% of their taxable income towards Medicare.

Medicare Levy Surcharge

High income earners without private health insurance pay an additional 1-1.5% tax on top of the Medicare Levy

The Pharmaceuticals Benefits Scheme

Provide essential medicines that are subsidized to reduce illness

National Disability Insurance Scheme

National insurance scheme

Provides services and support for people with disabilities as well as their family and carers

Funded by the federal and state governments

Who can access the NDIS?

Australian citizens or people who hold a permanent visa or a Protected Special Category Visa

What are the disability requirements for the NDIS?

• Have a condition that is likely to be permanent

• Condition reduces your ability to perform tasks

• You are likely to require support under the NDIS for your lifetime

What is the Private health insurance?

A type of insurance where members pay a fee in return for payment towards health-related costs not covered by Medicare. 

How is private health insurance funded?

private health insurance companies

What does private health insurance cover out of hospital?

• dentists

• physiotherapists

• chiropractors

What does private health insurance cover in hospital?

• patients get their choice of doctor

• can have their own room and dont have to wait

• usually charge more than the scheduled fee for service, but private health insurance companies pay the additional costs