Introduction
The healthcare system in Australia is termed as one of the most successful in the world when it comes to the delivery of good healthcare. Additionally, the health outcomes, as well as the control of costs by the system, are remarkably effective as stated by Hall (2015). Such achievements have however been achieved through the interaction of the public and private financial backing, public and private provision of services, and the sharing of key duties between the federal as well as the state governments (Hall, 2015). In the US, no single system of health insurance covers the nation. Health insurance covers get purchased privately in the marketplace or get provided to certain individuals by the Government (Ridic, Gleason, & Ridic, 2012). America’s healthcare spending is much more than that of other high-income countries.
This essay compares and contrasts some of the features of Australia’s healthcare system with those of the US.
Question 1: The overall structure of the Australian healthcare system compared to USA’s healthcare system.
The health care system of Australia is not only accessible but is affordable and comprehensive, worldwide. The system receives its funding from several government levels that are also responsible for administrative functions as stated by Australian Bureau of Statistics (2016). Private health insurance arrangements support the funding and administration of the healthcare system of the country. The levels of government tasked with administrative and financial concerns of Australia’s health system are the national, state or territory, and local arms of the government (Australian Bureau of Statistics., 2016). Also, the system encompasses different regulatory and funding approaches as well as mechanisms. As stated by The Health Education and Training Institute (2016) all levels of government together with the service users have a function regarding funding, administration, and the provision of care for individuals who are elderly.
The local government is responsible for the delivery of services that include sanitation and hygiene, the safety of food and monitoring the quality of water. Also, the national government of Australia has the primary task of developing national policies that are broad, regulating, and funding the health sector (Health Education and Training Institute, 2016). On the other hand, state, territorial, and local governments deliver and manage public health services and also regulate health professionals and hospitals that are private. Three major national schemes (the 30 % Private Health Insurance Rebate, The Pharmaceutical Benefits Scheme, and Medicare) of subsidy are included in Australia’s government funding of the health sector (Health Education and Training Institute, 2016).
In the US, there exists a unique system of healthcare as compared to the other countries that are industrialized. There lacks a uniform health system as well as a health coverage that is universal as stated by (Department of Professional Employees, 2016). Legislation that promotes comprehensive health coverage for every citizen of America got enacted just recently. Therefore, the system can get described as one that is hybrid. Such is because the system does not operate a national health service, a system of national health insurance termed as single-payer, or even a fund of a multi-payer universal health insurance. For example, in the year 2014, 48% of spending on healthcare rose from funds that were private, with 28% getting generated from households and 20% of businesses that were private (Department of Professional Employees, 2016).
Question 2: The funding models for both healthcare systems; reviewing the roles and contributions of the government, private insurance companies, and the individual
The Affordable care Act of 2010 puts emphasis on the importance of primary healthcare that advocates for preventive measures to aid with cost cutting (Lathrop & Hodnicki, 2014). The provisions of the act got designed in such a manner that insurance coverage could get expanded as well as improve primary care accessibility and promote health services that are preventive in nature (Lathrop & Hodnicki, 2014). To this effect, approximately 61% of insurance coverage for health in America is employment related. This is as a consequence of the associated cost saving effects that come with group plans that can get bought through an employer. About 26% of the American citizens get funded by public medical insurance. Medicare and Medicaid are the two principal public health insurance covers (Blaik, 2014). Medicare is a uniform public health insurance that is national and caters for the aged and individuals living with disabilities. Medicare isprovided by the federal government and is the largest insurer in the country with a coverage of about 13% of the citizens.
On the other hand, Medicaid provides health care coverage for certain groups that are economically disadvantaged. There is a joint funding of Medicaid by both the federal and state governments. Depending on the rising healthcare needs, the federal government provides state governments with funds that range between 50% and 77% depending on each state’s per capita income (Blaik, 2014). In Australia, the funding and administration of the health system are the duty of the various government levels (Oliver-Baxter & Brown, 2016).
Private health insurance also supports the financing of the system. Australia’s health system has two funding models based on both the population and the patients. The population-based approaches of funding focus on the funding need at the level of the population. Funds get allocated to the providers of services in a lump sum periodically based on the health needs and the size of the population. On the other hand, patient-focused approaches are methods that apply incentive use and provide support to the improvement of the quality of care offered to patients as stated by Oliver-Baxter & Brown (2016). Additionally, the government is responsible for directly funding the system, as well as influencing funding by developing policies that are appropriate. The role of the individual is to make both Aboriginal their tax and contribution on the Medicare levy addressing their income and also through private health insurance. Private health insurance can cater for hospital charges that are both private and public as stated by The Health Education and Training Institute (2016).
