These are some of the services provided by the 1 Malaysia clinics: Treatment for cough, cold, flu; after care for stable asthma patents, diabetic patients; Washing of wounds, and removal of stitches; Venue to notify of dengue cases and Advice on health.  That's about all.

Private hospitals are very expensive, and new graduates are all advised to buy a health insurance policy, besides a life insurance policy straightaway on starting work.  How is it in your country?  How can healthcare be more affordable?

Friends, does this make you laugh?

Italian expenditure data in the National Health Service for the years 2009-2012 clearly show that the containment measures put in place at both the national level (es.further block of national collective agreements to work for the validity of three years with effect from 2010 interventions in the field of drugs, etc..) and at the regional level due to the measures taken for the implementation of recovery plans and operational programs (eg accreditation of private operators with the assignment of expenditure ceilings and allocation of budget, reorganization of the hospital network, etc..) have put a strong brake on growth.

In 2012, spending on the NHS amounted to 113.683 billion euro (an increase of 1.3% over the previous year), of which 113.036 billion euro relating to the regions and autonomous provinces of € 0.647 billion and other bodies the NHS funded directly by the state. The ratio between the total expenditure of the NHS and GDP stood at 7.3%.

The resources devoted to the financing of the NHS for the year 2012, not considering the revenues from extraordinary operations and those for the intramural, totaled 112.641 billion euro, of which 111.994 billion euro relating to the regions and autonomous provinces and 0.647 billion euro relating to other bodies of the NHS funded directly by the state. The increase in percentage of the total funding of the NHS nationally is 1.0%.

The ratio of the total funding of the NHS and GDP came in at 7.3%, higher than the previous year's 7.1%.

Beyond these figures, the state owes big money to private companies providing risk of closure for this and are getting more performance and medications that the citizen must pay entirely out of pocket despite paying a regular contribution to the NHS.

We tell in Italy "the cat is biting its tail."

Healthcare is a State issue; however when it comes to premium care the corporates are there....The free and subsidized welfare of health to all citizens below a certain earning capacity are covered under the respective state's Chief minister's Health Insurance scheme. The Health ministry governs the Government Hospitals and Health Clinics, wherein the insured are treated without fees and others nominal fees are to be paid for facilities and services available within the Hospital. For certain ailments and emergencies or services which the government hospital does not have the capability or infrastructure; they can 'refer patients' to other private hospitals; who as well can claim from the insurance for the services provided or any third party medical insurance coverage such as 'Mediclaim' or "pay for service'.

For the huge population containing health related issues is a mammoth task, Indian government and the respective state governments are doing a commendable job....

In addition the Public sector Undertaking (PSU) organizations have their own dedicated Hospitals with all modern facilities....

In Jordan, there is the King Hussein Cancer Center which is the only specialized cancer center in the Middle East treating both adult and pediatrics. Around 75% of patients seeking medical care at the center are Jordanians and 25% from neighboring countries.

Health care in the UK provided by NHS is free. However, patients who are not students and earn above a certain threshhold must pay a prescription charge. Moreover, patients pay part of dental treatment whcih can be fairly expensive.

There are some private hospitals which are more expensive. They make up a small proportion of the whole mdeical care system.

The shortcomings of free public health care includs:

the drugs are not the latest and often not the best

long waiting time for appointments and results to come out

bed shortage

sometimes lack of doctors and nurses (and brain drain to USA and some middleast countries)

waste

sometimes poor management

vulnerability to abuse by a very small number of people

Thank you friends, for informative posts :)  My office internet has just recovered, it was not functioning for the past 3 days.

@Enzo, Ouyang, thanks for listing the disadvantages of NHS.  I'm sure a lot of your taxes goes to upkeep NHS.

@Prithvi, thanks for the info on health care in India.

Despite the fact that Mahfuz mentioned of the Cancer Center in Jordan, still we need more comprehensive strategy for health care.

The health care field is a very huge one and, therefore, all organizations and society should participate in providing this service.

Dear @Miranda, it is a sad, very sad story about Serbia! "Serbian healthcare system got 451 of possible 1,000, and the Netherlands received the most of them – 870. Serbia shares the bottom of the list with Romania, Latvia, Poland and Bulgaria.

http://inserbia.info/today/2013/11/serbian-healthcare-system-again-the-worst-in-europe/

World bank again helps Serbia:"...Total health spending in Serbia accounts for about 10.4 percent of GDP. It is critical for Serbia to increase the productivity of its health spending, particularly given an environment of fiscal constraints and increasing demands for health care from an ageing population. To address these issues, the Second Serbia Health Project will support the improvement of health care financing and efficient purchasing of pharmaceuticals and medical products."

http://www.worldbank.org/en/news/press-release/2014/02/25/world-bank-helps-serbia-improve-health-care-system-and-strengthen-confidence-in-the-financial-system

Thanks for the info that you share.

