.
Patients eligible for Medicare who want to be private patients in public hospitals are charged by doctors, and are charged by the hospital for hospital care, at a much lower rate. If the patient has private insurance, this is often sufficient to pay for all hospital charges (Department of Health and Ageing, 2005).
Medicare pays subsidises part of the doctors' fees and private insurance pays an additional amount to cover doctors' fees. Private insurance benefits can also be used top pay the costs of allied health / paramedical and other costs incurred during the patient's stay in the hospital (Department of Health and Ageing, 2005).
Patients may also choose to be treated in a private hospital. Private patients in private hospitals are charged fees by doctors and some allied health / paramedical staff, and are billed by the hospital for accommodation, nursing care and other hospital services. If the patient holds private insurance it will contribute to these costs. If the patient is eligible for Medicare as a permanent resident of Australia, the Medicare benefits cover doctors' fees generally (Department of Health and Ageing, 2005).
Future Trends
The Australian Medicare has been in placed for more than 20 years. Recent changes in the Australian community have been noticed such as the rise of elderly Australians availing of the health services to 156 per cent. Changes in the roles of the public and private in delivery and financing of health care are also observed.
Public hospitals have achieved great strides in providing health care services to the people such as the introduction of same day surgery. The efforts of public hospitals though still do not suffice in meeting the needs for their services. Despite the introduction of reforms, public hospitals have still to address issues such as cutting waiting lists, delays incurred in emergency departments or the numbers of ambulances being redirected because the hospital's emergency department is already congested.
Even if changes have been adopted by hospitals to make their services more efficient, the funding arrangements still leave a lot to be desired of. Funding is not supporting these changes including the way funding is allocated.
State and territories health ministers are concerned with the Commonwealth's inability to introduce necessary health reforms. Medicare framework is strong but there is still room for improvement.
In order to be able to fully address these pressing health care concerns, issues regarding how services are delivered and funded should be fully satisfied. Health ministers addressed this issue in 2002 when a group of experts were called to advice on health care issues. One of the findings of experts is that health care benefits were focused on hospital care alone. But since health services are geared towards caring for people in their homes, community or without a ward stay in hospital then health care should include those kinds of patients. Also, in order to attain flexibility in health care delivery and funding, stronger partnerships between state, territory and federal governments is greatly sought after.
State and territory governments must work hand in hand with the Commonwealth to be able to provide quality health care. To be able to achieve their joint goals, sufficient funding should be provided to ensure excellence in services.
The current level of Australian Health Care Agreement (AHCAs) grants is not enough to cover costs of providing services. The 1998-2003 AHCAs has underestimated the real costs of health care services.
An expert appointed by the Commonwealth and state/territories recommended that the formula to compute health cost increases should be consumer price index plus 0.5 percent. The first four years, the index averaged 2.9 percent annually.
The Commonwealth committed an error of using its own index in calculating funding costs in 1998-2003 agreements which resulted in an average of only 2 percent per year. Consequently, public hospital funding was short of $904 million.
To address this underpayment, it is important that the 2003-2008 negotiations, the AHCA grant must apply the expert's index not the inadequate Commonwealth's index. This means an additional $350 million should be added to the starting point of the grant. Additional funding of $619 million from Commonwealth is also required to cover capital costs which used to be funded exclusively by the states and territories.
Elderly Care
Currently, residential care places for Australia's elderly is not enough to meet the needs. Care for the elderly is primarily a Commonwealth job. Commonwealth should have provided 190,686 but it was only able to secure 173,253 places. This translates into under funding of at least $367 million per year. Problems with regards to shortage of services for the elderly to be able to return home after staying in hospitals, insufficient transitional accommodation and deficient supply of interim care also arose. Since Commonwealth has strict rules with regards to aged care money allocation, funding for these services cannot be taken from other aged care funding. As a result, older Australians stay in public hospitals while waiting for residential care which costs an additional $295 million per year. Funding problems also prevent adoption of programs that can improve elderly care (Australian Health Care Agreement, 2003-2008).
