2. Intro: Comparing Healthcare
Healthcare in the United States has often been ridiculed for the
large amount of money spent and the low return on investment in
terms of the country’s coverage. Comparing the healthcare system
of the USA with that of Australia will give an idea of the similarities
and differences between healthcare across countries. These two
countries can be compared and contrasted by looking at the
healthcare coverage for citizens, and the amount of government
spending on healthcare.
3. Healthcare Coverage
USA
49% of healthcare coverage comes from employers
16% Medicaid
13% Medicare
1% Other Public
5% individual
16% Uninsured
The average cost of a routine office visit in the US is $68
4. USA Coverage Continued
Private insurance – US citizens have the right to find their own private
insurers to aid them from extreme medical costs if they were to
become severely ill.
Medicaid – Covers over 65 million Americans in groups who are
most needy such as:
Pregnant women and infants
Those who are 138% below the Federal poverty level
Medicaid gives these low income families insurance that is as good
as private insurance.
5. USA Coverage ctd.
Medicare – Covers people age 65 or older
people under age 65 with certain disabilities, and
people of all ages with End-Stage Renal Disease (permanent kidney
failure requiring dialysis or a kidney transplant).
Part A of Medicare covers hospital insurance such as inpatient care
Covers hospice care also
Part B covers doctor’s services and outpatient care
Prescription drug coverage usually requires a premium
6. USA Uninsured
How does the lack of insurance affect access to health care?
The uninsured have much worse access to care and are less likely to
receive preventive care or treatment for chronic diseases
25% of uninsured adults go without necessary care due to the cost
What does lack of coverage mean financially?
Uninsured in the USA are likely to go into medical debt when they
receive treatment due to high medical bills
35% of uninsured payment is out of pocket.
They also typically are charged more than the insured.
7. Healthcare Coverage
Australia
Australian Citizens and members with a permanent resident visa are
eligible for Medicare in Australia
Medicare provides benefits for:
Consultation fees for doctors and specialists
Tests and examinations by doctors needed to treat illnesses, including Xrays and pathology tests
Eye tests performed by optometrists
Most surgical and other therapeutic procedures performed by doctors
A number of surgical procedures performed by approved dentists
8. Coverage: Australia ctd.
Medicare patients who choose to be treated at a public hospital
receive services for free.
This includes care, treatment, and after-care.
Medicare pays 85% of the schedule fee for out of hospital services.
The Medicare schedule fee is a scale for what specific services should
cost. Doctors and hospitals can choose to charge more than the
service fee.
40% of Australian Citizens still elect for private insurance.
If a citizen chooses to be treated privately, they are able to choose
their own doctor.
75% of schedule fee is covered for private patients.
9. What is not covered? - Australia
Medicare does not cover:
Private patient hospital costs (for example, theatre fees or
accommodation)
Dental examinations and treatment
Ambulance services
Home nursing
Physiotherapy, occupational therapy, speech therapy, eye
therapy, chiropractic services, podiatry or psychology except
when part of the Enhanced Primary Care (EPC) program
Acupuncture (unless part of a doctor’s consultation)
Glasses and contact lenses
10. What is not covered – Australia ctd.
Hearing aids and other appliances
Prostheses
Medicines (except for the subsidy on medicines covered by the PBS)
Medical and hospital costs incurred overseas
Medical costs that someone else is responsible for
Medical services which are not clinically necessary
Cosmetic surgery
Examinations for life insurance, superannuation or membership of a friendly society
Many of these procedures can be covered by private insurance,
accounting for the reason 40% choose to go private.
12. Government Spending - Australia
Health spending increased 74% over the past decade, compared
to the GDP growing by 46%.
Costs are rising due to aging population
Citizens 50 years or older are seeing doctors much more than they were
10 years ago
Australia spent $120 billion on healthcare in 2009-10
Government contributes 44% of overall healthcare costs
13. Government Spending - USA
The US government spent nearly a trillion dollars on healthcare
spending in the 2013 fiscal year.
The number is expected to grow even larger in the future due to
aging of the population
the rise of healthcare costs per person
number of people enrolled in federal programs growing
Healthcare accounts for 26% of the Federal government’s total
spending.
15. Conclusion
Comparing the two countries’ healthcare systems shows some
interesting results. Australia spends about half the percentage of
their GDP compared to America, and covers every citizen
completely. The USA government spends a large amount on
healthcare, and still 16% of the population is uninsured.
Both countries face similar problems such as the rising spending on
healthcare. The two countries are seeing the aging of the
population play a major part in the spending increase, and each
has had to deal with the average cost per person going up.
Each country offers private insurance as well as coverage from the
government, but the plans vary greatly.
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