The Australian health system

Learn how Australia’s health system works, who pays for it and how people get health care at low or no cost.

Australia has both a public and a private health system.  

The aim is to give people choice and deliver safe, good quality care when and where it’s needed. 

Our approach is working well. Australians enjoy some of the highest life expectancies in the world.  

Medicare and public hospitals give Australians access to health care at low or no cost. 

Private health insurance can help pay for some hospital and everyday health costs outside of the public system. 

Medicare – the foundation of our health system 

Medicare is Australia’s universal health care scheme.  

Medicare gives people access to many health and hospital services, no matter where they live or how much money they have. 

Medicare helps pay for: 

  • medical services 
  • hospital services 
  • tests, imaging and scans. 

Medicare is available to: 

Medicare covers the full cost of public hospital services.  

It also covers part or all of the costs of some other health services. 

For example, Medicare may help pay for: 

  • a GP appointment 
  • sessions with a psychologist 
  • a visit from the community nurse after you leave hospital 
  • basic dental services for children. 

Learn more about what Medicare covers and how to access it. 

The Medicare Benefits Schedule 

The Medicare Benefits Schedule (MBS) is the list of all health services the Australian Government helps pay for. 

Medical experts regularly review the list to make sure it is up to date, safe and based on best practice. 

The MBS has safety nets. These can lower what you pay for out-of-hospital services after you reach a yearly amount. 

Read more about safety nets and how much you need to spend to be eligible. 

The Pharmaceutical Benefits Scheme 

Your Medicare card also gives you access to cheaper medicines through the Pharmaceutical Benefits Scheme (PBS). 

More than 5,200 medicines are listed on the PBS. 

These include antibiotics and medicines for common conditions such as: 

  • high blood pressure 
  • diabetes 
  • reflux. 

For most PBS medicines, you pay up to a set amount called a co-payment. The government pays the rest. 

If you spend a lot on PBS medicines in a calendar year, the PBS safety net can lower your costs even more. 

Visitors from countries with reciprocal agreements can also access PBS medicines. 

Private health insurance 

Many Australians have private health insurance cover. 

There are 2 types of cover: 

  • hospital cover for some or all of the cost of treatment as a private patient in hospital 
  • general (‘ancillary’ or ‘extras) cover for services Medicare does not usually cover, such as dental and optical. 

Some people have hospital cover or extras cover. Some people have both. 

If your income is below a certain limit, you may be able to get a rebate on your private health insurance. 

Read more about private health insurance and how it works with the public health system. 

Primary health networks 

Primary Health Networks, or PHNs, are another important part of Australia’s health system. 

PHNs are independent organisations that plan and coordinate local primary health care services. 

They look at what their communities need and arrange services to meet those needs. This helps people find care in their local area when they need it. 

PHNs also: 

  • support community health centres, hospitals, GPs, nurses, specialists and other health workers to improve patient care 
  • help different parts of the health system work better together, for example, when a patient leaves hospital and returns to their GP 
  • provide extra local services, such as: 
  • after-hours services 
  • mental health services 
  • health promotion programs 
  • support and training for GPs. 

Learn more about how the 31 PHNs across Australia support their communities. 

Government responsibilities 

The Australian Government, state and territory governments, and local governments all help run the health system. 

Australian Government responsibilities 

The Australian Government is responsible for: 

State, territory and local government responsibilities 

State and territory governments are responsible for: 

  • managing public hospitals 
  • delivering preventive services such as immunisation programs 
  • funding and managing community and mental health services 
  • providing public dental clinics 
  • providing ambulance and emergency services 
  • offering patient transport and subsidy schemes 
  • regulating food safety and handling 
  • regulating, inspecting, licensing and monitoring health premises. 

Find out more through your state or territory health department

Local governments, or councils, also play an important role. 

Councils may provide environmental services, public health programs, and community-based health and home care services. 

You can find out more on your local council’s website. 

Shared responsibilities 

The Australian Government and state and territory governments share responsibility for some parts of the health system. 

These include: 

  • funding public hospital services 
  • preventive services, such as free cancer screening programs 
  • registering and accrediting health professionals 
  • funding palliative care  
  • national mental health reform 
  • responding to national health emergencies. 

Health system challenges 

Australia’s health system faces ongoing challenges, including: 

  • an ageing population 
  • more chronic disease 
  • the cost of medical research and innovations 
  • keeping up with new health technologies 
  • health data that is not well connected. 

These pressures affect how care is funded, planned and delivered now and in the future. 

Ageing population 

As the population gets older, more people need ongoing care. 

This increases demand for services and for skilled health workers across Australia. 

Chronic diseases 

Chronic conditions such as diabetes, heart disease and asthma increase the need for long-term and well-coordinated care. 

Health and medical research 

Health and medical research can improve diagnosis, treatment and prevention. But pursuing new solutions can also be expensive and may raise legal or ethical questions. 

New technology 

Digital tools and other new technologies can improve care. But they also change how services are delivered and can affect patients and the health workforce. 

Health data 

Australia’s health system includes many services, providers and levels of government. This can make it hard to connect and use health data. 

Better connected health data can improve policy, services and patient care. 

Other challenges 

Other challenges include rising costs, new health threats, uneven access to services, and hospital waiting times. 

Cost of health care in Australia 

Australia’s health system is complex and so is the way it is funded.  

In 2023 to 2024, Australia spent an estimated $270.5 billion on health. 

That was about $10,037 per person and 10.1% of gross domestic product (GDP). 

The breakup of spending was: 

  • 39.3% by the Australian Government 
  • 30.3% by state and territory governments 
  • 16.3% by individuals through out-of-pocket costs 
  • 7.8% by private health insurers 
  • 6.4% by other non-government sources. 

The Australian Government pays for a large share of medical services and subsidised medicines.  

Public hospitals are funded by both the Australian Government and state and territory governments. 

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