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AUSTRALIA Hospital funding is set through policy decisions by the federal government, with states required to manage funding within their budgets. Through the 2015–2016 budget, the federal government also consolidated the back-office functions of a number of its health agencies to generate AUD106 million (USD69 million) in savings. Beyond these measures, the major control is through the capacity constraints of the health system, such as workforce supply. What major innovations and reforms have been introduced? In 2015, the federal government announced a number of reforms to primary care, including implementation of the aforementioned PHNs and the MBS Review. In addition, the government has established the Primary Health Care Advisory Group to consider innovations to funding and service delivery for people with complex and chronic illness, including mental health. Together, these three reforms seek to ensure that primary care is being delivered efficiently and effectively and that Medicare is put on a sustainable funding trajectory. The group’s advice, which was submitted to the government at the end of 2015, will consider how to best utilize the PHNs. The government is also reforming care for the aging. In addition to the implementation of the Commonwealth Home Support program outlined above, a new funding model is pursued whereby allocations will be made directly to consumers based on their care needs instead of directly to service providers, affording them greater choice in providers and stimulating provider competition. This reform will take effect in February 2017. 18 The Commonwealth Fund
References AUSTRALIA Australian Bureau of Statistics, Australian Government (2013). “Cat no: 4364.0.55.002 - Australian Health Survey: Health Service Usage and Health Related Actions, 2011–12.” ABS: Canberra. Australian National Audit Office (2010). Audit Report No. 5 2010–11. Performance Audit: Practice Incentives Program. Canberra: ANAO. Australian Taxation Office, Australian Government. https://www.ato.gov.au/General/New-legislation/In-detail/Direct-taxes/ Income-tax-for-individuals/Net-medical-expenses-tax-offset-phase-out/. Accessed Nov. 16, 2015. Australia’s Institute of Health and Welfare (AIHW), Australian Government (2015). “Health Expenditure Australia 2013–14.” Canberra: AIHW. AIHW, Australian Government (2015a). “Medical Workforce 2013 Detailed Tables, Table 4.” Accessed Aug. 12, 2015. Canberra: AIHW. AIHW, Australian Government (2015b). “Mental Health Services in Australia.” https://mhsa.aihw.gov.au/home/. Accessed Nov. 18, 2015. AIHW, Australian Government (2015c). http://www.aihw.gov.au/aged-care/residential-and-community-2011-12/aged-care-inaustralia/. Accessed Nov. 18, 2015. AIHW, Australian Government (2014). “Australia’s Health 2014.” Canberra: AIHW. AIHW, Australian Government (2014a). “Australia’s Hospitals 2013–14 at a glance.” Canberra: AIHW. AIHW, Australian Government (2014b). “Hospital resources 2013–14: Australian hospital statistics.” Canberra: AIHW. AIHW, Australian Government (2013). “Australia’s Welfare.” Canberra: AIHW. The Commonwealth of Australia (2013). “Budget Paper No. 1: Budget Strategy and Outlook 2013-14.” The Commonwealth of Australia: Canberra. http://www.budget.gov.au/2013-14/content/bp1/download/bp1_consolidated.pdf. Accessed Dec. 9, 2015. Department of the Prime Minister and Cabinet, Australian Government (2015). “Reform of the Federation White Paper: Roles and Responsibilities in Health. Issues Paper 3.” Canberra, DPMC. Department of Health, Australian Government (2015). General Practice Workforce Statistics. http://www.health.gov.au/ internet/main/publishing.nsf/content/F210D973E08C0193CA257BF0001B5F1F/$File/GP%20Workforce%20Statistics%20 2013-14%20PUBLIC%20Web%20version.pdf. Accessed Aug. 12, 2015. Department of Health, Australian Government (2015a). http://www.ehealth.gov.au/internet/ehealth/publishing.nsf/Content/ pcehr-statistics. Accessed Nov. 16, 2015. Department of Human Services, Australian Government (2015). http://www.humanservices.gov.au/. Accessed Nov. 16, 2015. Department of Human Services, Australian Government (2015). http://medicarestatistics.humanservices.gov.au/statistics/ do.jsp?_PROGRAM=%2Fstatistics%2Fdgp_report_selector&statisticF=count&reportTypeFH=report&variableF=&drillTypeFH= on&DIVISIONS=&DGPSORT=divgp&groupF=999&schemeF=PIP&reportNameFH=piprrma&reportFormatF=by+time+period &reportPeriodF=quarter&startDateF=201310&endDateF=201312. Accessed Aug. 12, 2015. Department of Social Services (2015). https://www.dss.gov.au/our-responsibilities/ageing-and-aged-care/aged-care-reform/ commonwealth-home-support-programme#03. Accessed Sept. 6, 2015. Health Workforce Australia, Australian Government. http://data.hwa.gov.au/webapi/jsf/tableView/tableView.xhtml. Accessed Sept. 6, 2015. Independent Hospital Pricing Authority (2015). “National Efficient Price Determination 2015-16.” IHPA: Sydney. Ley, Susan (2015). Media release by Susan Ley (Minister for Health): “Pharmaceutical Benefits Scheme to be reformed.” Accessed Sept. 6 from: https://www.health.gov.au/internet/ministers/publishing.nsf/Content/FDA6A9682797EDD7CA257E52 001F423C/$File/SL063.pdf. National Mental Health Commission, Australian Government (2014). “Contributing lives, thriving communities: Report of the National Review of Mental Health Programmes and Services.” NMHC: Canberra. Private Health Insurance Administration Council, Australian Government (2015). “Statistics: Private Health Insurance Membership and Coverage, Sept. 2015.” PHIAC: Sydney. Private Health Insurance Ombudsman, Australian Government. http://www.privatehealth.gov.au/healthinsurance/ whatiscovered/privatehealth.htm. Accessed Nov. 16, 2015. International Profiles of Health Care Systems, 2015 19
Page 1 and 2: JANUARY 2016 2015 International Pro
Page 3: 2015 International Profiles of Heal
Page 6 and 7: Table 1. Health Care System Financi
Page 8 and 9: Table 3. Selected Health System Per
Page 11 and 12: The Australian Health Care System,
