chapter 4

• components of effective health systems (SAFE)

  • sustainability
  • access
  • funding
  • equity
• Medicare 


  Australia's universal health insurance scheme, which provides all Australian residents (and some overseas visitors ) access to necessary healthcare at a subsidized cost of for no cost at all
• schedule fee 


  the amount of money the government decides Medicare will pay for various consultations and treatments instead of the patient
• what does Medicare cover

  • public patient in a public hospital
  • schedule fee for a gps appointment
  • tests and exams required to diagnose illness
  • eye test performed by optometrist
  • selected dental procedure (kids from 2-17 can be covered by child dental benefit schedule
• bulk billing 


  when a service provider does not charge a patient more than the schedule fee ($37.05)
• Medicare safety net 


  provides extra financial support to individuals and families who experience high medical costs by further reducing the costs of Medicare services once they have reached a designated threshold
• how Medicare is funded

  • the Medicare levy
  • the Medicare levy surcharge
  • general income taxation
• medicare levy surcharge 


  people who dont have private health insurance and earn over a certain amount will be taxed an extra 1-1,5 %
• how Medicare promotes sustainability

  • only covers healthcare deemed medically necessary keeping cost down to continue to cover services
  • people are more likely to get treatment preventing development of more serious health conditions
• how Medicare promotes access

  • removes financial barriers
  • available to all permanent residents
  • triage system ( people who need more care will get seen first)
• how Medicare promotes equity

  • Medicare safety net assisting family's with significant financial costs
  • low income earners are exempt for levy surcharge
• private health insurance 


  an optional type of health insurance which people can have in addition to Medicare, in which members pay a premium in return for payment towards services that are not covered by Medicare
• private health insurance advantages

  • choose doctor
  • reduce waiting times for non emergency treatments
  • can choose the hospital they would like to be treated at
  • more likely to have a private room
  • reduce pressure on public system
  • cover a wider range of services
• private health insurance demonstrates sustainability

  • reduce strain on public system meaning people can get treated sooner
  • PHI incentives
• private health insurance demonstrates access

  • greater acces to services
  • lower wait times for elective surgeries
• private health insurance demonstrates equity

  • low income earner have a greater rebate on premium costs
  • levy surcharge only for high income earners
• pharmaceutical benefit scheme 


  a program run by the government that subsides various essential prescription medicines for Australians and the others
• PBS safety net prices 


  general patients $41.30 until reached $1497.29then costs $6.60

  concession card holders $6.60 until $316.80 then is free
• PBS sustainability

  • only meds with greatest benefit to public on the list
  • prices adjusted each year to align with inflation
  • reduce hospital stays because conditions can be treated on prevented though medication
• PBS access

  • reduce cost to remove financial barrier
  • available to all Australians
• PBS funding 


  through government (taxes) and patient co payments
• PBS equity 


  PBS safety net allows patients with high medication costs can access medications for cheaper
• national disability insurance scheme 


  an insurance scheme that provide support and services to people with a disability, their families, and their carers
• NDIS requirements

  • permanent condition
  • decreased ability to complete tasks
  • cant participate socially or economically
  • if you are the career you are under 65 and are live in Australia legally
• NDIS steps

  1. create an individual plan
  2. use the plan
  3. review plan ever 12 months
• NDIS sustainability

  • alllowed 3 years to build up funding
  • assist in individuals gaining employment (more tax collected)
  • decrease reliance on heathcare systems
• NDIS access

  • allows participants to enjoy an ordinary life
• NDIS equity

  • provides care based on specific needs
  • not based on income