The Australian Health Care System: A Case Study

Benjamin Franklin once stated “in this world nothing can be said to be certain, except death and taxes” (Freakonomics, 2011). Over two centuries have pass since Franklin’s death, and many would argue the addition of universally accessible healthcare to his list of life’s certainties. At some point, even the healthiest among us will be faced with the need for medical assistance, and without health insurance, medical bills could cause dire financial consequences to those in need, or be denied access to healthcare all together.
Countries like Australia have developed complex frameworks to ensure all of their citizens have access to medical care, either from public or private sources. During the development of such complex systems, many facets

must be considered such as the countries demographics, financing and reimbursement rules, how healthcare is ultimately delivered, as well as the quality and characteristics of hospitals through both public and private sources.
Demographics
Australia is estimated to be 7,692,024 square kilometers and the sixth largest nation after Russia, Canada, China, the United States of America, and Brazil.

It has, however, a relatively small population. Australia is the only nation to govern an entire continent and its outlying islands. The mainland is the largest island and the smallest, flattest continent on Earth. It lies between 10° and 39° South latitudes. The highest point on the mainland, Mount Kosciuszko, is only 2,228 meters. Australia is the driest inhabited continent on earth, and its interior has one of the lowest rainfalls in the world, for about three-quarters of the land is arid or semi-arid, but its fertile areas are well-watered, and these are used very effectively to help feed the world. Sheep and cattle graze in dry country, but care must be taken with the soil. Areas of grazing land became desert when the long cycles that influence rainfall in Australia turned to drought (About Australia,

2016).
The Australian federation consists of six States and two Territories. The largest state, Western Australia, is about the same size as Western Europe. The estimated resident population for each state and territory as of March 2011 was as follows: New South Wales 7,287,600; Victoria 5,605,600; Queensland 4,561,700; South Australia 1,654,200; Western Australia 2,331,500; Tasmania 510,200; Northern Territory 229,200; and Australian Capital Territory 363,800 (About Australia, 2016).
Australia’s estimated resident population as of March 2011 was just over 22.5 million, an increase of 1.4% over the previous year. The growth of Australia’s population has two components: natural increase (the number of births minus the number of deaths) and net overseas migration. The growth rate has been declining since the peak of 2.2% for year ended December 2008, and was the lowest growth rate since September 2005. All states and territories experienced positive population growth for the year ended March 2011. Western Australia recorded the fastest growth (2.2%) and the Northern Territory the slowest (0.4%) (About Australia, 2016).
Australia’s culturally diverse society includes its Indigenous peoples who arrived more than 50,000 years ago, and settlers from countries all around the world. Immigration is an important feature of Australian society. Since 1945, over six million people from 200 countries have come to Australia as new settlers. Migrants have made a major contribution to shaping modern Australia and people born overseas make up almost one quarter of the total population. The federal government sets immigration intake numbers on a yearly basis, for Australia’s immigration policies are non-discriminatory and all applicants to migrate must meet the same selection criteria. In recent years the mandatory detention of unauthorized arrivals with the intention of applying for refugee status by boat has generated great levels of controversy. Mandatory detention laws were introduced in Australia by the Keating Labor government, with bipartisan support, in 1992. The legislation was proposed as a result of an influx of Vietnamese, Chinese, and Cambodian refugees over the previous few years (About Australia, 2016).
Australia has one of the highest life expectancies of any country in the world, at 82.2 years in 2013 for males and females at birth combined. Australia is ranked sixth among Organization for Economic Co-operation and Development (OECD) countries. The highest life expectancy at birth was 80.7 for males in Switzerland, and 86.6 for females in Japan (AIHW, 2016). In 2013, 2 in 3 deaths occurred among people aged 75 or over, 3 in 10 deaths were due to circulatory diseases, 4 in 5 deaths were due to natural causes involved more than one disease, and people living in remote and areas had mortality rates 1.4 times as high as those people living in major cities. The gap in life expectancy between Indigenous males and non-Indigenous males is 10.6 years at 69.1 years and non-Indigenous males at 79.7 years; and the gap was 9.5 years for Indigenous and non-Indigenous females at 73.7, and 83.1 years (AIHW, 2016). Mortality rates for infants 3.6, which is the number of infant deaths per 1,000 live births in Australia in 2013. This represents a decline of more than 95% since 1907 (AIHW, 2016). 1 in 2 or 51% of the deaths that occurred during 2011–12 were among people admitted to a hospital. They often received palliative care (AIHW, 2016).
According to the Bureau of Statistics, the average number of babies’ Australian women are having has fallen to the lowest level in 10 years, the level it was when the federal government introduced a baby bonus to boost population growth. The national fertility rate has dropped to 1.8 children per woman, down from 1.88 children last year, for this rate has been declining since 2008, though not reaching the low recorded in 2001, according to said AJ Lanyon, the regional director at the Australian Bureau of Statistics (2016). Altogether, 299,700 births were registered in Australia in 2014, down from 308,100 in 2013. The country's fertility rate started increasing in 2002 and sat at two children per woman from 2007 to 2010, coinciding with the peak of the mining boom. However, it has all been downhill since 2010, despite the introduction of government-funded paid parental leave in early 2011 (Bettersby, 2015).
Overall, women aged between 30 and 34 were the most fertile, recording 120 babies per 1000. They were followed by women aged 25 to 29, with 95 babies per 1000. Teenagers and women over 40 now have roughly the same fertility rate being 12.9 babies and 14.4 babies per 1000 women respectively. This is a historical low for teen pregnancies, which fell from a peak of 55 babies per 1000 girls in 1971. However, there has been an increase in the number of babies born in Australia for the first time in five years. The latest figures from the Australian Institute of Health and Welfare (AIHW) show that over 307,000 mothers gave birth to more than 312,000 babies in Australia in 2012. Those figures were up 3.4 per cent from 2011 and 21.5 per cent since 2003. The overall birth rate was 65 per 1,000 women, which is the highest rate in the last decade and similar to the 2007 birth rate of 64.9 per 1,000 women (Bettersby, 2015).
Australia has a developed modern market economy and has had one of the most outstanding economies of the world in recent years with high-growth, low-inflation and low interest rates.

