medicare

• DEFINE medicare:

  Australian universal health insurance scheme which provides all australian residents access to neccessary healthcare at a subsided cost/no cost at all
• what does medicare cover?

  • out of hospital expenses
  • whole/partial amount of consultation fee for doctor
  • test/examination req for diagnosing illness
  • eye-tests
  • gp procedure & tests
  • selected dental procedure
  • in-hospital expenses
  • treatment and accommodation as public patients in public hospital
  • 75% of schedule fee
• what does medicare not cover?

  • majority private hospital expenses
  • majority dental examinations
  • ambulance services
  • majority allied health services - services provided by trained health professionals
  • health aids
• schedule fee: amount of money government decides medicare will pay for various consultations & treatments instead of patient
• patient co-payment: payment made by consumer for health products/services in addition to amount paid by government
• medicare safety net:

  • provides extra financial support to individuals & families who experience high medical costs of medicare services
  • once an individual/family contributes to a certain amount in a calendar year → charged at a significantly cheaper rate for the remainder of the year
• advantages of medicare:

  • choice of doctor (out-of-hospital)
  • available to all aus citizens
  • reciprocal agreement between australian & other countries allows aus citizens access free healthcare in selected countries ·
  • covers test/examinations, doctors and specialists fee
  • medicare safety net provides extra financial contribution for medical services
• disadvantages of medicare:

  • no choice of doctoor for in-hospital treatment
  • significnant wait times
  • often doesn’t cover full amount of doctors visit ·
  • doesn’t cover many alternative therapies
• how does medicare show sustainability?

  • Only covers healthcare deemed to be ‘medically necessary’
  • Enables them to keep costs under control 
  • Preserving funds for most necessary services
  • By providing subsidised medical treatments, people are more likely to access healthcare earlier
  • Reduces need for more expensive treatment later on
  • Keeping cost of Medicare under control and sustainable for the future
• how does medicare show access?

  • Seeks to remove financial barriers to accessing healthcare by providing basic healthcare at little or no cost
  • Allows individuals to exercise their freedom of choice
  • Operate on a triage system - patients who are most in need receive treatment first
• how does medicare show funding?

  • Funded through Medicare Levy, Medicare Levy Surcharge and general income tax
  • to allow for subsidised healthcare allowing for more conditions to be treated, and therefore improve better health outcomes
• how does medicare show equity?

  • Medicare safety net assist individuals and families with significant medical costs, relieving financial stress
  • Allowing low-income earners to be exempt from the Medicare Levy provides extra financial support for those who need it
• DEFINE patient co-payment:

  Patient co-payment: payment made by consumer for health products/services in addition to amount paid by government
• medicare levy:

  •  funds some of the costs of Australia's public health system, known as Medicare. The Medicare levy is 2% of your taxable income
• medicare levy surcharge

  • Aims to encourage people to take out PHI to use private system to reduce demand on public Medicare system
  • 1-1.5% of income
• general tex (medicare)

  • Tax – A financial charge that must be payed by law to fund various public expenditures.
  • Income Tax – We are taxed in Australia based on our income – the more you earn the more you pay