1. What role do health care facilities and services play in achieving better health for all Australians

2. Students learn about: HEALTH CARE IN AUSTRALIA
Range/types of health facilities and services
Responsibility for facilities and services
Equity of access to health facilities and services
Health care expenditure vs expenditure on early intervention and prevention
Impact on emerging new treatments and technologies on health care eg cost, access
Health insurance
COMPLEMENTARY AND ALTERNATIVE HEALTH CARE APPORACHES
Reasons for growth of complementary and alternative health products and services
Range of products and services
How to make an informed consumer choice

3. Health care in Australia
Health care in Australia provides a wide range of services from surgery to rehabilitation and from pre-natal to aged care.
Australia's government is largely responsible for the oversight of health care in Australia and aims to provide equity of access to these facilities and services.
Australia has begun to increase their expenditure on early intervention and prevention, but still spend the large majority of funding in health care.
Emerging treatments such as MRI and drug development impact health care by increasing cost and reducing access, while increasing health outcomes.
While there are plenty of incentives to have private health insurance, Medicare still funds most Australians who use the health care system

4. Health facilities and services can be institutional, such as:
Hospitals and nursing homes
Non-institutional, such as:
General practitioners
Dentists
Research groups
Pharmaceutical services
Hospitals provide a range of services including:
Emergency care
Elective surgery
Rehabilitation
Midwifery services

5. Hospitals can be either ‘Private’ or ‘Public’ with patients having the choice of being a private patient in a public hospital or remaining as a public patient.
Medicare covers the cost of public hospitals – more accessible to low SES people
Private hospitals require either full payment by the patient or a combined payment using a private health insurer
Nursing homes services people suffering from chronic disease or disability and mostly care for the elderly. It is a growing industry due to a growing and aging population
Can be charitable (private)
Private (for profit)
Government owned
Government provides most of the funding for nursing homes
Private homes requires further payment from the individual

6. General practitioners are a community service – first point of access into medical and health services
Medicare covers most of the cost (many GP’s add additional fees on top of that provided by the government) Some ‘bulk bill’ (no extra cost to the individual)
After hours GP’s have increased to reduce the use of emergency services
Dentists are not generally covered by Medicare (exception is under the Chronic Disease Benefit Scheme combined with the Allied Health Initiative) – patients have to pay out of their pocket or through their private health
Allied Health is a term used to describe the broad range of health professionals who are not doctors, dentists or nurses.
Pharmaceutical services are funded through the PBS (pharmaceutical benefit scheme). Provides partial payments for many medications. PBS provides extra funding for special needs such as: pensioners, concession and war veterans

7. Range and types of health facilities and services

9. Responsibility for health facilities & services
The people who have overall responsibility for health facilities and services are the Australian health ministers (Commonwealth & State) – referred to as the Standing Council on Health.
The running of the individual systems fall to the relevant health ministers and health departments in each jurisdiction.
Standing council implements the Government national health reforms and focus on achieving ‘a better health service and a more sustainable health system for Australia’.
Also focus on closing the gap between Indigenous and non-Indigenous Australians.
Areas of responsibility include:
Hospitals
Community Health
Primary Health Care
Health Promotion
Mental Health
National Drug Strategy
Aged Care

10. Responsibility for health care facilities and services

11. Equity of access to health facilities and services
Access to health services and facilities is essential to health and well-being.
The cornerstone of Australia’s health care system is Medicare. Medicare is designed to allow simple and equitable access to all Australian citizens regardless of location and socio-economic status.
Supporting programs, such as the Medicare Safety Net (the amount of what people need to pay is capped) and Pharmaceutical Benefits Scheme (government subsidising medicines), are also in place to promote equity of access.
Although, in principle, equity of access is the intention, some individuals and groups find it difficult to access appropriate health services and facilities – ATSI and Rural and Remote.
Medicare does not fully cover, or provide access to, a range of medical services that are vital for maintaining good health. This places people of low SES at a disadvantage. EG speech therapy and physiotherapy.
Access to health services has also been hampered in recent years by overcrowding and lack of bed availability in public hospitals.
Royal Flying Doctors, e-Health records and Telehealth technology has been introduced to address inequity
People from non-English speaking backgrounds and different cultures might also not take full advantage of the services available to them.
Actively involving these communities in the establishment and delivery of their health services will result in more effective care and improved health choices.

