Australia healthcare sector has been recognised for a very long time as being the most outstanding and offers health care services of high quality. Its organisation, management and leadership are of high quality which makes it possible to cater to the needs of the people there. Nevertheless, it has faced some challenges as a result of changes occurring in the health sector regarding requirements like the proliferation of demand and rise of healthcare expenditures. Additionally, the pressure to advance the outcomes and inequalities are the major problem today. This healthcare is also having difficulties in enrolling adequate workforce as well as inefficacies. The state and territory governments have got the mandate to formulate policies for the providence of healthcare services in hospitals and also, regulate, inspect, license as well as monitoring of all health sectors, institution and individuals within their authorities. The main target of Australia, health care system, is to ensure that all people get equal access to services and allows people to access even private health services via substantial engagement of private healthcare system in provision and financing. It is clear that the financing system of Australia is the tax-oriented system. This means that the health care is financed by the general government expenditure.
The government of Australia have developed so many policies concerning the health system to ensure that they solve the problems affecting this sector. This paper will look at the health care financing policy starting with its formulation process, stakeholders of this policy and their interest, implementation process up to the evaluation stage(Meurk, Leung, Hall, Head, & Whiteford, 2016). Furthermore, we shall discuss all sectors that are involved in the funding of Australia healthcare system that includes public health insurance.
Australian constitution is not so strict about the roles that are assigned to the varied categories of government regarding health care financing(Davis, Stremikis, Squires, & Schoen, 2014). Due to this reason, the government has arranged Australian ministry of health to have conferences where health ministers representing different levels of government come together to discuss and come up with health policies as well as programs concerning matters of health care. Generally, the health department together with the Commonwealth government is accountable to all the policy made and all matters regarding health(Healy & Sharman, 2006). Specifically, it has got the mandate to control the issues concerning financing schemes like pharmaceutical benefits schedule and Medicare benefits schedule nationally.
There were many stakeholders consulted during the development of health care financing policy such as college representatives who were about ten from the specialist sample(Nolte, Knai, & McKee, 2008). Also, there were several jurisdictions representatives, the Australian private hospital association, and the medical indemnity insurers association of Australia, the Australian medical association, the Australian health insurance association, public hospital health area administrators as well as multiple private hospitals involved in specialist coaching. In addition, all the matters discussed was also shared with several senior doctors who were so much involved in factors of medical training. Many of the sessions were supervised by PwC, and the departmental representative was supposed to be present. The minimal consultation was done by DoHA for logistical explanations(Weiner, 2005). The medical specialist training directing committee was in charge of organising the setting where the discussions were to be held. They also outlined the places that needed to be enlarged, and during consultations, these places were confirmed and then categorised into four groups which include private hospitals, community setting, rural and regional hospitals and private counselling practice. A common agreement from the stakeholders was that all the trainees were to take training in the environments that they were to practice their skills or come across as they work in medical sector(Shigayeva, Atun, McKee, & Coker, 2010). Nevertheless, so many ideas were brought forward regarding the range of amending of the training programs to cater for this aim. All who were included in consultations also displayed the need for maximising financing of the specialist training, and even they were concerned about the health professional’s supply outside the main capital cities.
They were much concerned with the matters of the provision of specialist services to remote and rural areas as well as the overall professional’s conditions like pathology, rehabilitative medicine and psychiatry were the major areas of concern to them. In addition, most of the opinions given throughout the consultation period were about the medication of the patient by trainees and patient consent(Schoen & Doty, 2004). They raised the concerns about the services that patients get and the insurance cover that is used by so many individuals when seeking health care both in public and private health sector.
