401362 Health Services Financing: Comparative Health Systems Report Assessment Answer

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Question :

School of Health Sciences

Western Sydney University

Unit Code: 401362 

Unit Name: Health Services Financing 

Credit Points: 10 

Unit Level: 

Assumed Knowledge: Competent use of Microsoft Excel, and high school mathematics (arithmetic, formulas and 

algebra, reading graphs).

 Report: Comparative Health Systems Report

Rationale 

When compared to other Organization of Economic Co-Operation and Development (OECD) member countries, Australia performs equal to or better than many other countries on a range of measures. However, in other measures, such as obesity, Australia’s performance is ranked amongst the lowest of the OECD member countries. 

Task

For this assignments students are required to: choose two other OECD member countries and compare and contrast the financial structure and financial performance of the Australian healthcare system to the two chosen systems.

Within this report, students must address the following areas:

– In what performance measures is Australia performing better, worse and equal to the other two OECD countries? 

– What are the financial implications for the healthcare systems of Australia and the other two countries of their performance in those measures? (i.e. are the countries ultimately spending more by not addressing specific measures?) 

– From a financial perspective, what are the challenges the healthcare systems face in providing equitable access  to care to their respective populations. 

– Provide recommendations for improvement of the Australian healthcare system with consideration to both  financial and social implications. 

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Answer :

Introduction 

In regards to the particular assignment, two OECD member nations shall be selected and their economic structure and financial performance will be compared with that of Australia in the healthcare sector. The economic implications of the health care sector in Australia will be discussed and the assignment will also emphasize on the challenges, the healthcare sector is experiencing to provide equitable care to the population. In regards to the issues, suitable recommendations shall be provided over improving the financial and social status of the healthcare sector in Australia. 

Performance of Australia in comparison to selected OECD countries

In this regard, the performance measure of Australia will be compared to that of the United Kingdom and France. The healthcare system of Australia comprises of institutions which are funded by private companies and governmental authorities simultaneously (Ross, 2018). Australia takes the better out of the United Kingdom in regards to doctors and beds in hospital per 1000. In contrast to the UK, Australia provides the double number of hospital beds and 3 more doctors per 1000 in comparison to UK (Aph.gov.au, 2020). In comparison to the citizens of the UK, Australian citizens tend to live for 11 more years, which suggests the better quality of care provided by the Australian Healthcare system (Ons.gov.uk, 2020). In this regards France is also known for providing quality care to patients with the second-best rate of life expectancy for women across the globe. One of the fascinating facts of France Healthcare system is that the patients have the opportunity of choosing specific doctors on their own instead of always depending on referrals. The UK government has done well in regards to outcomes of health services, however, in regards to the provision of patient safety, the overall performance was not up to the mark. However, both Australian and UK healthcare system has excelled in the field of medical sciences and is known to provide equal assistance and care to both the rich and poor population of the community. In this context, it can be said that irrespective of the fact France is well known for its high-quality services, but it is always coming with a huge price tag (Healthcarecoach.Org, 2020). This is because individuals have to pay a high amount of health-related taxes which may not be always affordable by poorer sections of the society. Furthermore, the individual who does not need too much of medical attention may perceive it as a financial burden. On an overall note, it can be stated that effective healthcare service is provided by all the healthcare system of the above-mentioned countries, however, there are areas of improvement as well which needs attention.

Financial implications of the Australian Healthcare Sector in comparison to the selected member nations of OECD

