australias healthcare system Flashcards
(21 cards)
MEDICARE *must be word perfect
medicare is Australia’s universal health insurance scheme that provides access to healthcare that is subsidised by the federal government
MEDICARE- who gets it?
australian citizens
permanent residents
countries with reciprocal agreements (NZ + UK)
MEDICARE- whats covered?
pathology such as blood and urine tests
doctor and specialist consultations * word perfect
MEDICARE- what isn’t covered?
cosmetic surgery
ambulance services
Schedule fee
the amount that medicare contributes towards certain consultations and treatments, determined by the government
bulk billing
when the doctor or specialist charges only the schedule fee, therefore there is no out of pocket expense for the patient
out of pocket cost/patient co-payment
the payment made by the patient for the service, that is in addition to the cost covered by medicare
advantages of medicare
choice of doctor for out of hospital services
available for all australian citizens
disadvantages of medicare
waiting list for many treatments
does not cover alternative therapies
medicare funding
MEDICARE LEVY
an additional 2% tax placed on the taxable income of most taxpayers - everyone
medicare funding
MEDICARE LEVY SURCHARGE
1-1.5%. this is payable by higher income earners who do not have privare health insurance
medicare funding
general taxation
medicare funding
MEDICARE SAFETY NET
provides extra financial assistance for those that incur significant out of pocket costs for medicare services in a 12 month period
PHARMACEUTICAL BENEFIT SCHEME
PBS:
the federal government subsidy for essential medicines
not all medicines are covered
patients make a co payment
medications tested prior to being placed on the list
PBS SAFETY NET
provides extra financial support for individuals and families if their out of pocket expenditure on PBS listed medications exceed a certain amount in a 12 month period
NATIONAL DISABILITY INSURANCE SCHEME
NDIS: provides services and support for people with permanent significant disabilities, and their families and careers
funded by the federal and state/territory governments
assists individuals with disabilities to live an ordinary life
eligibility- under 65 years old and must be an australian citizen
through the individualised plan, the NDIS assists participants to
know 2
ACCESS MAINSTREAM SERVICES AND SUPPORT: healthcare, agecare, education
ACCESS COMMUNITY SERVICES AND SUPPORT: community groups, sports clubs
MAINTAIN INFORMAL SUPPORT ARRANGEMENTS: help people get from friends/family. e.g. car, no care
RECIEVE REASONABLE AND NECESSARY SUPPORT: funding for assistive technology (mobility cane, shower stool, bed rails +wheelchairs)
PRIVATE HEALTH INSURANCE
an optional medical insurance that can be taken out in addition to medicare. users pay a premium to join a scheme
people can also opt for extras cover which can cover services provided by dentists, physiotherapists + chiropracters, which are not covered by medicare
private health incentives/funding
LIFETIME HEALTH COVER- those who take out insurance after the age of 30 pay an extra 2% on their premium for every year they’re over 30
PRIVATE HEALTH INSURANCE REBATE- based on income, some people with private health insurance are eligible for a rebate (refund) from the federal government of an average is 30% but is income tested
MEDICARE LEVY SURCHARGE: high income earners who dont have PHI pay a higher premium. this is income tested so those with higher incomes pay a higher surcharge 1-1.5%
AGE BASED DISCOUNT: insurers have the option of offering young people aged 18-29 a discount of up to 10% for hospital cover. the discount allows for a 2% reduction in premiums for each year
ADVANTAGES of PHI
choice of doctor while in public or private hospital
shorter waiting times for some medical procedures, such as elective surgery
DISADVANTAGES of PHI
costly in terms of the permiums that have to be paid
qualifying periods apply for some conditions, such as pregnancy