The Commonwealth is responsible for financing the following areas like aged care, pharmaceutical health benefits, the public hospitals, and the medical benefits(Saltman, Rico, & Boerma, 2006). This policy touches on very broad areas since the financing of Australia comprises of so many parts that include the tax, insurance, money from the pockets of the patients as well as donations from the charity organisations or individuals(Mckee & Healy, 2002). In this policy, so many ways were devised on how financing will be carried out, and the method of collecting the funds to cater for the health needs of the people and the facilities need for the running of the health sectors. Three ways of collecting funds were proposed with different responsibilities allocated to them(Zikmund, 2003). They include general taxation method, through Medicare levy and via health insurance plans. Let discuss each one of them.
Medicare tax. This Medicare tax was made a must with the aim of providing support to the Commonwealth government so that it can be able to meet the duty of provision of universal health care services to all individuals(Cabral & Mahoney, 2013). This is because there were additional costs that were increasing each and then that it could not be in a position to cater to all patient. Australian taxation officers are responsible for collecting the Medicare tax which began from one per cent of taxable income and went on rising to about one point five later. However, all the families with low income and the individuals are included in the payment of this tax through the process of income imposition thresholds. All individuals earning less than AUS$15,902 are exempted from paying of the Medicare levy(Stavrunova & Yerokhin, 2014). Families and individuals who get high salaries have got an added Medicare tax of one per cent.
General taxation. This entails a wide range of groups that pay taxes depending on the kind of business they do. All individuals who participate in the specified areas like industries and companies and generally all areas that pertain using of the government resources and grounds(Jackson, 2006). Research shows that about seventy-five per cent of the funds come from the general taxes collected annually. Hence general revenue comes from all these varied sectors of taxing.
Health insurance plans. The primary controlling agency of private health insurance is the private health insurance administrative council which is an independent statutory sector in Australia (Einav, Finkelstthe in, & Cullen, 2010). Therefore, any institution wishing to use the insurance services in Australia is supposed to consult the requirement of this council and ensure that it is registered by it. Also, this council also control and monitors all the financial operations of health insurance money that are given by the health insurance companies to ensure that every need regarding the funds in the health sector is met and also enough to provide quality healthcare(Handel & Kolstad, 2015). Recently there are about forty companies that are dealing with insurance services in the sector of health. The Commonwealth government inspires individuals to apply for the private health insurances to help them cater to the bills of medical services.
We have three pillars which include access to care, cost savings and prevention also called patient-centered care (Ataguba & McIntyre, 2012). Let look at each one of them in details beginning with access to care which encompasses health provision to the Patient who needs treatment. All therapies developed are considered to be of no help if they were not going to help the patient. The main thing in this pillar is to ensure that there are proper medication and adherence to the quality health provision. This is one of the major things that was considered during the formulation of health care financing policy because they aim was to ensure that health care is accessible and assisting who are in need all the time. The other pillar is the cost saving pillar which mainly addresses the issue of rendering health services to every whether adult or child and that everybody should access it even if one has the money for treatment or not. This pillar considers the patient who has less income and would prefer not to seek medication before putting food on the table. It will also research on strategies that can be followed to ensure that the care prices for every family are reduced. The third pillar is prevention also known as patient-centred care. This pillar aims at devising ways through which frequent patient visits the hospital rooms could be minimised through proper education to the people to practice prevention measure to infection (Normand & Thomas, 2008). This could reduce the financial the trains to cater for medication.
The research done concerning the policy process shows that the stakeholders’ decision and political agreements are the ones that determine the success of the policy implementation. The government had an authority of controlling this health care financing policy. Some of the challenges they face were stakeholders’ absenteeism as well as lack of communication plan to facilitate achievement of the health care financing policy (Busse & Blumel, 2014). In addition, the management strategy is also the major elements that affected this policy.
Health care financing as got five primary instrument which includes societal health insurance, community- based health insurance, private out of the pocket instrument, government financing, as well as private health insurance (Atun, Weil, Eang, & Mwakyusa, 2010). This is the major instrument that was being involved in the policy of funding the health sectors. Social insurance and private insurance are the major sources of money in this policy.
