Australian Health System 8 Essay Example
Australian Health System 8
According toDwyer J and Eagar K (2008) Funding of health services is split between the Commonwealth, State and municipal governments, and the private sector. Medical services provided outside public hospitals — general practitioner services, medical specialist visits, pathology, and radiotherapy — are provided almost entirely by private medical practitioners who charge fee-for-service.
Public hospitals provide free in-patient care to all Australian citizens and a range of outpatient services including specialty clinics, accident and emergency services, and some community support services. Public hospitals are jointly funded by Commonwealth and State Governments under various arrangements (Katherine 2009).
Katherina adds in her report that Public health services are mainly the responsibility of the Commonwealth, with contributions largely reflecting historic allocations. The Commonwealth determines the number of nursing home beds within each region as a function of the elderly population, with payment based on a formula designed to reflect level of care requirements. In this way nursing homes are funded under a weighted capitation formula, with weights determined by age and nursing dependency Where as Private hospitals provide a large range of in-patient and outpatient services, with an historic focus on minor surgery, diagnostics, and obstetrics. The Commonwealth covers medical services in private hospitals, up to the scheduled fee, with the remainder covered by patient fees.
The private health insurance markets (PHI) covers almost half of the Australian population. The policy makers have encouraged the development of private financing and delivery arrangements operating in parallel to the public system. PHI is seen as a vehicle for enhancing individuals’ choice of provider and care options, and for reducing cost and demand pressures on public hospitals. The PHI in the Australian context has been successful in addressing some policy objectives, although outstanding challenges – including important cost considerations – remain. Private health cover enhances choice over providers and access to timely elective care. It helps financing the development of private hospital facilities, thereby providing insurees with an alternative to public hospital care (Francesca and Nichole 2003).
Though the Australia health system seams to appear to be doing well in promoting access to
private cover and safeguarding equity of resources in public hospitals due to the insuarence market services, this aspects may require monitoring. This is because most of theses markets aim at making priofits hence may not concider very well the health of the Austrelian citizens therefore the commonwealth and the goverment should try and rectify all the loholes they experiences so as to be in a good posiotion to take major roles in consumption of health within the government.
2 What do you think is the equity objective (s) of the Australian health care system and why? How do we know if we are meeting our national equity objectives? Discuss with specific reference to the Australian context. (provide references as necessary)
Australian health system
The Australian health system is widely regarded as being world-class, in terms of both its effectiveness and efficiency. The system is a mixture of public and private sector health service providers and a range of funding and regulatory mechanisms. The Australian population has a generally good health status, with life expectancy at birth at 75.2 years for boys born in 1994-96 and 81.0 years for girls born in that period. There are some groups with poor health status, notably Aboriginal and Torres Strait Islander peoples. Otherwise the pattern of disease is similar to that of other developed countries.
The objectives of the health system
Musgrove (1996), observed that the ‘four main general objectives that people usually want these are; good health, low cost, satisfaction on the part of both consumers and providers, and equity, both medical and financial. Normally many international health systems exhibit significant differences. This difference is usually lies in both the breadth of the objectives themselves and the necessity, within an environment of limited resources, for some trade-off between competing objectives.
fiscal equalization alone is unable to ensure equity. This is because of problems of how to assess the needs for and costs associated with providing health care services in areas of dispersed population. He concludes that equity is more likely to be achieved when policy is oriented to health care rather than medical care and when provision and distribution of resources relates more to service outcomes than to service inputs. Humphreys 2010. He states thatEquity, as a distributional principle, is an important consideration both in determining the actual amount and nature of resources available and in deciding who will get how much of what is available. Compared with other social goods, there is a particular insistence on equity with respect to health care services.
According Katherine (2009) Equity is defined in terms of ‘access’ to health services, with the vertical equity objective to achieve ‘equitable access for unequal need’. Using the Australian Indigenous population as an illustrative case study, the magnitude of the equity weight is constructed using the ratio of the costs of providing specific interventions via Indigenous primary health care services compared with the costs of the same interventions delivered via mainstream services. Applying this weight to the costs of subsequent interventions deflates the costs of provision via Indigenous health services, and thus makes comparisons with mainstream more equitable when applied during economic evaluation.
of providing equitable health care rather than on outcomes, and therefore supports application of equity weights to the cost side rather than the outcomes side of the economic equation. processesShe adds on her paper that based on achieving ‘equitable access’, existing measures of health inequity are suitable for establishing ‘need’, however the magnitude of health inequity is not necessarily proportional to the magnitude of resources required to redress it. Rather, equitable access may be better measured using appropriate methods of health service delivery for the target group. ‘Equity of access’ also suggests a focus on the
Stuart and Leonie (1999) in their report states that the funding of public hospital services is dependent on State and Commonwealth funding, with the contribution by State Governments determined as part of the budgetary cycle. As a result, there is potential for significant disparities in hospital funding between States. For instance, in 1997-98, the New South Wales Government allocated 13% more per head on public hospitals than the Victorian Government ($531 compared with $470) and 22% more per head than the South Australian Government ($531 compared with $436). This has resulted in significant differences in the role of the public and private hospital sector, and access to and utilisation of public hospitals. New South Wales and the Northern Territory rely heavily on the public hospital sector. Victoria, Queensland and Tasmania rely more on private hospitals, implying a far greater patient contribution to hospital costs in those States.
Access to medical services is highly dependent on location, with major disparities between rural and remote regions and metropolitan centres. Access to, and use, of medical practitioners is highly correlated with population density. There is a serious shortage of medical services both general practitioner and specialist medical practitioner services outside major cities. This translates into a lower use of private medical services in rural communities, and a corresponding higher use of acute care services (Stuart and Leonie 1999)
From this literature, it can be noted that the equity objectives of Australian health care system have not been fully achieved this is due to the inequality distribution of health care resources. Distribution of medical services highly depends on location affecting mostly rural and remote regions. The funding system can be described as complex and loosely organised leading to ineffective achivement of these equity objectives.
Colombo, F. and Tapay,N. (2003).
Private Health Insurance in Australia A Case Study; OECD HEALTH WORKING PAPERS NO. 8
Dwyer, J. and Eagar, K. (2008). Options for reform of Commonwealth and State governance responsibilities for the Australian health system. Commissioned paper for the National Health and Hospitals Reform Commission Occasional; Papers: Health Financing Series.Volume 1
; Armidale, NSW, AustraliaSocial provision and service delivery: Problems of equity, health, and health care in rural Australia
; Occasional Papers: New Series No. 1A cost-based equity weight for use in the economic evaluation of primary health care interventions: case study of the Australian Indigenous population2009). Carter,R.(andAnderson,I.,M.,Kelaher, Katherine,S. O.
; West Heidelberg Vic 3081, Australia.Equity and the Funding of Australian Health Services: Prospects for Weighted CapitationStuart and Leonie (1999).
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