Introduction
According to Australian government (2010: para4) the healthcare in Australia is offered by both the government and the private sector. The health policy in Australia is set by the ministry of Health and Aging. In 1984, the government established a healthcare system known as Medicare. Medicare exists alongside the private sector medical services to provide healthcare to different people in Australia. The function of Medicare is to assist eligible residents of Australia to access healthcare services at low costs while at the same time allowing each individual to freely choose between the Medicare services and private sector medical services (Australian government 2010, para4-5). The cost of running the government’s Medicare is met through revenues drawn from the taxes paid; the taxes are got from Medicare taxes imposed on personal financing. In Australia, Medicare is established under the Human Services Department and is also charged with the responsibility of giving the course of action in relation to payment of approved medical services. As much as the government of Australia is providing subsidized medical care to all who live in Australia, it encourages individuals to take private health insurance. This is an attempt by the government to strike a balance between the private sector medical care and the public one. In some way, through this encouragement the government may be seeking to reduce the amount it spends in subsidizing healthcare services.
Australian Healthcare Policy Challenges
It is safe to argue that the Australian healthcare services have lots of challenges it faces in terms of social welfare of all its inhabitants. The healthcare in Australia has experienced a lot of changes which has impacted on multiculturalism. This follows after the government of Australia adopted the policy of multiculturalism in 1970 (Garrett, p45). During this period, the Australian government was greatly concerned with addressing the issue of social inequality in terms of healthcare accessibility. Different groups fought to pressurize the government to ensure equal opportunity for all to access universal and affordable health care irrespective of one’s social background. As a result, the government came up with a policy of universal medical insurance and also supervised the formation of a program to deal with the community health. However, according to Derose and Baker as quoted in Garrett (2009), the healthcare policy of Australia has not addressed the challenges brought about by language barrier while in the process of acquiring health services. The two argue that this has instead reduced the equal access to medical care by immigrants. The policy only benefits the English speaking residents of Australia and neglects the non-English speakers living in Australia. This scenario has even made it almost impossible for the non-English speakers in Australia to participate in healthcare policy formulation.
As much as the government healthcare policy geared towards ensuring equity in the accessibility of healthcare services, it has also not addressed the issue of culture that may affect the relationship between the healthcare provider and the patient. In certain cases, when the health provider and the person seeking services of health provider happen to have cultural identity then it is highly likely that the patient will get better healthcare services. Contrarily, when the two are culturally different the patient is patient is highly likely to get difficulties acquiring proper healthcare services. This has brought a lot of confusion amongst the seekers of healthcare services. Such people feel marginalized when they cannot find health professionals who are culturally identical to them. There are cases where the interpreters are involved; many times the interpretations are only consistent with the beliefs and understanding of the interpreters hence representing certain misunderstandings within the Australian healthcare sector. This is one of the major flaws with the Australian healthcare policy of interpreters.
The healthcare policy of Australia doe not provide a link that exist between the healthcare service providers and the healthcare itself. This has left healthcare related decision making be only established on the premise that issues of life and death are associated with psychosomatic stresses. This is a policy arena that requires a redress to ensure that the there is a direct link between the healthcare services and the providers. Another area where there is policy problems in the cases where the use of modern technology in healthcare is required. While the medical policies are meant to provide healthcare to individuals in Australia at low cost or possibly free of charge, the growing demand for modern technology in healthcare services makes the medical products to be very expensive and almost unaffordable to most people.
Pegging the re-imbursement of health cost to the amount charged by the doctor is not a sound idea and in fact may encourage even corruption to thrive in the health sector. It is not clearly stated in the policy the amount that the doctors should charge for their medical services rendered to patients. There is likelihood that the doctors can collude with the patients to charge high prices so that the balance is shared between the doctor and the patient. The policy does not clearly spell out the terms and conditions that should be considered in approving the medical refunds to patients.
A major blow to the healthcare policies of Australia is the fact that the aging population keeps on increasing yet the population does not contribute to the funds used for providing subsidized healthcare. Life expectancy in Australia is averaged at around 82 years, usually this group is not actively involved in contributing for healthcare yet most the citizens in this age category suffer certain chronic ailments; this is supported by Palmer (pp3-4). This means that the government uses a great percentage of Medicare levy in meeting the medical demands of the old people. This is an area where the healthcare policy has failed to address. This means that the public funds contributed towards healthcare subsidies are used to take care of inactive contributors hence leading to relatively high cost of medical care. The members of the public are still complaining about the cost of medical care yet they are contributing towards the funding. This kind of failure cannot be blamed on anybody but the government’s failure to recognize the weakness through enactment of fair healthcare policies. However, according to Coory (2004: para5) even though there has been an increase in medical cost due to this scenario, the cost increase is minimal and actually within manageable limits. According to Rodgers (2010: para4-8) the increasing medical cost is accounted for by the increasing aging population and the baby boomer which press more medical demands.
Allowing medical professionals to practice both in the private and the public sector compromises the quality of healthcare given to patients. Usually the private sector is more profitable than the public sector; this therefore means that medical practitioners will pay more attention to their private practice rather rely on the government’s subsidized healthcare services. This policy has even made it difficult to have sufficient medical professional to match the growing numbers of ailing population. The challenges here is that those who work in the private sector also work in the public sector; these are virtual double employment for individuals yet there are many qualified medics who have not been placed or posted to work anywhere as medics. It is safe to argue that the aging professionals therefore, become hard to replace when their productivity slows down.
