Health care in Australia

The purpose of the Australian health care system is to provide equitable service to ALL Australians via healthcare facilities and services which promote healthy living, diagnose and treat illness, provide rehabilitation, and palliative care for individuals who suffer from illness, injury or are unable to live independently.

Range and types of health facilities and services

Australian health facilities and services are categorised into 2 groups.

                                             INSTITUTIONAL FACILITIES AND SERVICES 

Hospitals provide targeted care for illness, disease or other chronic conditions. 

There are several types of hospitals which operate in Australia, including public, private and psychiatric.

                                                    NON-INSTITUTIONAL FACILITIES AND SERVICES 

Medical services are an example non-institutional care. There are a number of experts who provide medical services to Australians, including doctors, specialists and other healthcare professionals.

The most common medical practitioners in Australia are General Practitioners. This is because work in medical centres, private surgeries and hospitals, making them accessible to the majority of people. GPs can also offer prompt diagnosis and treatment for minor illness/disease, or ailments or refer the patient to a specialist who can provide care for specific illnesses. For example, a patient experiencing severe rashes and skin irritation may be referred to a dermatologist; a doctor who specialises in the health of the skin.

The next service we look at are Health-related services.

Health-related services provide types of improve healthcare, which improve the general wellbeing and quality of life of individuals.

Dentistry, physiotherapy, optometry, dietary consultation, counselling and occupational therapy are all examples of health-related services.

Pharmaceuticals are another type of health-related service. Shops and pharmacies serve people by dispensing prescriptions or over-the-counter medicines to individuals.

 Responsibility for health facilities and services

Activity: Responsibility of Health Care  

Using the notes below and  attached sheet complete the summary table attached

There are five groups responsible with providing a range of health facilities and services in Australia

Federal Government

The Federal Government is the responsible for the development and implementation of national health policies. They receive and control taxpayer dollars and then distribute the budgeted funds to states, territories and local governments so they can manage their health expenditures.

Medicare and the Pharmaceutical Benefits Scheme are examples of federal government initiatives, along with selected national health and advocate selected programs.

State or Territory Government

State and territory governments receive their funds from the federal government. They use this budget to finance and manage various health and community services, including public hospitals, medical practitioners and family health services. These agencies also devise state health policies, regulate private hospitals and surgeries, and make immunisation programs easily accessible.

Local Government

Local governments must implement and support policies devised by state or territory governments. They are also responsible for regulating any environmental issues, including restaurant hygiene, safety standards, maintaining parks and recreational amenities, along with home care services.

Private sector

Health services in this sector are generally privately owned, funded and controlled by individuals, businesses, charities or religious organisations. However, in some instances, private organisations receive government funding (e.g. Cancer Council). They offer a variety of health services including private hospitals, private surgeries and alternative health services, like dental, optical, physiotherapy and occupational therapy.

Community Groups

Community groups may take on the responsibility of raising awareness for specific issues, promoting health and organising support services. Examples include Diabetes Australia and Alcoholics Anonymous.

Equity of access to health facilities and services

Learn to: Evaluate health care in Australia by investigating issues of access and adequacy in relation to social justice principles: 

Questions explore: 

How equitable is the access and support for all sections of the community?

How much responsibility should the community assume for individual health problems?

Activity: Brainstorm with a partner all the barriers that Australians face in accessing health facilitites and services

In health promotion equity revolves around the achievement of a good level of health for all, which means that each person is given the same amount of control over their own health in order to achieve good health. In other words equity in health promotion is about enabling EVERYONE to achieve health, not just specific groups.

• Access to health facilities and services is about the health system’s ability to provide affordable and appropriate health care to people when they require it. 

• Access also refers to equitable distribution of health-care facilities and services to all sections of the Australian population. 

• An individual’s ability to access health-care facilities and services can reflect their:

-knowledge of available services

- socioeconomic status

- geographic isolation

- cultural and religious beliefs

• Access might also be affected by issues such as:

-shortages of qualified staff

- lack of funding or equipment

- patient waiting lists for surgery or other treatment in public hospitals

- waiting times in outpatient clinics or emergency departments.

• The majority of Australians have access to fundamental medical care through the national health insurance system — Medicare. 

• Medicare does not cover all health services such as dental and physiotherapy. As a result, some health services are inaccessible to those who cannot afford them.

• An individual’s ability to access services and facilities can also be influenced by their knowledge and understanding of health information and the services available to help them. 

• A knowledge gap may exist as a result of the individual’s lack of education, their poor literacy skills or, in the case of migrants and some Indigenous groups, a language barrier.

:Telehealth Funding Inquiry

Rural healthcare concerns

Read the snapshot 'Rural healthcare concerns highlighted by the Royal Flying Doctors Service survey

Answer the following questions: What remote area equity issues did the RFDS survey reveal?

From a Social Justice point of view, why is it important for the Healthcare services to be available to people in remote communities? 

Explain how proposed changes to Medicare might help people in remote communities to access better healthcare.

