Healthcare Delivery and Reform: A Comparative Analysis of Australia, United Kingdom, and United States of America

RUNNING HEAD: HEALTHCARE DELIVERY AND REFORM 1
Healthcare Delivery and Reform
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HEALTHCARE DELIVERY AND REFORM 2
Healthcare Delivery and Reform
INTRODUCTION
Structure and functioning of the Healthcare system in Australia
The Australian healthcare system is very complex in terms of the roles as well as
responsibilities across all the levels of the government. This is because in Australia, there is the
federal system of governance that is supplemented by the national or rather the commonwealth
government and the six states of territories. At the federation level, the responsibility of health
falls within the states. However, it is the commonwealth government that is responsible for
raising the revenue (Keirns, 2017). This therefore implies that the States still rely on the
commonwealth government for funding. Besides, the structure of the healthcare system in
Australia is further complicated by the fact that there is a complex interplay between both the
public as well as private sectors. The source of funding in the healthcare system in Australia is
through general taxes from the citizens. Besides the general taxation, there is also a specific form
of tax geared towards the healthcare system and is known as the Medicare levy. This however
only raises a small fraction of the finances. In Australia, the Healthcare system also relies heavily
on the out of pocket payments which contributes 17% of the total expenditure (Mossialos,
Wenzl, Osborn, & Sarnak, 2016,). It is however the government that provides a junk of the
expenditure at 43% through the commonwealth government as explained earlier. The remaining
25% of the expenditure is from other levels of the government. Since the Commonwealth
government is the gigantic in expenditure towards the healthcare system, it makes it the
dominant force when it comes to policy making.

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In the Australian Healthcare system, State as well as Territory Governments own and
operate all the public hospitals. Besides, the government also offer services like mental health,
dental, health promotion, school health and finally community based health programs (Squires &
Anderson, 2015). The good thing about the healthcare system in Australia is that there is an
agreement with the commonwealth whereby all citizens are subjected to free treatment as public
patients in all public health facilities. Public hospitals can admit private patients who have the
freedom to choose their preferred doctors. Public patients on the other hand work with Doctors
who are assigned to them by the hospital. Emergency departments are located in all public
hospitals. The teaching and research departments are however found only in very large public
hospitals.
In Australia, it is the role of the Pharmaceutical Benefits Scheme to provide subsidized
drugs at lower prizes to welfare recipients. The Pharmaceutical Benefits Scheme was set up more
than fifty years ago and currently it is estimated that close to 600 different drugs in around 1500
formulations are covered by the PBS .Of all the drugs, more than 90% of the prescriptions are
written within Australia (Paolucci, Paolucci, & Ergas, 2011). Regardless of the cost of drugs
patients receive, they make a set of co-payment services. It is the role of the Government to
negotiate the prices of the drugs with the pharmaceutical company. Besides, Australia was the
pioneer countries to introduce a necessary need for comparative effectiveness as well as the
economic valuation.
Governance of the Healthcare system in Australia
The governance of the health system in Australia is under the Australian Government, the
state and the territory government health ministers. The relevant health minister is the one who is

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particularly responsible of managing both the individual national as well as the state and territory
health systems.
Collectively, these health ministers are known as the Health Council under the leadership
of the Council of Australian Government. This is termed the highest intergovernmental forum in
Australia. The Health Council has the responsibility of providing a forum through which
cooperation on matters concerning health more so the primary and secondary care are concerned.
The Health council also considers raising cost pressures ("Healthcare Information Management
Systems," 2016). In support of the Health Council is the Australian Health Ministers Advisory
Council which is made up of heads of the Australian Government Health Departments, the states
as well as well as territory health departments.
Key Health Care System Reforms in Australia
The bigger political context
There are different healthcare reforms in Australia. One such reform is the introduction of
an array of policy initiatives with the aim of increasing participation in private health insurance
and this include government funded rebate for premiums, the Medicare Levy Surcharge and
finally the lifetime Health Cover. After the elections, the prime minister did indicate to review
different sectors with the health sector being among them.
Priority areas for health
The current ruling party in Australia known as the Australian Labor Part has prioritized
different areas for health. Some of the areas include implementation of national drugs strategy
with the aim of preventing potential drugs abuse. The other key area is integration of current
technology in providing healthcare services and better management of patient information. Focus