How Does the Australian Healthcare System Work?

How Does the Australian Healthcare System Work

Australia is incredibly fortunate to have such a comprehensive and robust healthcare system that produces excellent outcomes. However, our healthcare system is complex and can be confusing to people who have little to no experience with it. 

Millions of Australians come into contact with the healthcare system every single day. Our health system has proven to be successful, with our life expectancy being higher than other developed nations and our preventative care methods, including immunisation and cancer screenings, avoiding thousands of instances of illness or death each year. However, our healthcare system is far from perfect. 

Who is in charge of our healthcare system?

Providing safe and affordable healthcare to all Australians, our healthcare system is run by all levels of the Australian government- a joint effort that makes healthcare available to as many individuals as possible. Our healthcare system is made up of a mixture of Commonwealth and government-funded services available to the public as a whole and privately owned for-profit and not-for-profit services funded by private health insurance. 

Our healthcare system is huge and complex, reflecting the importance of good leadership in healthcare. Without informed, passionate and strong leadership, our healthcare system would not run smoothly. 

The responsibility for the public health system is shared by Australian, state, territory and local governments. Within the healthcare system are leaders of all kinds, from hospital CEOs to nursing supervisors. These people manage the day-to-day operations of hospitals or other healthcare facilities, and they have a big job keeping a busy, chaotic medical environment running smoothly, ethically and effectively. The healthcare system is ever-evolving, and every day brings something big. Our healthcare system is run on all levels by resilient and level-headed individuals committed to making the world of healthcare a better place.

Who delivers healthcare?

The medical professional you see the most will be, ideally, your general practitioner. From treating mild illnesses and health concerns to referring you to a specialist for more serious concerns, they are your first point of contact- your gateway, if you will, to the wide and varied world of healthcare. 

They may prescribe medications, perform simple tests, and discuss things with you as well as refer you to a specialist for things that fall out of their area of expertise. If you’re planning a pregnancy, for example, they may discuss preparing you and your body for pregnancy as well as give you advice and refer you for any further services you require. Or, if you have concerns about your mental health, they may have you fill out a questionnaire and refer you to the mental health professional who is best equipped to help you.

If you’re experiencing health concerns that your GP can’t treat, you’ll see a specialist. Specialists may include allied health professionals such as a dietician or optometrist, and other specialists such as cardiologists, surgeons, or dermatologists. 

Public and Private Healthcare

Our public health system is impressive, providing vital care to Australians of all ages. It is made up of numerous components. We are able to access everything from primary health care, routine immunisations, tests and screenings for a myriad of cancers and genetic diseases, specialist care, and hospital and emergency department care.

The public system is funded through taxes, and all these services are available to the public at affordable prices- or free! Additionally, the general public is made aware of various health risks and dangers through promotions for things like sun safety, immunisations and the dangers of smoking cigarettes and vaping.

However, public healthcare doesn’t cover everything and, due to the massive number of people seeking healthcare, combined with a shortage of healthcare professionals, waiting lists can be unbearably long. That’s where private healthcare comes in.

Australians who can afford to pay for private health insurance will be able to access private healthcare. Private healthcare enables people to access services not covered by Medicare- and usually these are able to be accessed in a more timely manner. In a lot of cases, people with private health cover can also choose their own doctor. Ambulance cover, allied health services, dental, optometry, and other services are available via private healthcare.

Private hospitals may be privately owned and operated, but they are still regulated by the government.

Medicare

The linchpin of our healthcare system: Medicare. Our universal health insurance scheme underpins the entire healthcare system, and many are surprised to find out that it faced relentless opposition when the idea of it was first proposed. In addition to paying rebates for medical care provided by private practitioners, Medicare ensures that we have access to a range of medications subsidised by the PBS (pharmaceutical benefits scheme).

Australian and New Zealand citizens and residents plus overseas visitors from countries with a reciprocal agreement can access Medicare, and can choose whether to be covered by Medicare alone or to combine Medicare with private health insurance.

Under Medicare we can access free services in public medical practices, hospitalisation, and Medicare can even cover or partly cover specialist visits.

Types of Healthcare

The first point of contact in our healthcare system is generally primary care. Your GP (general practitioner) is generally a doctor who is local or relatively near you who is familiar with you and the ins and outs of your health- but they likely won’t be the only medical professional you see.

Your GP will generally be the first person you visit when you require medical care. They can treat or prescribe medication for simple conditions and refer you to a specialist for anything else. Other primary care providers may include nurses, pharmacists, dentists and allied health professionals. Primary care encompasses medical care that does not require a hospital visit, and is generally covered by medicare. In many ways, it is the gateway to the wider health system.

Secondary care is generally performed by a specialist, usually upon referral by your GP. Aside from primary and secondary healthcare, hospitals are an integral part of the wider healthcare system. 

People who require urgent medical attention should visit an emergency department. Emergency rooms aren’t just for severe life-threatening emergencies- if you require after hours care and your GP only operates during business hours, you will generally visit an emergency department, unless there are after hours or call-out services in your area.

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