@Jose, thanks for expressing it graphically.  I happen to be the right-brain girl :)

@Prof Ljubomir, it's sad about the health care in Serbia.  It's about the same here.  So we just try to stay healthy, avoid all bad feeding habits.  I'm so glad that you gave up smoking.  Hoorah :) 

[I'm busy setting test questions.  Thank God, my internet has recovered, and I can print!)

Smoking is not the problem for me any more! I like to eat, I love unhealthy food!

The Indian Council of Medical Research (ICMR), New Delhi, the apex body in India for the formulation, coordination and promotion of biomedical research, is one of the oldest medical research bodies in the world. The Council's research priorities coincide with the National health priorities such as control and management of communicable diseases, fertility control, maternal and child health, control of nutritional disorders, developing alternative strategies for health care delivery, containment within safety limits of environmental and occupational health problems; research on major non-communicable diseases like cancer, cardiovascular diseases, blindness, diabetes and other metabolic and haematological disorders; mental health research and drug research (including traditional remedies). All these efforts are undertaken with a view to reduce the total burden of disease and to promote health and well-being of the population.

The ICMR comprises permanent institutes and regional medical research centres.

http://www.newindigo.eu/india/info/medical.html

@Prof Lala Sukla, thanks for a great link.  One of the institutes/centers is NIOH:

The NIOH has been carrying out significant studies on various aspects of occupational/industrial health involving epidemiological studies and surveillance of hazardous occupations including air pollution, noise pollution, agricultural hazards, industrial hazards in organised sectors as well as small scale industries, carcinogenesis, pesticide toxicology, etc., in different parts of India, apart from laboratory and clinical studies for recognition and evaluation of risk factors for occupation/environment related diseases and designing of appropriate measures for prevention of hazards and/or control of the risk factors at work places.

All these efforts are undertaken with a view to reduce the total burden of disease and to promote health and well-being of the population.  [I hope the population is the whole population, and there is no segragation by castes, as Prof Debi said on 1 of my threads.]

Dear Prof Ljubomir, I think that many people have been conditioned to like fast food and unhealthy food.  My dad used to love 'hawker food' and Penang is a food paradise. So I learned to cook that; BUT reducing the salt and oil.  But then I left home to study at UPM, so he became very unhealthy.  He passed away quite young :(

Now my colleagues love McDonalds and Kentucky.  Our country is the expert on halal or kosher food.  But it's very salty, although McD says it has reduced its salt content. So I eat McD when my old students come to visit me here in Banting :)

I think that on one of Prof Lala's threads, I answered his question about salt.  I think it's even more serious in raising BP than oil or fat.

http://www.mcdonalds.co.uk/ukhome/whatmakesmcdonalds/questions/food/salt-content/why-is-the-salt-content-in-certain-foods-you-sell-so-high-for-example-sausage-and-egg-mcmuffin.html

Thanks for the link Prof Ljubomir.  I'm glad that World Bank is helping Serbia.

'Lower-income groups will benefit from this efficiency as they cannot opt out of the public health care system. Cost savings should contribute to ensuring that public funds deliver a maximum level of service for everyone.

In addition, the project aims to improve the standards of quality and efficiency of care in the Serbian health sector through two main approaches: (i) strengthening quality improvement systems; and (ii) modernizing cancer management at selected tertiary facilities.'

IN india, most of the middle class does not go to the public health care units for their avialing their services, except in some eminent super-speciality institutes, which are few and far between. They avail the services of private hospitals and private practioners. Virtually no government could reduce corruption and lack of work culture in public hospitals. Only poor people go there. They hardly have the power to challenge the system , and ask for their rights.

@Jose, thanks for breakfast :)  I owe many of you many cups of Tea and Coffee.  Wonderful friends aren't easy to find but they are here on RG.  People like Profs Ljubomir, Kamal, Ian Kennedy, Debi, Mahfuz, Beata, Valentina, Raoof, Tobias, Enzo, Irina, Aftab, Pardis and a score others that I can't name here.  Some make it a point to follow me, although they know well I'm so busy.  

So allow me to present to ALL of you the Subway salad.  Subway uses OLIVE OIL.  It's the fast food that's quite healthy :)

@Prof Debi: thanks for telling us as it is.  Of course it is sad that 'Virtually no government could reduce corruption and lack of work culture in public hospitals. Only poor people go there. They hardly have the power to challenge the system , and ask for their rights.'

PhilHealth "contribution and membership" has been socialized. The marginalized, even if they do not contribute, enjoy health care benefits.

