Part A Medicare And Private Health Insurance

The Australian health care system is not a very complicated one, it is solely based on two main sectors which are the ‘public’ and ‘private’. The public sector allows one to claim health care benefits and payments through the universal health coverage developed by the Australian government, called Medicare. Medicare is completely free and paid by the government through income tax received to help pay for medical, optical and hospital care (Humanservicesgovau, 2016). It also has a sub-division called the ‘Medicare safety net’ which is more so given to those on significantly low incomes to aid in financial distress. Similarly, the private sector is made up of different companies entitling different benefits, usually consisting of two plans, ‘hospital’ and ‘generic’ (Privatehealthgovau, 2016). The private health care system is more so for people who need immediate attention as the public health system has a waiting list for many different types of operations. Private health system is also customisable in circumstances such as

Compare and contrast Medicare and Medicaid; including funding sources, fraud and/or abuse, and eligibility requirements for recipients

In 1928, a national health insurance scheme was proposed but not implemented because it would have required businesses to provide contributions to health insurance for their employees (Evolution of Government Involvement in Health Care, n.d). Another national health insurance scheme was proposed in 1938 but it was also rejected (Evolution of Government Involvement in Health Care, n.d; Hilless & Healy, 2001). The next proposal was the 1945 Pharmaceuticals Benefits Act. This Act was not implemented because the Australian Medical Association challenged it in the High Court of Australia and it was decided that parliament had “exceeded its constitutional power” (Hilless & Healy, 2001). In 1946, under the Hospital Benefits Act, the Commonwealth began to subsidise public hospitals under the condition that patients would not be charged (Evolution of Government Involvement in Health Care, n.d; Hilless & Healy, 2001). This act is similar to the current Medicare system.

The Federal Government became increasingly involved in health provision following the Second World War, with a focus on ensuring access and equity to health care. When Medicare was implemented in 1984, the Federal Government, States and Territories agreed to provide free health care for all Australians in all public hospitals.

The healthcare system in Australia is complex involving many funders and healthcare providers. In 2011 to 2012 the health expenditure in Australia was estimated to have been $140.2 billion, which made up 9.5 percent of gross domestic product in that year (AIHW, 2013). Responsibilities are split between different levels of government, and between the government and non-government sectors. With non-government sources funding for about 30 percent of the total health expenditure each year (AIHW, 2013). Australians make their contribution to their healthcare system through taxes, including the Medicare levy, and through private financing such as private health insurance. Private health insurance in Australia is a voluntary facility for private funding of hospital care and ancillaries. Insurance funds may cover the costs of treatment for private patients in private or public hospitals and can include some services that Medicare does not cover. The Australian governments fund for almost 70 percent of the health expenditure each year (AIHW, 2013). The federal government contributes to approximately two-thirds, while State, Territory and local governments together contribute for the other one-third (AIWH, 2013). As a generalization the Australian government is primarily responsible for the funding of healthcare, through health insurance arrangements and direct payments to the state and territories, while state and territories are primarily responsible

Since its establishment in 1965 we have seen Medicare change as people’s needs change however being a federal program these changes do have an incredible amount of lag time. One of the first major changes to Medicare occurred in 1972 when President Nixon signed the Social Security Amendments of 1972 which extended coverage to individuals under age 65 with long-term disabilities, expanded benefits to include some chiropractic services and speech and physical therapy. During this time we see the American public growing tired of the Vietnam Conflict and lack of support and care for those returning Marines and soldiers with severe disabilities. As the protests escalate and the peace initiatives fail a key piece of legislation is signed showing government support and a willingness to extend health care benefits to this growing and vocal population of veterans (The Vietnam War, 1999). Also included in this Amendment is the encouragement of the use of Health Maintenance Organizations, President Nixon’s administration caught in the scandal of Watergate and pending hearings appeased the left and proposed the HMO Act, which Congress passed in 1973 (Phillips, 2003).

The following paper is based on the differences between two healthcare systems in two different countries, these systems are the Australian healthcare system which is Medicare, and England’s National health system which is known as the NHS.