The Australian Healthcare sector is sometimes termed as mixed owing to its connectivity to both private and public funding. Near about 45.5% of the population are having private hospital coverage, while the rest 54.6 % are having the coverage of ancillary services (Aph.gov.au, 2020). The government of Australia takes active participation in providing mean tested rebate in regards to the cost involved in premiums of health insurance. Individuals who have high earning status are bound to pay a surcharge of Medicare levy if they are not having the hospital coverage. About 67.3 % of the total health spending is funded by the Australian government. In this context, it can be stated that private funding spends nearly 8.8% of the total expenditure on health in the year 2015(Aph.gov.au, 2020). The spending of the country is justified as it has one of the best rates of life expectancy. The healthcare system of Australia has always been a dependent private and public form of finances. But the surcharges associated with the public health insurances are perceived as unfair by the individuals residing in rural regions where less provision of private care is available(Willis, Reynolds, & Keleher, 2016). Some sections of the surgeries are carried out in a predominant manner within the private sector and approximately, 57% of citizens of Australia keeps on waiting for lots of months. Therefore, it is creating a challenge related to equity, where accessing care is dependent on the capability to pay other than the need (Callander, 2019). Specialist surgical training is remaining concentrated within the public sector, which is subjected to diminished cash loads. Heavy regulation is experienced within the insurance sector of Private health in Australia. Private insurance of health is similar for active as well as indolent. The same is applied to individuals who are prudent and profligate. The health funding is responding by shifting the bad risks towards the public sector (Miles & Francis, 2019). For instance, they are not paying for renal dialysis which is done at home and also limiting the payment scheme to particular dialysis centres. Furthermore, it is stated that the innovations which are linked to the financing of the health services are pressed to margins and flourishing within the programs of healthcare. In comparison, the UK, the expenditure of the UK was approximately 197.4 million in the year 2017. As per estimates of 2017, it can be estimated that near about 79% of the total spending in healthcare was funded by the government (Ons.gov.uk, 2020). In regards to the United Kingdom, the total spending on health care accounted for nearly 9.6% if the total GDP, which has a low rank when compared to other developed nations. One of the major challenges is that the medical advancements are raiding the price tag and with an increasingly ageing population, the infrastructure is not well equipped to provide the needful care. Lack of service quality from NHS is shifting the focus towards utilisation of private services. Therefore, the spending pattern of the UK is not satisfying the requirements of care which the patient shall be getting. In this comparison, the life expectancy rate is relatively high for France. The spending on healthcare is nearly 11.3 % of total GDP which is the best when compared to Australia and the UK. The high quality of services justifies the needful spending initiated by French healthcare.

Financial challenges experienced in regards to the provision of equitable access towards care 

The rising of costs associated with healthcare in Australia is connected to advancement in medical technology. In this regards, diagnostic and therapeutic advancement are viable at a considerable amount of cost. Listing it for the subsidy for aspects of PBS enhances the availability and usage, therefore reflecting upon community cost (Armstrong et al. 2007). However, the healthcare system of Australia is failing to subside it effectively, which is indeed raising questions about the unavailability of the medical devices for the population of Australia. It is a known fact that Australia has a favourable record in assessing pharmaceutical products as it is based on cost-effective principles. Contrastingly, the assessment of the surgical interventions, technologies and medical devices are lacking the rigour of cost-effective initiative for the vaccinations and pharmaceutical products. The situation further becomes more challenging because different criterion is followed in government and private Australia hospitals, and some of the expensive drugs are not available readily on the list of Pharmaceutical Benefits Scheme (Epp, Parkinson & Hawse, 2020). Furthermore, the medical errors within the healthcare system of Australia have cost nearly 2 billion dollars annually. However, Quality management identified that much of these errors would have been preventable if more advanced treatment and medicinal facilities were readily available. In this regard, it can be stated that due to financial challenges, Australia has not been able to alleviate the issues associated with healthcare services. However, new agencies for improved quality and health safety are built, but the demonstration of its effectiveness is yet to be measured (Briggs, 2017). Access to health services is becoming less equitable in the Australian context. The patient "out of the pocket" costing has enhanced by 50%, which is posing a threat for quality provision of care.

Proving recommendations to the healthcare system of Australia in regards to economic and societal implications 

In addressing the challenges, it can be stated that the approaches towards prevention and provision of primary and acute care need to be implemented in an effective manner. Proper structuring of the healthcare system will be instrumental in providing quality care to the patients. In regards to better dealing with the issues faced by the indigenous people of Australia; the overall service provision shall be more accessible. Out of the pocket costing needs to be lowered, so that the individuals can get the needful care properly at times of emergency (Duckett, 2020). Next, the healthcare system should be reducing the excess waiting time, mainly happening in public hospitals. Successful application of brand premium policy could prove to be effective for reducing cost and lowering pharmaceutical consumptions in the healthcare sector.

It is well known that price which is being payable by the PBS is being set at low price branding of bio-equivalent medicines. If a particular brand is being prescribed to the patient and the price is not low in comparison to the bio-equivalent, then the patient will need to pay the amount of brand premium amongst the co-payment level and price of branding (Aph.gov.au, 2020). The primary objective is focused on stimulating the competitiveness of price and encouraging developing of the generic pharma industry in the country.

Effective agreement of price volumes may also serve to be effective, as PBS should take active participation in negotiating the price it is paying to the manufacturer for the drugs partially based on the anticipating utilisation of those type of drugs (Aph.gov.au, 2020). The theory suggests that if the anticipated market is large, the low price needs to be paid for the drugs. In areas, where there is the expectancy of large sales volumes, PBS should be taking the initiative of establishing agreements with the manufacturers for varying the pricing it is paying within the aspect of the actual variations in the market.

Conclusion 

While concluding, it can be stated that there is a considerable amount of challenges associated with the health spending of Australia, however, it comparatively fairs better than the UK, but lagging behind France. For addressing the challenges related to extra pocket spending and PBS related issues, policies related to brand premium and agreements of price volume has proven to be effective.