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87 Cards in this Set

  • Front
  • Back

How did people die in early settlement in Aus? 4

- infections disease and inadequate treatment

- at childbirth

- disease (diptheria, whooping cough, scarlet fever)

- injuries

Who had better care than the poor?

The rich

Where was care delivered in early Aus? 4

- community hospitals

- private hospitals

- church run hospitals

- public hospitals (teaching - gov finances)

What is the international trent?

- for organised medicine (doctors) to be hostile towards state intervention

What was the conditions medically speaking for doctors in 1900? 3

- doctors were paid fee for service and in private practice

- hospitals were independently administered with govt. subsidies

- after federation, fed governments attempted to introduce welfare type systems + compulsory contributions

Who are the political players in health? 4

- doctors (aus medical association is the most successful union in aus)

- politcal parties (liberal - free enterprise, small gov contribution, user pays)

- beauraucrats who advise gov, implement gov policy, are "experts"

- consumers (sick people vote)

What happened in 1996 for health planning in relation to politics?

Howard privatised system - 2 tier - private insurance or very long waiting lists + a run down public system

What happened in 1983 politically speaking for health?

Hawke (labor) reintroduced compulsory scheme (medicare)

What happened in 1947 to health politically speaking?

labor gov legislated a free system - failed - 90% of doctors refused to cooperate

What happened in 1952 politically speaking to health?

liberal gov - page system introduced

What happened in 1970 politically speaking to health?

Voluntary scheme restructured

How much of our income goes to health?


When was medibank introduced?

1970s whitlam government

What did Howard introduce re: taxes?

Private health insurance rebate

What was the health program in 1973?

Community health program - local community involvement

When did community health become a state responsibility?


Why did commenwealth/fed gov intervention come more involved in sate matters over time? 2

- the health budgets were large during ww2 - the states gave the rights to income taxes to the federal gov

- the fed government developed a hospital system for returned servicemen

What are the levels of service delivery?




What do primary services include?

- general practice, usually in private practice, allied health and community health

What do secondary services include?

- general hospital care - private and public

- specialist services

- mental health services

What are tertiary services?

Specialist services e.g. nursing homes, transplant services, long term mental health services

How many hospital beds in Aus are private?


What are examples of private non-inpatient services?

- medical practitioners (GPs and specialists) provide most out-of-hospital medical services

- most dental and allied health services are provided by private practitioners (e.g. physio + psychology)

What is the new focus of health in Aus?

Primary health care

What is planned to increase in Aus?

What is this plan called?

primary HC - increase GPs and community clinics

National Preventative Health Strategy

What is the AHCS?

Australian Health Care System

What are the two features of the AHCS?

1. federal structure: operation of national government in parallel with six states

2. public/private division of responsibility

How much health funding is led by the federal gov in the AHCS?


How much health funding led by state and local government?


How much health funding in AHCS led by private?


Under the current liberal gov the move is to a more free enterprise system with more user pays... list three points

1. Subsidies for Private Health insurance ‐ you need private insurancebecause queues for public services are too long

2. increased GP payments – but increased gap (user pays)

3. Reduced no. of bulk billing GPs

Who visits private hospitals?

Visiting medical officers provide private medical services to patients in a private hospital

The Government subsidises private health care costs andprovides incentives for people to maintain privateinsurance: list two incentives:

1. 1/3 of fees are reimbursed

2. deduction in annual fee if you join under 30 years old and maintain insurance

What exists for high income earners who don't have private health insurance?

Levy (cost)

What is the private sector health expenditure ?

Private sector expenditure on health accounts forabout 1/3rd of total health expenditure

How is the revenue generated in private health insurance?

60% of revenue are fees generated from individuals out of pocket expenses

Do private hospitals get money from the federal government?

Not at all

How many private hospitals in Australia, and what is the break down?


- 289 acute or psychiatric

- 175 for - profit

- 124 not-for-profit

-271 day surgery

What are the 2 largest multinational health organisations in Aus?

Ramsay Health Care and Healthscope

When and by who was Ramsay Health Care established?

Paul Ramsay, SYD, 1964

What is the scope of Ramsay Health care?

Grown to become a global hospital group operating 116 hospitals and day surgery facilities across Australia, UK, France, Indonesia.

What does Ramsay healthcare offer? 4

-day surgery

- complex surgery

- mental health

- rehab

How many beds, jobs and patients does Ramsay Healthcare have?

Beds 10,000

Staff 30,000

1 million PTs

What is the largest not-for-profit health care system in Aus?

Catholic services

What do catholic services offer scope wise to health care?

Largest grouping of health, community and aged care services in Aus

9500 beds in 75 (private and public) healthcare facilities including 7 teaching hospitals

What are 2 elements of Catholic healthcare that are different?

- providing a wider range of services (palliative care)

- some catholic hospitals are located in geographic regions which are not appealing to for-profits

How much do Australians spend on complementary and alternative medicine?

1.8 billion from personal budget

What do alternative healing and complementary medicine promote? 3

agency, self determination and subjectivity

What is a limitation of complementary and alternative medicine ? 3

-socially constructed

-weak research

- promote hyper-positivity & self-responsibility to the terminally ill

What does complementary and alternative medicine include?

Homeopathy, natropathy, herbs, chiro, osteopathy, massage, reiki, therapeutic touch

What is unique to Australia and founded in 1928?