Extended response question:

HOMEWORK QUESTION: Discuss the issue of equitable access to health-care facilities and services across the Australian population (5 marks) 

Answers: 

Health care expenditure versus expenditure on early intervention and prevention

Notes - read and highlight for homework

Study Group Challenge:

Choose an emerging treatment or technology

1. Create a shared doc with your group addressing the following things

a) A timeline of the development (dates, images etc)

b) An explanation of the treatment/technology

c) Explain the benefits eg less intrusive surgery/quicker recovery

d) Access/Cost to the community

Activity:

What do you know about Medicare and Private heath insurance?

Understanding Medicare 

Health insurance: Medicare and private

Advantages and disadvantages of Medicare and private health insurance

• Medicare, was stablished in 1984, and is the primary healthcare system in Australia. 

• The aim of Medicare is to provide all Australians with accessible, affordable and high quality healthcare. 

• All Australians contribute via tax payments, with the levy calculated based on the income of the individual. 

• Medicare provides all Australians with free treatment in public hospitals as well as free or subsidised treatment from various medical professionals including GPs, specialists and, in some instances, dentists and optometrists

• Drawbacks of the Medicare policy include long waiting lists for surgery and the additional strain on hospitals. As a result, costs of healthcare rise and the State Government has to provide more funding. 

• Under the Medicare policy patients sometimes have to pay a service gap, making several treatments unaffordable to low-income earners.

Private Health Insurance is provided jointly by the Federal Government and other private entities. The policy cost has to be paid either on a monthly or an annual basis. The cover under private health insurance can be categorised into three types:

– Hospital Cover

– General Treatment Cover (ancillary/extras)

– Ambulance Cover

Some of the advantages of private health care insurance for both the patients and the government are the flexibility to opt for extra medical, ancillary, dental and optical covers and the fact that patients can choose from a wide range of public and private hospitals. Insured patients receive special benefits such as overseas cover and shorter waiting times for surgery. They also reduce the demand and strain on public facilities.

There are many specialist surgeries, which are primarily provided by the private division, meaning Australian citizens who lack private health insurance often have to wait for months before undergoing elective surgery under Medicare. This has led to increased inequity in the healthcare system as people who are able to afford better levels of healthcare receive medical attention quicker in than Medicare patients.

Private health insurance also has a major drawbacks including the fact that the premium paid for cover remains the same, regardless of whether the individual has used the service or not. Individuals who signup for private insurance also still have to pay their Medicare levy, adding to their overall healthcare costs. Additional insurance provides cover for various costs, including private hospital expenses, ancillary costs and aids like dental, physiotherapy, chiropractic, and ambulance services or even for aids, like glasses. However, patients may need to pay the ‘excess’ when using certain treatments. A higher excess translates to a lower premium, whilst a lower excess raises premium prices. The treatments requiring excess payments are dependent on the type of private cover the individual has.

The healthcare system in Australia is dependent on both public and private finances. Unfortunately, the equity of healthcare access is diminishing and patients spend more of healthcare than they did 10 years ago. Individuals living in regional and rural parts of Australia are less likely to be covered by private health insurance than their urban counterparts. This is primarily due to the lack of access to private in-patient facilities in remote regions

Increasing the amount of people covered by private health insurance, would reduce government liability and spending, leaving more funds to put towards other initiatives.

When Medicare was established, there was a sudden drop in private health insurance, as the premium was high and people found public insurance to be more cost-effective. As a result there was a sudden pressure on the public health system, to provide care and support to people in need and an ageing population.

To counter these rising costs the government developed several, successful strategies to entice more individuals to purchase private health insurance.

30% Rebate by the Federal Government

To encourage people to purchase private health insurance and pay premiums for hospital and/or extras cover, the federal government provides a 30% rebate on the overall cost of insurance.

The rebate is available to the policyholder, even if the insurance covers others, such as their spouse and/or children (providing the spouse and/or children are eligible for Medicare).

The Medicare Levy Surcharge

• An extra 1% will be charged, along with the normal 2% charged for Medicare, for individuals who have an annual income more than the threshold amount and have not opted for private health insurance cover

To further promote private health insurance, the Government of Australia has introduced the following schemes:

Incentive Scheme

Individuals who earn over $75,000, or couples who earn over $150,000 per annum, do not have to pay a 1% surcharge if they opt for private health insurance. Individuals earning over $90,000 and couples earning over $180,000 have to pay an additional surcharge each year if they do not purchase private health insurance.