How equity of access to healthcare can be assured
According to Rice and Smith (2001: Para 2), among the several goals that are set up by the health care systems by the policy makers, undertakings in regard to such issues as equal access to health care, in most cases play a very significant role. The popularity of the objectives or goals such as these gives an indication that concerns in regard to equity is a significant feature of the ethical bases that underlie the structure of the health care systems.
Working towards achieving equity in the health status is a critical component of the new public health. According to Ducket (2003: Para 3) equity is a situation where there is minimal barriers to access, and in this case, access to health care. There has been carrying out of research on an increasing level in the last decade as well as documentation of health inequalities in health care. More so, there have been many concerns from the national governments as well as the global agencies to bring down the level of the health inequities. Fran (2002: 228) gives an example of the government of the United Kingdom which has led a policy focus on bringing down the level of inequities in the status of health. This growing interest may give an indication of the fact that inequalities are rising between nations as well as within the nations.
According to Anonymous (Factors for consideration in an integration in an integrated health funding approach, 2005: Para 5), equity in health care is a goal of all those systems that are funded publicly. It carries several meanings depending on whether it is relating to health itself, whether it relates to the utilization of the health care, or relates to access to it. In horizontal terms, equity assumes that all the people are the same and equal and therefore people should be given equal treatment. In vertical terms, equity is about the unequal but there must be equitable treatment of the unequal.
Smith (2001: Para 2), puts that the considerations on the basis of geography play a very critical part in bringing influence on access to health care. Geography has a direct effect on the health status of a person, it may also play a crucial part in the nature of the health care given to a person, and more so, the geographical health care distribution facilities may have an effect on use of this health care through opportunity of access to services disparity.
Insufficiencies in the social support structures like transport, education services, and social care may have great impacts on the local health outcomes. Having concern to bring down the level of inequities in access to health care brings in a high likelihood of enhancing a geographical policy response. In order to realize equity of access to health care in this case, policies should be set up that ensure that people in all geographical regions are accessible to health facilities that efficient and sufficient. The facilities are not supposed to be distributed on the basis of the geographical regions where people in rural areas are not accessible to adequate health care while those in the urban areas enjoy better facilities.
There are many things the government can do ensure equality in terms of the access to health insurance and other medical facilities. The government should come up with clear policies that should be able to be interpreted by any other medical practitioner and also the seekers of medical services. This will eliminate the biases associated with the medical policy interpreters. The government should separate the doctors working in either private or public health sectors. It should formulate a policy that deters a medical practitioner working in the public health sector from working in the private sector and the converse. This will ensure that the quality of the public sector healthcare is not compromised by medics whose main interests are in the profitable public sector (Humphreys & Wakerman 2010: pp14-27).
It is important for the government to come up with a policy that requires that the aging working class should take some determined percentage of private health insurance policies which are to be supplemented in case of medical needs at old or retirement age. This will reduce the total overdependence of the aged on government’s fully subsidized healthcare services. It is also important for the government to ensure that a policy is in place that recognizes the role of non-medics like medical sociologists play in healthcare sector, both in public and private care.
Conclusion
The Australian medical care is divided into private sector and the government medical care through the existence of Medicare. As much as the healthcare policies have been meant to benefit inhabitants of Australia, it has faced a number of challenges in the arena of social policies. Theses challenges have included language barrier that have made it difficult for the non-English speakers in Australia to access proper medical services and also to participate in decision making that pertains to healthcare policies. There are cases where medical policy interpreters are involved; in this situation the interpretations are not very much reliable because the interpreters may do interpretations according to their beliefs and biases. In some cases; the interpreters are influenced by their cultural background which may give contradictory interpretations to both the healthcare provider and the patients.
The policies have also allows the medical practitioners to work in both public and private sector to provide healthcare services. This compromises the quality of such medics’ services in the public sector. The healthcare services in the private sector are always better than that of the public sector. Also, with the growing population the government has encouraged the members of the public to consider taking private insurance in a bid to balance the private and the public sector. Such a policy cannot work better because the public healthcare cannot compare to the private healthcare services. This may also appear to be government’s strategy to reduce its expenditures on providing free or subsidized healthcare to the citizens and immigrants. The policy challenges in healthcare sector are also affected by the changing demographics. The life expectancy in Australia is approximated at 77 for men and 82 for women. The country is also rich and is able to take care of its citizens and immigrants. This means that the number of aging population keeps on increasing. Unfortunately, this aging population do not constitute the working population hence do not contribute to the healthcare fund.
There are many things the government can do ensure equality in terms of the access to health insurance. The government should come up with clear policies that should be able to be interpreted by any other medical practitioner and also the seekers of medical services. This will eliminate the biases associated with the medical policy interpreters. The government should separate the doctors working in either private or public health sectors. It should formulate a policy that deters a medical practitioner working in the public health sector from working in the private sector and the converse. This will ensure that the quality of the public sector healthcare is not compromised by medics whose main interests are in the profitable public sector.
Reference
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