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Australia has one of the most affordable, accessible and comprehensive health care systems in the world. Its health system is complex. The health system can be described as a ‘web’: a web of providers, services, recipients and organizational structures. Its health system is widely regarded as being world-class in terms of both its efficiency and effectiveness. Australian health system comprises of public and private sector health care providers. It also involves a range of funding and regulatory mechanisms. For most Australians, most of their first contact with the health system involves visits to a general practitioner or a pharmacist before they are referred to a more specialized medical worker.
Health Statistics and Costs
Life expectancy has dramatically improved in both sexes in Australia in the last one century particularly at birth. Life expectancy for males is 79.7%, and that of women is 84.2% as compared to those of other countries. The standardized death rate in 2001 for males was 6.7 deaths per 1000 males, and that of females was 4.7 deaths per 1000 females (Dwyer, 2004). The major illnesses in Australia are cancer, musculoskeletal disorders, behavioral disorders, cardiovascular diseases, mental disorders. From 1964 to 2014, the gross domestic product (GDP) annual growth rate averaged 3.48%. The total expenditure per capita on health is $4,068.
Life expectancy in the US for males is 74.89 years while that of females is 80.67 years. The overall age-adjusted mortality rate in the US in 2011 was 740.6 deaths per 100,000 people. The main health conditions in the US are heart disease, cancer, chronic lower respiratory diseases, and stroke. The GDP annual growth rate increased to 2.7% in the last quarter of 2014. The per capita expenditure on health was $8,895 in 2014 (Holtz, 2008). This per capita expenditure is high when compared to that of Australia, which is $4,068.
Health Care Financing
The Australian health care funding from the government is by the three national subsidy schemes. These schemes include Medicare, the Pharmaceutical Benefits Scheme (PBS) and the 30% Private Health Insurance Rebate (PHIR). Medicare and PBS cover all Australians and subsidize all their private health care payments and part of prescription medications (Hilless & Healy, 2001). Under Medicare the state government also jointly funds public hospital services. Citizens make their contribution to the health system through taxes and the Medicare levy based on the income. They also contribute to private financing such as private health insurance.
In the US, the health care providers are paid by private insurance, government insurance programs, and personal contributions. The government also directly provides some health care in public hospitals and clinics staffed by government employees (Pillay & Holtz, 2009). Government insurance programs include Medicare, State Children’s Health Insurance Program, Tricare and Veterans Health Administration (VHA). When care is not covered from other sources, citizens pay for the services out of their savings.
In Australia, the overall coordination of the public health system is done by the Australian health ministers. These ministers include the Commonwealth, state and territory ministers. The health ministers are collectively called the Standing Council on Health. Other members of the council include the Commonwealth Minister for Veteran’s Affairs and the New Zealand Health Minister (Dwyer, 2004). The Council of Australian Governments (COAG) protects the standing council. The standing council oversees the implementation of COAG’S national health reforms.
The US health system administration is a bit different from that of Australia. At the top, we have the federal government that sets the tone for the entire system. Many entities over the years have been formed to regulate the health system in the US. These entities include the Department of Health and Human Services (HHS), the Center for Medicaid and Medicaid Services (CMS) and the Food and Drug Administration (FDA) (Holtz, 2008). They also include the Center for Disease Control and Prevention (CDC). These entities interpret, implement and ensure compliance in the health industry. At the state level, state legislatures, state and local government, health departments, state medical boards and state insurance commission also play a vital role.
Health Care Personnel and Facilities
In Australia, health care industry is one the largest industry, and it employs approximately 1.2 million people. This number accounts for about 11% of the total Australian workforce. Most of these workers are aged 45 years and above, and this will add to the existing shortage of health care workers when they retire (Hilless & Healy, 2001). Australia is currently facing shortage of all types of healthcare workers. Healthcare services are provided by both public and private hospitals. There is no shortage of healthcare facilities in Australia. Creation of local health networks and local hospital networks has enabled building of many hospitals to meet most of the healthcare demand.
In the US, healthcare is the fastest growing sector of the US economy. This sector employs over 18 million healthcare workers. Despite this high number of healthcare workers, US still face a shortage (Pillay & Holtz, 2009). The US has fewer numbers of physicians and nurses per capita when compared to Australia. There are 5686 hospitals in the US. Just like Australia, US has invested in enough health facilities that can meet the demand for health services.
Access and Inequality Issues
There is a problem with the access to primary health care in rural and remote areas in Australia. These areas lack enough GPs to attend to these people who have poorer health as compared to those living in urban areas (Hilless & Healy, 2001). Meeting the cost of the healthcare services is still a barrier to the access to healthcare for these people. In addition, these people have low social economic status, hence can’t afford to purchase an insurance cover (Dwyer, 2004). GPs don’t prefer to work in these areas because of the hardship associated with these areas. Hence, social economic status is a disparity in the access to primary health care in Australia.
U.S and Australia almost face similar problems of accessibility of health care. Most Americans are caught in the middle, where they either earn too much to be eligible for Medicaid or not old enough for Medicaid. They cannot earn enough to pay for a private health insurance (Flood, 2003). Cost is also a barrier to accessing health care. Disparities also exist between race, ethnicity and social economic status. These disparities reduce accessibility of healthcare by the Americans.
Dwyer, J. M. (2004). Australian health system restructuring–what problem is being solved? Australia and New Zealand health policy, 1(1), 6.
Flood, C. (2003). International health care reform: a legal, economic and political analysis (Vol. 24). Psychology Press.
Hilless, M., & Healy, J. (2001). Health care systems in transition: Australia.
Holtz, C. (2008). Global health in developed societies: United States. InC.
Pillay, Y., & Holtz, T. H. (2009). Textbook of international health: global health in a dynamic world. Oxford University Press.