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CGP
08-10-2009, 10:28 PM
Another member suggested (wisely) that it might be instructive to discuss health care systems in other countries to see how they are maintained. Here is a brief overview of the Australian health care system - it's a mixed model whereby all citizens have coverage through Medicare (tax funded) and people can additionally choose to take out private insurance (for extra benefits) if they wish to and/or can afford to. There are a large numbe of both public and private providers of health care in Australia.

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1. PUBLIC HEALTH CARE SYSTEM: UNIVERSAL ACCESS

Medicare (http://www.medicareaustralia.gov.au/about/whatwedo/medicare.jsp)


Medicare is Australia’s universal health care system introduced in 1984 to provide eligible Australian residents with affordable, accessible and high-quality health care.

Medicare was established based on the understanding that all Australians should contribute to the cost of health care according to their ability to pay. It is financed through progressive income tax and an income-related Medicare levy.

Medicare provides access to:

- free treatment as a public (Medicare) patient in a public hospital, and

- free or subsidised treatment by medical practitioners including general practitioners, specialists, participating optometrists or dentists (for specified services only)

The Department of Health and Ageing (DoHA) is responsible for the policy development of Medicare and the Medicare Benefits Schedule. Medicare Australia is responsible for:

- ensuring Medicare benefits are paid to eligible health care consumers for services provided by eligible medical practitioners, and

- assessing and paying Medicare benefits for a range of medical services, whether provided in or out of hospital, based on a schedule of fees determined by DoHA in consultation with professional bodies.

Medicare Australia is also involved in detecting and preventing fraud and abuse of the Medicare system and registering and recording details of medical practitioners including:

- those eligible to have Medicare benefits paid for their services, or

- those not entitled to have Medicare benefits paid for their services but who are able to raise valid referrals or requests for specialist services for Medicare benefit purposes.



2. PRIVATE HEALTH CARE SYSTEM: PRIVATE ACCESS

Private Health Isurance: Australia (http://www.healthdirectory.com.au/Health_insurance/)


Australians enjoy universal public health insurance, Medicare, financed through progressive personal income tax and an income-related levy. They also have the option to take out privately funded health insurance to cover the costs of becoming a private patient in a private or public hospital, medical costs in hospital, and costs associated with services not covered under Medicare (such as ambulance, natural therapies and private dental care).

Health insurance funds offer hospital covers and ancillary covers and a combination of these.

Private health insurance is provided through organisations registered under the National Health Act 1953. There are two types of private health funds: restricted membership organisations (such as employees of a particular firm or industry) and funds open to the general public.

Private health insurance funds are registered with and monitored by the Private Health Insurance Administration Council, a statutory authority. Private health insurance providers adhere to the the Private Health Insurance Code of Conduct, a voluntary, self-regulatory industry code.

The Private Health Insurance Ombudsman deals with inquiries and complaints about any aspect of private health insurance. The Private Health Insurance Ombudsman is an Australian Government agency but acts independently in dealing with complaints and is independent of the private health funds and health service providers.

Australians under 65 years of age, eligible for full Medicare benefits, enjoy the Federal Government's 30% rebate on private health insurance premiums. The rebate is 35% for people aged between 65 and 69 and 40% for those aged 70 and over.

Australians who took out hospital cover before 1 July 2000 and maintain it, only pay a base rate regardless of their age, pursuant to the Federal Government's Lifetime Health Cover initiative.

Private health insurance organisations are regulated by the Federal Government to ensure affordable access to private health insurance for all through the principle of community rating. Pursuant to this principle, the insurance premium is the same regardless of the health status or claims history of a member or new member. Reinsurance supports the principle of community rating by sharing between health insurers the hospital and medical costs of high risk members admitted to hospital. Funds with a greater proportion of low risk members contribute into a reinsurance pool and those with a greater proportion of high risk members receive transfers from it.

At this link (http://www.healthdirectory.com.au/Health_insurance/), there are additional links to 45 private health insurance companies that operate in Australia.

Some of the biggest insurers are:

Medibank Private (http://www.medibank.com.au/)

MBF Australia (http://www.mbf.com.au/)

Health Cover Fund (http://www.hcf.com.au)

JLB123
08-10-2009, 11:20 PM
Yep, they offer rebates so that private citizens can buy private insurance, just like we are advocating here with medical savings accounts.

Our plan is better, because it would be a 100% rebate, and there would be no limit on private insurance companies, so the costs would be lower from more competition, and care would be better.

Since we already have Medicare, no Obamacare is needed.

Private Health Insurance Rebate
You are here: PrivateHealth.gov.au > Private Health Insurance Information and Facts > Surcharges & incentives > Private Health Insurance Rebate

The Australian Government introduced the Private Health Insurance Rebate (also known as the Federal Government 30% Rebate) initiative in January 1999. For every dollar that you contribute to your private health insurance premium, the Government will give you back at least 30 cents as a Private Health Insurance Rebate.

