Health Care Delivery and Reforms

Running head: HEALTH CARE 1
Health Care Delivery and Reforms
Name
Institutional Affiliation

HEALTH CARE 2
Health Care Delivery and Reforms
World Health Organization (WHO) defines health as a state of completely being
physically, mentally and socially fit and not the absence of a disease or infirmity. This is
according to the Constitution of WHO Principles. Every human being has the right to enjoy the
highest attainable health care available, without being discriminated in terms of age, gender,
religion, race, political belief or social economic status. The quality of a health care system is
determined by many factors which include governance, good health policies and structure.
Health status of a given population is also built on pillars like genetic factors, health behaviors,
socioeconomic factors and environmental factors. They determine the wellbeing of a society and
reveal the necessary gaps in terms of resources and interventions to help curb the limitations.
Demand for health care continues to increase despite advancement in health care system of some
developed nations. Some of the factors include growing population, ageing population,
increasing prevalence of chronic diseases, improved management of risk factors, professional
and technological advancement and increased level of diagnosis and early screening. A good
health system consist of organizations, institutions, resources and personnel whose aim is to
improve health. This is according to WHO. Inequity in health system across the world has led to
inadequate health service provision beyond health and wellbeing. A good health system should
be efficient, effective and ensures equity. Many countries are at a stage of developing proposals
to aim at reforming their health systems. Health systems of three countries, Australia, the U.K.
and the U.S. will be analyzed in this assignment.

HEALTH CARE 3
Question 1: Governance, structure and function of Health Systems
Australia
Australia’s health system largely consist of private and government operated hospitals.
The cost of medical and hospital bills is paid by insurance agencies, both private and
governmental and out of pocket for some individuals.
Governance
Effective health care governance removes barriers, gives directions and allocates enough
resources to enable change in health care delivery (Dwyer &Eagar, 2008). Australian health care
expenditure represents almost 9% of Gross Domestic Product (GDP), and is a function of the
national government. The main source of funding for Australian universal health care system is
Medicare, a kitty that forms the biggest part of financing health. Medicare is in turn funded by
Medicare levy, which makes up 2% and excludes the low income earners. It funds 100 percent of
the public in hospital costs, 85 % of specialist and 75% of a general practitioner. (Australian
Government, 2010). Both government and private health sector provide funding to Australian
health system. Government provides funding through the Medicare scheme. The levy imposes a
3% tax on high income earners who do not possess a private health insurance. Private health
insurance is provided by health funds. Medibank provides the largest scheme of 30% and is
government owned. The Private Health Insurance Act of 2007 regulates most aspects of health
insurance in Australia. Despite all these improvements in health financing, out of pocket
payments still stand at 17% of total expenditure. Government provides about 43% of total
expenditure.

HEALTH CARE 4
Federal initiatives for Australian health care system is not only limited to Medicare.
There is a Pharmaceutical Benefits Scheme (PBS) that subsidizes medications to patient. PBS
card holders of low income are entitled to cheaper medicine. National Immunization Program
Schedule immunizes children free of charge. Australian Organ Donor Register is a national
database that registers those eligible to be organ donors. Therapeutic Goods Administration
regulates the use of medicines and medical devices. Australian border is manned by Australian
Quarantine and Inspection Service in order to reduce risks from influx of goods and people. The
Australian Institute of health and Welfare provides information related to health care. Other
agencies include the Food Standards Australia New Zealand and Australian Radiation Protection
and Nuclear Safety Agency, according to 2015 WHO report on Health Systems.
Structure and function of Health Systems
The Health System report of WHO also shows that The Australian national government
controls its health functions. The country has public hospitals, private hospitals and non-
governmental organizations. The state and Territory Governments own and operate public
hospitals. They also offer mental, dental, and social and community health programs in addition
to health promotion. Free treatment is provided for patients in public hospitals, and private
patients who incur out of pocket charges. A treating doctor is assigned in a public hospital. The
private sector also exists and patient is responsible for choosing their doctor. NGOs include
Australian Red Cross and the National Health and Medical Research Council that provide health
services and funds for medical research respectively.