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Australia

Australia's population of 19,169,083 people is roughly the same as that of Texas (20,851,820). Its infant mortality rate is 5.04 per 1,000 live births, noticeably better than the US's 6.82. Life expectancy at birth is 76.9 years for men and 82.75 years for women, about 2.6 years longer than in the US for each sex.

Their per capita GDP is $22,200 in US dollars, about 65% of the US's $33,900. Australia spends 8.6% of its GDP on health care. The US spends 12.9%. This works out to $1909 per capita for Australia, vs. $4373 for the US - but the Australians get better results.

The Australian government administers the compulsory national health insurance program (Medicare). National health insurance is funded by a mixture of general tax revenue, a 1.5% levy on taxable income (which accounts for 18.5% of federal outlays on health), state revenue, and fees paid by patients. The government funds 68% of health expenditures (45% federal and 23% state) and has control over hospital benefits, pharmaceuticals, and medical services. States are charged with operating public hospitals and regulating all hospitals, nursing homes, and community based general services. Additionally, the states pay for the public hospitals with federal government assistance negotiated via five yearly agreements. Mainly not-for-profit mutual insurers (private insurance) cover the gap between Medicare benefits and schedule fees for inpatient services. Private insurance covers 1/3 of the population and accounts for 11% of health expenditures.

Patients are free to choose their GP. Primary care physicians act as gatekeepers, and physicians are generally reimbursed by a fee-for-service system. The government sets the fee schedules, but physicians are free to charge above the scheduled fee or they may directly bill the government when there is no patient charge. Prescription pharmaceuticals have a patient co-payment, and out-of-pocket payments account for 19% of health expenditures. Physicians in public outpatient hospitals are either salaried or paid on a per-session basis.


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