Healthcare by country

Question

This piglix contains articles or sub-piglix about Healthcare by country

Answer 1

Health care in Colombia

Health care in Colombia refers to the prevention, treatment, and management of illness and the preservation of mental and physical well being through the services offered by the medical, nursing, and allied health professions in the Republic of Colombia.

Tropical diseases are important issues in Colombia because they area major causes of death. Malaria affects nearly 85% of the national territory, mainly the Pacific ocean coast, the Amazon jungle and eastern savannas, with an estimated of 250,000 cases/year and a mortality rate of 3/100,000. The main agent is Plasmodium vivax with 66% of the cases, except on the Pacific coast, where Plasmodium falciparum causes 75% of the cases.

Yellow fever and Dengue fever are major public health concerns, because of their high epidemic potential, high mortality rate and wide distribution of Aedes aegypti. The Colombian government develops vaccination campaigns against yellow fever on a regular basis.

Chagas disease is endemic to the Santander Department and nearby areas. Other diseases such as Leishmania, rabies, Venezuelan equine encephalitis virus and West nile virus are also present in Colombia.Snakebites are a big concern, because of the shortage in antivenom supplies countrywide.

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Answer 2

Healthcare in China

Healthcare in China consists of both public and private medical institutions and insurance programs. About 95% of the population has at least basic health insurance coverage. Despite this, public health insurance generally only covers about half of medical costs, with the proportion lower for serious or chronic illnesses. Under the "Healthy China 2020" initiative, China is currently undertaking an effort to cut healthcare costs, and the government requires that insurance will cover 70% of costs by 2017. The Chinese government is working on providing affordable basic healthcare to all residents by 2020.

China has also become a major market for health-related multinational companies. Companies such as AstraZeneca, GlaxoSmithKline, Eli Lilly, and Merck entered the Chinese market and have experienced explosive growth. China has also become a growing hub for health care research and development.

The above applies to Mainland China. Taiwan and the Special Administrative Regions of Hong Kong and Macau maintain their own separate universal healthcare systems.

Traditional Chinese Medicine (TCM) has been practiced for years, and served as the basis for health care in China for much of its history. Western-inspired evidence-based medicine made its way to China beginning in the 19th Century. When the Communist Party took over in 1949, health care was nationalized, a national "patriotic health campaign" attempted to address basic health and hygiene education, and basic primary care was dispatched to rural areas through barefoot doctors and other state-sponsored programs. Urban health care was also streamlined. However, beginning with economic reforms in 1978, health standards in China began to diverge significantly between urban and rural areas, and also between coastal and interior provinces. Much of the health sector became privatized. As state-owned enterprises shut down and the vast majority of urban residents were no longer employed by the state, they also lost much of the social security and health benefits. As a result, the majority of urban residents paid almost all health costs out-of-pocket beginning in the 1990s, and most rural residents simply could not afford to pay for health care in urban hospitalities.

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Answer 3

Healthcare in Denmark

Healthcare in Denmark is largely financed through local (regional and municipal) taxation with integrated funding and provision of health care at the regional level.

In 2014, the Danish healthcare expenditure amounted to 10.6 per cent of GDP, which is more than the OECD average of 9.0 per cent. Approximately 84 per cent of healthcare expenditure is publicly financed (2015). Life expectancy in Denmark has increased from 77.9 years in 2005 to 80.6 years in 2015. Danish women have a higher life expectancy (82.5 years in 2015) than Danish men (78.6 years in 2015).

There is 1 doctor for every 294 persons in Denmark.

Most primary care in Denmark is provided by general practitioners, who are paid on a combined capitation and fee-for-service basis in a similar way to those in the United Kingdom. The regions determine the number and location of general practitioners, and their fees and working conditions are negotiated centrally between the physicians' union and the government. The municipal health services provide health visitors, home nurses and school health care.

Hospital care is mainly provided by hospitals owned and run by the regions. This is similar to the model in other Scandinavian countries.

There are few private hospital providers, and they account for less than 1% of hospital beds.

The central government plays a relatively limited role in health care in Denmark. Its main functions are to regulate, coordinate and provide advice and its main responsibilities are to establish goals for national health policy, determining national health legislation, formulating regulation, promoting cooperation between different health care actors, providing guidelines for the health sector, providing health and health care-related information, promoting quality and tackling patient complaints.

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Answer 4

Healthcare in Egypt

Healthcare in Egypt consists of both a public and private sector. Public health coverage is offered through Ministry of Health, which operates a series of medical facilities providing free health services. There are two main private insurers. The Health Insurance Organization covers employed persons, students, and widows through premiums deducted from employee salaries and employer payrolls. It operates its own network of medical facilities and at times contracts with private healthcare providers. The Curative Care Organization operates in specific governorates, and contracts with other entities for provision of care. There are also private insurance options, and a network of private healthcare providers and medical facilities. Many mosques also operate their own clinics, especially in the large cities.

Medical care offered by the public health insurance system is generally of poor quality. Government hospitals are known to be rife with negligence and generally provide minimal care. Only about 6% of Egyptians covered by the Health Insurance Organization actually utilize its services due to dissatisfaction with the level of services it funds. In 2008/2009, 72% of health expenditure in Egypt was paid out of pocket by people seeking treatment. Egypt is currently working on an overhaul of its public healthcare system to improve its quality.

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Answer 5

Healthcare in Estonia

Healthcare in Estonia is supervised by the Ministry of Social Affairs and funded by general taxation through the National Health Service.

Estonia is a pioneer in the use of Electronic health records because when general practice was moved out of hospitals in 1998 the records were kept in the hospitals, so GPs had to start their own system. Dr Madis Tiik established an electronic record system though it was officially illegal until 2002. He was a founder member of the eHealth Foundation and became its chief executive. There is now a central record system which is available to all healthcare professionals and can be viewed by the patient. Some tasks are automated, so that doctors do not have to certify that people are fit to drive. The application automatically checks their medical history.

Upon giving birth, the Estonian government grants one of the parents 100% of their former salary for 18 months, plus 320 Euros of one-time support per child. After 18 months, the parent has the right to resume her/his former position. In addition, the parent and child receive free healthcare. Parents who did not work before giving birth (unemployed, students, etc.) receive 278 Euros a month; the top salary is capped at 2,157 Euros a month. These measures, which have been in force from 2005, have not been proven to have had a major positive effect on the birth rate in Estonia, which has increased already since 2001.

Those policy measures concentrate on the first 18 months of the child's life. After 18 months, the monthly state support to a child goes down to 19 Euros a month (for the first two children) and 58 euros (for three or more children), plus free healthcare. There are many exceptions and added bonuses to the rule. For example, the child of a single parent receives twice the sum of child support. The child of an army member receives five times the sum of the child support, and children in foster families receive 20 times the sum of the child support. Despite considerable variation and fluctuations in the support to the family with children, the majority of Estonian families do not face great hardships and the State of The World's Mothers 2011 report ranked Estonia as the 18th best country in the world to be a mother, ahead of countries like Canada and the United States. According to the CIA World Factbook, Estonia has the lowest maternal death rate in the world.

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Answer 6

Healthcare in Finland

Health care in Finland consists of a highly decentralized, three-level publicly funded healthcare system and a much smaller private sector. Although the Ministry of Social Affairs and Health has the highest decision-making authority, the municipalities (local governments) are responsible for providing healthcare to their residents.

Finland offers its residents universal healthcare. Health promotion, including prevention of diseases has been the main focus of Finnish healthcare policies for decades. This has resulted in the eradication of certain communicable diseases and improvement in the health of population.

The quality of service in Finnish healthcare is considered to be good; according to a survey published by the European Commission in 2000, Finland belongs to the top 5 of countries who are most satisfied with their healthcare. In average 88% of Finnish respondents were satisfied compared with the EU average of 41.3%.

Finland’s journey to a welfare state has been long, from a very modest start. The history of modern medicine in Finland can be considered to have begun at 1640 when the first university of Finland, The Royal Academy of Turku, was established. At the time Finland was a part of the Swedish Empire. As the field of medicine did not enjoy very high status in society at the time, the importance of trained medical faculty remained low for a long time. Until 1750, the professor of medicine was the only trained medical doctor in Finland.

An example of early treatment facilities for tuberculosis and leprosy was a hospital on the island of Själö (or Seili in Finnish) which was established on the 1624 and run by the church. It was chosen due to its remote location from the mainland. It was not however until 1759 that the first hospital, albeit a modest hospital, was established in Turku. Consisting of six patient beds in a simple wooden building, it nonetheless marked the first step toward the modern Finnish medical system. It is noteworthy that at the time, Finland had a much lower doctor-patient ratio comparing to neighboring countries. This lasted all the way until the 20th century.

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Answer 7

Health care in France

The French health care system is one of universal health care largely financed by government national health insurance. In its 2000 assessment of world health care systems, the World Health Organization found that France provided the "close to best overall health care" in the world. In 2011, France spent 11.6% of GDP on health care, or US$4,086 per capita, a figure much higher than the average spent by countries in Europe but less than in the US. Approximately 77% of health expenditures are covered by government funded agencies.

Most general physicians are in private practice but draw their income from the public insurance funds. These funds, unlike their German counterparts, have never gained self-management responsibility. Instead, the government has taken responsibility for the financial and operational management of health insurance (by setting premium levels related to income and determining the prices of goods and services refunded). The French government generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments. Supplemental coverage may be bought from private insurers, most of them nonprofit, mutual insurers. Until 2000, coverage was restricted to those who contributed to social security (generally, workers or retirees), excluding some poor segments of the population; the government of Lionel Jospin put into place universal health coverage and extended the coverage to all those legally resident in France. Only about 3.7% of hospital treatment costs are reimbursed through private insurance, but a much higher share of the cost of spectacles and prostheses (21.9%), drugs (18.6%) and dental care (35.9%) (figures from the year 2000). There are public hospitals, non-profit independent hospitals (which are linked to the public system), as well as private for-profit hospitals.

France 1871–1914 followed well behind Bismarckian Germany, as well as Great Britain, in developing the welfare state including public health. Tuberculosis was the most dreaded disease of the day, especially striking young people in their 20s. Germany set up vigorous measures of public hygiene and public sanatoria, but France let private physicians handle the problem, which left it with a much higher death rate. The French medical profession jealously guarded its prerogatives, and public health activists were not as well organized or as influential as in Germany, Britain or the United States. For example, there was a long battle over a public health law which began in the 1880s as a campaign to reorganize the nation's health services, to require the registration of infectious diseases, to mandate quarantines, and to improve the deficient health and housing legislation of 1850. However the reformers met opposition from bureaucrats, politicians, and physicians. Because it was so threatening to so many interests, the proposal was debated and postponed for 20 years before becoming law in 1902. Success finally came when the government realized that contagious diseases had a national security impact in weakening military recruits, and keeping the population growth rate well below Germany's.

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Answer 8

Healthcare in Germany

Germany has a universal multi-payer health care system with two main types of health insurance: "Statutory Health Insurance" (Gesetzliche Krankenversicherung) known as sickness funds (Krankenkassen) and "Private Health Insurance" (Private Krankenversicherung).

The turnover of the health sector was about US$368.78 billion (€287.3 billion) in 2010, equivalent to 11.6 percent of gross domestic product (GDP) and about US$4,505 (€3,510) per capita. According to the World Health Organization, Germany's health care system was 77% government-funded and 23% privately funded as of 2004. In 2004 Germany ranked thirtieth in the world in life expectancy (78 years for men). It had a very low infant mortality rate (4.7 per 1,000 live births), and it was tied for eighth place in the number of practicing physicians, at 3.3 per 1,000 persons. In 2001 total spending on health amounted to 10.8 percent of gross domestic product.

According to the Euro health consumer index, which placed it in 7th position in its 2015 survey, Germany has long had the most restriction-free and consumer-oriented healthcare system in Europe. Patients are allowed to seek almost any type of care they wish whenever they want it.

Germany has the world's oldest national social health insurance system, with origins dating back to Otto von Bismarck's social legislation, which included the Health Insurance Bill of 1883, Accident Insurance Bill of 1884, and Old Age and Disability Insurance Bill of 1889. Bismarck stressed the importance of three key principles; solidarity, the government is responsible for ensuring access by those who need it, subsidiarity, policies are implemented with smallest no political and administrative influence, and corporatism, the government representative bodies in health care professions set out procedures they deem feasible. Mandatory health insurance originally applied only to low-income workers and certain government employees, but has gradually expanded to cover the great majority of the population. The system is decentralized with private practice physicians providing ambulatory care, and independent, mostly non-profit hospitals providing the majority of inpatient care. Approximately 92% of the population are covered by a 'Statutory Health Insurance' plan, which provides a standardized level of coverage through any one of approximately 1,100 public or private sickness funds. Standard insurance is funded by a combination of employee contributions, employer contributions and government subsidies on a scale determined by income level. Higher income workers sometimes choose to pay a tax and opt out of the standard plan, in favor of 'private' insurance. The latter's premiums are not linked to income level but instead to health status. Historically, the level of provider reimbursement for specific services is determined through negotiations between regional physicians' associations and sickness funds.

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Answer 9

Healthcare in Iran

For health issues in Iran see Health in Iran.

Healthcare in Iran is based on three pillars: the public-governmental system, the private sector, and NGOs. The healthcare and medical sector's market value in Iran was almost US $24 billion in 2002 and was forecast to rise to US $31 billion by 2007. With a population of 75 million (2012), Iran is one of the most populous countries in the Middle East. The country faces the common problem of other young demographic nations in the region, which is keeping pace with growth of an already huge demand for various public services. The young population will soon be old enough to start new families, which will boost the population growth rate and subsequently the need for public health infrastructures and services. Total healthcare spending is expected to rise from $24.3 billion in 2008, to $50 billion by 2013, reflecting the increasing demand on medical services. Total health spending was equivalent to 4.2% of GDP in Iran in 2005. About 90% of Iranians have some form of health insurance. Iran is also the only country with a legal organ trade. However, the legal character of organ donations is deemed to be a gifting of organs and not their sale and purchase.

According to the World Health Organization (WHO), as of 2000, Iran ranks 58 in healthcare and 93 in health-system performance. In 2016, Bloomberg News ranked Iran 30th most efficient healthcare system ahead of United States and Brazil. The report shows life expectancy in Iran is 73 years and per capita spending on healthcare is $346. The health status of Iranians has improved over the last two decades. Iran has been able to extend public health preventive services through the establishment of an extensive Primary Health Care Network. As a result, child and maternal mortality rates have fallen significantly, and life expectancy at birth has risen remarkably. Infant (IMR) and under-five (U5MR) mortality have decreased to 28.6 and 35.6 per 1,000 live births respectively in 2000, compared to an IMR of 122 per 1,000 and a U5MR of 191 per 1,000 in 1970.Immunization of children is accessible to most of the urban and rural population.

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Answer 10

Healthcare in Indonesia

Government expenditure on healthcare in Indonesia is about 3.1 percent of its total gross domestic product.

According to data from the Ministry of Health of Indonesia, there are 2454 hospitals around the country, with a total of 305,242 beds - a very low figure of 0.9 bed per 100,000 inhabitants. Most hospitals are in urban areas. Among these, 882 of these hospitals are government owned and 1509 are private hospitals. According to the Worldbank data in 2012, there are 0.2 physicians per 1,000 people, with 1.2 Nurses and Midwives per 1,000 people in Indonesia. Out of all the 2454 hospitals in Indonesia, 20 have been accredited by Joint Commission international (JCI) as of 2015. In addition, there are 9718 government financed Puskesmas (Health Community Centre) listed by the Ministry of Health of Indonesia, which provide comprehensive healthcare and vaccination for the population in the sub-district level. Both traditional and modern health practices are employed.

Indonesia's community health system are organised in three tiers: on top of the chart is Community Health Centre (Puskesmas), followed by Health Sub-Centres on the second level, and Village-Level Integrated Posts at the third level.

In 2010, an estimated 56 percent of Indonesians, mainly state employees, low-income earners, and those with private coverage had some form of health insurance. The rate is expected to reach 100 percent by 2019, following the implementation of a system of universal social health insurance coverage that was launched in 2014. The aim is to grant free services for all hospitalisations in basic (class-3 hospital beds).

Healthcare provision in Indonesia has traditionally been fragmented, with private insurance provision for those able to pay for it alongside basic public coverage for the poorest in society and NGOs working in specialised areas providing services to those not covered by public or private schemes. In January 2014, the Indonesian government launched Jaminan Kesehatan Nasional (JKN), a scheme to implement universal health care in Indonesia. It is expected that spending on healthcare will increase by 12% a year and reach US$46 billion a year by 2019. Under JKN, all Indonesians will receive coverage for a range of treatments via health services from public providers as well as those private organisations that have opted to join the scheme. The formally employed pay a premium worth five percent of their salary, with one percent being paid by the employee and four percent being paid by their employer. Informal workers and the self-employed pay a fixed monthly premium of between 25,500 and 59,500 IDR (£1.34-£3.12). However, the scheme has been criticised for being over-ambitious, a lack of competency in administration, and a failure to address the need for improving healthcare infrastructure in remote areas. An official for the programme's administering organisation, the social security agency Badan Penyelenggara Jaminan Sosial Kesehatan, has stated that JKN exceeded its target for enrolling members in its first year (registering 133.4 million members compared to a target of 121.6 million) and that, according to an independent survey, the customer satisfaction rate was 81 percent, awareness of JKN was 95 percent, and that complaints had been resolved within one and a half days on average. JKN is expected to be implemented in stages. When the initial stages came into effect in January 2014, 48% of the country's population became covered. It is expected that the entire population will be covered in 2019.

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