Over the past decade, inflation has typically been 2–3% and the base interest rate 5–6%. There is an efficient government sector, a flexible labor market and a very competitive business sector. Since 1992 Australia has averaged greater than 3 per cent economic growth and recorded over 17 consecutive years. This economic stability places Australia in the top echelon of developed countries in terms of sustained rates of growth. The Australian economy is dominated by its service sector, representing 68% of Australian GDP. The agricultural and mining sectors account for 57% of the nation’s exports. With its abundant physical resources, Australia has enjoyed a high standard of living since the nineteenth century. Australia is a major exporter of agricultural products, particularly wheat and wool, minerals such as iron-ore and gold, and energy in the forms of liquefied natural gas and coal. It has made a comparatively large investment in social infrastructure, including education, training, health and transport. According to the Reserve Bank of Australia, Australian per capita GDP growth is higher than that of New Zealand, US, Canada and The Netherlands. The past performance of the Australian economy has been heavily influenced by US, Japanese and Chinese economic growth (About Australia,

2016).
The Gross Domestic Product (GDP) in Australia was worth 139.54 billion US dollars in 2015. The GDP value of Australia represents 2.16 percent of the world economy. GDP in Australia averaged 386.58 USD Billion from 1960 until 2015, reaching an all-time high of 1563.90 USD Billion in 2013 and a record low of 18.60 USD Billion in 1960 (Trading Economics, 2016). In the first quarter of 2016, final consumption expenditure grew by 0.7 percent, adding 0.5 percentage points to GDP growth. Household spending rose 0.7 percent while government expenditure increased by 0.9 percent. In contrast, gross fixed capital formation declined by 1.7 percent, subtracting 0.4 percentage points to growth. Private investment fell 4.2 percent, mainly due to a decrease in new engineering construction, new building and machinery and equipment. Meanwhile, public investment rose 0.7 percent. Exports of goods and services rose 4.4 percent. Imports of goods and services fell 0.8 percent. Net exports contributed 1.1 percentage points to GDP growth in the March quarter. The change in total inventories was an increase of AUD651 million in seasonally adjusted terms compared to an increase of AUD 522 million in the December quarter. This increase was driven by rises in wholesale trade and mining industries.
Australia’s industry positive contributions came from agriculture, forestry, and fishing. This was driven by 2.5% from livestock production, 6.2% from mining, 0.2% from manufacturing, supported by a rise in food, beverage, tobacco products, and lastly, machinery equipment and retail trade equaled 0.8%. In contrast, construction declined by 1.1 percent, driven by weakness in non-residential building construction and heavy and civil engineering construction (Trading Economics, 2016).