Medicare
Fill in the blank: Medicare is Australia's (BLANK) health insurance scheme.
Universal
The fee paid to cover the cost of Private Health Insurance is also known as the what?
Premium
Which level of government is responsible for the Pharmaceutical Benefits Scheme?
Federal
What is the name of the independent organisation responsible for the implementation of the NDIS?
The National Disability Insurance Agency
INDIVIDUALS are one way funding for our health care system is provided. Identify the two levels of government and the major type of insurance fund, which also provide significant funding.
State/ Federal/Private Health Insurance.
The amount that Medicare contributes towards certain consultations and treatments, is known as what?
Schedule Fee
Identify the three Private Health Insurance incentives
Private Health Insurance rebate/ Lifetime health cover/ Medicare Levy Surcharge
The patient co - payment for PBS subsidised medications is $39.50, what individuals only need to make a $6.40 contribution?
Those with a concession card
Which level/s of government is the NDIS funded by?
Federal and State
Explain how increasing access to health care can improve the health and wellbeing of Australians.
Free from illness/disease due to available treatment (physical).
Decrease in stress as not worrying about financial barriers of accessing healthcare (mental).
Identify 4 services covered by Medicare
GP consultations/ Specialist Consultations/ X - rays/ eye tests/ pathology (blood/urine)/ treatment and accommodation in public hospitals/ some dental services for children under the Dental Benefits Scheme/ 75% of the schedule fee for treatment in a Private Hospital
Identify 3 disadvantages of Private health insurance
premiums are costly/ Sometimes have a "gap" payment, meaning that even though you have paid a premium, you still need to cover part of the cost/ Qualifying periods or waiting periods apply for certain things (eg: pregnancy etc)/ policies can be complex and may create confusion for the average person
The PBS has been evolving since 1948. What is the primary difference between the way the PBS worked then, versus how it works today?
The PBS use to provide lifesaving and disease preventing medication, free of charge, it now subsidises the medication and consumers make a co-payment
Identify the two residency requirements to qualify for the NDIS
1) Be an Aus citizen (or hold a permanent visa or protected special category visa)
2) Live in Aus where the NDIS is available
4 major interventions have been put into place to increase ACCESS to healthcare for people of all SES backgrounds. Identify three of these interventions.
1) Free treatment in public hospitals and subsidised consultations through Medicare
2) Subsidised meds through the PBS
3) Subsidised Private Health Insurance through the Private health insurance rebate.
4) Support provided through the NDIS
Identify 4 services not covered by Medicare
Cosmetic/ unnecessary or elective surgery/ most costs associated with private hospital care/ o accommodation in private hospitals/ most dental examinations and treatments/ home nursing care and treatment/ ambulance services/ most allied health services/ alternative medicine (Chiro, acupuncture, remedial massage, aromatherapy, naturopathy)/ glasses/ contact lenses/ hearing aids/ prosthesis (artificial limbs)/ pharmaceuticals/ medical costs for which someone else is responsible
Identify the amount of money a single and a family would need to be earning in order to be charged the Medicare Levy Surcharge. ALSO, what % range of the income is taken?
A) 1-1.5%
B) 1.5-2%
c) 1-2%
$90,000 singles $180,000 families and A) 1-1.5%
What is put in place to protect people from large overall expenses from PBS listed medications? AND how many brands of prescription medications are covered by the PBS?
PBS Safety Net. Approx 5,000
Outline the 4 disability requirements to qualify for the NDIS
1) You have a condition or impairment that is likely to be permanent
2) your impairment substantially reduces your ability to participate in activities unless you have assistance (from others/ from technology/ or still cant without assistance from either of these)
3) Your impairment affects your capacity for social and economic participation
4) you are likely to require support under NDIS for a lifetime
An equitable health system must recognise and respond to those with special needs. An example of an intervention designed to promote equity within the health care system is the PBS Safety Net. Identify 3 other interventions which promote EQUITY.
Intro of NDIS/ Medicare Safety Net/ Public Dental health Services (Royal Dental hospital of Melbourne) providing to vulnerable groups/ continuity between health care providers/ mental health treatment plans
Identify the three ways Medicare is funded and explain in detail, one of these ways.
1) THE MEDICARE LEVY ( an additional 2% tax placed on taxable income of most taxpayers) 2) THE MEDICARE LEVY SURCHARGE (An extra tax for those earning a certain amount of money, that do not have private health insurance - $90,000 for singles and $180,000 for families. The surcharge ranges from an extra 1% - 1.5%) 3) GENERAL TAXATION (As the levy and levy surcharge do not cover the full operating costs of Medicare, general taxation is also used)
Identify 5 advantages of Private Health Insurance
enables access to private hospital care/ choice of doctor in public or private hospital/ shorter waiting periods for some surgery/ some extras may be covered depending on level of cover (dentistry, physio etc)/ helps to keep the cost of running medicare low/ high income earners avoid paying the medicare levy surcharge/ government rebate for eligible policy holders/ lifetime healthcover incentive/ reduces burden on Australia's Health care system
Available medications are reviewed how many times a year? And by who are they reviewed?
3 times a year, by the Pharmaceutical Benefits Advisory Committee.
The first step once accepted into the NDIS is to create an individualised plan. Through this individualised plan, the NDIS assists participants to do 4 main things. Identify these 4 things.
1) Access mainstream services and supports
2) Access community services and supports
3) Maintain informal support arrangements
4) Receive reasonable and necessary funded supports
Explain how access to healthcare can improve health status and burden of disease of Australians.
Links to health status indicators and YLL/YLD/DALYs.