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Health System in Australia

Arguably, Australia has one of the best health care systems in the world. Australians are living longer, more people are surviving cancer, fewer people are dying from heart disease, less people are smoking, childhood vaccinations rates have increased and dental health is improving.

Australia’s health care system comprises public and private sectors, both of which are substantially funded by the Federal Government.

The public health care system through Medicare aims to provide readily available and low-cost health care to Australian citizens and permanent residents. Alongside Medicare the Pharmaceutical Benefits Scheme heavily subsidises most prescription medications.

1 Visits to Family Doctors: it covers consultations provided by family doctors (General Practitioners/GPs) at the rate of the Medicare Schedule Fee for GP services through either Bulking Billing or Medicare Claims.

2 Diagnostic Services: including x-rays, ultra-sound, blood tests, pap smears, scans & etc.

3 Eye Examinations by Optometrists.

4 Consultations with Podiatrists and Dieticians: GP’s referrals are required to be eligible to claim a medicare rebate.

*** Bulk billing is one of the key features of Medicare. It was designed to be a powerful incentive to doctors, pathologists, optometrists and other medical practitioners in private practice to provide patients with free health care on the presentation of a Medicare card. Bulk billing currently works on an all-or-nothing basis, either a doctor bulk bills or she or he must charge the patient a fee and the patient can then make a claim on Medicare for a rebate.

5 Part of Specialists Fees: 85% of the Schedule fee can be claimed back from Medicare. However, many specialists charge well above the Schedule fee. In those cases, patients will have to bear the rest of the costs themselves. To be eligible make a claim, a GP’s referral to a specialist service is required.

6 Hospital Care: Under the public health care system, all eligible Australians receive free care as public patients in public hospitals, including free accommodation, free medical, nursing and other health care. Medicare allows patients receiving private doctor’s services and some optometrist’s services to be reimbursed, either fully or in part.

Medicare Funding & Benefits for Australians

Medicare is funded partly by a 1.5% income tax levy that is in addition to our usual personal income tax liability, with exceptions for low-income families. However, most of the public health care funding comes out of general revenue.

An additional levy of 1% is imposed on high-income earners without private health insurance.

There are many types of assistance available for Australian families for their healthcare:

• Pharmaceutical Benefits Scheme: subsidised medications for concension card holders.
• Net medical expenses tax offset: where you can claim a tax offset of 20% – 20 cents in the dollar – of your net medical expenses over $1,500. There is no upper limit on the amount you can claim.
• Medicare Safety Net and PBS Safety Net: safeguard your medical costs - once you reach a safety net threshold, your medical costs may end up costing you less.

Private Health Insurance

There is a large and vigorous private sector in health services complimenting the public health care system.

The Commonwealth Government considers that strong private sector involvement in health services provision and financing is essential to the viability of the Australian health system.

For this reason the Commonwealth Government provides a 30% subsidy to individuals who acquire private health insurance and has introduced additional arrangements to foster lifelong participation in private health insurance. All Australians that fit the age criteria, who are eligible for Medicare and who are members of aregistered health fund, are eligible for the higher rebate. People aged from 65 years to 69 years are eligible for a 35% rebate and for those people over 70 years of age the rebate available is 40%.

The Australian Health Insurance Association (AHIA) is the Australian private health industry's peak representative body that represents 23 health funds throughout Australia and collectively covers approximately 94% of the private health insurance industry.

Overseas visitors on temporary visas are not eligible for Medicare benefits unless they are from a country with which Australia has a 'Reciprocal Health Care Agreement'. Currently, Australia has agreements with United Kingdom, Malta, Finland, Sweden, Italy, New Zealand, the Netherlands and Ireland.

A number of private health funds also provide cover for overseas visitors. Some have special tables of benefits for overseas visitors and others provide similar coverage under hospital tables available to Australian residents. Benefits available, membership costs and eligibility can vary between Funds.

Children’s Health Care

Prevention, early detection and early intervention with respect to health, education and social problems can improve outcomes for children. In Australia, all levels of government have committed great resources into children’s health care, from before birth through to young adulthood.

As a result, over the last 20 years we have reduced child mortality rates by half, and immunisation coverage rates for one-year-olds have increased to over 90% since 2000.

• Various specialized children’s hospitals: provide medical treatment and assessment for children with medical conditions, injuries and developmental or learning difficulties.
• Baby Clinics: Maternal and Child Health Nurses provide health checks, and immunisation for children and can provide information, support, advice and education for mothers and families including feeding, sleep, safety and relationships.
• Community Health Centres: Community Health Centres aim to keep individuals and families in better health. A focus on health promotion and disease prevention and management is designed to improve the health and wellbeing of local residents, as well as take pressure off the acute care health system. Community Health Centres have a range of services for children, such as early intervention programs, speech therapies, dental clinics, as well as information, support and education for parents and carers. Many centres work closely with local councils.
• Public Dental Clinics: Through NSW Health Services Oral – Dental Program, all persons 0 - 4 years and all school aged persons are eligible for free care based on clinical need and the ability of the Area Health Service to meet demand. Adults with concession cards are also eligible for these services.
• School Dental Screening Programs: Organized by NSW Health Services, school children are screened or inspected for their dental health in school during school hours with their parents or guardians’ permission. The results will be sent back to parents and guardians after the screening.
• The Australian Childhood Immunisation Register (the ACIR): is a national register administered by Medicare Australia that records details of vaccinations given to children under seven years of age who live in Australia,helping Australian parents to ensure that their children grow up healthy and are fully immunised.