Health care in Australia
Encyclopedia
Health care in Australia is provided by both private and government institutions. The Minister for Health and Ageing
Minister for Health and Ageing (Australia)
The Minister for Health and Ageing is a portfolio in the Government of Australia with the responsibility for national health policy. The current Minister for Health and Ageing is Nicola Roxon...

, currently Nicola Roxon
Nicola Roxon
Nicola Louise Roxon is an Australian politician, and is the Minister for Health and Ageing. She has been a Labor member of the Australian House of Representatives since 1998, representing the Division of Gellibrand, in the inner-western suburbs of Melbourne, Victoria.-Early and personal life:She...

, administers national health policy. Primary health care
Primary health care
Primary health care, often abbreviated as “PHC”, has been defined as "essential health care based on practical, scientifically sound and socially acceptable methods and technology made universally accessible to individuals and families in the community through their full participation and at a cost...

 remains the responsibility of the federal government, elements of which (such as the operation of hospitals) are overseen by individual states
States and territories of Australia
The Commonwealth of Australia is a union of six states and various territories. The Australian mainland is made up of five states and three territories, with the sixth state of Tasmania being made up of islands. In addition there are six island territories, known as external territories, and a...

.

In Australia
Australia
Australia , officially the Commonwealth of Australia, is a country in the Southern Hemisphere comprising the mainland of the Australian continent, the island of Tasmania, and numerous smaller islands in the Indian and Pacific Oceans. It is the world's sixth-largest country by total area...

 the current system, known as Medicare
Medicare (Australia)
Medicare is Australia's publicly funded universal health care system, operated by the government authority Medicare Australia. Medicare is intended to provide affordable treatment by doctors and in public hospitals for all resident citizens and permanent residents except for those on Norfolk Island...

, was instituted in 1984. It coexists with a private health system. Medicare is funded partly by a 1.5% income tax
Income tax
An income tax is a tax levied on the income of individuals or businesses . Various income tax systems exist, with varying degrees of tax incidence. Income taxation can be progressive, proportional, or regressive. When the tax is levied on the income of companies, it is often called a corporate...

 levy (with exceptions for low-income earners), but mostly out of general revenue. An additional levy of 1% is imposed on high-income earners without private health insurance
Health insurance
Health insurance is insurance against the risk of incurring medical expenses among individuals. By estimating the overall risk of health care expenses among a targeted group, an insurer can develop a routine finance structure, such as a monthly premium or payroll tax, to ensure that money is...

. As well as Medicare, there is a separate Pharmaceutical Benefits Scheme
Pharmaceutical Benefits Scheme
The Pharmaceutical Benefits Scheme or PBS is a program of the Australian Government that provides subsidised prescription drugs to residents of Australia. The PBS ensures that all Australians have affordable and reliable access to a wide range of necessary medicines.-History:The PBS was established...

 that heavily subsidizes prescription medications. In 2007-08, Australia spent 9.1% of GDP
Gross domestic product
Gross domestic product refers to the market value of all final goods and services produced within a country in a given period. GDP per capita is often considered an indicator of a country's standard of living....

 on health care
Health care
Health care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...

, or A$4874 per capita.

Statistics

The life expectancy of Australia in 1999-2001 was 79.7 years (77.0 years for males and 82.4 years for females). The infant mortality rate of Australia in 2000 was 5.2 per 1,000. The death rate of Australia in 2000 was 6.7 deaths per year per 1,000 people. The neonatal infant mortality rate of Australia in 2000 was 3.5 per 1,000. The postneonatal infant mortality rate of Australia in 2000 was 1.7 per 1,000.

National health policy

Health care in Australia is universal
Universal health care
Universal health care is a term referring to organized health care systems built around the principle of universal coverage for all members of society, combining mechanisms for health financing and service provision.-History:...

