Australia's Healthcare System: An Analysis

Australia’s Health Care System

• Mollie M. Ludeman

Abstract

Health care systems are created to provide quality and efficient care to patients when they need treatment. The health care system in Australia is universal. Therefore, it provides free health coverage for citizens in public hospitals. It also covers a portion of the fees in private hospitals; however, the patient has to pay the remainder of the payments at private hospitals out of pocket. Australia does not only have public health insurance, but it has private health insurance as well. Citizens who are capable of affording it are encouraged to apply for private health insurance. Having private health insurance on top of the public insurance is extremely beneficial. The health care system in Australia has provided some of the best care to the citizens of its country.

Australia’s Health Care System

Australia has a developed health care system that is substantially beneficial to the residents of the country. It supplies universal health care to all citizens; which means that the government pays for all or most of the health care services. Some visitors are also eligible to receive the health care in Australia while visiting. According to the World Health Organization website, “the goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financially when paying for them.” Financial issues are typically the main reason for why people refrain from getting medical treatment until it becomes serious and they are sent to the emergency room. In the United States, this is a problematic issue that comes into play. However, the health care system in Australia does not make the citizens refrain from getting treatment. The health care system has allowed Australian health care providers to give some of the best care in the world to its citizens.

The Australian government has attempted from the very beginning to give its country the best possible care through its health care system. According to the World Health Organization website, “a good health care system delivers quality services to all people, when and where they need them.” This is something that the government in Australia has worked very hard to do for its citizens. Australia has managed to have some of the highest life expectancy rates in the world, and some of the lowest mortality and infant mortality rates. In Australia, the life expectancy for males is 78.9 years of age, and 83.6 years of age for females (Leiyu Shu, 2014). Although, Australia typically has good health overall throughout the population, there are always some groups that do not have the best health. These people are considered to be the vulnerable populations; those that live in the rural areas. The vulnerable people in Australia are not left unknown or unaware of how to receive treatment when it is needed. The government has made known of these populations, and have set up programs to decrease this “gap.” Decreasing this gap will increase the overall percentage of excellent health that Australia has as a whole (Armstrong, Gillespie, Leeder, Rubin & Russel, 2007).

After the Second World War, the number of people covered by health insurance had increased dramatically. However, there still was a large portion of the population that lacked sufficient coverage. Gough Whitlam was elected in 1972. His plan was to extend the health coverage to the entire population to eliminate the large portion of the population that lacked any health insurance coverage (Dwyer, 2004). Medibank was the name of the health system that passed in 1974 to increase the amount of people with health insurance. However, Medibank only lasted a couple of years before it was forced to shut down in 1981. On February 1, 1984, Medicare was created by Hawke Labor Government. Today, this is still the current health care system in Australia. Medicare is a universal health care system that gives free health care to the citizens in public hospitals, and in private hospitals it lowers the cost of payments. However, it is not considered to be completely free health care because the citizens are paying a percentage of the care with their taxes. Therefore meaning that is tax funded, but ran by the government (Dwyer, 2004).

The health care system, Medicare, works with both public and private sectors. The public health sectors are provided by all of the levels of government: local, state, territory, and the Australian Government. The private health sectors are provided by private hospitals, medical practices, and pharmacies. However, Medicare is the primary source of funding for health care and funding for primary health care in Australia. Medicare typically covers the majority of costs in public hospitals, and a portion of costs in private hospitals (Australian Government). The Australian government highly recommends that people also get private insurance on top of their Medicare if possible. They recommend this due to the fact that there are often long waiting lines and long waiting lists to get treatment. Regarding the long waiting lines and lists, when you have private insurance you do not have to wait as long for treatment because you are able to pick from a public or private institution to receive the treatment. Also, if you have private insurance you are able to pick your doctor. When you just have Medicare, you do not get to pick your doctor. You typically are just assigned to whatever doctor is available at the time. If you have complications, and need to go back to a hospital for treatment, often times you do not see the same doctor. Therefore, there are many benefits to having private health insurance on top of the public health insurance that is provided to all residents of the country. However, it is not always possible for every citizen to obtain private insurance on top of their public insurance. This is due to low income status of some residents (Australian Government).

