2. Funding and National Schemes

a: Medicare

Medicare is the Australian universal healthcare system based on the principle of equal access to health care.

Medicare

Medicare use is monitored and allows the Government to see how and where people are accessing and using the public health system

All Australian residents are entitled to Medicare. Some visitors to Australia can also access Medicare.

The Australian public, pay a Medicare levythis is a contribution of up to 2% of taxpayers taxable income through the tax system.
Government contributions further support Medicare.

Medicare enables all Australian residents to have access to free or low cost treatment by health professionals. This includes general practitioner visits, dental for children; those with chronic or complex conditions, optometric care and public hospital care.

People are still free to choose private sector healthcare.


The Medicare Benefits Scheme and Schedule outlines restrictions on what Medicare will cover. Updated in 2017, the MBS is an outline of the Medicare services subsidised by the Australian Government.
Medicare does not cover:
  • elective surgery
  • long-term care (also called custodial care)
  • routine dental for adults
  • eye care
  • dentures
  • cosmetic surgery
  • acupuncture
  • hearing aids
  • routine foot care

The best place to learn more about Medicare is on the Government supported web page. We are directing you to the page provided for consumers, the people who use Medicare and that way if they need more information you know where to direct them.

play https://www.humanservices.gov.au/customer/dhs/medicare

Medicare

In this activity, you select services that medicare does not cover

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b: Private Health Insurance

Private Health InsurancePrivate Health Insurance does result in shorter waiting times for people needing elective surgery. is a system where individuals or companies pay a premium for health care insurance cover.

medicare
Private health care covers two areas, hospital cover or ancillary treatments which include physiotherapy, obstetrics, orthodontic or specialised health services.

Private health providers will argue that private health insurance for the rich is a myth. Over 11.7 million Australians are covered by private health insurance.

Private health insurance does tend to advantage those who are already socio-economically advantaged.

Private health insurance also receives commonwealth government funding. Lobbyists argues that the funding would be better spent on developing a better and more advanced public health care system.


Key points to remember about private health insurance:
  • Speedier access to some medical and surgical services.
  • Private health insurance contributes to the public sector by engaging and expanding the health care sector.
  • Advantages those who are already socioeconomically advantaged
  • Draws funding away from the public sector

The Australian Government Private Health Insurance Ombudsman,

play http://www.privatehealth.gov.au/

Watch on YouTube: Your Health Care Choices

play https://www.youtube.com/watch?v=7uRFFoTpVRw

Private health insurance

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c: Pharmaceutical Benefits Scheme

The PBS - Pharmaceutical Benefits Scheme allows most of our medicines to be heavily subsidised by the Australian Government.

prescription

There are restrictions to the medications subsidised by the PBS such as those prescribed by dentists and optometrists, non-prescription medications, experimental drugs, natural remedies and anabolic steroids.

This reduces the cost of medicine to the public and provides free in-patient medicines in public hospitals.

PBS is part of Australia’s Broader National Medicines Policy which, quoted by the Australian Government Department of Health is: “a cooperative endeavour to bring about better health outcomes for all Australians, focusing especially on people’s access to, and wise use of, medicines.


play

play The Pharmaceutical Benefits Scheme

This website contains information on the Pharmaceutical Benefits Scheme including details of the medicines subsidised by the Australian Government as well as information for consumers, carers, health professionals and the pharmaceutical industry.

The PBS is part of Australia’s broader National Medicines Policy.

Pharmaceutical Benefits Scheme

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d: National Disability Insurance Scheme

The National Disability Insurance Scheme (NDIS) is designed to support and allow more independence for those living with a disability or carers of those with a disability.

disabled swimer

The Government has introduced a tax levy which means most taxpayers (dependent upon income) will contribute to funding the NDIS

In the past, block fundingthis is an annual lump sum of money was provided to organisations. Under the NDIS, eligible people can apply to be assessed and the funding is individualised.

This scheme recognises that individuals required different levels of care and support services.

The individual is now the central focus of the care modelalso referred to as patient centric care, this means they have more opportunities to make decisions on the services needed and the health professionals they can access.

Individualised funding means they can choose where they wish to spend their funding.

The term ‘medicine’ includes prescription and non-prescription medicines, including complementary healthcare products.”


To be eligible for the NDIS, an applicant must:
  • Be an Australian resident or citizen
  • Be under 65 years of age
  • Have a disability that is classified as permanent and that significantly impacts everyday activities

With any type of government information, like this strategy, it’s important to go to the source of information to ensure it is accurate and current:

play Australian Department of Human Services

National Disability Insurance Scheme

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