Health and Aged Care in Australia
Australia’s health policy is funded and delivered by several levels of government and is supported by private health insurance arrangements. In place are systems for the delivery of health, income support, and housing and community services to support aging people. Medicare, the national health insurance scheme, is funded and administered by the Australian (commonwealth) government and provides coverage for a range of primary care services, including visits to medical practitioners. This is supported by optional private health insurance for ancillary services and private hospital treatments. The public hospital system is funded jointly by the Australian, state, and territory governments and is administered at the state/territory level.
Most nonhospital medical services, pharmaceuticals, and health research receive funding directly or indirectly from the Australian government. Public hospital services and home and community care for aged and disabled persons are funded jointly by the Australian, state, and territory governments. Residential facilities for aged persons are funded by a number of sources, including the Australian government.
The states and territories are primarily responsible for the delivery and management of public health services and the regulation of health care providers and private health facilities. They deliver public hospital services and a wide range of community and public health services. Public hospitals, which provide the majority of acute care beds, are funded by the Australian, state, and territory governments.
The private sector, operating in the delivery of, and insurance for, health services, receives both direct and indirect government subsidies. Within this sector, organizations operating for-profit and not-for-profit play a significant role in providing health services, public health, and health insurance. For example, privately owned nursing homes provide the majority of long-term aged care beds.
Aged care services in Australia have been significantly restructured since 1985, when the Home and Community Care Act was introduced. During the late 1990s and the beginning years of the new century, a series of inquiries and national reviews have been undertaken. Government attention to the implications of population aging was sharpened with the release of the first Intergenerational Report by the Australian Government Treasurer in 2002. A succession of government inquiries and reports have had an impact on health and aged care services in terms of policy, funding, and programs, with the most recent being Economic Implications of an Aging Australia from the Productivity Commission in 2005, a report prepared at the request of the Council of Australian Governments.
Nationally, there are two main forms of care delivery: residential care and community care. Community care includes the Home and Community Care Program (HACC), Community Aged Care Packages (CACP; i.e., low-level care in patients’ homes), and Extended Aged Care at Home (EACH, high-level care in patients’ homes). Aged Care Assessment Teams assess people’s eligibility for residential care, CACP, and EACH.
There are also other flexible related aged care programs. Multipurpose Services provides services to people in rural and remote regions, and the Aged Care Innovative Pool, which provides flexible care places, aims to develop innovative services for health care delivery such as rehab and support services for older people after hospital discharge or people with dementia and alzheimer. Other aged care services programs include a commonwealth hearing services program, respite services, and day therapy centers.
Depending on individuals’ circumstances and needs, there are other services available outside the health care system, including income support (e.g., Carers Allowance), community services, and housing. Specialist health and hospital services for older people, including rehabilitation, geriatric evaluation and management, psychogeriatric and mental health care, and respite and palliative care, are available.