Medicare Services in Australia: System Critique and Future

This report provides a comprehensive analysis of Medicare services in Australia. It begins with an introduction to the healthcare system, emphasizing its role in providing accessible healthcare to Australian citizens and permanent residents. The report then details the functions of Medicare, including the Medical Benefits Scheme and its financing through a Medicare levy. It describes the services covered, such as general practitioner visits and specialist consultations, and the financial contributions from Medicare. A significant portion of the report is dedicated to critiquing the Medicare system, pointing out limitations such as the exclusion of certain benefits like vision, hearing, and dental care, as well as the out-of-pocket expenses for patients. The critique also touches on the system's vulnerability to fraud and the high administrative costs. The report concludes by advocating for improvements in the Australian healthcare system to ensure a better, affordable, and quality health plan for all residents. The report references several sources to support its findings and arguments.

Running Head: MARKETING
0
Welfare systems and Services in Australia
7/20/2019

MARKETING
1
Contents
Introduction...........................................................................................................................................2
Overview of Medicare services.............................................................................................................2
Critique on the Medicare services.........................................................................................................3
Conclusion.............................................................................................................................................4
References.............................................................................................................................................5

MARKETING
2
Introduction
The report brings about the discussion on the concept of Medicare services in context
to Australia and the related aspects. It is referred to the healthcare system that aims to ensure
best care services to the individuals living in the country. The discussion will provide the
background of the service system, and determine the effective performance (Dixit &
Sambasivan, 2018). Moreover, the report will describe the target clients or group of the
service system. In the later part, the essay will critique the Medicare service system and the
ways for the improvement in the future years.
Overview of Medicare services
Medicare is the universal healthcare system publicly funded in the Australia, has been
referred as the primary funder of health care. The function or aim of Medicare is to fund the
access to the healthcare in two main ways. The first is the medical benefits scheme that
provides benefit for the people i.e. out of the hospital medical services, inclusive of the
general practitioner and other services from specialist. Medicare ensures availability of the
health care services to the Australian and New Zealand citizens, and other permanent
residents in Australia (Australian Department of Human services, 2018).
Therefore, the aim of Medicare is to ensure free or low cost medical, midwifery, or
hospital care in certain circumstances. Medicare in Australia is financed through a two per
cent levy on the most of the Australian taxpayers. Medicare Australia is generally responsible
for administering the Medicare that works to provide subsidies for healthcare services. It
deals with the aspect of payment of the doctors, health professional and nursing staff, and the
financing of the state-run hospitals (Freed & Allen, 2019). This enhances the working and
effective management in the healthcare to ensure e high quality services to the patients. Thus,
Medicare is funded by an income tax surcharge, known as Medicare levy that is considered
2% of an individual’s taxable income.
Additionally, the main contribution of the Medicare services has been understood as it
covers costs and ensures low burden of the treatment on the patient. The amount paid by
Medicare includes, the patient health costs based on the Medicare benefits schedule.
Specifically, Medicare involves 100% of the schedule fee in respect to general practitioners,
85% of the specialists. It also covers other remaining services if the private patient has been

MARKETING
3
admitted into a public or private hospital. Besides, this Medicare also provides patients some
other benefits or concessions, and they may be continued to get benefits in their future life
(Chambers et al., 2018).
The federal Minister for health at present Greg Hunt is the one responsible for the
administration of the national health policy. In addition, the state and territory governments
manage or administer the elements of healthcare in their jurisdictions. The Medicare services
in context to Australia are targeted to the citizens of the country, and indigenous population
and other permanent residents. Therefore, Medicare services are aimed to provide optimum
care and best treatment to the individuals within nation (Wakerman et al., 2017).
Critique on the Medicare services
Now, the discussion in this particular section will analyse the critique or negative
aspects of the Medicare services. From the research it has been found that throughout the 50-
year history, Medicare has attained a great success, especially in terms of the medical costs.
However, there are certain aspects which are considered negative in context to the application
of Medicare services. Like prescription drug benefits stating that they are necessary to ensure
that the required drugs are covered by the Medicare plan. It means it does not covers or
include the rest of medicines or drugs, to avoid the full costs (Shishehbor et al., 2018).
No vision, hearing or dental benefits: If an individual is attending their routine
medical tests, i.e. may be eye check- up, visiting a doctor, hearing tests, then it is not covered
under the Medicare (Wakerman et al., 2017).
Out of pocket expenses or costs: It has been found that Medicare covers 80% of the
medical costs of the person, while rest 20% cost has to be borne by the individual only.
Therefore, above mentioned are some of the disadvantages of enrolling into the original
Medicare services. This further determines that there is a need for the improvement in the
system to ensure better healthcare service (Dixit & Sambasivan, 2018). Some other positive
and negative aspects of Medicare includes number of aspects:
Medicare costs very less every month, and this benefits to the people who cannot
easily afford high care services. Moreover, it provides some other additional plan coverage
or benefits to the Australians, such as private insurance benefits in the future. These all