Remote Aus Royal Flying Doctor Service

What does the royal flying doctors provide?

24h 364 aeromedical emergency and health care service to people in Aus remote areas

What is the scope of the royal flying doctor service?

21 bases

47 aircrafts

22million km/year

35,000 need transport each year

12,00 health clinics / year

What does AHPRA stand for?

Australian Health Practitioner Regulation Agency

What is AHRPA responsible for?

The registration and accreditation of 10 health professionals across Australia

What is AHRPA governed by?

The health practitioner regulation national law act 09 - nationally consistent legislation for 10 professions

Who does AHPRA work with?

Health Complaints commissions in each state to make sure the appropriate organisation investigates community concerns about individual, registered health practitioners

What does AHPRA support?

The boards in the development of registration standards, codes and guidelines

Who does AHPRA provide advice to?

Ministerial Council about the administration of the national registration and accreditation scheme

Why is health care an issue? (2)

Inequality (refers to unequal distribution in politics of power and resources)

Inequity (refers to unfairness: injustice by virtue of not conforming with rules or standards)

What is the life expectancy of indigenous disadvantage ?

Males and females at birth were on average going to live 11.5 to 9.7 years less than non-indigenous Australians

Where is most people's first presentation to health care?

via their GP

What is the social disadvantage regarding GPs?

Access is variable depending on locality

How does primary health care link with the social model of health? 5

1- Multidisciplinary in nature

2- base on community needs

3- integration of health, welfare, private, public, not for profit - a partnership approach - tensions can emerge

4- social context

5- data traditionally not collected in a consistent manner

What has changed about the original ideals of primary health care according to WHO?

HFA = Health for all declaration

The original ideals in 1978 have changed, in an attempt to make them more achievable e.g. from "comprehensive PHC" to "selective PHC"

What do Braum and Germov consider PHC as?

The philosophical underpinning of community health services which began with the community health policy in 1973 in Aus

What is the view of health under comprehensive PHC and selective PHC?

C = positive wellbeing

S = absence of disease

What is the view of locus of control over health in comprehensive and selective PHC?

C = communities and individauls

S = health professionals

What is the major focus in comprehensive PHC and selective PHC?

C = Health through equity and community empowerment

S = medical solutions for disease eradication

What is the difference between health care providers in comprehensive and selective PHC?

C = Multi-disciplinary teams

S - medical doctors

What is the difference in strategies for health between comprehensive PHC and selective PHC?

c = multi-sectoral collaboration

s = medical interventions

What are the 5 strategies of the ottawa charter for health promotion/central ideals of "health for all" ?

1. develop healthy public policy

2. create supportive environments

3. encourage community action

4. develop personal skills

5. reorient health services

What do health care systems in any country correlate with?

the economic/political systems in that country

When did the NHS (national health scheme) start and what are 3 elements of it?


- free system

- doctors employed by gov

- small private sector fee for service component

What is NHS the largest of ?

Employers in Europe (.75 million people)

What are the inherited problems of the NHS? 2

- inequity due to distribution of resources

- measurement and coordination due to variation in local practice

What is currently happening with the NHS?

Increasing demand causing financial strain - people living longer, diseases of old age, increased expectations

What healthcare system does the USA have (before Obamacare)?

Free enterprise = user pays

When was health insurance available to americans?

Via employment - limited health insurance available via your job - often people will not leave a bad job for fear of losing health cover (they wait to retire)

What are welfare socialist/decentralised systems like?

Government control, funding and policy making at a high level

Doctors are salaried in the public sector

Western EU, UK, Sweden, NZ, Japan

What are 3rd world healthcare systems like? 3

- low level of resourcing

- limited access

- generally a private sector exists for a wealthy minority

What are socialist HC systems like?

almost 100% state run e.g china, cuba, canada

What are the 4 principal features of the Australian health care system?

- private, for profit component (GPs, pharmacists, dentists, private hospitals, private specialists and alt practitioners)

- public component (com health centres, maternal + child health)

- a NGA (non-gov organisation) not for profit

- a domestic component (carers)

What are the 3 key health policies and programs of the Aus HC system?

1. Commonwealth national health act 1953 - universal health ins scheme and creation of the pharmaceutical benefits scheme

2. medibank 1975/medicare 1984

3. Council of Australian Governments (1995)

What are the missions of Australia's health care policies ? 5

1. universal access to basic health care

2. services should be of high quality

3. financing of health care should be equitable

4. services are delivered through a mix of private/public

5. accountability and efficiency

What are 8 problems with the current HC system in Aus?

- bed shortage

- hospitals need upgrades

- staff shortage (med, nurses, allied)

- increasing tech - increasing costs + expectations of access to certain tech

- lack of funding

- lack of rural services

- reduced no. of private GPs who bulk bill

- duplication of funding and poor coordination of services e.g. state and fed funding available for similar service which operate independently

What are the 7 strategic directions of the national preventative health strategy?

- shared responsibility - developing strategic partnerships at all levels of government, industry, unions etc

- act early and throughout life - working with individuals, families and communities

- engage communities

- influence markets and develop coherent policies e.g through tax

- reduce inequity through targeting disadvantage

- indigenous aus - close the gap

- refocus primary HC towards prevention