12. Health care expenditure V expenditure on early intervention & prevention

13. Health care expenditure vs early intervention and prevention
Australia spends over $160 billion a year on health care – and rising
Cost of health care is a large burden on Government expenses
Early intervention and prevention can help reduce this cost
Health care expenditure currently falls into one of four areas: Hospital (public and private) - 38%, primary health care (GP’s nurses, allied health, dental - 36%, other recurrent expenditure (research and patient transport - 20%, and capital (building, updating and developing health care facilities - 6%.
Prevention refers to ‘approaches and activities aimed at reducing the likelihood that a disease or disorder will affect an individual, interrupting or slowing the progress of the disorder or reducing disability’ (WHO 2004)

14. Prevention activities include:
Good hygiene
Safe environments
Sanitation and good food and water supply
Currently there is a focus on the increase of chronic diseases. Prevention seeks to improve lifestyle choices such as:
Decrease smoking
Increase physical activity
Decrease alcohol and drug use
Increase fruit and vegetable intake
Australia has many health promotion campaigns:
Life, be in it
Slip, slop, slap, seek and slide
Every cigarette is doing you damage
Go for 2 & 5

15. Preventative & early intervention strategies cost Aust. $2
Preventative & early intervention strategies cost Aust. $2.2 billion a year
Preventative & early intervention have a great impact on quality of life and life expectancy as well as decreasing the burden on the health care system
Despite the strength of the arguments supporting an increase in preventative measures over curative, there seems little hope for a significant shift in government expenditure in the short term.
Governments are reluctant to cut back on funding to curative health services and divert it towards preventative strategies.
The reason for this is that the results, especially financial savings, are not seen in the short term.
For example, a large amount of expenditure dedicated to reducing the number of young people who smoke or to limiting sun exposure will not be reflected in lower cancer rates—and resultant financial savings—for 15–30 years. For a government currently in office, that expenditure might be more beneficial politically if used to shorten hospital waiting lists or to provide for other over-burdened curative services

16. Impact of emerging new treatments & technologies on health care
Impact of emerging new treatments & technologies on health care includes many benefits, but also an increase in cost and raises questions of equity of access
New treatments and technologies include:
HPV vaccine (cervical cancer)
Keyhole surgery
Improved mechanics of replacement knees, hips, heart valves etc
New HIV drugs and chemotherapy
Artificial organs such as kidneys
Ultrasound, MRI used for imaging
These improve early detection of diseases and illnesses. Also improve treatment and prevention which in turn improves quality of life and life expectancy
These treatments come at a cost. Only accessible to people of higher SES (unless funded through Medicare)
Less available in rural and remote areas

17. Health insurance: medicare and private health
Medicare is health insurance that ensures all Australians have access to free or low-cost medical, optometric and hospital care. Australians are also free to choose private health services.
Medicare was introduced in Australia in 1984 as a national system of health care funding.
It is designed to protect people from the huge costs of sickness and injury by providing free or subsidised medical care, and free hospital treatment in public hospitals. All Australian residents are eligible for Medicare benefits.
Medicare is funded from general taxation revenue plus an additional contribution known as the Medicare Levy.
The Medicare Levy is 2 % of each taxpayer’s income, and people pay it in addition to their ordinary income tax.
Individuals and families on higher incomes may have to pay a 1-1.5% surcharge in addition to the Medicare Levy if they do not have private health insurance.
The government introduced this change in the hope of encouraging more financially able people to take out private health cover, and thus ease the pressure on the public health system

18. Medicare covers:
Free hospital care
Free or subsidised treatment by GP’s, specialists, optometrists and in special circumstances dentists and allied health professionals (Physios, chiro, OT’s)
Under Medicare, patient has little choice of care provider – can choose their GP or specialist but is using hospital care, no choice other than the hospital they go to
Private health brings the benefit of not paying the Medicare levy surcharge and often has the private health insurance rebate (Govt. contribution to your health insurance)
The government has further incentives for people to take out private health insurance through the lifetime health cover loading. This loading is 2% each year over the age of 31 where a person has not taken out private health insurance. In other words, if a person takes our private hospital insurance when they are 40 they will pay an extra 20% on top of the price they would have if they took out the cover before they turned 31. This person would also loose their rebate from the government resulting in higher private health insurance prices for people who wait to take out their private hospital cover.

19. Pharmaceutical Benefits Scheme
The Pharmaceutical Benefits Scheme (PBS) was introduced by the Commonwealth Government in 1986.
This scheme subsidises most prescription medicines bought at pharmacies in Australia. The major aim of the PBS is to allow all individuals, regardless of socio- economic status, access to necessary prescription medication.

20. Private health provides patients with choice of specialist, GP and care provider within the hospital system
Covers some costs for ancillary care (dentists and physio’s etc) and started to aid in preventative measures – joining a gym
Allows for faster access to elective surgery, avoiding waiting lists
Benefits those of higher SES. It is expensive and provides those who can afford it with greater health care than those who cannot.
Becomes a social justice issue as equity of access is vital in improving the health of all Australians