Australian Health Care

it's been a while since we've done an international health care system episode we thought you might need a break that break ends now Australia has the only continental universal health care system and it's the topic of this week's healthcare triage like pretty much every other country we've covered save the United States Australia has a universal health care system it's called Medicare what is the deal with that seriously do none of these countries have a thesaurus or something Medicare Medicare Medicare anyway Australia's national public system provides coverage for citizens permanent residents and even many people with temporary visas there's a program for visiting students and even people seeking asylum get coverage while their cases are under review Australia also has a voluntary private health insurance system which complements and supplements the public one it can give citizens access to private hospitals and some services not covered by the public system the tax system incentivizes the purchase of private insurance for many individuals and families Medicare also allows people to get free inpatient care and public hospitals free access to most medical services and prescription drugs the federal government also works with more local governments to provide population health mental health some dental care some physical therapy and services for veterans Medicare pays for somewhere between 85% and a hundred percent of outpatient services it also pays for 75 percent of the medical fee schedule for private patients who use public hospitals whatever isn't covered must be paid for by patients doctors can charge whatever they want although incentives are in place to make bulk billing more likely for the elderly poor people children and people who live in rural areas members of those groups also get a discount on drugs their co-pays on prescriptions are around five dollars and ninety cents Australian vs. thirty-six dollars and ten cents for everyone else there are out-of-pocket maximums when our Australian is paid out for under 21 dollars and seventy cents then medicare covers a hundred percent of the fee schedule for doctors for the rest of the year when they reach one thousand two hundred twenty one dollars and ninety cents then 80% of all out-of-pocket costs are covered for the rest of the year for people in the special groups I mentioned before the threshold is lowered to six hundred ten dollars and seventy cents yes that's complicated thanks Australia there are also ways for families to pool such spending and to hit the limits faster there are pharmaceutical subsidies for those who reach a threshold of one thousand three hundred ninety one dollars an account a year two for drugs the threshold is also lower for those in the special groups at $354 Australia is one of the cheaper healthcare systems at eight point nine percent of GDP Medicare is paid for mostly from general taxes patient fees and a one point five percent levy on taxable income in 2010 to 11 the government funded about 69 percent are spending 43 percent at the federal level and 26 percent from states and territories the rest grew about 31 percent of healthcare spending comes from non-government sources about 18 percent is out of pocket spending in co-pays or services not covered by insurance private health insurance accounted for about 8 percent of spending about half of people have private insurance which allows them more options and practitioners hospitals and care that they receive those who opt for private insurance before their 31st birthday get a reduction in premiums for the rest of their lives each year an Australian waits to start buying private insurance after their 30 sees their rates go up 2 percent from a base rate again for as long as they live subsidies have been available to many Australians based on income since 1999 most primary care doctors are self-employed and working groups about 8 percent of them are under contract with private agencies most work in a fee-for-service system most also get incentive payments for meeting standards set by the Royal Australian College of General Practitioners in other words they have a pay-for-performance system to try to improve quality I know you watched that video right patients can see any general practitioner they like GPS do however need to refer them to specialist specialists also work in a fee-for-service basis and many of them work in both the public and private parts of the system after-hours care is available either from primary care Doc's themselves or from private companies set up among various practices grants are available from the government to run after-hours care hospitals come in all flavors in 2011 about 55% were public 23% were private day hospitals and 21% were other types of private hospitals private hospitals combo and nonprofit and for-profit types Doc's that work in public hospitals are usually salaried although they can work in other reimbursement settings when seeing private patients long-term care is mostly provided by families with some people getting subsidies to help with the expenses some homes or care centers are available for those who are very dependent on assistance support is both means-tested and dependence tested the majority of long-term care facilities are nonprofit about 1/3 or private for-profit and about 10% are run by the government quality is generally measured and reported on by the Australian Commission on safety and quality in health care about 85% of general practices are accredited against standards and as I mentioned before pay for performance systems are in place to encourage better care some healthcare organisations and professional boards also have quality improvement programs all citizens and permanent residents can get a personally controlled electronic health record if they wanted a fairly large amount of infrastructure exists to make such records interoperable at many facilities across the continent costs are controlled in a number of ways the market uses generic drugs to keep pharmaceutical spending down almost all brand-name drugs are bulk purchased by the government which can also control pricing new drugs have to prove their cost-effectiveness before they're bought public spending is under global budgets but as with some other countries this can lead to increased wait times for elective things there are also broadly negotiated fees for many services the ox' against the system will be familiar to those of you who are familiar with the series Australia is worried about a shortage of professionals but who isn't in terms of quality Australia's sometimes comes behind some other countries we've discussed but certainly beats others like the US the private overlay makes some people they're concerned about a two-tiered system of care it's interesting though that only about half of people opt for private insurance Australia also has a disparities problem with many indigenous populations having lower quality outcomes and poor health than other citizens but life expectancy is high infant mortality is low obesity is extremely low and preventable deaths are rarer than a lot of other countries and Australia does it for a reasonably small amount of money in summary Australia has a pretty robust public healthcare system with a private overlay that half people used for better access and services if that sounds familiar it's because it's much like other systems we've talked about including France

Channel: Healthcare Triage

Views: 295,931

Keywords: Health Care In Australia, Australia, medicare, health, healthcare, insurance, universal, hospital, doctor, patient, payment, pay for performance, subsidy, Dental Degree (Degree), deductible, premiums

Id: ylsO0VVy29U

Length: 6min 58sec (418 seconds)

Published: Mon Dec 01 2014