. The federal government pays a large percentage of the cost of services in public hospitals. This percentage is calculated on:
  1. Whether the government subsidizes this service (based on the Medicare Benefits Schedule. Typically, 100% of in-hospital costs, 75% of General Practitioner and 85% of specialist services are covered.
  2. Whether the patient is a concession or receives other benefits
  3. Whether the patient has crossed the threshold for further subsidised service (based on total health expenditure for the year)


Where the government pays the large subsidy, the patient pays the remainder out of pocket, unless the provider of the service chooses to use bulk billing
Bulk billing
Bulk billing is a payment option under the Medicare system of universal health insurance in Australia. The health service provider, usually a Doctor is paid 85% of the scheduled fee directly by the government by billing the patient via their Medicare card. The service provider receives only 75% of...

, charging only the scheduled fee, leaving the patient with no extra costs. In some countries, this is commonly referred to as a copayment
Copayment
In the United States, the copayment or copay is a payment defined in the insurance policy and paid by the insured person each time a medical service is accessed. It is technically a form of coinsurance, but is defined differently in health insurance where a coinsurance is a percentage payment after...

. Where a particular service is not covered, such as dentistry
Dentistry
Dentistry is the branch of medicine that is involved in the study, diagnosis, prevention, and treatment of diseases, disorders and conditions of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Dentistry is widely considered...

, optometry
Optometry
Optometry is a health care profession concerned with eyes and related structures, as well as vision, visual systems, and vision information processing in humans. Optometrists, or Doctors of Optometry, are state licensed medical professionals trained to prescribe and fit lenses to improve vision,...

, and ambulance
Ambulance
An ambulance is a vehicle for transportation of sick or injured people to, from or between places of treatment for an illness or injury, and in some instances will also provide out of hospital medical care to the patient...

 transport, the patient must pay the full amount (unless they hold a Low Income Earner card, which may entitle them to subsidised access).

Individuals can take out private health insurance to cover out-of-pocket costs, with either a plan that covers just selected services, to a full coverage plan. In practice, a person with private insurance may still be left with out-of-pocket payments, as services in private hospitals often cost more than the insurance payment.

The government encourages individuals with income above a set level to privately insure. This is done by the those individuals being obliged to pay a surcharge of 1% of income if they do not taking out private health insurance, and a means-tested rebate. This is to encourage individuals who are perceived as being able to afford private insurance not to resort to the strained public health system.

Insurance

The public health system is called Medicare
Medicare (Australia)
Medicare is Australia's publicly funded universal health care system, operated by the government authority Medicare Australia. Medicare is intended to provide affordable treatment by doctors and in public hospitals for all resident citizens and permanent residents except for those on Norfolk Island...

, which funds free universal access
Universal access
Universal access to education is the ability of all people to have equal opportunity in education, regardless of their social class, ethnicity, background or physical disabilities. The term is used both in college admission for the middle and lower classes, and in assistive technology for the...

 to hospital treatment and subsidised out-of-hospital medical treatment. It is funded by a 1.5% tax levy on taxpayers with incomes above a threshold amount, an extra 1% levy on high income earners without private health insurance, as well as general revenue.

The private health system is funded by a number of private health insurance organizations. The largest of which is Medibank Private
Medibank Private
Medibank is an Australian government-owned private health insurer, established under the Fraser government in 1976 through the Health Insurance Commission . It is Australia's largest health insurance provider with 3.6 million members under two brands, and the only health insurer present in every...

, which is government-owned, but operates as a government business enterprise under the same regulatory regime as all other registered private health funds. The Coalition
Coalition (Australia)
The Coalition in Australian politics refers to a group of centre-right parties that has existed in the form of a coalition agreement since 1922...

 Howard
John Howard
John Winston Howard AC, SSI, was the 25th Prime Minister of Australia, from 11 March 1996 to 3 December 2007. He was the second-longest serving Australian Prime Minister after Sir Robert Menzies....

 government had announced that Medibank would be privatised if it won the 2007 election, however they were defeated by the Australian Labor Party
Australian Labor Party
The Australian Labor Party is an Australian political party. It has been the governing party of the Commonwealth of Australia since the 2007 federal election. Julia Gillard is the party's federal parliamentary leader and Prime Minister of Australia...

 under Kevin Rudd
Kevin Rudd
Kevin Michael Rudd is an Australian politician who was the 26th Prime Minister of Australia from 2007 to 2010. He has been Minister for Foreign Affairs since 2010...

 which had already pledged that it would remain in government ownership.

