Australia’s health care system:

what is Medicare?

Medicare is a national health care insurance scheme, which aims to deliver affordable , accessible and high-quality health care to all eligible Australian. Medicare promotes health through funding free or subsidized medical are in hospital, Aswell as medical services and general treatment.

what is Medicare funded:

Medicare is funded through 3 sources of funding.

1. Medicare levy: most taxpayer will pay a 2%tax.

2. Medicare levy surge: people without private health insurance and earn more than $90000 (individual) or $180000 (families) will pay an extra 1-1.5% levy. This encourages individuals to take out private health insurance to reduce the demand on the Medicare funded public system.

3. general taxation: as the Medicare levy and surge do not cover full operation cost of Medicare the remainder is covered through general taxation.

4. scheduled fee: the amount covered by Medicare for a health services.

5. co-payment: is the payment the individual accepts to pay which is the difference between the total cost of the services and the schedule fee.\

6. bult billing: when the doctor charges only the schedule fee and claimed through Medicare. this means there is not out of pocket expenses for the patient.

   Medicare safety net:

   provides extra financial assistance for those that incur significant out of pocket cost. once a certain amount if reached out of their own pocket to Medicare Servies in a calendar you ($470-in 2019), further financial support provided by the government, making Medicare Servies cheaper for the remainder of the year.

services cover by Medicare:

• x-ray

• eye test performed by optometrist

• doctor and specialist consolation.

Advantages : disadvantages:

• choice of doctor for out of hospital - no choice of doctor for in hopital treatment.

• available to all Australian citizens - does not cover allernative

  - waiting list

  - have to pay tax

Phamaceutical benefit scheme ( PBS)

what is it?

An Australian government program that provides subsidized prescription medication to Australian residence who hold a Medicare card.

Aim?

to provide access to necessary medication, in timely, affordable and reliable manner regardless of their ability to pay.

National disability insurance scheme NDIS

• is a scheme implemented by the national disability agency, an independent agency, the NDIA partners with the Australian government to provide support to Australian with disability sand their loved ones.

Is implemented by the national disability insurance agency that provides, services and support for Australian and permanent residence with permanent disabilities who are under the age of 65 as well as their families and corers in order to help them live a normal life.

what

Private health insurance

it is an optimal additional health insurance which provides people with coverage for health services not covered by Medicare. Private health insurance requires consumer to pay a fee, also known as an insurance premium.

types of covers:

hospital cover includes cost of in-hospital treatment by a doctor and hospital it includes accommodation and theater fees.

general treatment cover: dental, glasses, speech therapy.

combined cover: when you have both hospital and general treatment (extra) cover.

incentive insurance scheme:

• the federal government recognized the importance of encouraging those Australians who can afford private health insurance to take it out.

• this helps take pressure of public health system and will ensure the health care system can continue to meet the needs of Australian s in the future (sustainability).

private heath insurance rebate ( cash back):

the federal government offers a rebate on insurance premium cost, with the rebate varying based on income, with a lower rebate for higher earners.

lifetime Heathcare cover loading:

•a rebate (or refund) on part of the cost of the insurance premium paid by the Federal government. This is means (income) tested, the more you earn the lower the rebate (0% - 27%).

lifetime heath care cover loading:

individuals aged 20 and above are charged an additional 2% premium for PHI, with a maximum 3% loading, resulting in a premium cost of $280 instead of $2000.

Medicare levy surge:

higher income earners without private heath insurance face an aditional surcharge of 1.5% of taxable income promoting the use of insurance instead of higher taxes.

advantages disadvantage

enables access to private hospital care. costly in terms of premiums have have to be paid.

helps to keep the cos of operating qualifying periods apply for some conditions (pregnancy)

Medicare under control.

shorter waiting list/periods for some medical procedures.

Old public health

Government actions that focused on changing the physical environment to prevent the spread of disease, such as providing Safewater, sanitation and sewage disposal, improved nutrition, improved housing conditions and better work conditions.

Biomedical model of heath

The medical model focuses on the physical or biological aspects of a disease, focusing on diagnosis, treatment, and cure to return to pre-illness health. It relies on technology and does not consider prevention or public health.

advantages:

• creates advanced technology and research.

• enables diagnosis and treatment of a range of illnesses.

• enables common illnesses to be treated so they’re not serious anymore

• improves life expectancy

• improves quality of life

disadvantages

• relies on heath professionals and technology and the fore expensive for the government.

• doesn’t always encourage good health, as it has a “fix it” approach.

• not every condition can be treated.

• affordability, not everyone can afford medicine/technology.

