Comparison of Healthcare Systems in Australia, India and China

The paper compares the healthcare systems of Australia, India and China. It describes the healthcare systems in these countries and analyzes the differences in them. It also evaluates the performance of the health systems in Australia, India and China based on financial risk and affordable and equal access to care.

Running Head: HEALTHCARE SYSTEM
Healthcare System
Name
Institution

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Healthcare System
Introduction
The healthcare systems in the world have evolved and there are many reforms that have
been executed to ensure that the systems meet the changing health needs of its citizens. Many
governments around the world have put in place measures that ensure that health systems are
restructured to promote the safe, efficacy and quality of care to benefits its citizens. It is
important to embrace, as well as improve the (primary) healthcare systems in nations for
prospect patient profiles plus their related needs. All healthcare systems globally comprise
primary; nonetheless, the degree of expansion of primary care as component of healthcare
system differ considerably across nations (Nolte & McKee, 2011). The paper will compare the
healthcare systems of Australia, India and China to understand better these systems.
Description of Healthcare Systems in Australia, India and China
Australia Health System
The Australian healthcare system is generally acknowledged to have attained a successful
blend of best practice strategies towards the provision of cost-effective, equitable, as well as
high-quality care for all its citizens, which makes use of a judicious mix of public plus private
care. The Australian healthcare system is a two tier system that has been found effective in terms
of providing universal care to the citizens in the country. The Australian mode of healthcare
service provision is supreme for version by a centrally planned economy, like China’s with
willingness to adopt private segment participation with government-funded health services. The
Australia’s healthcare system allows 100 per cent citizens to access free healthcare inn public

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health facilities for all diseases, which comprise the most expensive, financed by a specific
surcharge on income tax, as well as through the general tax system. In this fundamental universal
healthcare system, the physician plus timing of care are selected by the Medicare system based
on the health need along with the medical priority. The Australia’s health structure permits half
of the citizens to select to take out private health insurance that permits access to personal choice
physician, flexibility as to timing of processes, as well as comfortable private hospital
accommodation (Baugh, Baum, Lawless & Freeman, 2019).
China Healthcare System
In China, the central government has a major role to play in the management and
coordination of the healthcare system. Thus, the current healthcare system in China has bee due
to the series of healthcare reforms and local experiments undertaken during the 1990s. The
fundamental structure of the Chine healthcare system follows a separation of the populace into
two primary groups: urban residents, which correspond to 45.7 per cent and rural residents that
correspond to 54.3 per cent of the total populace in China. Chinese government has the general
role for national health law, policy, as well as management of the healthcare system. The central
government is governed by the philosophy that each citizen in the country is legible to get basic
healthcare services, with local governments accountable for offering these services, with
differences for local situations (Chen, 2014).
India Healthcare System
The primary health care has been the foundation of the healthcare system in India. The
Bhore Committee Report of 1946 has been a primary benchmark report for the transformation of

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the India’s healthcare system. The report has been instrumental to the country’s current
healthcare policy along with the systems that has promoted its evolution. The proposal for three-
tiered healthcare system to offer preventive plus medicinal healthcare in rural, as well as urban
regions putting health personnel on state payrolls plus reducing the call for for private health
experts emerged to be the standards where the present public healthcare networks were
established in India. Similar to China, India’s central government has a leading role in the
management of the healthcare system to guarantee people’s right to access care and prioritize
public healthcare service (Gudwani, Mitra, Puri & Vaidya, 2012). The country has a three-tier
health system designed to provide care to all rural population in India. At then lowest level, the
primary health centres (PHCs) has been developed to offer basic health care, health education, as
well as health promotion to the citizens. The next tier in the system is sub-centres (SCs) that have
been designed to offer public health services. The last tier is the community centres and district
healthcare facilities that provide specialist services to the population. Based on the provisions of
the constitution, healthcare delivery in India is hugely the accountability of the regional states.
Thus, the central government has the role of defining policies, as well as offering a national
strategic framework, funds, as well as medical education towards the success of the healthcare
system. Because of the India’s federal government, the regions of governance along with
operations of healthcare system in the country have been divided between the union, as well as
the state administrations. Thus, the Union Ministry of Health and Family Welfare has a role of
implementation of different programs at the nationwide level in fields of health plus family
wellbeing, prevention along with control of primary communicable illnesses, as well as

