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The Australian Health System - Australian Government Department of Health PDF
The Australian Health System - Australian Government Department of Health PDF
Aust ralia’s healt h syst em is one of t he best in t he world. It provides qualit y, safe and affordable
healt h c are for you and your family. It ’s a key reason why we enjoy one of t he longest life
expec t anc ies in t he world.
There are many providers of healt h c are in Aust ralia, inc luding:
nurses
Medic are and t he public hospit al syst em provide free or low-c ost ac c ess for all Aust ralians t o
most of t hese healt h c are servic es. Privat e healt h insuranc e gives you c hoic e out side t he
public syst em. For privat e healt h c are bot h in and out of hospit al, you c ont ribut e t owards t he
c ost of your healt h c are.
Medic are has been Aust ralia’s universal healt h c are sc heme sinc e 1984. It s 3 major part s are:
medic al servic es
medic ines
Medic are is available t o Aust ralian and New Zealand c it iz ens, permanent resident s in Aust ralia,
and people from c ount ries wit h rec iproc al agreement s.
Medic are c overs all of t he c ost of public hospit al servic es. It also c overs some or all of t he
c ost s of ot her healt h servic es. These c an inc lude servic es provided by GPs and medic al
spec ialist s. They c an also inc lude physiot herapy, c ommunit y nurses and basic dent al servic es
for c hildren.
The ot her import ant part of Medic are is t he Pharmac eut ic al Benefit s Sc heme (PBS). The PBS
makes some presc ript ion medic ines c heaper.
The Medic are Benefit s Sc hedule (MBS) is a list of all healt h servic es t hat t he Government
subsidises. A t eam of medic al expert s keeps t he list up t o dat e, safe and best prac t ic e.
The MBS has a safet y net . It c an help by making sure you pay less for servic es onc e you reac h
a c ert ain amount of out of poc ket c ost s. This might be t he c ase if you have a year where you
pay a lot for medic al c are. Find out more about t he Medic are Safet y Net .
The PBS helps make medic ines c heaper. Wit hout t he PBS, medic ines would be more expensive.
In some c ases, t hey would c ost t ens of t housands of dollars more.
The PBS list s brand name, generic , biologic and biosimilar medic ines. There are over 5,200
produc t s on t he PBS. All produc t s are shown t o be safe and effec t ive before being sold in
Aust ralia. Independent medic al expert s advise on what is added t o t he PBS.
You only pay some of t he c ost of most PBS medic ines if you are enrolled in Medic are. The
Aust ralian Government pays t he rest . You pay even less if you have a c onc ession c ard.
If you spend lot s on medic ine, t he PBS Safet y Net helps keep c ost s down. When you reac h t he
Safet y Net Threshold amount , presc ript ions will c ost even less for t he rest of t he year.
Many Aust ralians have privat e healt h insuranc e c over. There are 2 kinds of c over:
hospit al c over for some (or all) of t he c ost s of hospit al t reat ment as a privat e pat ient
general t reat ment (‘anc illary’ or ‘ext ras’) c over for some non-medic al healt h servic es not
c overed by Medic are — suc h as dent al, physiot herapy and opt ic al servic es.
Some people wit h privat e healt h insuranc e have eit her hospit al c over or ext ras c over, and
some people have bot h.
The Government provides a means-t est ed rebat e t o help you wit h t he c ost of your privat e
healt h insuranc e.
Primary healt h net works (PHNs) are organisat ions t hat c oordinat e healt h servic es in loc al
areas. There are 31 PHNs ac ross Aust ralia.
PHNs:
support c ommunit y healt h c ent res, hospit als, GPs, nurses, spec ialist s and ot her healt h
professionals t o help improve pat ient c are
c oordinat e different part s of t he healt h syst em — for example, bet ween t he hospit al and GP
when a pat ient is disc harged
support for primary c are (GPs), inc luding c ont inuing educ at ion
Government responsibilities
The Aust ralian, st at e and t errit ory, and loc al government s share responsibilit y for running our
healt h syst em.