Some private health insurers are 'for profit' enterprises, and some are non-profit organization
Non-profit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...

s such as HCF Health Insurance
HCF Health Insurance
HCF was formed in 1932 to provide health insurance cover to Australians. Since then, it has grown to become one of the country’s largest combined registered private health fund and life insurance organisations...

. Some have membership restricted to particular groups, some focus on specific regions - like HBF which centres on Western Australia
Western Australia
Western Australia is a state of Australia, occupying the entire western third of the Australian continent. It is bounded by the Indian Ocean to the north and west, the Great Australian Bight and Indian Ocean to the south, the Northern Territory to the north-east and South Australia to the south-east...

, but the majority have open membership as set out in the PHIAC annual report. Membership to most of these funds is also accessible using a comparison websites or the decision assistance sites. These sites operate on a commission-basis by agreement with their participating health funds and allow consumers to compare policies before joining online.

Most aspects of private health insurance in Australia are regulated by the Private Health Insurance Act 2007. Complaints and reporting of the private health industry is carried out by an independent government agency, the Private Health Insurance Ombudsman
Private Health Insurance Ombudsman
The Private Health Insurance Ombudsman is an Australian Government agency but acts independently of the Government in dealing with complaints and reporting...

. The ombudsman publishes an annual report that outlines the number and nature of complaints per health fund compared to their market share.

The private health system in Australia operates on a "community rating" basis, whereby premiums do not vary solely because of a person's previous medical history
Medical history
The medical history or anamnesis of a patient is information gained by a physician by asking specific questions, either of the patient or of other people who know the person and can give suitable information , with the aim of obtaining information useful in formulating a diagnosis and providing...

, current state of health, or (generally speaking) their age (but see Lifetime Health Cover below). Balancing this are waiting periods, in particular for pre-existing conditions (usually referred to within the industry as PEA, which stands for "pre-existing ailment"). Funds are entitled to impose a waiting period of up to 12 months on benefits for any medical condition the signs and symptoms of which existed during the six months ending on the day the person first took out insurance. They are also entitled to impose a 12-month waiting period for benefits for treatment relating to an obstetric condition, and a 2-month waiting period for all other benefits when a person first takes out private insurance. Funds have the discretion to reduce or remove such waiting periods in individual cases. They are also free not to impose them to begin with, but this would place such a fund at risk of "adverse selection", attracting a disproportionate number of members from other funds, or from the pool of intending members who might otherwise have joined other funds. It would also attract people with existing medical conditions, who might not otherwise have taken out insurance at all because of the denial of benefits for 12 months due to the PEA Rule. The benefits paid out for these conditions would create pressure on premiums for all the fund's members, causing some to drop their membership, which would lead to further rises, and a vicious cycle would ensue.

There are a number of other matters about which funds are not permitted to discriminate between members in terms of premiums, benefits or membership - these include racial origin, religion, sex, sexual orientation, nature of employment, and leisure activities. Premiums for a fund's product that is sold in more than one state can vary from state to state, but not within the same state.

The Australian government has introduced a number of incentives to encourage adults to take out private hospital
Private hospital
A private hospital is a hospital owned by a profit company or a non-profit organisation and privately funded through payment for medical services by patients themselves, by insurers, or by foreign embassies. This practice is very common in the United States and Australia...

 insurance. These include:
  • Lifetime Health Cover: If a person has not taken out private hospital cover by the 1st July after their 31st birthday, then when (and if) they do so after this time, their premiums must include a loading of 2% per annum. Thus, a person taking out private cover for the first time at age 40 will pay a 20 per cent loading. The loading continues for 10 years. The loading applies only to premiums for hospital cover, not to ancillary (extras) cover.