This policy was mainly established due to the challenges that are facing the health sector, and the government struggles to cater to all the needs of people who require health services (Ataguba & McIntyre, 2012). The budget or funds that were set aside by the government for health was not adequate to cater to all the areas in health. Some of the major reasons are:
Low-quality health services: the health services offered decline because the facilities required were insufficient and that universal health services that they aim to render could not be possible to achieve. Medicare is one of the agents that the government uses to finance the health sector, but challenges increased in the number of individuals in need of health services (Kutzin, 2013). Initially, the Medicare used to offer free medical services, but as time passed, it was unable to.
High level of use of pocket money to pay health services. Most of the people were used to paying health services using direct cash especially those who have the ability to go to private health sectors. This policy objective was to come with strategies that could help people to get insurance cards whether in the private or public sector. Insurance can help even in times when an individual has no money or needs emergency health services and not prepared financially.
Need to retain health professional. Most of the health professionals tend to move in countries that pay them well for the services they make. If they are not given a good salary, they fly to other countries and the country is left with an inadequate health specialist. This is a disadvantage because people will be forced to go outside county to seek quality health services which is even more expensive(Wagstaff & van Doorslaer, 2000). This policy puts into consideration all these factors to ensure that they prevent a condition like this to happen.
Universal health care. The main focus of Australian health ministry is to offer equal and quality health services to all citizens despite the social status and ability to pay. This policy allows even the lower class people to receive health services because it provides incentives to the health sectors(Knaul et al., 2012). All the money collected using the required means should like taxation is organised and budgeted to health sector accordingly.
To reduce donor dependency. The government had a plan to create a health system that is self-sustainable. Though donations are not bad for a country, it is better to have a self- sustaining financing mechanism. Health financing policy aims at ensuring a continuous flow of money and resources need in the health sector as well as keep on advancing accordingly, with the change in it,etc., technology(Blaya, Fraser, & Holt, 2010).
The policy has several priorities some options were considered during it establishment:(Schieber, Gottret, Fleisher, & Leive, 2007).
The policy has got about three components that it aims to achieve that is vision, goal or purpose and its capabilities(Akazili, Garshong, Aikins, Gyapong, & McIntyre, 2012) Let us analyse each one of them:
Vision. Better health and wellbeing for all Australians, now and for future generations.
Goal or purpose. The prompt movement toward universal coverage via rising adequate finance the and advancing effectiveness and equality. Also, to lead and figure Australia’s healthcare sector and noticing outcomes via evidence-oriented policy, well-focused programs as well as outstanding service guideline.
Capabilities the policy. The best management of cost and investing in long time sustainability, enhance leadership at different levels as well as building strong interactions.
The policy implementation process involved many strategies that entailed the allocation of duties to the various department to ensure that all health sector matters are sorted out effectively. Australia government is divided into different categories, and in each category a duty to control funding and overall running of a particular branch in health were allocated(Ekman, 2004). The initial focus of the government health care financing policy is to set national health policies besides providing subsidies in health services offered by the state as well as territory governments including also private organisations. The federal government is in charge of financing several sectors such as pharmaceuticals, providing guidance in policy, financing universal medical services, controlling and funding the public hospitals and helping in paying of the health services for the elderly(Ataguba & McIntyre, 2012). According to this policy, the government also has got the mandate to monitor therapeutic goods and services as well as pharmaceutical operations.
Similarly, controls the supply of funds to those branches to ensure that there is smooth running of the health services needed. Medicare in this policy aims to advance equity of accessing health care services in that equality in health services is enhanced. The fund’s collection program form taxation in diverse organisations was planned and approved and started working during that time(Schmid, Cacace, Götze, & Rothgang, 2010). Since out-of-pocket spending is the major often used the method of making payment for the services of health, this policy aims at eliminating it at all cost through coming up with insurance services. Taxation is one of the main sources of funds it is as well supported by insurances benefits. We have several types of insurance like private insurance, social insurance and many others aided by the general taxation(Hsiao, 2007). This helps the government to get several sources for health care.
