Medicare
Fill in the blank: Medicare is Australia's (BLANK) health insurance scheme.
Universal
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
Explain how Medicare reflects sustainability.
Sustainability is reflected by Medicare as not every health service and treatment are subsidised under Medicare as Medicare only covers those treatments that are deemed to be ‘medically necessary’ (e.g cosmetic procedures are generally not covered). This helps keep the costs of the scheme under control and sustainable for the future.
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
Explain how the NDIS reflects equity
The NDIS reflects equity as it ensures that those people in the community with a disability who need support are able to access the support they need. The NDIS is also one of the only schemes that isn’t income tested and therefore it provides fair access to all people who are eligible.
How does Medicare reflect equity? Explain the specific component of medicare that helps to prevent people from going into poverty.
Equity is reflected in Medicare as the Medicare Safety Net ensures financial costs are as ‘fair’ as possible, particularly for those people who have a high reliance on medical services. Additionally, Medicare provides access to health services at bulk billing services. By removing the cost of medical treatments, it ensures all people, including those earning a low income earners, can improve their health.
The Medicare Safety Net provides extra financial assistance for those that incur significant out of pocket costs for Medicare services. Once an individual or family has contributed a certain amount out of their own pocket to Medicare services in a calendar year ($700 for singles and $1000 for couples and families in 2017), further financial support is provided by the government, making Medicare services cheaper for the remainder of that year.
Identify 3 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
Outline 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
No - needs to be likely to be permanent and a significant disability. They also need to be an Australian citizen.
4 major interventions have been put into place to increase ACCESS to healthcare for people of all SES backgrounds. Identify two 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
Explain how PHI reflects sustainability, access and equity
Sustainability
Access
Equity
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
Sustainability
From 2014 the Medicare Levy was raised to help fund the NDIS, which helps to make the NDIS sustainable. Additionally, the aim of the NDIS is getting people with disability to achieve higher levels of social and economic participation, which will address sustainability for the future.
Access
The NDIS aims to increase access to mainstream services (e.g. health care) for people of all socioeconomic backgrounds, to lead an ordinary life. The previous scheme was seen as underfunded, unfair and inefficient, which gave people with a disability no certainty of access to appropriate supports.
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 2 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 all 3 of these
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)
Outline 3 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.
Explain the NDIS and provide 2 examples of what the NDIS does for it's participants
The NDIS is a national insurance scheme that provides services and support for people with permanent, significant disabilities, and their families and carers
Explain how the PBS reflects each of the 4 principles of the HC system
Funding
Sustainability
Access
Equity