Australian healthcare system may seem a bit complicated, moreover, it is changed from time to time.

Let’s make it simple.

Healthcare system has two major parts:

  1. The public health system or Medicare.
  2. The private health system.

The public health system includes

  • public hospitals,
  • community-based services,
  • affiliated health organizations (owned by state and territory governments).

Australians access the public health system for free or at low cost through Medicare (https://www.humanservices.gov.au/individuals/medicare). This system is funded local, state and federal governments (by tax).

The private system includes:

  • private hospitals,
  • specialist medical and allied health.

This system is partially funded by government and the other part is covered by private entities. Here is the combination of both:

  • Private health insurance premiums (paid by customers),
  • Private health organizations,
  • People paying directly for private treatment,
  • Government incentives on private health insurance,
  • Other government and private funding.

When a patient gets to a hospital, he/she can be provided treatment through either the public or the private system.

Private Hospitals VS Public Hospitals

Public Hospitals Private Hospitals
Can I go there in case of emergency? Yes.

They are where a patient usually goes in case of an emergency.

Most probably, no.

Some private hospitals have emergency departments, but not all of them.

Should I wait for a non-urgent treatment? Most probably, yes.

You may need to wait longer until a space becomes available.

Most probably, no.

You’ll have the reduced waiting time for elective or planned surgeries.

Can I choose a doctor? No.

A doctor on-call will take care of you in most cases.

Yes.

 

Can I have a private room while my stay in a hospital? No.

Most probably you’ll have a shared room while you recover.

Yes.

In case of availability and medical appropriability this is up to you.

Who pays for healthcare?

Public hospital costs

Most treatment in public hospitals is free for Australian citizens and permanent residents according to Medicare program.

Patients do not pay for:

  • hospital clinical services,
  • doctor’s fees,
  • medication,
  • accommodation,
  • other operating fees.

Patients may have to pay some extra costs for:

  • TV option,
  • Internet connection.

In case a private patient goes to a public hospital, Medicare covers 75% of all costs listed in MBS (Medical Benefits Schedule – http://www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Home)

Private hospital costs

Medicare also covers 75% of all costs for treatments listed in MBS.

Private patients may have to pay for:

  • intensive care,
  • accommodation,
  • operating fees,
  • dressings and bandages,
  • blood tests, x-rays or CT scans,
  • medication,
  • 25% of the doctors’ services fee,
  • extra doctors’ fees.