Australian Health System: Funding Sources and MBS Assessment Criteria

This assignment provides a detailed overview of the Australian health system's funding mechanisms. It begins by outlining the roles of the federal and state governments in funding healthcare, with the federal government primarily responsible for setting national policies and funding through Medicare, which offers subsidized medical services and covers a wide range of healthcare services. State governments manage public hospitals, fund ambulance services, and support community-based services. The assignment also explains the role of health consumers and their contribution through private health insurance to cover services not included in Medicare. The assignment further explores the Medical Benefits Schedule (MBS) and the criteria used to assess new items or services for inclusion, including cost-effectiveness, efficacy, and safety. The document offers insights into the structure and financing of the Australian healthcare system, including the roles of different stakeholders and the criteria for service inclusion.

Running head: HEALTH SYSTEM
Australian Health System
Name of the Student
Name of the University
Author Note

HEALTH SYSTEM
Question 1
Federal Government
The federal government of Australia play the key role of setting national policies in
the nation’s health system and fulfils its responsibility of funding the health system with the
help of Medicare. This provision includes the subsidizing of the medical services and
integrating the territory and state health services with joint funding. Medicare is the universal
health insurance scheme of Australia that covers all the Australians with medical aids,
providing range of services at low cost or no cost at all. The Australians can redeem the
facility in prescription medicines, hospital treatments and medical services provided by health
care professionals (Duckett, 2018).
In addition to this, the federal government supports the access to private health
insurers and runs to Pharmaceutical Benefits Scheme to fund the pharmaceutical companies.
Furthermore, the major funding to the National Health and Medical Research Council and
other medical research is provided by the federal government. The health services to the
veterans.
State Government
The state government play the crucial role of taking care of the public health care
system at more specific and geographically limited level. This includes funding and
management of the public hospitals, licensing of the private hospitals and funding the
ambulance services in their region. The state government is responsible for ensuring proper
funding to the primary health services and public community based services, which includes
drug services, alcohol, dental health and mental health. Furthermore, the state government
also ensures funding for the preventive services such as immunization programs and cancer
screening programs (Mahimbo et al., 2017). The state government also funds the health

HEALTH SYSTEM
services specifically for the Aboriginals and Torres Strait Islander people and other
population based health programs.
Health Consumers
There are several medical services that are not covered under the universal insurance
program of Medicare provided by the federal government, which includes physiotherapy,
optical, dental and other ancillary treatments. To cover up these expenses, the health
consumers choose for private insurance, which contributes to a significant portion of the
overall funding of the Australian health system. These can be categorized as out-of-pocket
expenses that the Australians have to pay for getting private insurance which covers specific
treatments that are not provided under Medicare or the individual might opt for a total private
treatment. However, the private health insurance services are more expensive in comparative
to the Medicare service by the federal government.
Question 2
The Medical Benefits Schedule or MBS is the fee for service guide, for each item or
service covered by the federal government funded Medicare (Calvert, 2018). When new
items or services are added to Medical Benefits Schedule, they are assessed for few different
criteria. These criteria includes assessment of cost-effectiveness, efficacy of the service and
assessment of the safety associated with the service or new item.

HEALTH SYSTEM
References
Calvert, P. (2018). Medicare Benefits Schedule Review Taskforce.
Duckett, S. (2018). Expanding the breadth of Medicare: learning from Australia. Health
Economics, Policy and Law, 13(3-4), 344-368.
Mahimbo, A., Seale, H., Smith, M., & Heywood, A. (2017). Challenges in immunisation
service delivery for refugees in Australia: a health system
perspective. Vaccine, 35(38), 5148-5155.