  • Medicare Levy Surcharge: People whose taxable income
    Taxable income
    Taxable income refers to the base upon which an income tax system imposes tax. Generally, it includes some or all items of income and is reduced by expenses and other deductions. The amounts included as income, expenses, and other deductions vary by country or system. Many systems provide that...

     is greater than a specified amount (currently $70,000 for singles and $140,000 for couples) and who do not have an adequate level of private hospital cover must pay a 1% surcharge on top of the standard 1.5% Medicare Levy. The rationale is that if the people in this income group are forced to pay more money one way or another, most would choose to purchase hospital insurance with it, with the possibility of a benefit in the event that they need private hospital treatment - rather than pay it in the form of extra tax as well as having to meet their own private hospital costs.
    • The Australian government announced in May 2008 that it proposes to increase the thresholds, to $100,000 for singles and $150,000 for families. These changes require legislative approval. A bill to change the law has been introduced but was not passed by the Senate. A changed version was passed on 16 October 2008. There have been criticisms that the changes will cause many people to drop their private health insurance, causing a further burden on the public hospital system, and a rise in premiums for those who stay with the private system. Other commentators believe the effect will be minimal.

  • Private Health Insurance Rebate: The government subsidises the premiums for all private health insurance cover, including hospital and ancillary (extras), by 30%, 35% or 40%. In May 2009, The Labor Government under Kevin Rudd announced that as of June 2010, the Rebate would become means-tested and offered on a sliding scale.

Federal initiatives

Medicare Australia
Medicare Australia
Medicare Australia is an agency of the Australian Government that administers health-related programs including Medicare, the Pharmaceutical Benefits Scheme , and others. It is a prescribed agency under the Financial Management and Accountability Act 1997 and a statutory agency within the...

 is responsible for administering Medicare, which provides subsidies for health services. It is primarily concerned with the payment of doctors and nursing staff, and the financing of state-run hospitals.

The Pharmaceutical Benefits Scheme
Pharmaceutical Benefits Scheme
The Pharmaceutical Benefits Scheme or PBS is a program of the Australian Government that provides subsidised prescription drugs to residents of Australia. The PBS ensures that all Australians have affordable and reliable access to a wide range of necessary medicines.-History:The PBS was established...

 provides subsidised medications to patients. The level of subsidy depends on the above noted tests. Low income earners may receive a card that entitles the holder to cheaper medicines under the PBS. A National Immunisation Program Schedule that provides many immunisations free of charge by the federal government, the Australian Organ Donor Register
Australian Organ Donor Register
The Australian Organ Donor Register is an Australian government register, recording individuals who have agreed to donate organs and tissues in the event of their death. The register is administered by Medicare Australia.- Operation :...

, a national register which registers those who elect to be organ donors. Registration is voluntary in Australia and is commonly recorded on a driver's licence or proof of age card are also managed by the federal government.

The Therapeutic Goods Administration
Therapeutic Goods Administration
The Therapeutic Goods Administration is the regulatory body for therapeutic goods in Australia . It is a Division of the Australian Department of Health and Ageing established under the Therapeutic Goods Act 1989 ...

 is the regulatory body for medicines and medical device
Medical device
A medical device is a product which is used for medical purposes in patients, in diagnosis, therapy or surgery . Whereas medicinal products achieve their principal action by pharmacological, metabolic or immunological means. Medical devices act by other means like physical, mechanical, thermal,...

s in Australia. At the borders the Australian Quarantine and Inspection Service
Australian Quarantine and Inspection Service
The Australian Quarantine and Inspection Service is the Australian government agency responsible for enforcing Australian quarantine laws...

 is responsible for maintaining a favourable health status by minimising risk from goods and people entering the country.