MARKETING
4
aspects have led to an increased or better medical standard within healthcare system
(Robinson et al., 2015).
However, Medicare covers a huge cost of administration as it has been found that
currently it covered almost 15% of the overall federal budget. Poor health of the people costs
higher and hospital stay costs is still the same which ultimately affects the low-income group
living in the country. Apart from this, the Medicare service system has been found attractive
to the fraudulent doctors, and professionals who work for false rehabilitation, adding more to
the poor health of people.
The issues or challenges faced by the healthcare system in the country in context to
Medicare can be improved by taking suitable actions. Revising the policy of healthcare,
managing expenditures, undertaking the effective responsibility of the insurance schemes for
the betterment of citizens’ wellbeing can lead to improved services (Sharman et al., 2016).
Conclusion
To conclude the above discussion it has been analysed that debate over Medicare
services is still in progress and would continue in future. The report has mentioned several
advantages or positive aspects of the care provided to the individuals in terms of reduced
medical costs. Moreover, the discussion has also mentioned some of the cons or negative
aspects of Medicare services. Healthcare services have become more efficient with the
introduction of Medicare in Australia. Therefore, it requires that the Australian healthcare
system must work towards the improvement of Medicare. This would ensure a better,
affordable, quality health plan for the individuals living in the country.

MARKETING
5
References
Australian Department of Human services. (2018). Medicare. Retrieved from:
https://www.humanservices.gov.au/individuals/medicare
Chambers, G. M., Randall, S., Mihalopoulos, C., Reilly, N., Sullivan, E. A., Highet, N. &
Austin, M. P. (2018). Mental health consultations in the perinatal period: a cost-
analysis of Medicare services provided to women during a period of intense mental
health reform in Australia. Australian Health Review, 42(5), 514-521.
Dixit, S. K. & Sambasivan, M. (2018). A review of the Australian healthcare system: A
policy perspective. SAGE open medicine, 6, 2050312118769211.
Freed, G. L. & Allen, A. R. (2019). Outpatient consultant physician service usage in
Australia by specialty and state and territory. Australian Health Review, 43(2), 200-
206.
Robinson, S., Varhol, R., Ramamurthy, V., Denehy, M., Hendrie, D., O'Leary, P. & Selvey,
L. (2015). The Australian primary healthcare experiment: a national survey of
Medicare Locals. BMJ open, 5(3), 7191.
Sharman, M. J., Hensher, M., Wilkinson, S., Campbell, J. A. & Venn, A. J. (2016). Review
of publicly-funded bariatric surgery policy in Australia—lessons for more
comprehensive policy making. Obesity surgery, 26(4), 817-824.
Shishehbor, M. H., Jaff, M. R., Beckman, J. A., Misra, S., Schneider, P. A., Lookstein, R. &
White, C. J. (2018). Public health impact of the Centers for care and Medicaid
Services decision on pass-through add-on payments for drug-coated balloons: a call to
action. JACC: Cardiovascular Interventions, 11(5), 496-499.
Wakerman, J., Humphreys, J., Wells, R., Kuipers, P., Entwistle, P. & Jones, J. (2017). A
systematic review of primary health care delivery models in rural and remote
Australia 1993-2006.

MARKETING
6