According to Barton (2010) Long-term Care “emphasized continuous care over a period of at least 90 days for a range of acute and chronic conditions. Regardless of the length of time (i.e., from weeks to years), LTC is an array of services provided in a range of settings to people who have lost some capacity for independence because of an injury, a chronic illness, or a condition” (pg. 349). This is the description of someone who may have been in a debilitating car accident, an elderly person with Alzheimer’s and dementia, a person diagnosed with chronic mental illness, and individuals who are developmentally delayed or “disabled.” People who are placed in these type of long-term care facilities are usually screened using two different

About one third of all hospital beds in Australia are provided by Private Hospitals. Although half of all Australians have private health insurance, the Government is seeking to achieve an even higher balance of Australians with private cover, while preserving Medicare as the universal safety net. An example of how the private system works is; if a private patient was admitted to either a private or public hospital, they would have a choice of doctor to treat them. Medicare would pay 75% of the Medicare

Medicare Part D Drug Plan was created by Congress in 2003 to aid the elderly, disabled, and sick persons in affording their medication. Coverage for the drug plan went into affect January 1, 2006. This plan was called the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) (Cassel, 2005). The final bill that passed, was influenced by drug-company and health insurance lobbyists and focused mainly on the needs of those industries instead of the seniors it was meant to serve (Slaughter, 2006). These plans are operated by insurance companies and some private companies that have been approved by Medicare. Part D is optional only if a person carries health insurance that includes prescription coverage. If at retirement

The Federal Government became gradually involved in health provision following the Second World War, with a focus on ensuring access and equity to health care. When Medicare was implemented in 1984, the Federal Government, States and Territories agreed to provide free health care for all Australians in all public hospitals.

Medicaid and Medicare are two different government programs. Both programs were created in 1965 to help older and low-income families be able to buy their own private health insurance. These programs were part of President Lyndon Johnson’s “Great Society” plan, a commitment to helping meet the needs of individual health care. They are social insurance programs, which allow the financial load of patient’s illnesses to be shared by other healthy, sick, wealthy, and lower income individuals and families.

The major purpose of this work is to completely discuss about the Medicare Part D which will set an influence on the different interest groups and all the entities of government which have been set under the policy changing process. There has been a complete set environment which involved and shape the policy to make efforts as to how all the groups of the stakeholders are influences with the Medical Part D. All the legislation and the specific strategies are made in correspondence to the politics. (Powell et al., 2015). The Medicare Part D is also said to be Medicare prescription drug benefit which directs to setting the United States Federal government programs to work on the subsidizing costs of all the drugs of prescription which insure premiums for the Medicare in US. There is a great enactment which has been based on Medicare Modernization Act of 2003. In December 2003, there are major Medicare Prescriptions which have become into the Improvement and Modernisation Act to become a proper law. There has been a great benefit from the drugs which provides an entire coverage to all the disables and the elderly people who could not have the ability to manage it.

Australia is a two tiered system including a private and public sector. Medicare is a universal health insurance scheme under the public system. It was introduced on the 1st of February 1984 by the Australian Labor party the principal is for all Australian to have equal access to health. There are three levels of government these include Local, State or territory and Federal, all three have different roles to perform in terms of health care. The local government is responsible for towns and districts, moreover, local councils or shires function is to operate systems and projects such as sewage, garbage disposals and maintenance of the safety food standard. Both state and federal direct different parts of Medicare. State government manages public hospital within their territory or state, the state government receives 40%-50% of the total cost of expenditures for the public hospital from the Federal government. Lastly, Federal role includes payments to primary health services there include GPs, the majority of nurses, medical specialists and allied health professionals. In 1996 Budget guaranteed the renewal of private health insurance.

Private health insurance members enjoy benefits: Greater flexibility: choose the right doctor for you, we can quickly visit Australia's best doctors and experts. More than half of all surgeries in Australia are paid by private medical funds. When you want health care: Selective surgery is less time to wait Medical insurance does not provide services such as ambulances, spine therapy, dental, physiotherapy, optics, diet advice and some alternative therapies Relieve the pressure of the public hospital system, let go of government funds to upgrade the