The Australian Institute of Health and Welfare
Australian Institute of Health and Welfare
The Australian Institute of Health and Welfare is Australia's national agency for information and statistics on Australia’s health and welfare. Statistics and data developed by the AIHW are used extensively to inform discussion and policy decisions on health, community services and housing...

 (AIHW) is Australia's national agency for health and welfare statistics and information. Its biennial publication Australia's Health is a key national information resource in the area of health care. The Institute publishes over 140 reports each year on various aspects of Australia's health and welfare.

State programmes

Public Hospitals
Each state is responsible for the operation of public hospitals.

Healthcare Initiatives
State based projects are regularly setup to target specific problems such as breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...

 screening programs, indigenous youth health programs or school dental health
Dental public health
Dental public health is a non-clinical speciality of dentistry.Dental public health is involved in the assessment of dental health needs and improving the dental health of populations rather than individuals....


Non-government organisations

The Australian Red Cross
Australian Red Cross
The Australian Red Cross is one of the many national Red Cross societies around the world. The Australian organisation was established in 1914, nine days after the commencement of World War I, by Karen Tenenbaum, when she formed a branch of the British Red Cross.the organisation grew at a rapid rate...

 collects blood donation
Blood donation
A blood donation occurs when a person voluntarily has blood drawn and used for transfusions or made into medications by a process called fractionation....

s and provides them to Australian Healthcare Providers. Other health services such as Medical imaging
Medical imaging
Medical imaging is the technique and process used to create images of the human body for clinical purposes or medical science...

 (MRI and so on) are often provided by private corporations, but patients can still claim from the government if they are covered by the Medicare Benefits Schedule.

Quality of Care

In an international comparative study of the health care systems in
six countries (Australia, Canada, Germany, New Zealand and the United
States), found that "Australia ranks highest on healthy lives, scoring
first or second on all of the indicators," although its overall
ranking in the study was below the UK and Germany systems,
tied with New Zealand's and above those of Canada and the
U.S.

A global study of end of life care, conducted by the Economist
Intelligence Unit, part of the group which publishes the Economist
magazine, published the compared end of life care, gave the highest
ratings to Australia and the UK out of the 40 countries studied,
the two country's systems receiving a
rating of 7.9 out of 10 in an analysis of access to services, quality
of care and public
awareness.

Indigenous health

Indigenous Australian health and wellbeing statistics indicate Aboriginal Australians are much less healthy than the rest of the Australian community. One leading indicator, infant mortality
Infant mortality
Infant mortality is defined as the number of infant deaths per 1000 live births. Traditionally, the most common cause worldwide was dehydration from diarrhea. However, the spreading information about Oral Re-hydration Solution to mothers around the world has decreased the rate of children dying...

 rates, including stillbirths and deaths in the first month of life, show Aboriginal child mortality is twice as high as non-indigenous child mortality. Another revealing statistic is the 17-year gap in average life expectancy
Life expectancy
Life expectancy is the expected number of years of life remaining at a given age. It is denoted by ex, which means the average number of subsequent years of life for someone now aged x, according to a particular mortality experience...

 between indigenous and other Australians.

Preventable diseases

Cigarette smoking is the largest preventable cause of death and disease in Australia. Australia has one of the highest proportions
Obesity in Australia
Obesity in Australia has been described as an "epidemic" with "increasing frequency." The Medical Journal of Australia found that obesity in Australia more than doubled in the two decades preceding 2003, and the unprecedented rise in obesity has been compared to the same health crisis in...

 of overweight citizens in the developed nations
Developed country
A developed country is a country that has a high level of development according to some criteria. Which criteria, and which countries are classified as being developed, is a contentious issue...

 in the world.

Other

Australian health statistics show that chronic disease such as heart disease
Heart disease
Heart disease, cardiac disease or cardiopathy is an umbrella term for a variety of diseases affecting the heart. , it is the leading cause of death in the United States, England, Canada and Wales, accounting for 25.4% of the total deaths in the United States.-Types:-Coronary heart disease:Coronary...

