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Health care in Australia is a combination of both private and government institutions. The Department of Health develops overall health policy, including that of the Medicare state-funded insurance scheme, which is delivered by the Department of Human Services. Medicare coexists with a private health system mainly funded by private health insurance. Health facilities, including hospitals, are the responsibility of Australia’s six individual states, although the federal government pays a large proportion of the cost of service in public hospitals. There are more than 1,300 hospitals located throughout the country (2012).
Australia has a life expectancy of 82 years – one of the highest in the world. Statistics show a sustained increase in life expectancy, up from 77 years in 1990 and 80 years in 2000. Gains have been primarily due to reduced child and maternal mortality, and improved longevity for other age groups, particularly for older people with chronic diseases.
In 2012, roughly a third of health care in Australia (33%) was paid for by patients or funded by other non-governmental entities, such as private insurers, charities or employers.
In 2014, the rate of infant mortality was three deaths per 1,000 live births, while in 2012, the under-five mortality rate was four deaths per 1,000 births – down from nine deaths in 1990. In 2010 the two most prominent known causes of death for children below the age of five years were congenital anomalies (28%) and prematurity (21%).
Non-communicable diseases (NCDs) accounted for an estimated 91% of all mortality in Australia in 2012, the most prevalent of which were cardiovascular diseases, accounting for 31% of total deaths across all age groups. Cancer accounted for 29% of all deaths.
Less than 0.2% of those within the 15-49 age bracket are known to have contracted HIV (2012). These levels have risen slightly since 1990.
In 2013 government expenditure on health was 6% of GDP. In the most recent survey, conducted between 1997 and 2011, there were 327 doctors, and 1,065 nurses and midwives per 100,000 people. Additionally, in the period 2007–12, 99% of births were attended by qualified health staff and in 2012, 94% of one-year-olds were immunised with one dose of measles. In 2014, 100% of Australia’s population had access to improved water sources and adequate sanitation facilities.
It is generally recognised that the health status of Australia’s Aboriginal and Torres Strait Islander population is inferior to that of the rest of the Australian population. This disparity is largely caused by a lack of access to health care, particularly for remote communities – Medicare services can be hundreds of miles from some Aboriginal settlements. The Australian government has taken steps to try and bridge this gap, and there are special services under Medicare dedicated to improving access to health services for native people. In 2014–15 the government’s Department of Health allocated more than A$920 million in funding for the provision of health programmes specifically for Aboriginal and Torres Strait Islander people.
In July 2014 the Australian government established the Indigenous Australians’ Health Programme, which consolidated four existing indigenous health funding streams: primary health care base funding; child and maternal health activities; Stronger Futures in the Northern Territory (Health); and the Aboriginal and Torres Strait Islander Chronic Disease Fund.
Australia has signed and ratified the International Covenant on Economic, Social and Cultural Rights, which includes ‘the right of everyone to the enjoyment of the highest attainable standard of physical and mental health’. The covenant commits signees to providing healthy and hygienic environmental conditions, controlling epidemic diseases, improving child health and facilitating access to health services without discrimination.