For people aged between 65 and 69 years, the Rebate is 35% and for people aged 70 years and over, the Rebate is 40%.

All Australians who are eligible for Medicare and who are members of a registered health insurer are eligible for the Rebate - no matter what their level of cover, income or type of membership. The Rebate applies to both hospital and general treatment (also known as ancillary or extras) policies.

The Rebate is not applicable for overseas visitors health cover.

How to claim the Rebate
In order to claim the Rebate, your health insurance policy must be with a health insurer registered under the Private Health Insurance Act 2007. This site has a list of all registered insurers.

In addition, all the people covered by the policy must be eligible to claim benefits under Medicare.

There are three ways to claim the Rebate:

ask your registered health insurer to provide the Rebate as a premium reduction,
receive a direct payment from the Government through your local Medicare office, or
claim it back on your tax return, using a statement your health insurer will provide at the end of the financial year.
If your employer has paid your premium on your behalf, you are still entitled to claim the Rebate.

More information
The Australian Tax Office website has more information on the Private Health Insurance Rebate,
The Medicare website also provides information on Private Health Insurance Rebates and claiming the Rebate at Medicare offices.

CGP
08-10-2009, 11:21 PM
Since we already have Medicare, no Obamacare is needed.

In Australia, Medicare covers everyone, not just some select categories as it does in America. That's a big difference.

Laura Cereta
08-10-2009, 11:26 PM
- assessing and paying Medicare benefits for a range of medical services, whether provided in or out of hospital, based on a schedule of fees determined by DoHA in consultation with professional bodies.



Does this mean that if the doctor/medical practictioner agrees to treat the patient, then they agree to accept the payment fee already established by the Medicare administration for the particular service they are rendering?

JLB123
08-10-2009, 11:29 PM
In Australia, Medicare covers everyone, not just some select categories as it does in America. That's a big difference.

And Medical Savings Accounts would cover everybody too, but would be cheaper and have better care. There would be no government intervention.

CGP
08-10-2009, 11:31 PM
Does this mean that if the doctor/medical practictioner agrees to treat the patient, then they agree to accept the payment fee already established by the Medicare administration for the particular service they are rendering?

Yes, but in addition they can add on their own fee if they choose to. They are not prevented from doing so. I don't know if there is a limit on how much of an additional fee they can add on to the Medicare payment (?) - I am assuming not as over-the-counter fees seem to vary quite a lot.

Say for example Medicare pays $100 for a particular consultation - The doctor can charge $125 if they wish and the patient will have to cover the $25 shortfall. Some people don't mind paying additional fees whereas others are only willing to see a doctor who charges the base Medicare fee - the latter is referred to as "bulk billing".

CGP
08-10-2009, 11:32 PM
And Medical Savings Accounts would cover everybody too, but would be cheaper and have better care. There would be no government intervention.

The "care" doesn't change. It's the same providers - they are just paid differently.

Laura Cereta
08-10-2009, 11:38 PM
Yes, but in addition they can add on their own fee if they choose to. They are not prevented from doing so. I don't know if there is a limit on how much of an additional fee they can add on to the Medicare payment (?) - I am assuming not as over-the-counter fees seem to vary quite a lot.

Say for example Medicare pays $100 for a particular consultation - The doctor can charge $125 if they wish and the patient will have to cover the $25 shortfall. Some people don't mind paying additional fees whereas others are only willing to see a doctor who charges the base Medicare fee - the latter is referred to as "bulk billing".

O.K.... it's the general care provided by the U.S. doctor's that accept only the Medicare fee that bothers me so much. It's not just that even though they are insured, the impoverished or elderly or disabled are being treated more poorly then those with money; it is also the corrupt nature of the medical practitioners who herd these patients through, give them mediocre care, and then stick tax-payers with the bill. I don't like it.

JLB123
08-10-2009, 11:40 PM
The "care" doesn't change. It's the same providers - they are just paid differently.

Not true. Medical care providers also would have to compete for that money, so you would see (just like you do now) more MRIs per ctizens, shorter waits for treatment, etc.


If you are running a hospital in Britain, where is the monetary incentive to provide better care?

CGP
08-10-2009, 11:46 PM
If you are running a hospital in Britain, where is the monetary incentive to provide better care?

The entire country is divided up into trusts, all of which are basically run like businesses from a financial point of view. In order for a hospital to survive/prosper it has to be financially viable. But, on another note, money is not the only driving force behind effective organizational performance. I keep bringing up examples of other government-funded services (fire, police, military) that aren't driven by the need for profit, why should health care be treated differently?

foxyladi
08-11-2009, 09:50 AM
And Medical Savings Accounts would cover everybody too, but would be cheaper and have better care. There would be no government intervention.

i like that no gov.intervention part.:thumbsup: