In its final report to government the National Health and Hospitals Reform Commission outlined three options for reforming the structure of the Australian health system. The third option, discussed in this paper, proposed a fundamental restructure of the Australian health system.

The proposal, called Medicare Select, was foreshadowed in the Commission’s interim report (where it was labelled as Option C). It was described as a compulsory social health insurance system along the lines of those operating in many European countries. In the Commission’s final report, the proposal was branded as ‘a uniquely Australian governance model for health care that builds on and expands Medicare’.

Perhaps because the description of the proposal has changed, there is much confusion about what, precisely, Medicare Select is. Therefore, this paper addresses key questions about the Medicare Select proposal in order to help explain what is and how it would change the Australian health system if it were implemented. In particular this paper:

• examines the differences between Medicare and the Medicare Select proposal
• explains how Medicare Select differs from managed care and ‘privatising’ the health system
• identifies other countries with similar systems, and
• outlines the potential benefits and risks of implementing Medicare Select in Australia.