There has been a lot of discussion about the Australian healthcare system lately. The Australian healthcare (Medicare) system is quite different from the healthcare system in the United States. Public hospitals are owned and operated by the State and Territory Governments. Public hospitals are rare in the United States. In addition to the public healthcare (Medicare) in Australia, there is also private health insurance. "Nearly half of the Australian population (47%) had private hospital coverage and nearly 56 percent had general treatment coverage in 2015." It would appear the Australian Medicare system is dependent on public facilities.
"President Trump is right. The Australian healthcare system provides healthcare to all of its people at a fraction of the cost than we do," Sanders commented on Twitter." A fraction of the cost of U.S. healthcare? I'm not sure the numbers support that statement. According to a 2015 report from The Commonwealth Fund, The U.S. spend 17.1% of GDP on health care compared to 9.4% in Australia. The average annual growth of health care spending per capita in the U.S. is 1.24%, in Australia it is 2.42%. Out of pocket health care spending per capita in the U.S. is $1,074, in Australia it is $771. Maybe they are catching up with us.
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Most of this information was obtained from The Commonwealth Fund, "Health Care System and Health Policy in Australia."
Austrialia has Medicare, which "covers universal access to free treatment in public hospitals and subsidies for medical services;"
Public hospitals are owned and operated by the State and Territory Governments.
The public patient (patient covered by Medicare) has a treating doctor assigned by the hospital. You don't get a choice of doctor. Private patients have choice of doctor,
Both city and country people have good access to nurses but doctors, and especially specialists, are concentrated in the cities.
There is a dramatic gap in the health indicators for the indigenous population compared to non-indigenous Australians.
Australian life expectancy is the third longest in the OECD. In 2014, life expectancy at birth in the U.S. was 78.8 (77.9 in 2008) whereas in Australia it was 82.4 (81.5 in 2008).
The system is financed largely through general taxation.
There is a specific income tax levy (the Medicare levy at 1.5%), but it raises a small portion of total finance.
There is also a high reliance on out of pocket payments, at 17% of total expenditure.
Government dominates funding, with 43% of total expenditure provided through the Commonwealth, and 25% through other levels of government.
Three major components of Medicare cover public hospitals, medical services, and pharmaceuticals.
There is a strong and growing private hospital sector.
There is government support (subsidies) for private health insurance which covers both hospital inpatient treatment and out of hospital services not covered by Medicare.
Medical practitioners are free to set their own fees above the MBS fee, thus exposing patient to out-of-pocket charges. Overall, around 70% of all medical services are bulk billed (direct billed to Medicare) in which case there is no out of pocket fee; bulk billing rates are over 80% for primary care attendances, and vary by specialty.
The Pharmaceutical Benefits Scheme (PBS) provides subsidized drugs at a set co-payment (at a lower level for welfare recipients). It was established more than 50 years ago and now covers about 600 drugs in over 1,500 formulations. This comprises over 90% of all prescriptions written in Australia.
Private health insurance - Since 1996, there have been incentives to encourage the purchase of insurance, often described as ‘carrots and sticks’.
The carrots comprise a 30% rebate on private insurance premiums.
The sticks are an income tax surcharge for higher income earners without private cover.
Since 2000, there has been a financial incentive to purchase insurance by the age of 30 and to stay with cover.
Nearly half of the Australian population (47%) had private hospital coverage and nearly 56 percent had general treatment coverage in 2015.
From a 2013 OECD report: The United States is one of the few OECD countries that has not achieved yet universal health coverage for a core set of services. In 2011, it had the highest proportion of its population without health coverage among all OECD countries, with 15% of the U.S. population uninsured. The Affordable Care Act is expected to expand health insurance coverage, which will become mandatory for nearly all citizens and legal residents from January 2014.
The United States does have a way to go to provide universal health coverage. Based on the review of this one country that does provide universal coverage, a lot of analysis is needed. With our current costs much higher than other countries something needs to be done to reduce costs to enable universal health coverage. For example, according to this report from The Commonwealth Fund, in 2013 there were 35.5 magnetic resonance imaging (MRI) machines per million population in the U.S. In Australia, there are on 13.4. In addition, there were 106.9 MRI exams per 1,000 population in the U.S. and 27.6 in Australia. Are these good or bad things? Who wants to be the one to not get an MRI when it is possibly needed?
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