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promotion of conventional plus native systems of medicines and developing guidelines that state
regimes adapt (Forgia & Nagpal, 2012).
Analysis of Differences in Healthcare Systems in Australia, India and China
Australia combines one the global longest life expectancies with extensive chronic
disease: 77 per cent of the population have at least one such condition. The nation has different
crucial resources to manage its present healthcare challenges, comprising well-developed,
universal-access healthcare system-Medicare that has been instrumental in promoting health
access for the citizens. In addition, Australia has strong stress on primary care; and a hospital
system, which offers efficient treatment for both the chronic, as well as acute patients. The
country’s healthcare system is not with economic challenges-spending on healthcare constitutes
around 11.5 per cent of the GDP, which is slightly higher than that of OECD average. However,
Australia has many challenges that many reformers have been attempting to deal with in the
latest decades. The primary challenge that faces the Australian healthcare system is
fragmentation that makes it difficult to coordinate the care system in the country. This issue of
fragmentation emanates from the fact that there are constitutional divisions, which make
coordination inherently hard.
In China, the healthcare system is experiencing many challenges linked to the aging
population as it is in the case of Australia and the growing incidence of chronic diseases amongst
the older persons. There is also a growing problem of increases in healthcare use and cost that
has affected the delivery of healthcare services to the populace. In the last four decades, the
comparatively incorporated three-tier system of treatment plus appointment established in the
period of planned economy in the country has been broken (Liu, 2015). With the expansion of a

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marketplace economy, delegation plus a decline in monetary allotments from the central
government resulted in the collapse of the integrated system in China. Nowadays, the healthcare
system in the country suffers from disintegration and absence of coordination between diverse
healthcare entities plus community care organizations do function as gatekeepers to other entities
in the healthcare system (Jiang & Ma, 2015).
In Australia, public-funded health insurance emanate from the government, in which the
total expenditure between 2014 and 2015 was 10 per cent of the GDP. The healthcare insurance
covers nearly all citizens that are eligible for Medicare in Australia. The federal government
subsidizes around 67% of the insurance costs, where the Medicare, which is a universal public
health insurance plan that offers free or funded access to healthcare for entitled persons in
Australia (Runciman, Hunt & Hannaford, 2012). In addition, the private health insurance (PHI)
is currently accessible plus offers more alternatives of providers, more rapid admission to non-
emergency healthcare services and reimbursements for healthcare services. Furthermore, the
government policies in Australia motivate registration in private health that is funded through
taxes and specific revenue. Around 47% of the Australian have private health insurance plan,
whilst about 56% have universal healthcare system as of 2016 (Huber & Shipan, 2011).
Evaluation of Performance of the Health Systems in Australia, India and China
Financial Risk
China and India
In order to determine how effective a system is in offering healthcare services, it is
crucial to determine whether the system offers financial risk protection to its citizens may be

