Medicare
The National Disability Insurance Agency is the independent organisation responsible for the implementation of the NDIS. NDIS works to assist individuals with ..........
Permanent and significant disabilities to live an ordinary life.
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.
States & Territories/ Federal/Private Health Insurance.
Identify the FOUR Private Health Insurance incentives
Private Health Insurance rebate/ Lifetime health cover/ Medicare Levy Surcharge/ Age-base discount
The patient co - payment for PBS subsidised medications pay a maximum of $31.60, what individuals only need to make a $7.70 maximum contribution?
Those with a concession card
Which level/s of government is the NDIS funded by?
Federal and States & Territories
Promoting Disease Prevention and Ensuring an efficient Health system and workforce are two of the key considerations of a sustainable health system.
What are the other two key considerations?
Funding and regulation/Research and monitoring
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/policies can be complex and people often don't know whats covered.
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
In order to be eligible for NDIS, a person must meet the residency requirements which are.....
1)Live in Australia and Be an Australian citizen
2) or hold a permanent visa or protected special category visa.
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
Identify the amount of money an INDIVIDUAL would need to be earning in order to be charged the Medicare Levy Surcharge (MLS). ALSO, what % range of the income is taken?
A) 0% MLS
B) 1% MLS
C) 1.25% MLS
D) 1.5%
A) 0% MLS Ind. $97,000 or less
B) 1% MLS $97,001–$113,000
C) 1.25% MLS $113,001–$151,000
D) 1.5% $151,001 or more
What is put in place to protect people and families once they spend $1647.90 on PBS listed medications within a calendar year? 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 TWO 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 - $97,000 for singles and $194,000 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 elective surgeries/ 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 health cover incentive/aged based discount for 18-29 up until 45 years of age/ reduces burden on Australia's Health care system
Available medications are reviewed HOW MANY TIMES EACH YEAR and WHO ARE THEY REVIEWED BY?
BONUS MARK.... WHAT IS TAKEN INTO ACCOUNT BEFORE RECOMMENDING THAT A MEDICATION IS ADDED TO THE PBS LIST?
3 times a year, by the Pharmaceutical Benefits Advisory Committee.
BONUS:
What medical conditions it will help, its effectiveness, safety and cost effectiveness (value for money) compared to other treatments.
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
Identify 5 of the WAYS FUNDING Australia's Health Care System, assists in promoting health outcomes.
Health care infrastructure/ highly trained health professionals/ subsidised health services/ personnel/ essential medicines/ medical supplies/ support and assistive technology/ increased access to private health services/ public health programs (quit etc)/ advances in knowledge and technology through research