Lifetime Health Cover Scheme

Individuals aged above 30 are advised to opt for private health insurance. If people do not opt for a private health insurance by the age of 30, they will have to pay an extra surcharge of 2% each year when they do opt in. For example, when an individual reaches the age of 40, they would have to pay a surcharge of 20% additionally (10 years X 2%) towards the premium. That means if the premium usually costs $3000 – they will need to pay 20% on top, costing them $3600 per year for private health insurance for the rest of their life ($3000 x 120% = $3600)

Singles, couples and families must consider the risks when choosing or not choosing private health insurance, including:

– Paying a premium they may not use/need within that year

– Paying a premium and requiring treatment which could be easily, quickly and cheaply treated in the public sector

– Not buying private health insurance and requiring treatment for a medical condition that is costly and having to endure long waiting times

Some people, with little to no medical conditions, view private health insurance as a waste of money each year. Others view it as a safety net for future risks or serious conditions.

Activity:

Research two private health insurers and compare their benefits for a family looking to take out top hospital cover

Activity:

Speak to your parents about Private Health Insurance. Does your family choose to take out Private Health Insurance? Find out the Name of the Company, the policy and what particular extras you are covered for. Discuss the price and payment options with your parents.

Create some notes from the discussion with your parents

Activity:

List as many different types of health care (alternative and complementary as you can think of)  now share those with the person next to you 

Research  one type of complementary and one type of alternative health care approach analyse why some people may find this a useful approach to healthcare and how to mak ean informed decision 

Complementary and alternative health care approaches

There are many healthcare services available to Australians, which compliment or are an alternative to the mainstream solutions available. In fact, over the years, general healthcare has incorporated a selection of alternative health services into it’s system.

There has been trend toward self-care in Australia, with individuals wanting more control over types of health products and services they use. This, along with the popular opinion that ‘natural’ implies healthier, has led to the to growth of natural therapies and other alternative treatments.

Patients suffering from chronic or incurable conditions are also more likely to seek out complimentary or alternative services in an attempt to find relief or a cure. In the age of the internet, finding information on these treatments has become simpler, and so more and more people are experimenting with healthcare services beyond the mainstream. There have also been some scientifically confirmed cases, which demonstrate the success of alternative treatment for some individuals who have sought treatment for serious conditions like HIV/AIDs and cancer.

There are a number of benefits to providing complementary or alternative products and services, including:

– Range and variety of services available

– Greater accessibility

– Relatively low cost

Alternative treatment are popular with many individuals because they typically involve natural methods or ingredients and are less likely to utilise synthetic chemicals or technology. Alternative methods of healthcare also employ a holistic approach to treatment and prevention, meaning they assess and provide care that targets the lifestyle and entire body of the individual, rather than a specific condition.

Reasons for growth of complementary and alternative health products and services

The World Health Organisation (WHO) has identified a variety of alternative practices as a reputable sources of health care, contributing to the growth and popularity of alternative medicine. There are several other factors, which have been instrumental to the rise of complementary and alternative health products and services.

The recognition by More Courses and Licensing has improved the credibility and reputation of alternative health providers. Consumer demand for more medical options, a growing awareness of alternative medicine an public concerns about the dangers of synthetic materials have also been a factor.

Alternative providers have responded with effective marketing strategies and a flexible approach, which is not restricted by the same regulations as other health services. Additionally, a number of Private Health Insurance programs now cover alternative treatments like Acupuncture.

As Australian society has become more multicultural and accepting, alternative treatments have also been introduced by migrants. Although mainstream medicine is more established, alternative and complimentary services have a high rate of effectiveness for some individuals.

Range of products and services available

There are a range of complementary and alternative products and services available throughout Australia. For example, most chemists now stock a broad range of herbal medicines and natural products like Fish oil, omega 3 and Glucosamine.

Individuals interested in alternative treatments also have access to the following services:

– Meditation

– Acupuncture

– Chiropractic

– Massage

– Naturopathy

– Aromatherapy

How to make informed consumer choices

There are advantages to using complementary or alternative products and services, but that does not mean they are without any risk.

A majority of individuals risk avoidable pain and injury they are not aware of the dangers. Finding reliable information can be challenging for people and as a result they don’t know what to look for before undertaking complementary and alternative medicines.

An example of a potential risk is relying on therapy or adopting a new diet on the advice of a naturopath with limited qualifications and experience.

There are laws, implemented by Australian federal and state governments, to protect consumer rights and safety from unsafe or unreliable medicinal practices. However, despite serious consequences, illegal practices still occur.

It is imperative for individuals to seek out reliable information and professional advice before using any complementary and alternative products and services so that they can make an informed decision. Specifically, people should attempt to find answers the following questions:

– What is the treatment?

– How it is implemented?

– Is it beneficial?

– Is it reliable?

– What are the chances of success?

– What are the qualifications held by the practitioner(s)?

– What is the practitioner’s accreditation, training and experience?

– How does this treatment compare to mainstream options?

– What is the cost?

– What are the side effects and/or potential risks?

– Is the service recommended by friends, family or medical professionals?

– Has the product been approved by the Australian Therapeutic Goods Association?

– Has the treatment been endorsed by trusted leaders, health experts, the World Health Organisation, or the Australian Federal Government?

Remember, consumers have the right to ask the provider for further information, report misleading or false advertising, and check that health providers uphold current government safety standards.