, particularly strokes which reflects a more affluent lifestyle is a common cause of death. Australians are prone to skin cancer
Skin cancer
Skin neoplasms are skin growths with differing causes and varying degrees of malignancy. The three most common malignant skin cancers are basal cell cancer, squamous cell cancer, and melanoma, each of which is named after the type of skin cell from which it arises...

 with cancers affecting Queensland the most.

Other issues include compensation for victims of asbestos
Asbestos
Asbestos is a set of six naturally occurring silicate minerals used commercially for their desirable physical properties. They all have in common their eponymous, asbestiform habit: long, thin fibrous crystals...

 exposure related disease and the slow development of HealthConnect
HealthConnect
HealthConnect has been Australia’s change management strategy to transition from paper-based and legacy digital health records towards electronic health records planned system of electronic health records....

. The provision of adequate mental health
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...

 services and the quality of aged care
Elderly care
Elderly care or simply eldercare is the fulfillment of the special needs and requirements that are unique to senior citizens. This broad term encompasses such services as assisted living, adult day care, long term care, nursing homes, hospice care, and In-Home care.-Cultural and geographic...

, are other problems in some parts of the country.

Initiatives

  • National Alcohol Strategy 2006-2009
  • Health insite - Reliable health information
  • DoctorConnect - To encourage overseas doctors, to work in Australia.

Peak bodies

  • Australian Medical Association
    Australian Medical Association
    The Australian Medical Association is a professional association for Australian doctors and medical students.The AMA uses a representative structure involving state branches and committees to work with members to promote and protect the interests of doctors.The mechanisms that allow this include:*...

  • Royal Australian College of General Practitioners
    Royal Australian College of General Practitioners
    The Royal Australian College Of General Practitioners is the professional body for General Practitioners in Australia.The Royal Australian College of General Practitioners is responsible for maintaining standards for quality clinical practice, education and training, and research in Australian...


See also

  • Demographics of Australia
    Demographics of Australia
    This article is about the demographic features of the population of Australia, including population density, ethnicity, education level, health of the populace, economic status, religions, and other aspects of the population....

  • HIV/AIDS in Australia
    HIV/AIDS in Australia
    The history of HIV/AIDS in Australia is distinctive. Australia was a country which recognised and responded to the AIDS pandemic relatively swiftly, with one of the most successful disease prevention and public health education programs in the world...

  • Health care compared
  • Emergency medical services in Australia
    Emergency medical services in Australia
    Emergency medical services in Australia are provided by state ambulance services, which are a division of each state or territorial government, and by St John Ambulance in both Western Australia and the Northern Territory.-Land Ambulance:...

  • Health care systems
  • Medical education in Australia
    Medical education in Australia
    Medical education in Australia is concerned with both the basic training of medical practitioners and with the post-graduate training of medical specialists.-Medical school:...

  • Nursing in Australia
    Nursing in Australia
    -Historical:Prior to the transfer of nursing education to the university sector, nurses were trained in a course of instruction in hospital nursing schools that awarded a certificate in general nursing. These courses were generally for a three year period, and nurses were paid employees of the...

  • Paramedics in Australia
    Paramedics in Australia
    A paramedic in Australia is a health care professional who responds to and treats all types of medical and trauma emergencies outside of a hospital setting before and during transportation to an appropriate medical facility...

  • Poverty in Australia
    Poverty in Australia
    Poverty in Australia is a contentious political issue. There is little doubt there is absolute poverty in Australia especially in Aboriginal communities....

  • Euthanasia in Australia
    Euthanasia in Australia
    Euthanasia is illegal in Australia, but was legal for a period in the Northern Territory.-Current situation:Although it is a crime to assist in euthanasia, prosecutions have been rare. In 2002, relatives and friends who provided moral support to an elderly woman who committed suicide were...

  • Catholic Health Australia
    Catholic Health Australia
    Catholic Health Australia operates 75 hospitals and 550 residential and community aged care services and comprises Australia's largest non-government not-for-profit grouping of health and aged care services...

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
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