support ing and monit oring t he qualit y, effec t iveness and effic ienc y of primary healt h c are
servic es
subsidising aged c are servic es, suc h as resident ial c are and home c are, and regulat ing t he
aged c are sec t or
c ollec t ing and publishing healt h and welfare informat ion and st at ist ic s t hrough t he
Aust ralian Inst it ut e of Healt h and Welfare
funding for healt h and medic al researc h t hrough t he Medic al Researc h Fut ure Fund and t he
Nat ional Healt h and Medic al Researc h Counc il
funding vet erans’ healt h c are t hrough t he Depart ment of Vet erans’ Affairs
funding c ommunit y c ont rolled Aboriginal and Torres St rait Islander primary healt hc are
organisat ions
maint aining t he number of doc t ors in Aust ralia (t hrough Commonwealt h-funded universit y
plac es) and ensuring t hey are dist ribut ed equit ably ac ross t he c ount ry
regulat ing medic ines and medic al devic es t hrough t he Therapeut ic Goods Administ rat ion
(TGA)
c oordinat ing nat ional responses t o healt h emergenc ies, inc luding pandemic s
prot ec t ing t he c ommunit y and t he environment from radiat ion t hrough nuc lear safet y
researc h, polic y, and regulat ion
delivering prevent ive servic es suc h as breast c anc er sc reening and immunisat ion programs
regulat ing, inspec t ing, lic ensing and monit oring healt h premises
Shared responsibilities
The Commonwealt h also shares responsibilit y wit h t he st at es and t errit ories for ot her ac t ivit ies
under nat ional agreement s suc h as t he Counc il of Aust ralian Government s (COAG). These
ot her ac t ivit ies inc lude:
prevent ive servic es, suc h as free c anc er sc reening programs inc luding t hose under t he
Nat ional Bowel Canc er Sc reening Program
Loc al government s play an import ant role in t he healt h syst em. They provide a range of
environment al and public healt h servic es, c ommunit y-based healt h and home c are servic es.
Ageing population
A healt hier older populat ion will need different t ypes of healt h servic es. To meet t hese new and
different needs, we will need a flexible and well-t rained healt h workforc e in all areas of t he
c ount ry.
Chronic diseases
Managing c hronic c ondit ions is anot her c hallenge. The rise in many c hronic c ondit ions also
inc reases demand for flexible, person-c ent red t reat ment models.
To address t his, government s are t aking a nat ional approac h t o c oordinat ed c are in t heir
healt h plans and polic ies, inc luding GP-led t eam-based c are for pat ient s wit h c hronic and
c omplex c ondit ions. We c ont inue t o work on ways t o improve sharing of healt h and medic al
informat ion bet ween providers.
Advanc es in medic al sc ienc e are set t o c omplet ely c hange healt h c are. For example, genomic
t est ing will help doc t ors diagnose healt h c ondit ions and diseases earlier, as well as provide
bet t er prevent ion and t reat ment opt ions for people. But t hese advanc es are very c ost ly and
c ome wit h some diffic ult et hic al and legal issues t hat need t o be worked t hrough.
New technology
New t ec hnologies also have an impac t on healt h and medic al servic es — from digit al healt h
t ec hnologies t o aut omat ed healt h and diagnost ic servic es. These t ec hnologies help t o improve
t he healt h syst em, but t hey c an affec t pat ient s and t he healt h workforc e.
To meet some of t hese c hallenges, t he Aust ralian Government is invest ing in medic al researc h
and t ec hnologic al innovat ion t hrough t he Medic al Researc h Fut ure Fund. This will see more
innovat ions developed, t est ed and made available for Aust ralians in all areas of healt h c are.
Comprehensive dat a c an help us t o improve healt h polic y, programs and servic es. That ’s why
linking different healt h informat ion ac ross t he healt h syst em is an import ant part of our work.
Other challenges
Aust ralia shares ot her healt h syst em c hallenges wit h c ount ries around t he world — t he rising
c ost of t he healt h syst em, being able t o respond t o new healt h issues, inequalit y in ac c ess t o
healt h servic es and hospit al wait ing t imes.
Aust ralia’s healt h syst em is c omplex — and so are it s funding arrangement s. It is funded by:
17% by individuals (for produc t s and servic es t hat aren’t fully subsidised or reimbursed)
9% by privat e healt h insurers
Healt h spending was about 10% of gross domest ic produc t . This means $1 in every $10 spent in
Aust ralia went t o healt h.
The Aust ralian Government usually funds most of t he spending for medic al servic es and
subsidised medic ines. It also funds most of t he $5.5 billion spent on healt h researc h in Aust ralia
in 2016–17.
St at e and t errit ory government s fund most of t he spending for c ommunit y healt h servic es.
The Aust ralian Government and st at e and t errit ory government s share funding of public
hospit al servic es.
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