According to the Australian Institute of Health and Welfare, our healthcare system can be best described an intricate web of public and private providers and health-related services. Australians are lucky to have a universal public health insurance scheme called Medicare, which was introduced in 1984. Medicare aims to provide affordable and adequate healthcare for all Australians. This includes providing financial rebates for services listed under the Medicare Benefits Schedule and free treatment for public patients in public hospitals. In Australia, we can choose to only have public health insurance or a combination of public and private health insurance.
What happens if you need to see a doctor?
Our first point of contact in the health system is with the local General Practitioner (GP). From there, a GP is able to order diagnostic blood tests, write prescriptions, refer patients on to a specialist or public hospital for specialist care or pursue various treatment options.
Who decides what medicines a doctor can prescribe?
Before a drug can be marketed in Australia, it must be evaluated by the Therapeutic Goods Administration (TGA). In addition to evaluating the quality, safety and efficacy of drugs, the TGA must also consider their timely availability. New chemical entities and applications which require expert advice are referred to the Australian Drug Evaluation Committee (ADEC). Although the ADEC can make recommendations, the TGA makes the final decision to register a drug for use in Australia. In addition to evaluating prescription drugs, the TGA is also responsible for other medications, including over thecounter medicines, 'alternative medicines' and medical devices.
Doctors will generally recommend what they believe is the best option, taking into consideration the cost of the medication. Under the Medicare system, there is a subsidisation of a wide range of prescription medicine under the Pharmaceutical Benefits Scheme (PBS).
Practically, what is it like to live with type 1 diabetes in Australia?
We are lucky to also have the National Diabetes Services Scheme (NDSS), which started in 1987. This provides subsidies for majority of diabetes medications and supplies required to manage type 1 diabetes. Registration to the NDSS is free and all Australians diagnosed with diabetes are strongly encouraged to register.
However, to get an insulin pump, people with type 1 diabetes need to have basic hospital cover with a private health insurance for at least 12 months. Most private health insurances will then cover the cost of an insulin pump every four to five years. The NDSS also provides subsidy for insulin pump consumables. However, this is not available for people with type 2 diabetes. Currently Continuous Glucose Monitors (CGMs) are not covered by any subsidy.
What about getting admitted to hospital?
Thanks to Medicare, if you’re a public patient admitted to a public hospital, there should be no out of pocket expenses. However, if you’re admitted as a private patient, there may be some additional costs.
How does diabetes care vary throughout the country?
With Medicare and NDSS available nation-wide, diabetes care should be standardised. However, health services are often limited or hard to access in remote and rural areas. Additionally various states and territories may have different guidelines or requirements for certain things such as obtaining or retaining a driver’s license for people with diabetes.
Thanks to Ashley Ng for her help with this information.
To learn more about life with type 1 in Australia, check out our blog post:
Type 1 in Sydney, NY, and Latin America