Australia

Population and published Cancer/Chronic disease rates1 

  • Current estimated population of 25.5m (~0.33% of the world population).
  • It is estimated that almost half of Australians had 1 or more chronic conditions in 2017–18. 
  • Common chronic conditions include cancer, cardiovascular diseases, arthritis, asthma, diabetes, chronic kidney disease and mental and behavioural conditions
  • Around 45,500 new cases of cancer will be diagnosed in Australia in 2020
  • The most commonly diagnosed cancers are prostate cancer (16,700 cases -males), breast cancer (19,800 cases females), melanoma of the skin (16,200 cases), colorectal cancer (15,300 cases) and lung cancer (13,200 cases)
  • Leading causes of death are coronary heart disease, dementia, cancer and chronic lower respiratory diseases

Healthcare System Overview2 

Australia has a two-tier health system that consists of public and private funding.  The health system offers universal health care for all citizens.  Medical services, hospital visits and medicines for Australians are mainly subsided by the government and funded through general taxation. Private services are owned and operated through private businesses as well as out of pocket expenses. 

Around 50% of the population have private health insurance which funds additional services and provides benefits, depending on the level of cover that has been taken by the individual .3 

Private health insurance is community rated so people cannot be refused coverage, and everyone has the same premiums. PHI rarely covers High-cost medicines and therapies, and there are a nominal subsidy for medicines not listed on the pharmaceutical benefits schedule (PBS) through the public system, provided as ancillary benefits.
Australia is a federated country made up of six states and two territories governed by three tiers of government that influence different aspects of healthcare:

The Australian Government: 

  • develops national health policies, 
  • subsidises the costs of medical services and tests through Medicare benefits scheme (MBS) and medicines through the Pharmaceutical Benefits Scheme (PBS), blood and blood products through the National Blood Authority and vaccines through the Australian Immunisation Register (AIR). 
  • provides funds to states and territories for public hospital services,
  • funds population-specific services, including community-controlled Aboriginal and Torres Strait Islander primary health care, health services for veterans, and residential aged care, funds health and medical research, regulates medicines and medical devices, 
  • supports access to and regulates private health insurance.
  • regulates private health insurance subsidy of registered medical devices through the prosthesis list.


State and territory governments: 

  • fund and manage public hospitals, 
  • regulate and license private hospitals and other health premises,
  • regulate products with health impacts such as alcohol and tobacco, deliver community-based and preventive services (for example, cancer screening and immunisation), ambulance services, and services to address complaints against any of these.

Local governments in some jurisdictions can be involved in: 

  •  delivery of community and home-based health and support services, environmental health services (for example, waste disposal, water fluoridation), public health activities.


Health costs and funders4 

  • In 2017–18 total health spending was $185.4 billion, equating to $7,485 per person and 10% of GDP
  • Health spending increased by 1.2% that year, which was lower than the decade average of 3.9%.
  • Around two-thirds of health spending was funded by governments: $77.1 billion from the Australian Government and $49.5 billion by state and territory governments. Major cost categories: hospitals (40%), primary health care (34%), PBS (9%) and MBS (20%).5
  • Non-government entities (including individuals, private health insurance providers, injury compensation insurers and other private sources) spent $58.8 billion with individuals being the largest contributor at $30.6 billion (52%).
  • Most of the $16.6 billion spent by private health insurers was spent on private hospitals ($8.2 billion) and primary health care ($2.9 billion).
  • In 2017, forty-one percent of health care expenses were funded by the Australian Government, 27% by state and territory governments 17% by individuals (for products and services that aren’t fully subsidised or reimbursed), 9% by private health insurers and 6% by non-government organisations

Health system challenges

  • equity of patient access to emerging therapies and technologies 
  • an ageing population and increasing demand on health services
  • rising rates of chronic disease
  • high costs of medical research and innovations
  • conventional approaches to health technology assessment for reimbursement of medicines, services and tests
  • making better use of health data
  • people living in rural and remote and lower socioeconomic areas, people with disability, and Aboriginal and Torres Strait Islander people experience higher rates of illness, hospitalisation and death than other Australians

Sources:

  1. Reference: Health expenditure Australia 2017–18
    Publication Release Date: 25 Sep 2019 Author: AIHW
  2. https://www.health.gov.au/about-us/the-australian-health-system
  3. https://www.aihw.gov.au/reports/australias-health/private-health-insurance
  4. https://www.health.gov.au/sites/default/files/documents/2019/10/department-of-health-annual-report-2018-19_0.pdf
  5. https://www.pbs.gov.au/info/statistics/expenditure-prescriptions/pbs-expenditure-and-prescriptions-report