The implementation of diverse roles of health financing policy influences the performance of the health system to attain the task of providing universal health benefit goals. The role involves raising of revenue, funds pooling as well as buying of services and benefits package design(Levac, Colquhoun, & O’Brien, 2010). Reforms and establishment of health care financing policy targets on the roles mentioned above. This healthcare financing policy links with other areas of the health sector specifically delivery(Kamuzora & Gilson, 2007). Below is a framework of how health benefit shall be awarded to the citizens based on social statuses.
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The percentage of groups by income level |
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Higher income individuals |
Well-off Tax-financed public health care with beneficiaries’ fee schemes coverage. Complimentary private coverage |
Social transfer |
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Official sector Tax-financed civic health care with beneficiaries’ SHI coverage |
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Informal part (uneven salary). Tax-financed civic health care with user fee schemes CBHI coverage Gradual moves to SHI |
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Lower income individuals |
Poor. Tax-funded public health care with user fee schemes HEF and other subsidisations. |
One of the aims of this policy was to increase accessibility to civic health services for all, particularly people who are poor and also to minimise catastrophic spending for the health. This target was achieved via regulation of usage of fees at public facilities(Sekabaraga, Diop, & Soucat, 2011). Furthermore, implementing nationwide identification of poverty, discover other financing mechanisms to eliminate debts about healthcare like microfinance initiatives and cash transfers transactions. Extension of availability of community health protection systems to every family countrywide. Another focus for this policy was to establish social health insurance coverage of all the employed individuals either in public or private organisations (Moat & Lavis, 2013). The plan followed to achieve this goal are the development of mandatory health insurance for a public servant and private organisation employed workers. In addition to ensuring that there is a suitable design for compulsory insurance schemes in order to attain the goals of health organisation as well as its priorities.
Inclusive health financing information on every source and utilisation of financing health as well as details on speeding of health intervention are the preferred results in the policy. The health ministry monitoring and evaluating the health system focus on this particular outcome. There is a strengthening of information gathering based on the donor’s contribution reports, reports base on a payment that is made using the out-of-pocket money, the establishment of accounts for health operation and other types of spending tracking tools(Moore et al., 2015). Since the development of health care financing policy, mortality that occurs due to lack of proper health care has reduced, and there is need to give an applause stakeholder of this policy and the ones supervising it up to this stage.
From the time when health care financing policy was developed several areas that were having in accessing quality health care like rural and remote areas have benefited a lot. This policy ensured that incentive is an offer to every person willing to work in rural and remote areas like scholarships. Additionally, medical students enrolling to study for practising their career in those areas are given scholarships. Another benefit if this policy is the provision of quality and equal health care services to all individuals regardless of their social status. Health insurance system has been the most convenient way of dealing with issues about costs of health.
The only weakness of this policy is funds mismanagement sometimes and delay in disbursing the funds needed to cater for specific things in the health sector. Such delays lead to poor health service delivery to the patient in need of that service. Also, the government sometimes may tend to over tax individuals too much only for this health system which seem like a disadvantage mostly to the employed personnel.
Conclusion
Health care financing policy is one among the policies of health formulated by the government to help the health ministry perform its duties effectively. This essay has outlined in a more detailed manner the process of formulation of this policy. It has also highlighted key issues such as the stakeholders of the policy, the need for the policy as well as the priorities of health care financing policy. Moreover, the components of this policy like a vision statement, its goals and capabilities statements have been stated in this essay. Three pillars of this policy have been discussed, the implementation process and assessments of the policy as well as a comprehensive framework of health benefits allocation based on social levels of people. The last part is the strengths and weaknesses of the policy discussion. I recommend that the government establish strong groups of people to deal with the financing sector of the health system as well as ensuring that the health professionals work under stress-free environment. The salary for the health professionals should be at a proper amount to keep them comfortable and motivated to work. With all this put into practice, Australia will continue advancing and providing the best health care in the world. Both private and public healthcare sectors have got the mandate of ensuring that health goals are attained.
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