Australia has a complicated healthcare system which is confusing to understand because of the different tiers and types of services it provides to patients. In Australia, the setup of the healthcare system is institutionalized with a publicly financed health system through Medicare. The system is based on the principles of universal access which means that Australian residents are entitled to subsidized healthcare services from professionals and free treatment from publicly funded organizations (Eagar, Lin, & Garrett, 2020). The structure of the healthcare system is complex because it’s responsibilities and funding is shared among the federal, state, and territory governments.
The healthcare system in Australia has a comprehensive program that offers a variety of services to its clients. There is general and preventive healthcare, from the management of mild sicknesses to the treatment of a complex condition that requires specialist care. The different healthcare services include primary care services that are provided by general practitioners, a medical specialist who delivers specialized care for complex conditions, allied health workers, and nurses who manage different conditions.
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In collaboration with other healthcare professionals, nurse practitioners practice is increasing access to healthcare services for Australians. They do so through disease prevention, health promotion, and management strategies in the community. Registered nurses have the responsibility of administration of medication, management, and assessment of patients, specialized and complex nursing care (Duckett &Willcox, 2015). They work alongside other healthcare professionals in the diagnosis and treatment of diseases.
The Australian healthcare system has a preventative model that encourages Australians to live a healthier lifestyle and campaigns for the prevention of diseases. The government has programs to educate the public on the right foods and nutrition, encourage people to exercise, provide subsidized immunization, and support mental health, preventing communicable diseases and chronic conditions, and awareness campaigns such as anti-drug and anti-alcoholism campaigns (Dixit & Sambasivan, 2018). The Australian healthcare system can be described as a multi-level system that encourages cost-shifting between the various healthcare provider types and funding streams. There is also a robust private sector in Australia which has most of the physicians and other healthcare professionals.
The Australian government finances most of the expenditure incurred in the provision of medical services, medicines, and research. Under the Medicare program, private healthcare organizations are allowed to charge what is referred to as a gap fee which means out-of-pocket expenses that an individual is supposed to pay. Although the gap fess was previously capped, they are no longer capped. However, the government policy uses incentive payments to pay the healthcare providers so that they can only charge the patients the Medicare scheduled fee which is considered bulk billing. In 2002/03, the gap fees increased by 30% and the government stepped in and is engaged in a process of implementing the Medicare Safety Net (Eagar, Lin, &Garrett, 2020). In this program, the government pays a higher debate for the expenses incurred by the patients when they exceed a threshold. There is private health insurance that complements the Medicare program to ensure there is universal access to all Australians.
The responsibilities of the public sector are allocated but at times there is an overlapping of responsibilities between the federal, state, and local governments. The states have a statutory mandate of providing community-based services including mental health, allied health, and home and community healthcare. The states participating in the promotion of public health activities (Duckett & Willox, 2015). The federal government is mainly mandated to fund healthcare rather than providing the services. Patients without insurance and cannot pay for their healthcare have to register with the Medicare program so that they can receive healthcare services for free in public hospitals.
Under private health insurance, there is a rebate scheme which is an income based program. The income of a person determines the amount to be paid. People in this scheme access healthcare based on their contribution (Dixit & Sambasivan, 2018). They can access high and specialized healthcare services in private hospitals while people with low income can afford such care.
The advantage of the Australian healthcare system is that it is tax-funded and therefore it is more affordable to the public. The subsidy of private insurance by the government helps in decongesting the public hospitals because people can access dental care and private hospitals. The system focuses on prevention which ensures that there are reduced incidences. The disadvantage of the system is that, because of the out-of-pocket expenses in the private sector, most people go to public facilities, and therefore there is congestion in the public healthcare facilities. The weakness of the system is that it fails to provide life, dental, vision, and long-time insurance (Eagar, Lin, & Garrett, 2020). Another weakness is that there is fragmentation that arises from the conflict between state and commonwealth funded services and there is also poor coordination of service planning and delivery.
Survey has shown that more than 50% of Australians are satisfied with the healthcare system. The respondents said that they were more satisfied with services offered by the pharmacists and the private specialists and hospitals come in second. The public has high confidence in the services provided by the system saying that they felt that the services were safe and quality (Eagar, Lin, & Garrett, 2020). Although many Australians were confident that they would access healthcare, they were concerned about the costs.
The American healthcare system is oriented in a manner that ensures that people can provide themselves with healthcare by putting the responsibility of cost on an individual. In the U.S., there is a push for the creation of a private sector that is independent of the government. Through their employers, Americans can purchase their healthcare insurance and so funding of healthcare in American is mainly by employment (Singh, 2015). On the contrary, the design of funding of healthcare in Australia is majorly by two contributors, the public sector, from the national revenue and taxation, and the private sector which involves private insurance. In both countries, there is a mixed market structure which is evident in the involvement of both the public and private sectors in funding healthcare (Dixit & Sambasivan, 2018). Unlike the U.S., the Australian system has an ideology that all Australians have equal rights in access to healthcare. Because there no ideology of equality in the American system, there is low accessibility of healthcare in the country. However, in Australia, there is congestion and it takes longer in Australia to access healthcare in the public facilities.
References
Dixit, S. K., & Sambasivan, M. (2018). A review of the Australian healthcare system: A policy perspective. SAGE open medicine , 6 , 2050312118769211.
Duckett, S., & Willcox, S. (2015). The Australian health care system (No. Ed. 5). Oxford University Press.
Eagar, K., Lin, V., & Garrett, P. (2020). Health planning: Australian perspectives . Routledge.
Singh, D. A. (2015). Essentials of the US health care system . Jones & Bartlett Publishers.