Question 3: The health outcomes of each healthcare system to global averages
In Australia, the government is marred by challenges that relate to the funding and delivery of healthcare. However, the healthcare system is at a good international standing that is reflected in the continued high average expectancy of life and an infant mortality rate that is low (Aiken et al., 2012). For example, when compared to other countries of the Organization for Economic Co-operation and Development, the life expectancy is the sixth highest. The health system is however stretched by a population that is aging, increased incidences of illnesses that are chronic, and the organization of the system that is outdated when compared to countries such as Germany, France, and even the US. The high rates by which Australians get admitted to hospital because of chronic diseases also indicates that primary healthcare needs to get strengthened. There are also inequalities in health between the most and least advantaged citizens in the country (Aiken et al., 2012).
Gourevitch et al., (2012) explained that evidence suggests that other nations are still ahead of the US in the healthcare sector performance rankings. For example, the country got ranked 36th globally by the World Health Report of Health systems in life expectancy and in infant immortality, it ranked 39th (Gourevitch et al., 2012). Since 2010, the health system in the US has resulted in widening the coverage of insurance, improving system efficiencies to lower costs, and expanding programs for prevention and wellness. There are still variations regarding the different regions of the country, ethnic groups in the states as well as mortalities that occur as direct consequences of illnesses that can get prevented. The above authors mentioned that the system in the US failed to offer particular attention to the design, financing, and evaluation of solutions that are targeted to the current situation such as deaths resulting from causes that are preventable.
Question 4: Healthcare policies and the social impact of health care delivery to Indigenous populations or minorities groups within each country
According to The Department of Health (2016), the system for the transfer of funding for primary health care for Australia’s minority group from the Torres Strait Islander Commission plus the Aboriginal and thus to the Commonwealth Health Department led to increased funding for the group. Such increased the access to healthcare by the minorities and ultimately improved their life expectancy rates as well as their social wellbeing. Australia also reformed the Medical and Pharmaceutical Benefits Schemes policy that made it possible for the aboriginals to access funding through such insurance covers. Ong et al., (2012) however explained that the Indigenous Health Service Delivery Template of Australia is an indicator that there are gaps in the ways through which interventions of health get delivered to the minority groups. Such differences exist because the allocation of resources occurs mainly through the economics of health as opposed to prioritization. Ultimately the indigenous Australian population could access employment, and they could also deliver better services at their places of work. In the United States of America Thomas (2014) postulated that the Affordable Care Act of 2010 was an important piece of legislation as it aimed at improving access to primary healthcare for the minority groups in the States.
Given the widening gap in the health and healthcare disparities, it was important that the 2010 Act became implemented fast. Also, the social impact of the lack of such policies meant that the minority groups cannot afford healthcare. There is also a lack of the provision of care that is culturally competent, and minorities die because of conditions that can get easily prevented. Culturally competent health care is recognized as one of the most important approaches for the prevention of mortalities that are avoidable as stated by Truong, Paradies, & Priest (2014).
Question 5: The Strengths and Weaknesses of both healthcare systems
The Australian Health System has got strengths such as a good geographic presence, enhancement of the provision of services that are innovative, is a target for specific groups of people, and its possibility to develop a teamwork approach among health care professionals. Also, the system links primary healthcare to other services and enables the recruitment and retaining of health practitioners. The system, however, has weaknesses like; not being cost effective, not targeting care to those who need them most, difficulty in managing the demand for healthcare, and varied approaches to quality assurance. A health reform was set in place to cater for the challenges noted in primary healthcare service in Australia precisely the isolated communities that are marred by poor quality care (Buykx et al., 2012). The strengths of the State’s healthcare system include the availability of services that are of high quality for insured individuals as well as the presence of clinical research. Also, the system enjoys significant technological advances as well as a large number of healthcare professionals (Cooper and Taylor, 2016). The weaknesses of the system include; high costs of care, many people are not insured and cannot get the best medical care, high administrative costs and discrimination of indigenous groups. Also, individuals that pay small amounts of money to get charged more to compensate for costs that are not compensated and the lack of adequate primary healthcare
Question 6: A health promotion program that highlights the Australian healthcare system
The Australian Primary Healthcare program uses a health promotion approach that describes the Australian Healthcare system as an approach to the prevention of disease. The program plays a pivotal role in the assessment, prevention, and management of harmful alcohol intake, diet that is poor, and physical inactivity (Harris & Lloyd, 2012). The program also specifies the roles that the healthcare providers have to play in the prevention of illnesses. Such roles also get defined by highlighting the evidence of the efficacy of interventions offered by healthcare practitioners, allied providers of healthcare and group programs. Primary healthcare in Australia also calls for partnerships with health services of the state, local governments, and non-governmental organizations to materialize new services and programs that are meant for the prevention of poor health (Harris & Lloyd, 2012). Partnerships are therefore the most important component for the implementation of the program.
Conclusion
The organization of the health Systems in the US and Australia is distinct to a larger degree, even though the primary goal is to increase the accessibility of services to citizens. Both systems have their weaknesses and strengths. With the distinctions in both systems, there exist opportunities for the two countries to learn from each other.
References
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