First report - Public hospital funding and options for reform

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First report - Public hospital funding and options for reform

11 July 2000

© Commonwealth of Australia 2000

ISBN 0 642 71044 9

View the report as a single document - (PDF 481KB)

View the report as separate downloadable parts:


Membership of the Committee	(PDF 7KB)

List of acronyms	(PDF 8KB)

Preface	(PDF 19KB)

Chapter 1 - Public hospital services and the australian health system	(PDF 131KB)
Background Community interest in health care issues Health sector expenditure International comparisons Key issues and challenges: public hospital sector Indigenous Australians and public hospitals Key issues and problems: public hospitals and the Australian health system Complex nature of the health system as it relates to public hospitals Relationship between the Commonwealth, States and Territories Complexity of the health system: patient's perspective Complexity of the health system: funding arrangements Complexity of the health system: governments' role in medical practice Cost shifting Forms of cost shifting Estimating the monetary value of cost shifting Impact of cost shifting on patients Level of concern at cost shifting Relationship between the public and private sectors
Chapter 2 - The adequacy of funding for public hospitals	(PDF 175KB)
Profile of the public hospital sector Historical overview of the funding arrangements for public hospitals Arrangements prior to Medicare Medicare Agreements 1984-1988 Medicare Agreements 1988-1993 Medicare Agreements 1993-1998 Australian Health Care Agreements 1998-2003 Casemix-based funding Overview of State and Territory funding arrangements for public hospitals Adequacy of funding level for public hospitals The Commonwealth's position The position of the States and Territories The consumer perspective Perceptions of a funding `crisis' in public hospitals Public hospital sector efficiency Adequacy of funding in rural Australia Patient travel assistance schemes Concluding comments
Chapter 3 - Options for reform	(PDF 165KB)
Introduction Aspects of the health system off the reform agenda Options for reform Funding and delivery of services: proposals relating to fundamental overhaul The single funder model: evidence Commonwealth as the single funder: assessment States/Territories as single funders: assessment Pooling of Commonwealth and States/Territories funds: regional budget holding Funding and delivery of services: incremental/partial reform proposals Commonwealth to fund all pharmaceutical services Commonwealth to fund all medical services Extension of Coordinated Care Trials/trial of regional budget holding Health care financing: proposals relating to fundamental overhaul Single national insurer Transferable Medicare entitlements Health Savings Accounts Health care financing: incremental/partial reform proposals Reform proposals addressing specifically identified issues Further options for reform A National Health Policy Community debate and transparent priorities Managed Competition Redefining the role and services of hospitals Concluding comments

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