Medicare covers a variety of different fees in the hospitals and different practices. Therefore giving free or lower cost treatments for patients. In public hospitals, Medicare covers 100% of the treatment. Which means that a patient may go into a surgery, come out, and have not a single payment to make. This means that many Australian citizens will not go into debt or go bankrupt trying to pay their medical expenses. Having medical bills taken care of completely in public hospitals is significantly beneficial; however, there are drawbacks to public hospitals in this country. The waiting lists for some surgeries can be anywhere from one hundred to two hundred days (Healthcare in Australia, 2014). This can cause complications if a person is in serious pain. Often times the waiting lists will force some people to go to private hospitals to receive treatment or get a surgery done.

Receiving treatment or getting a surgery done at a private hospital can be extremely expensive without health insurance. Medicare will cover up to 75% of the fees and services that are taken care of in a private hospital (Australian Institute of Health and Welfare, 2013). However, the patient still has to pay out of pocket the portion that the government does not take care of; this could be up to a couple thousand dollars or more. Often, people will take out private insurance, if they can afford, to cover out of pocket costs. It still needs to be taken into consideration that just because an individual has private insurance on top of their public insurance, it does not mean that they will not have any out of pocket payments for their medical expenses. Private insurance also entitles the patient to be able to choose their doctor; something that a patient with only public insurance does not have the option to do. Therefore, a patient with private insurance may have a doctor that they know and work well with, and they can continue to go to this doctor as long as they have private insurance as well. Private insurance may also provide other services that are not available to the citizens who only have the public insurance. For example, “physiotherapy, dental, optometry, and podiatry services” (The Australian Immigration Book). Medicare also only covers the services that are necessary. For example, if a patient has a serious heart condition and needs heart surgery, this will be covered. On the other hand, if a patient wants to have plastic surgery but the surgery does not have anything to do with any acute or chronic health condition, this will not be completely covered by the government. The Australian government does an excellent job in assorting what is covered by the government completely, and what receives lower cost treatment for the individuals in the country (The Australian Healthcare system).

The Australian health care system has a variety of strengths and successes. The biggest and main strength and success that is portrayed through the health system would be the availability and access of care. The citizens in the country do not have to struggle to pay for care or treatment because they are receiving it for free, or at a lower cost. This is beneficial to their overall health because they are not waiting for the symptoms to become severe before they seek help and treatment; which is a rising problem in some countries that do not provide universal health care. It does not matter if a citizen makes 100,000 dollars a year or 15,000 dollars a year, each person receives the same quality of care as the other (Hsieh, 2014).

The health care system has many strengths; however, there are a few weaknesses that need to be considered. One weakness in Australia deals with disease patterns. Serious diseases that are related to age and the vulnerable populations. The country attempts to reach out to the vulnerable populations; however, the outreach is not effective enough to the people who are actually at risk with the diseases. The country needs to find ways to reach out to the community in ways that will be effective and help decrease or treat the chronic diseases (Armstrong, 2007). Another weakness that has been viewed in the system is the shortage of health care providers; whether it be doctors or nurses. Healthcare providers are less willing to work overtime hours due to the attempt to balance work and family life. However, it appears that the high percentage of shortages in health providers are in lower income areas (Armstrong, 2007).

The health systems of Australia and the United States are significantly different. The Australian government spends less money on GDP than the United States. However, Australia has higher life expectancy rates than the United States. Therefore, the U.S. is spending a much larger amount of money on health care but is lagging behind in life expectancy rates even with all of the money being put forth (Leiyu Shu, 2014). A large difference between the health systems is that Australia has universal health care, and the United States does not. There are many people in the United States that fail to receive treatment when they need it because they cannot afford to see a doctor. This is a key factor in what may lower the life expectancy rates from Australia. In Australia you would expect to have higher life expectancy rates due to the fact that there is universal health care and that citizens do not have to worry about medical expenses putting them into debt (Leiyu Shu, 2014). In the United States that is a serious issue to be taken into consideration. Both countries systems use “Medicare”. However, they stand for different things in each country. In Australia, Medicare is the name of the universal health coverage provided to everyone. In the United States, Medicare is a program that is provided for people who are 65 or older. These people have owned a right to be in this program because they have worked through their life and received social security benefits. Also, people with disabilities are also eligible to qualify for Medicare. The United States also has a program called Medicaid that is for those who low income. A person has to have a certain income or disability to be able to qualify for Medicaid. Australia does not have programs like the United States does because of the universal health care coverage that is provided (Leiyu Shu, 2014).

