Health in Australia: a quick guide - August 2018 update (original) (raw)

Australia's health outcomes are among the best in the world. At the same time, as Australia's Health 2018 notes, Australia's health system is a complex network of services and settings, involving a mix of health professionals, service providers, funders and regulators. This updated guide provides an overview of Australia's complex health system: what governments do, the role of private health insurance, how much we spend on health care, how Australian health outcomes compare internationally, the health care workforce and links to further information and resources. The Australian health system The Australian health system involves multiple layers of responsibility and funding provided by governments, individuals and private health insurers. Primary care (the first level of contact with the health system) is mostly provided in the community by general practitioners (GPs) who are generally self-employed. GPs also operate as 'gatekeepers', referring patients to specialist medical services where needed. The national public health insurance scheme Medicare provides subsidies for most medical and diagnostic and some allied health services. Acute care is provided in either public or private hospitals. Public hospital treatment is free for public patients, but can be subject to long waiting times for elective surgery. Private hospitals cater to patients who want choice of doctor and private ward accommodation. Additionally, they include a growing number of 'day-only' specialist facilities. For private hospital care Medicare pays 75 per cent of the Medicare schedule fee, with the balance met by private health insurance (if the individual is covered, and depending on gap cover arrangements). A range of free or low-cost public health services, including immunisation and mental health services, are provided by community health facilities. Subsidised aged care services, such as residential aged care, are provided by a mix of not-for-profit, for-profit and government organisations. Prescription medicines are dispensed by private community pharmacists who are paid by the Australian government (under a Pharmacy Agreement) to dispense medicines subsidised under the Pharmaceutical Benefits Scheme (PBS). Which level of government does what? Responsibility for funding and regulating the health system is largely shared between the Australian, state and territory governments. However, their respective roles are not always clear. Broadly, the Australian Government has responsibility for: • Medicare, the national scheme which provides free or subsidised access to clinically relevant medical, diagnostic and allied health services as specified in the Medicare Benefits Schedule (MBS). Medicare is funded through a 2.0 per cent Medicare levy on taxpayers and general taxation revenue. High out-of-pocket costs are partially offset by the Medicare Safety Net and the Extended Medicare Safety Net © Commonwealth of Australia Creative Commons With the exception of the Commonwealth Coat of Arms, and to the extent that copyright subsists in a third party, this publication, its logo and front page design are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Australia licence.