The Australian health system.

Abstract

Healthcare in Australia is a mixture of private enterprise and publicly supported programs. The total expenditures in 1997–1998 were $47.3 billion dollars, representing 8.4% of gross domestic product (GDP). Approximately 68% of the $47.3 billion overall health costs comes from commonwealth, state, and local governments. The remaining 32% is made up of direct charges to patients, health insurance premiums, and other nontax sources.2 In Australia, there are two complementary systems of health insurance. The biggest and most well known is Medicare, a publicly funded compulsory scheme, run by the commonwealth government, which covers basic medical and hospital care for all Australian residents. The second is the private health insurance system, which also covers basic medical and hospital care, as well as additional insurance for dental care and superior accommodation facilities in public and private hospitals. The government has recently encouraged people to enroll in private health insurance plans, and introduced a Medicare surcharge for highincome earners without private health insurance, a 30% rebate on insurance premiums, and lifetime health coverage for early and longterm health fund membership, especially for young people. Medicare contains two components: hospitals and other medical services. Medicare is administered by the Commonwealth government and is funded by a levy linked to general taxation. The Commonwealth allocates funds to the states and territories as part of an agreement, which is renegotiated every 5 years, from which they provide public hospital and related services. The Health Insurance Commission makes payments directly to medical practitioners and patients for medical services provided in the community. This mixture of funding sources and administrative structures reflects the general attitudes of Australia, as a federation and its commitment to public support for social welfare.