This assignment provides an in-depth analysis of the Healthcare System in Australia along with comparisons with countries being members of the OECD. It analyses the position of Australian Healthcare in terms of various parameters which includes the financial structure as well.
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Running Head: HEALTH FINANCIAL MANAGEMENT Health Financial Management Student Name: Student Number: Name of the University: Author’s Note:
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1 HEALTH FINANCIAL MANAGEMENT Table of Contents Executive Summary........................................................................................................................................................2 Introduction to OECD and Australian Healthcare System.............................................................................................3 Comparison of Australian Healthcare System with member nations of OECD.............................................................5 Australia’s Healthcare vs United States..................................................................................................5 Australia’s Healthcare vs The United Kingdom.......................................................................................6 Major areas of inefficiency in Australian Healthcare system.........................................................................................8 Recommendations for improvement of Australian Healthcare system..........................................................................9 Australia's health system compared to OECD averages.......................................................................................9 References11
2 HEALTH FINANCIAL MANAGEMENT Executive Summary In this assignment, an in-depth analysis of the Healthcare System in Australia is provided along with comparisons with countries being members of the OECD i.e. the Organization of Economic Co-operation and Development. We shall analyse the position of Australian Healthcare in terms of various parameters which includes the financial structure as well. We shall analyse the areas where Australian Healthcare needs more improvement and also the areas where it is performing better than other countries. We shall understand whether the Australian Healthcare is taking adequate steps and providing equitable healthcare facilities to all its citizens. We shall identify areas of scope to further improve the overall system. The role of member nations in the OECDshallbeunderstood.Inthesegments tofollow,weshalldiscuss various concerns ofthe Healthcare System globally. (Önen and Sayın, 2018)
3 HEALTH FINANCIAL MANAGEMENT Introduction to OECD and Australian Healthcare System The OECD is a unified platform for nations across the globe to come together and share the eco-social problems that are in common, cooperate with each other on the concerns and find solutions. There are thirty four member nations who have joined OECD as a sign of their commitment to market economy and self-democracy.Most of them are high income economies who use OECD as a platform to develop best practices, coordinate numerous policies and find solutions to common issues by working together with fellow nations who have similar issues. The funding comes from voluntary contributions of members. Australia is not a founding member of OECD. It joined OECD in 1971, twelve years after it became an official operating organization. OECD helps member countries in proper handling of funds, budgets and other monetary aspects. Taxation is another area where the OECD has shown enormous focus. Coming to Healthcare, it is one amongst many concerns on which the OECD supports its member nations. It helps its members achieve high performance in health systems by recording health outcomes and the use of resources. It analyses policies that can significantly improve access, efficiency and the quality of health care. (Weeramanthri and Bailie, 2015) Now, coming to the Australian Healthcare system, in terms of the general measures and life expectancy, Australia’s population is more than the OECD nations in average. The smoking consumption is low, exposure to Air pollution is low and the overall results are mixed. The areas of concerns are the obesity rates and skipping consultations to avoid costs. A comparative analysis of Australia’s Heathcare system along with deviations from standard OECD averages is shown below:
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4 HEALTH FINANCIAL MANAGEMENT Thus, we see that Australian Healthcare System has performed better in terms of overall Health status than the average with better life expectancy and lower mortality rates. All Australians have access to Healthcare facilities with decent quality of care. However, the health care spendings are higher than the OECDaveragealongwithriskfactors likealcoholconsumptionandobesity ranges.Thehospital admission rates for asthama and COPD are seen to be high. Even the antibiotic prescribing is higher. (Wubulihasimu, Brouwer and van Baal, 2016)
5 HEALTH FINANCIAL MANAGEMENT Comparison of Australian Healthcare System with member nations of OECD In this segment, we shall compare the Australian Healthcare system with two other member countries of OECD and evaluate results. The member nations we shall compare with are the United States and the United Kingdom. Australia’s Healthcare vs United States AUSTRALIAUNITED STATES AustraliahasaUHCi.e.UniversalHealth Coverage where everyone in the country has right to use the excellent health facilities and is sheltered towards the financial risks. (Carey, Malbon, et al., 2015) The United States is without a Universal Health System (UHC). The citizens of United States are notprotectedagainstfinancialchargesincurred during healthcare. Australia has a 2-tier system of private and public healthcare where all holders of visa and permanent residents are entitled to free high excellence civic hospital care through Medicare. TheUnitedStatesprovidescoveragetolow- incomeearnersandagedpeoplebywayof Medicare and Medicaid. 57%ofAustralianschooseprivatecoverover public cover as private cover supplements allied health services not covered under the public one. Serviceslikedentalandoptometryarealso included. MostAmericansobtainprivateinsurancecover through their employer, if employed full time. The self-employedandmanyothershavetofund private insurance on their own which is many a times beyond their means. The health services are funded through general taxation as well as 2% medicare income tax levy. An additional 1% levy is applied to high income earners without private cover. IntheUSSystem,MedicareandMedicaidare funded by US Payroll taxes. (Obama, 2016) For funding of medications, Australia has a PBSIn the USA, patients rely on the medications being
