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Australia's Economy

Medicare and the PBS

How Australia combines public Medicare with private insurance, and how the Pharmaceutical Benefits Scheme negotiates low medicine prices.

Australia has a mixed health system.

Medicare

  • Introduced in 1984, Medicare provides universal coverage for doctor visits and public hospitals, funded by taxes and a Medicare levy.
  • Bulk billing means some doctors bill Medicare directly, so patients pay nothing.

Private insurance

  • About half of Australians have private health insurance.
  • Higher earners without it pay a Medicare Levy Surcharge, encouraging private cover.

PBS

  • The Pharmaceutical Benefits Scheme (from 1948) subsidises medicines.
  • The government negotiates prices with drug companies, using cost-effectiveness assessments.
  • Australians pay much less for many medicines than Americans.

Bargaining power

A single national buyer has strong bargaining power to lower prices.

Challenges

  • Declining bulk billing rates raised out-of-pocket costs; the government increased incentives in 2023-25.
  • Waiting lists in public hospitals.
The subsidised medicine

An Australian pays a small co-payment for a prescription that might cost many times more in the US, thanks to PBS negotiations.

Thinking universal systems ban private insurance

Australia combines Medicare with private insurance.

Key takeaways
  • Medicare provides universal coverage since 1984.
  • About half of Australians have private insurance.
  • The PBS negotiates low medicine prices.
  • Declining bulk billing raised costs.
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