New public Health

They way in which government monitor, regulate and promote health and wellbeing, and prevent illness. Public health is everywhere and affects everyone. these efforts typically target the factors that Couse illness rather than treating consequences. like biomedical model, the aim of public health is to promote and prevent illness.

social model of health

is part the ‘new public health’ and was developed in the 1970’s and due to an increase in lifestyle related disease such as cardiovascular disease, obesity and type 2 diabetes. it recognizes that improvement in health can only be achieved by directly effort towards addressing the behavioral social-cultural and environmental factors of health that have an impact on an individual focus of biomedical model and move towards population and different groups through a community approach.

• if factors are address, manage disease and illness can be prevented altogether. polices, education and health promotion activate are key aspect of the social model of health.

• for health promotion campaigns to be effective they must address the principle of the social model. these principal act as a checklist . the more principles that are addressed the more effective the campaign is improving health outcomes.

the five guiding principles: AREA

Adress the broader determinates of health

Act to reduce social inequities

Empower individuals and communities

Act to enable access to healthcare

Reduce social inequalities

Ottawa charter of health promotion

• targe the community not individual

• aim to prevent diseases through health promotion

• has 5 elements that need to be met in order to have a successful health promotion strategy.

BCSDR bad cats smell dead rates:

Building healthy public policy’s:

This involves government and policy/rule maker passing rule/laws related to health promotion that it easier for individuals to make healthier choices.

e.g. :banding smoking in public places such as cafes

Creates supportive environment:

having an environment that assist people in making healthy lifestyle choices leads to increased health. the environment that we live in and work in should support healthy choices and avoid health risk, making it easier to praise. healthy behaviors.

e.g. shade cloth in schools and playgrounds

Strengthen community action:

group in community and individuals working to promote health and achieve a common goal. they can set priorities, make decisions plan and implement strategies.

e.g. immunization strategy involving school: cancer council uses media and school.

Develop personal skills:

this involves educating people, so they have the knowledge and skill necessary for healthy behavior to occur and gain better control for their lives. it often occurs in school, workplace, community setting.

e.g. learning how to check for skin cancer.

Reorient health services:

this is moving beyond and away from biomedical model of treating illness and moving towards health promotion. Doctors may refer on the health promotion initiative rather than intervention.

referral to a dietitian to control weight; recommendation change in diet.

target in health promotion -skin cancer

what is skin cancer?

skin cancer is a disease in which abnormal cell divide uncontrollably and destroyed body tissue. the different types of skin cancer are named from the skin cell where the skin cancer develops. skin cancer is the result of regular overexposure to the sun without adequate sun protection.

Health promotion:

is the process of enabling people to take control over and improve their health.

what is SunSmart?

jointly funded by cancer council Victoria and the Victorian health promotion foundation ( Vic health) since 1988, the SunSmart program run across each state through the cancer council.

aim?

to reduce skin cancer incidence, morbidity and mortality through a targeted prevention and early detection program. target priority populations and use a combination of grass roots tactics, mass media campaign and advocacy to influence attitude, knowledge and behavior in sun protection.

Australian Dietary guidelines:

The Australian Dietary Guidelines, developed by NHMRC, aim to combat diet-related diseases by promoting healthy eating habits, addressing trends like excessive processed food consumption and insufficient fruits and vegetables intake, but not suitable for serious medical conditions.

g1:To achieve and maintain a healthy weight, be physically active and choose amounts of nutritious food and drinks to meet your energy needs.

• Children and adolescents should eat sufficient nutritious foods to grow and develop normally. They should be physically active every day and their growth should be checked regularly.

g2:Enjoy a wide variety of nutritious foods from the following five groups every day and drink plenty of water.

• Plenty of vegetables, including different types and colours, and legumes/beans

• Fruit

g3:Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.

1. Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks.

   • Replace high fat foods that contain predominantly saturated fats such as butter, cream, cooking margarine, coconut and palm oil with foods that contain predominantly polyunsaturated and monounsaturated fats such as oils, spreads, nut butters/pastes and avocado.

g4: Encourage, support and promote breastfeeding.

this assist in the baby’s growth and development as the baby get the nutrients needed.

g5: Care for your food; prepare and store it safely.

to avoid things like cross contamination causing food poisoning

THE AUSUSTRALIAN GUIDE TO HEALTHY EATING:

is a government organization that is a food selection guide which visually represents the proportion of the five food groups recommended for consumption each day. it is intended to be used by Comsumer to assist the planning selecting and consuming adequate proportions of foods from the five food groups.

NUTRITION AUSTRALIA:

non-government, not-for profit, community-based organization that aims to promote optimal health for all Australians encouraging food variety and physical activity at a national level.