6 HEALTH FINANCIAL MANAGEMENT (Pharmaceutical Benefits Scheme) that caps out of pocket costs for most medications. covered by their private insurance. The health care costs in Australia are not very high and mostly affordable. Australia therefore has lower healthcarecostsandhigherlifeexpectancy. (Gearhart, 2016) The Healthcare costs in the US is much higher than many nations because of higher service costs, lack ofcontrolsandgreateradministrativecosts.It burns a hole in the patient’s pocket. USA therefore hashigherhealthcarecostsandlowerlife expectancy which is quite alarming. Australia’s Healthcare vs The United Kingdom AUSTRALIAUNITED KINGDOM Australia’sHealthcaresystemfunctionson Medicare, where the Medicare proceeds are used tofundhealthcareservices.Thisserviceis operated by the Department of Human Services and provides subsidized treatments to Australians. UnitedKingdomhasadoptedtheNHSi.e.the nationalhealthcaresystemwhichprovidesfree healthcare to UK Residents. This service is funded from tax to the extent of 98.8% and remaining from National Insurance contributors (Hadad, Hadad and Simon-Tuval, 2013). Australia has better health monitoring through the My Health Record online Health summary initiative andmanyotherhomegrownappsbutthe technology to undertake online searches, compare health providers and access full medical records instead of summary is unavailable. UKhasbetteronlineadministrationofHealth Services as compared to Australia. ThequalityofservicesbyDoctorissimilarto nurse-led in UK. The quality of services by Doctors is better in UK. A comparative analysis of the statistical data of the three economies is below (Data of 2004):
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7 HEALTH FINANCIAL MANAGEMENT ParticularsAustraliaUnited KingdomUnited States Percentage of GDP spend on Health care9%10.2%17.2% Healthcare spending per capital$ 4,207$ 4,094$ 9,364 Spending on Pharmaceuticals per capita$ 626$ 485$ 1,112 Average annual physician visits per capita7.3-4.0 Hospital spending per discharge$ 10,530$ 11,663$ 21,063 Use of electronic Medical Records92%98%84% Percentage of daily smokers13%19%13% Prevalence of Obesity28%26%38% If we see the above statistics, we see that Australia provides better healthcare services than the United States in terms of both costs and quality of services. When compared to the United Nations, most parameters are mostly at the same level with the UK performing slightly better than Australia on some. United States has majorly spent on Health care with lesser address to concerns. It is more than double of Australia and UK, This is primarily because of higher services cost in the USA. Another major reason could be the large population in US compared to Australia and UK. (Gallet andDoucouliagos, 2017)
8 HEALTH FINANCIAL MANAGEMENT Major areas of inefficiency in Australian Healthcare system The major areas of inefficiency and waste include: Too much payment to international pharmaceutical manufacturers for drugs. Inefficient hospital and pathology services. Unutilized skills of staff in hospitals and rural remote healthcare services. Increasing obesity rates, yet no ban on sugary drinks. Problems with safety and quality of care in hospitals. All states have reported cases of quality scandals.
9 HEALTH FINANCIAL MANAGEMENT Recommendations for improvement of Australian Healthcare system Although Australia’s healthcare system is enviable, there is still scope for a lot of improvement. The blend of both public and private funding along with involvements of both the federal and the state is what makes the system “marble cake federalism”. (O’Loughlin, Kendig, et al., 2017) Almost 80% of the General Practitioners are paid directly by the Government. The doctors are allowed to charge whatever they like with no cap on fees. The only concern is the out-of-pocket expenses which is significantly high. Because of this, a chunk of the patients delay or avoid seeing a specialist. Despite an untidy structure with both the federal and state involvements, the overall outcomes of Australia’s Healthcare is better than the OECD average. The cost outcomes are marginally above the average in terms of GDP spend on healthcare. (Bedir, 2016) Australia's health system compared to OECD averages VariableAustraliaOECD average Government’s share of total health expenditure67.30%72.50% Health expense as a share of GDP9.40%8.90% Indigenous life expectancy (males/females)69.1/73.7- Infant mortality rate per 1,000 live births3.23.7 Life expectancy at birth (males/females)80.4/84.577.8/83.1 Out-of-pocket share of current health expenditure (including voluntary health insurance)32.70%27.40% Population24 million- A good system, but not perfect, therefore needs to follow these recommendations:
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10 HEALTH FINANCIAL MANAGEMENT The Australian Healthcare System can be made more accessible and efficient by addressing the problems with indigenous health. Out-of-pocket costs should be covered under regulation and reduced. Dental care which is currently not covered under NUH should be included for all. Waiting time for elective procedures in public hospitals need to be reduced. Means of managing chronic diseases should be added to the list of subsidized items by the Government as chronic diseases are significantly increasing.
11 HEALTH FINANCIAL MANAGEMENT References Bedir, S. (2016).Healthcare expenditure and economic growth in developing countries.Advances in Economics and Business, 4(2), 76-86. Carey, G., Malbon, E., Carey, N., Joyce, A., Crammond, B., & Carey, A. (2015).Systems science and systems thinking for public health: a systematic review of the field. BMJ open, 5(12), e009002. Gallet, C. A., &Doucouliagos, H. (2017).The impact of healthcare spending on health outcomes: A meta- regression analysis.Social Science & Medicine, 179, 9-17. Gearhart, R. (2016).The robustness of cross-country healthcare rankings among homogeneous OECD countries.Journal of applied economics, 19(1), 113-143. Hadad, S., Hadad, Y., & Simon-Tuval, T. (2013).Determinants of healthcare system’s efficiency in OECD countries.The European journal of health economics, 14(2), 253-265. Obama, B. (2016).United States health care reform: progress to date and next steps. Jama, 316(5), 525- 532. O’Loughlin, K., Kendig, H., & Browning, C. (2017).Challenges and opportunities for an ageing Australia. In Ageing in Australia (pp. 1-10). Springer, New York, NY. Önen, Z., &Sayın, S. (2018). Evaluating healthcare system efficiency of OECD countries: A DEA-based study.In Operations research applications in health care management (pp. 141-158). Springer, Cham. Weeramanthri, T. S., & Bailie, R. S. (2015).Grand challenges in public health policy.Frontiers in public health,3, 29. Wubulihasimu, P., Brouwer, W., & van Baal, P. (2016).The impact of hospital payment schemes on healthcare and mortality: evidence from hospital payment reforms in OECD countries.Health economics, 25(8), 1005-1019.