Healthcare in Australia

Introduction

Australia is a large country with a land area of about 7.6 million square kilometres. Despite the vast land area, Australia has a small population, which was estimated at 21 million in 2007. About 89.3% of the population are of European descent and only 2.3% are indigenous or of Aboriginal descent.

Similar to other developed countries, Australia is characterized as having an “ageing society”. It also has a low fertility rate (1.4 births per female in 2005). According to experts, this figure is not enough to replace the impending ageing population. The Australian Government has been actively encouraging skilled and sponsored migration to help it sustain its population. The net migration rate recorded as of 2005 was 3.91 migrants per 1000 population.

Australian healthcare has generally improved in the last 10 years. Life expectancy increased to 78 years for males and 83 years for females in 2005. This is one of the highest rates among developed countries. The infant mortality rate is low at 4.3 deaths per 1000 population.
Some of the common health concerns in Australia are skin cancer, heat stroke, obesity, diabetes, dengue fever, and other chronic diseases common in developed countries.

Australian healthcare at a glance                                                    

The Australian healthcare system is generally based on a broader perspective as defined by the World Health Organization. It not only focus on the physical and mental health of its population, but also on their general state of social wellbeing. It is serviced by a mixture of public and private healthcare providers.
The Australian government takes a Commonwealth form with six states and two territories. In terms of health, the Commonwealth takes the lead in the development of national health policies, regulations and funding. The states and territories operate in matters not covered by the Commonwealth’s responsibilities, such as the execution, oversight, and regulation of public health services as well as healthcare providers.
Some of the government’s health strategies include the provision of clinical services and programs, improvement of the social, physical, and economic environment of groups or individuals at special risk, the reduction of health risk exposures, capacity building (to enable individuals to exercise control in their environment, thereby making appropriate health choices), and the provision of culturally relevant services. 
It is estimated that about 70% of Australia’s healthcare expenditure is funded by the government. The commonwealth shoulders 67% of this cost, covering three national subsidy schemes, Medicare, the Pharmaceutical Benefits Scheme and a 30% Private Health Insurance Rebate. The remaining 33% is covered by the states and territories.

Medicare in Australia                                                                        

Medicare is a National Subsidy Scheme that subsidises services and prescription medicines bought from pharmacies. It provides free treatment in public hospitals. Medicare also provides free or subsidised payments to health professionals for specific services.
Established in 1984, its aim is to provide high quality healthcare that is affordable and accessible to all Australian residents, regardless of their circumstances. For the period of July 2004 to June 2005 there were 20.5 million people who registered for Medicare benefits. There were also approximately 236 million services processed during the same period.
Medicare is financed through progressive income tax and Medicare levies derived from the incomes of Australian residents.
Claiming Medicare benefits can be done in several ways. One method is to pay the doctor’s fee in full and then seek a reimbursement. Another possible method is to request the doctor’s fee in advance from Medicare. Medicare shall issue a check payable to the doctor. Doctors may also deduct the subsidy that will be provided by Medicare from the fees and submit the benefit claim directly to Medicare. Claims can be made through the post or in person at Medicare offices or in designated agencies.

While in Australia, visitors that come from countries where the government has a reciprocal healthcare agreement can avail of Medicare benefits. However, the benefits of the reciprocal agreement do not cover those who come specifically for treatment. Visitors who are not eligible for Medicare can avail of comprehensive health insurance to cover unexpected medical expenses during their stay.

Pharmaceutical benefits scheme                        

Through the Pharmaceutical Benefits Scheme, the government provides high subsidies on a number of prescription medicines. This scheme is available to all Australian residents and international guests from countries which share a reciprocal healthcare agreement with Australia.
Individuals or families with heavy medicine utilisation can avail of the subsidised rates. Eligible patients are categorized as either concessional or general patients. Concessional patients are those that have Veterans’ Affairs Cards, Family and Children’s Services Cards, or have passed certain criteria and have been declared as being disadvantaged. Concession patients can claim higher subsidies than general patients.
Subsidies in this scheme are paid directly by Medicare to the pharmacy on a reimbursement basis.

Private health insurance                                      

Private health insurance represents about 11% of healthcare funding in Australia. It can be used in either a private hospital, or in a public hospital by patients who chose to be treated as private patients. Similar to other countries, private health insurance allows the patient to have a wider choice of doctors and hospitals. The timing of a procedure can also be chosen by the patient. Private insurance also covers some services that are not covered by Medicare. These include optical, physiotherapy, podiatry, and dental services.
The government provides a subsidy equivalent to 30% of the insurance premiums to those who have subscribed to private health insurance. The government facilitates payment of reduced premiums to health funds or directly to contributors as alternative payments. In the fiscal year 2004 to 2005, there were 4.7 million registered subscribers of private health insurance. Of this, about AU$2.7 million was paid to health funds and about AU$2.3 million in claims was paid directly to contributors.

Healthcare options for international travellers       

Prior to entering Australia, some visitors are required to undertake certain health examinations such as HIV, Hepatitis B and C, and/or a chest x-ray.

These tests shall be required if the visitor:

• Plans to attend a classroom environment,
• Intends to stay for more than 3 months and has recently been in a high tuberculosis risk country,
• Is 70 years of age or older,
• Is a parent sponsored migration applicant who intends to stay for more than 6 months,
• Has an existing medical condition, or
• Is expecting to enter a hospital or other healthcare facilities as a patient, visitor, trainee, or employee.