Although the two countries health systems are significantly different, there are a few aspects that are similar. The systems are similar in terms of wanting to provide the best quality of care for all patients. The two countries want to ensure that patients are being able to afford treatment when they are in need it of it. They also want to ensure that when they are receiving the treatment that they are the best quality care that is possible. Australia and the United States also want to ensure that patients are able to access the care when necessary.

The leaders of the United States could learn some valuable aspects for the Australian health care system. One thing that the United States leaders should take in consideration is implementing a universal health care system. The universal system in Australia has been beneficial to the citizens and their health. In the United States there are much larger groups of people who are considered to be vulnerable populations and do not receive treatment when they are in need. Health insurance in the United States can be very expensive if you want good coverage. However, there are people that cannot afford to have any health insurance. Although there are programs for people with low incomes; sometimes these people are over qualified to be eligible for these programs. Which means that these people do not have health insurance at all and have to pay any medical expenses out of pocket. This is the reason why many Americans fail to receive necessary treatment until they are rushed to the emergency room when the symptoms become serious. The United States could also look into spending less on GDP and making sure that the money spent on health insurance is going to improve the overall care and health the citizens. Thus far, the United States spends a significant larger portion of money than Australia and fails to have the quality of health care that Australia has overall (Mascarehhas, 2009).

Although the United States could learn valuable information for the Australian government in terms of health care; the United States could also assist the Australian government with their system. Hospitals in the United States do not have long waiting lists like the Australian hospitals. In the United States you may find out that you have an illness, and you are able to schedule the surgery and pick the date that you want without having to wait one hundred or two hundred days to receive the treatment. The United States could help share their techniques about scheduling surgeries with the leaders of the Australian health system. This way residents in Australia would not have to wait up to two hundred days to receive the treatment that they need to improve their health. The United States has a significant amount of health care providers unlike Australia. The United States could help them increase the amount of providers they have by letting them know the incentives and other key factors that are necessary for having more efficient health care providers.

The universal health care system in Australia, Medicare, is beneficial to the citizens of the country. It ensures that all citizens are capable of receiving treatment when they are in need. The treatment is free in public hospitals or it is at a lower cost in private hospitals. The universal health care has increased the life expectancy rates in Australia and has allowed the overall health of the country to be some of the best in the world.

References

Armstrong, B., Gillespie, J., Leeder, S., Rubin, G., & Russel, L. (2007, August). Challenges in health and healthcare for Australia. Retrieved from https://www.mja.com.au/journal/2007/187/9/challenges-health-and-health-care-for-Australia/

Australian institute of Health and Welfare. (2013). Australia’s health system. Retrieved from www.aihw.gov.au/australias-health/2014/health-system/

Australian Government. What is covered by Medicare. Retrieved from www.privatehealth.gov.au/healthinsurance/whatiscovered/medicare.htm

Australian Government. (2014). Australia’s health. Retrieved from www.aihw.gov.au/australias-health/2014/

Dwyer, J. (2004, November). Australian health system – restructuring- what problem is being solved? Retried from www.ncbi.nlm.nih.gov/pmc/articles/PMC544964/

Healthcare in Australia. (2014). Retrieved from www.nib.com/au/health-information/healthcare-in-australia

Hsieh, Paul. (2014, March). What the US can learn from the Australian health care debate. Retrieved from www.forbes.com/sites/paulsieh/2014/03/31/what-the-US-can-learn-from-australia/

Mascarehhas, A. (2009, August). What the US can learn from Aussie health care. Retrieved from www.globalpost.com/dispatch/asia/090819/what-can-aussie-health-system

Parliament of Australia. Health in Australia: A quick guide. (2013, November). Retrieved from www.aph.gov.au/about-parliament/parliamentary-departments/parliamentary_library/

The Australian healthcare system. Retrieved from www.heti.nsw.gov.au/international-medical-graduate/australian-healthcare-system/

The Australian immigration book. Australia’s health care system. Retrieved from www.aust-immig-book.com/au/general/health-australias-health-care-system

World Health Organization. Universal health coverage. Retrieved from www.who.int/universal-health-coverage/en/