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14 - The Australian health-care system

Kerry J. Breen
Affiliation:
National Health and Medical Research Council
Stephen M. Cordner
Affiliation:
Monash University, Victoria
Colin J. H. Thomson
Affiliation:
University of Wollongong, New South Wales
Vernon D. Plueckhahn
Affiliation:
Monash University, Victoria
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Summary

While doctors who obtained their undergraduate and postgraduate training in Australia are likely to have a reasonable understanding of the Australian health-care system, overseas-trained doctors may have more difficulty negotiating the Australian system to adequately meet the needs of their patients and to avoid legal problems for themselves. This chapter outlines the Australian health-care system in simple terms and describes in more detail the two main elements relevant to doctors: Medicare and the Pharmaceutical Benefits Scheme (PBS).

Medicare and the PBS are managed by Medicare Australia, formerly known as the Health Insurance Commission. These two elements are central to the clinical practice of medicine outside the public hospital system, as they provide government payments for medical services and pharmaceuticals and include centralised monitoring, enforcement and disciplinary procedures related to payments to doctors for medical services. Doctors who deliberately or through ignorance breach the regulations of these systems may face heavy fines and/or disqualification from participation. They are also likely to be subject to disciplinary action by medical boards. This chapter focuses on health services provided by doctors and does not canvas regulations relating to dentists, pharmacists or other health-care providers.

AN OVERVIEW OF THE HEALTH-CARE SYSTEM

People seeking medical attention in Australia are free to attend any general practitioner of their choice or to attend a public hospital to see a doctor employed by the hospital. General practitioners are part of what is called the ‘private’ component of the Australian health-care system.

Type
Chapter
Information
Good Medical Practice
Professionalism, Ethics and Law
, pp. 208 - 222
Publisher: Cambridge University Press
Print publication year: 2010

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References

,Medicare Australia. http://www.medicareaustralia.gov.au
,Professional Services Review. http://www.psr.gov.au
AMA Code of Ethics – 2004 (editorially revised 2006). http://www.ama.com.au/ codeofethics
,Therapeutic Goods Administration. http://www.tga.gov.au
Medicare Benefits Schedule Book. Issued annually by the Australian Government Department of Health and Ageing. http://www.medicareaustralia.gov.au/provider/medicare/mbs.jsp
Schedule of Pharmaceutical Benefits. Issued by the Commonwealth Department of Health and Ageing. http://www.pbs.gov.au/html/healthpro/home
Breen, KJ. Postgraduate training of the medical staff of Australian teaching hospitals. Med J Aust 1994; 161: 227 (letter).Google ScholarPubMed
The Accreditation Guide – Standards for Australian Health Care Facilities. Australian Council on Health Care Standards, Sydney. http://www.achs.org.au/Home/
Wilson, RM, Runciman, WB, Gibberd, RW et al. The Quality in Australian Health Care Study, Med J Aust 1995, 163: 458–71.Google ScholarPubMed
Australian Commission on Safety and Quality in Health Care. http://www.safetyandquality.gov.au/
Essentially Yours: The Protection of Human Genetic Information. The Australian Law Reform Commission and the National Health and Medical Research Council Joint Inquiry 2003.
Duckett, SJ.The Australian Health Care System. 3rd edn. Oxford University Press, Melbourne, 2007.Google Scholar

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