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evaluated using two metrics. The primary metric measures the proportion of households in
population, which have been pushed beneath the poverty level because of out-of-pocket
payments in the healthcare system to receive services that they need. The current evidence shows
that households both in Indian and China are prone to financial shocks linked to health problems
(MOH, 2015a). The latest study demonstrated that out-of-pocket healthcare spending raises the
proportion of individuals living below the poverty line (US$1.08/day) by around 20 per cent in
China, from 13.7 per cent to 16.2 per cent. On the other hand, India has increased spending of
out-of-pocket with high poverty rate of around 31.1 per cent to 34.7 per cent; in spite of smaller
comparative amplify as compared to China and Australia. In addition, another metric for
evaluating whether the healthcare system offers households with sufficient financial risk
safeguard is through computing out-of-pocket spending on healthcare as a share of revenues
(Zhao, He, Zhang, Sun & Chen, 2015). In China, the sharing of monetary risk guard as measured
by this metric is greatly uneven between high-plus low-income households in the lowly earnings
quintile spent around 11 per cent of their earnings on the healthcare, when contrasted with 5.6
per cent for those individuals in the uppermost income quintile (Meng, Yuan & Hou, 2009). In
rural regions, individuals in the lowly quintile spend a surprising 27 per cent, contrasted with
11.4% for the middle-income quintile and 7.7 per cent for the greater income quintile. Relatively,
in India in 2004, every citizen apart from those in the greatest quintile in urban regions spent
over 10 per cent of their earnings on health, which represent a double rise between 1995 and
1996, though different from China, both low-and high-income persons experience the same
financial risk (Jiang, Song & Guo, 2014).

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Australia
In Australia, the financial risk is minimal because the government provides incentives
that ensure that the citizens access universal care without much of the out-of-pocket. The federal
government in Australia finances Medicare. However, in the recent past, there has been growing
percentage of out-of-pockets that are paid in Australia that affects the low-income people in
Australia. Despite the Medicare scheme, the Australians continue to pay out-of-pockets in
treating chronic conditions, such as cancer. For instance, the median out-of-pockets costs were
greatest for breast cancer at $4,200 in addition to lowly for lung cancer at $1,100. This implies
that in Australia, whilst the debate the of the out-of-pocket costs in background of private health
insurance in addition to elevated physician fees, the poor Australians are priced out of visiting a
physician via the private scheme. Though people from low-income persons are more frequently
bulk-billed, where some individuals experience delay in accessing a physician, skip
appointments plus avoid preventive care since they will not afford the expenses. This implies
that the burden of out-of-pocket in Australia does not cushion the citizens from financial risks
making the healthcare system ineffective in addressing the needs of the population (Esmail &
MacKinnon, 2013).
Affordable and Equal Access to Care
Australia
The situation in China seems to be worse as compared to that of India and Australia. Data
from the National Health Services Survey confirm that in China, almost 50% of those citizens
reporting a disease did not seek outpatient care in 2003, which was up from 36% ion 1993.

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Among those citizens that did not seek care, 38% reported financial challenges as the main
rationale for not seeking care in healthcare facilities, which was up from 33% in 1993 (Ross,
2018). Remarkably, the percentage of sick persons not seeking care due to financial constraints
differs substantially by income level, 30% of the wealthy persons reporting financial challenges
as the main reason for not seeking appropriate care, compared to around 50% of the poorest
individuals. In regard to inpatient care, 30% of respondents reported that they did not get
hospitalized in spite of recommendation from a physician to do so, as well as 70% of those
respondents asserted financial challenges as the main reason for not being hospitalized. This
shows that the healthcare system in China has many challenges in regard to accessing affordable
care and there exists inequalities in the healthcare system in the country. This makes the
healthcare system in China ineffective in addressing the health needs of the citizens, especially
those on low-income regions (Edwards & Landon, 2014).
India
In India, the proportion of people who are sick and not seeking outpatient care is lower
than China. Nonetheless, contrasted with high-income individuals, low-income individuals are
much more probable not to see care due to financial constraints. A complete 37.6% of low-
income urban population and 43.3% of low-income rural population who did not look for care
when sick cited financial problems. Through comparison only, only 1.9% of wealthiest Indian
urban population and 21.2% of the wealthiest rural inhabitants who did look for care when sick
reported earnings as their main rationale. Through no similar figures on inpatient care is present
in India, qualitative reports indicate that early discharge from healthcare facilities is die to
financial problems that is prevalent in these facilities. In addition, the need for sizeable payments