Page 13 and 14: AUSTRALIA low-income adults, childr
Page 15 and 16: AUSTRALIA In 2013, the federal gove
Page 17: What is being done to reduce dispar
Page 22 and 23: CANADA What is covered? Services: T
Page 24 and 25: CANADA funding to 145 not-for-profi
Page 26 and 27: CANADA Organization of the Health S
Page 28 and 29: CANADA provides recommendations to
Page 30 and 31: CANADA Health Council of Canada (20
Page 32 and 33: CHINA Private health insurance: Com
Page 34 and 35: CHINA is not substantially more exp
Page 36 and 37: CHINA Organization of the Health Sy
Page 38 and 39: CHINA References Chen, X. (2014).
Page 40 and 41: DENMARK In addition, nearly 1.5 mil
Page 42 and 43: DENMARK Social psychiatry and care
Page 44 and 45: DENMARK Quality data for a number o
Page 46 and 47: DENMARK portion is small, it makes
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Page 50 and 51: ENGLAND immunization, and vaccinati
Page 52 and 53: ENGLAND Hospitals: Publicly owned h
Page 54 and 55: ENGLAND Organization of the Health
Page 56 and 57: ENGLAND How are costs contained? Ra
Page 58 and 59: ENGLAND Organisation for Economic C
Page 60 and 61: FRANCE VHI finances 13.8 percent of
Page 62 and 63: FRANCE The average income of primar
Page 64 and 65: FRANCE What are the key entities fo
Page 66 and 67: FRANCE inequities in prevention rel
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FRANCE Nolte, E., C. Knai, and M. M
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GERMANY There were 42 substitutive
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GERMANY The 16 state governments de
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GERMANY management system, by the s
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GERMANY What major innovations and
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INDIA Private health insurance: The
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INDIA provide after-hour care, reim
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INDIA are provided by other ministr
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INDIA How are costs contained? Ther
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86
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ISRAEL Together, these two types of
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ISRAEL Primary care physicians are
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ISRAEL Organization of the Health S
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ISRAEL • Using electronic health
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96
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ITALY during hospitalization (Thoms
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ITALY Some regions are promoting ca
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ITALY Organization of the Health Sy
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ITALY although the degree of evolut
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ITALY The author would like to ackn
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JAPAN What is covered? Services: Al
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JAPAN incentives for providers to c
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JAPAN Organization of the Health Sy
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JAPAN The author would like to ackn
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THE NETHERLANDS receive faster acce
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THE NETHERLANDS Hospital payment ra
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THE NETHERLANDS Organization of the
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THE NETHERLANDS References Organisa
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NEW ZEALAND provided in GP clinics.
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NEW ZEALAND management (e.g., clean
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NEW ZEALAND including such informat
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NEW ZEALAND largely through efficie
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NORWAY Primary, preventive, and nur
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NORWAY Patients are free to choose
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NORWAY What are the major strategie
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NORWAY The National System for the
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SINGAPORE Medifund is the governmen
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SINGAPORE Public hospital funding i
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SINGAPORE Public consultation: The
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SINGAPORE To keep demand for servic
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SWEDEN What is covered? Services: T
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SWEDEN Hospitals: There are seven u
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SWEDEN Care, which promotes use of
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SWEDEN What major innovations and r
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SWITZERLAND Insurers offer premiums
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SWITZERLAND Hospitals: About 70 per
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SWITZERLAND Organization of the Hea
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SWITZERLAND To control pharmaceutic
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UNITED STATES What is covered? Serv
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UNITED STATES Administrative mechan
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UNITED STATES The Institute of Medi
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UNITED STATES adopted at least a ba
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The COMMONWEALTH FUND Affordable, q
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