Analysis: Impacts of Medicare in Australian Welfare System

This report provides a comprehensive overview of the Australian healthcare system, with a specific focus on the impacts of Medicare. It begins with a brief introduction to the tax-funded healthcare system, emphasizing the roles of various healthcare practitioners and the division between public and private healthcare. The report then defines Medicare and its objective of providing accessible, affordable, and high-quality healthcare services to eligible Australian citizens. It details the funding mechanisms, including healthcare taxes and the Medicare Levy Surcharge. The report further examines the working of Medicare, including its role in covering expenses in public hospitals and the bulk-billing system. It also explores the Medicare Safety Net and the Pharmaceutical Benefits Scheme (PBS), which helps reduce the costs of regular health check-ups and medicines, respectively. Furthermore, the report discusses private healthcare insurance as a support to Medicare, covering additional costs and services. Finally, the report provides a comparison between private healthcare insurance and Medicare. The report concludes with references to various studies and publications related to Medicare and the Australian healthcare system.

Impacts of Medicare in the
Australian Welfare system

Impacts of Medicare in the Australian
Welfare system
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Brief introduction about the Healthcare System of
Australia
The healthcare system in Australia is mostly tax-funded.
The healthcare services are provided via the federal
system.
The publicly funded healthcare system in Australia is
known as Medicare.

Brief introduction about the Healthcare System of
Australia (Contd.)
Healthcare practitioners include doctors, nurses, medical
practitioners, optometrists, and psychologists.
The midwives and nurses mostly form the workforce of
healthcare services.
The healthcare system of Australia is divided into the
public healthcare system and the private healthcare
system.

What is Medicare?
Medicare helps in providing
accessible, affordable, and high-
quality healthcare services to eligible
Australian citizens.
Medicare allows accessing subsidized
medical treatment to Australian
patients in public hospitals.

Who are the payers of Medicare?
The principle of Medicare is that all Australian citizens
need to pay for Medicare based on their capabilities.
Australian government takes the responsibility of raising
the money for Medicare with the help of healthcare taxes.
The Australian citizens who earn more have to pay for
Medicare Levy Surcharge.

Working of Medicare
Medicare helps in covering the expenses of public
hospitals thereby reimbursing about 85% of the
mentioned fees by the healthcare organizations.
Some doctors and nurses bulk-bill where the patients
do not have to pay anything and the expenses will be
given by the Medicare scheme.

Medicare Safety Net
Medical costs are normally high for a regular health
check-up in Australia.
Medicare Safety Net helps in reducing the price of
regular health check-ups.
It covers a range of healthcare facilities that are being
mentioned in the Medicare Benefits program.

Pharmaceutical Benefits Scheme
There are so many medicines present in the
Australian markets which cost very high.
For reducing that amount the Australian government
introduces the Pharmaceutical Benefits Scheme.
This scheme helps in lowering the costs of medicines
and makes it affordable for Australian citizens.

PBS Safety Net
A.PBS safety net helps in bearing the costs of medicines
for Australian families.
B.After reaching the Safety Net threshold limit, the PBS
safety net can be obtained.
C.For choosing expensive brands of medicines an
individual needs to pay the extra amount.

What is private healthcare insurance?
A.This helps in providing additional support to
the Medicare scheme.
B. Private healthcare insurance covers ambulance
costs, extra costs, and hospital costs.
C. This insurance scheme helps in providing the
costs for treatment in optical departments,
dental departments, acupuncture, and check-up
in private hospitals.

Payers of private healthcare insurance
A.Australian citizens can pay a certain amount for
getting private healthcare insurance.
B.The federal government also pays 30% of the
insurance amount only for eligible candidates.

Working for private healthcare insurance
A.Medicare tries to cover several costs for specialist healthcare
services and hospital charges.
B. The private healthcare insurance program tries to bear the
additional amount for treating any private patients admitted in any
private or public hospitals.
C. The private healthcare insurance program tries to cover several
amounts which are not possible to be covered by Medicare
schemes.

Difference between private healthcare insurance
Insurance
type
Pros Cons
Medicare 1. The amount is
affordable for
Australian citizens.
2. It provides the same
treatment irrespective
of income.
1. The waiting list is more
for Medicare.
2. The selection of the
doctor is not applicable.
3. Hampers the public
healthcare system.

Difference between private healthcare insurance
(Contd.)
Insurance type Pros Cons
Private
healthcare
insurance
1. Covers extra expenditure
on optical treatment,
dental treatment, etc.
2. Hospitals can be chosen
for personal choice.
3. Waiting lists for private
healthcare insurance is
shorter.
4. The demands for public
healthcare services get
reduced.
1. Requires paying a huge
amount of money for
availing private healthcare
insurance services.
2. Annual costs for medical
treatment are higher.

References
 Awoke, M. A., Negin, J., Moller, J., Farell, P., Yawson, A. E., Biritwum, R. B., & Kowal, P. (2017). Predictors of public and private
healthcare utilization and associated health system responsiveness among older adults in Ghana. Global health action, 10(1), 1301723.
 Callander, E., & Fox, H. (2018). Changes in out‐of‐pocket charges associated with obstetric care provided under Medicare in
Australia. Australian and New Zealand Journal of Obstetrics and Gynaecology, 58(3), 362-365.
 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.
 Cumming, C., Kinner, S. A., Preen, D. B., & Larsen, A. C. (2018). In Sickness and in Prison: The Case for Removing the Medicare
Exclusion for Australian Prisoners. Journal of law and medicine, 26(1), 140-158.
 Duckett, S. (2018). Expanding the breadth of Medicare: learning from Australia. Health Economics, Policy and Law, 13(3-4), 344-
368.

References (Contd.)
 Gowland, R. (2017). Taking issue-Rob Gowland: Medicare or money care. Guardian (Sydney), (1803), 5.
 Hiscock, H., Mulraney, M., Efron, D., Freed, G., Coghill, D., Sciberras, E., ... & Sawyer, M. (2020). Use and predictors of health
services among Australian children with mental health problems: A national prospective study. Australian Journal of
Psychology, 72(1), 31-40.
 Hua, X., Erreygers, G., Chalmers, J., Laba, T. L., & Clarke, P. (2017). Using administrative data to look at changes in the level and
distribution of out-of-pocket medical expenditure: An example using Medicare data from Australia. Health Policy, 121(4), 426-433.
 Malalasekera, A., Blinman, P. L., Dhillon, H. M., Stefanic, N. A., Grimison, P., Jain, A., ... & Vardy, J. L. (2018). Times to diagnosis
and treatment of lung cancer in New South Wales, Australia: a multicenter, medicare data linkage study. Journal of oncology
practice, 14(10), e621-e630.
 Tompkins, R. (2017). Private Health Care in New Zealand: Five Policy Prescriptions. Journal of law and medicine, 25(1), 86-104.

References (Contd.)
 Turner, L. R., Pearce, C., Brijnath, B., Browning, C., Lowthian, J., Shearer, M., & Mazza, D.
(2018). General practice utilisation of Medicare Benefits Schedule items to support the care
of older patients: findings from the REDIRECT study. Australian Journal of Primary
Health, 24(1), 54-58.
 Wong, C. Y., Greene, J., Dolja‐Gore, X., & van Gool, K. (2017). The Rise and Fall in Out‐
of‐Pocket Costs in Australia: An Analysis of the Strengthening Medicare Reforms. Health
economics, 26(8), 962-979.
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