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before admission is likely to affect low-income persons from accessing inpatient care in private
healthcare facilities in India (Gyani, 2015).
China
In China, low-income and rural populations are the least covered by the health insurance
providers resulting in poor health outcomes. In China, the Cooperative Medical Scheme (CMS)
collapsed leaving the majority without a cover. The collapse of the scheme meant that 90% of
the peanuts were without scheme that would cover them. There is a huge disparity in insurance
coverage in China across the income levels. In urban regions, 805% of individual in the
uppermost income quintile have insurance cover while 24.0% of those in lowest income quintile
have insurance cover showing huge inequality in terms of coverage in China (National Bureau of
Statistics, 2014). In China, barely about 15% of the citizens have any kind of health insurance,
mainly via their employers. In 1999, the Indian regime opened the insurance marketplace for
private insurers; nonetheless, their marketplace share is still small that covers only 1.2% of the
population. Correspondingly, though there is no official figures that exist as to coverage by
income level, because insurance is principally provided via an individual’s employer, high-
income persons, urban-area-based employees plus government workers are the predominant
recipients, and low-income farmers, agricultural employees, unskilled workers in the informal
sector, as well as business people are less likely to be covered (Dong, Guo, He & Liang, 2015).
Evaluation of current or proposed reform in Reforms in Healthcare Systems
The three countries have undertaken many reforms that are geared to streamline their
healthcare systems to continue offering quality and safe care to its citizens.

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Australia
The federal government announced many healthcare reforms to primary care, comprising
execution of the PHNs plus the MBS Review geared towards streamlining the healthcare system.
The Australian federal government has developed the Primary Health Care Advisory Group to
promote health advancements to financing along with the service deliverance for citizens with
multifaceted plus chronic diseases, comprising mental wellbeing issues. The reforms try to make
sure that primary health care in Australia is being offered successfully and that Medicare is
placed on a sustainable financing course. In addition, the government has reformed care for the
ageing population in the country to promote the universal healthcare system. Moreover, to the
execution of the Commonwealth Home Support plan, a new financing model is pursued in which
allotments would be made unswervingly to clients founded on their health needs rather than
unswervingly to service providers. This will afford them higher choice in providers plus
promoting competition (Johnson, Hansen, & Bi 2018).
India
The Indian government developed a 12th five-year plan towards developing a universal
coverage to offer universal access to inspire impartial, affordable, as well as quality healthcare,
with supplementation form the private sector. In line to this plan, the National Health Mission
offers comprehensive strategies to restructure the healthcare system towards a world-class
universal healthcare system both in rural and urban regions. Also, in Indian government
introduced the RSBY scheme as a health system integration reform. This plan under the Ministry
of Health (MOH) and Family Welfare is designed to help the state along with the central
ministry to adopt a tax-funded and single-payer scheme (MOH, 2014). In India, there are many

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reforms that have been initiated to guarantee equity in resource allotment. The allotment choices
are taken into consideration in term of financial capability, development need, as well as high-
priority districts that target particular populace subgroups, geographical regions, healthcare
services plus gender-based matters (Balarajan, Selvaraj & Subramanian, 2011).
China
The sales of prescription medicines have been a primary income for many hospitals that
permitted a 15 per cent mark-up, as well as providers have well-built monetary incentives to
encourage demand for more costly drugs. The mark-up zero was an instrumental reform that has
been effective in streamlining the healthcare sector in China in terms of controlling prices of
drugs. The zero-mark-up policy has been confirmed to be instrumental in lowering total health
spending (Fu & Yang, 2013). The introduction of special health insurance in 2015 was
important reform in China for chronic illnesses, like kidney diseases, cancers, as well as acute
myocardial infarction (AMI) that supplements the standard publicly funded plans. Severe-disease
health insurance offers refund past the beyond the somehow low reimbursements ceilings.
Conclusions
The three healthcare systems have adopted many reforms that are geared towards
improving the quality in addition to safety of care provided to the citizens. It is apparent the three
countries have varying degrees of development of their respective healthcare systems.
Nonetheless, Australia has well-developed and effectual healthcare system followed by India.
Chinas healthcare scheme is wanting as it is ineffective because they country spends more but
the system remains unchanged (Liu, 2015).

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