Thanks Ed; congrats to the govt and people of Philippines who see the value of people beyond what they possess this world.

You are welcome, Miranda. This scheme started during the past administration and carried out up to this present administration. It actually benefits those who belong to the poorest in the country, their health expenses  of which are partly shouldered by those who belong to the middle and upper brackets of our society.

Dear @Miranda, as You have asked for research in this area, I am attaching a paper on HEALTH INSURANCE SYSTEM IN SERBIA – QUALITY, REFORM,FINANCIAL SUSTAINABILITY!

The second paper attached is "Health care system and spending in Serbia from 2004 to 2008"!

I do think that these resources might be helpful!

The United Kingdom National Health Service is a free at the point of deliver system of healthcare and as such it will always be in 'crisis'.  A free healthcare system (it is not really free since the taxpayer funds it) defies monetary economics.  Since there is no apparent cost there is no check on demand.  Politicians in the UK all talk of reducing hospital waiting lists while health economists know that is impossible in a free at the point of delivery system.  However much of the UK GDP was spent on health there would still be unfulfilled demand. 

Free at the point of delivery healthcare was pioneered in ancient Egypt.  Not only the original 'NHS' but governed by a system of medical ethics still around 4000 years later.

Thanks for the links Prof Ljubomir.  I will get into them soon.  As soon as I started to work I bought a life insurance policy, and after I worked a few years, I bought a health insurance policy.  Health care here is expensive and (I think) it's not very efficient.

@Barry, thanks for the info.  3 of my cousins are nurses in UK, but 1 of them recently decided to retire.  2 came back recently for a few weeks of holidays.  

In the Netherlands: Healthy people pay for sick people.

In Egypt: the Government pay for famous people! Rich people pay for themselves and no condolences for the poor majority...

In India, Govt provide free health care service in Govt. Hospitals for one who belong to lower socioeconomic class especially one below poverty line..

Free pick up and delivery service for pregnant lady in Govt hospitals..

Free vaccination for children and pregnant lady in Govt hospitals..

Medical facilities are very good in Germany, but they are expensive. Health insurance is compulsory, and most expatriate workers will have this included in their contract. It is usually necessary to show evidence of your health insurance in order to obtain a residence permit.

The majority of German nationals are insured under the national health insurance programme, which is subsidized by the Government. It is compulsory for everyone earning less than EUR3,825 per year to enrol in this scheme. Employers pay half of their employees' contributions, which amount to around 14% of monthly earnings and are tax-deductible up to a certain limit. The contributions cover a component for nursing care required as a result of old age or disability. Dependents of employees are also covered and receive the same benefits. Employees earning more than EUR3,825, and the self-employed, can also opt into the government scheme.

http://www.expatfocus.com/expatriate-germany-healthcare-medical?gclid=Cj0KEQjw6J2eBRCpqaW0857k9p4BEiQAWarYbLqo7bGlBIyjUY6WQaPraH5kCGwLsy6OHlj3pFGvF8oaAgkh8P8HAQ

@Alaa, so you are in the Netherlands now.  Do you come from Egypt?  The European countries seem to have better health care, as Liudmila also mentions: Medical facilities are very good in Germany...thanks for the link, Liudmila.

@Dhara, thanks.  Prof Lala Sukla, and Debi gave us a lot of info concerning health care in India.  Please see the earlier posts.  I cannot understand the caste system well enough to make comments...

Thanks Prof Kamal, for facts of health care in Jordan.  I congratulate the govt and people of Jordan for being hospitable and kind to refugees.  I put a link to help some of them.

https://humanappeal.org.uk/appeals/syria_crisis/index?gclid=CjwKEAjwi6OeBRCCrZqp-qaQhhISJACrfbtAfJEoTsuSWQ5ae-bOTZZbqX6wgTFz5IEzdxIALWKzwRoCr4Pw_wcB

@Jose, Prithvi, thanks for your posts.  Yes, Jose, I understand a bit of simple French and Spanish.  Congrats to the govt and people of countries that have a long life span. Just to let you know that Malaysia is nowhere there.  But in my church community, all of us young people have been taking care of our aged parents, uncles and aunts.  Most of the old folks in my church lived to >85 years.  We know that life is God's gift  :)

@Prithvi et al., it's a good question about dental care.  Thanks.  Do you think this is a good answer at all? :))

'Overhead costs are huge. Anywhere from 60% to 80% of what a patient pays goes toward the expense of running a modern dental practice. Dentists pay for rent or mortgage payments on their office space, payroll for hygienists, office managers and receptionists, health insurance, taxes, supplies, business insurance and technology -- just to name a few. "A lot of people would be surprised to know how tight the profit margins are," Dr. W. says. And many dentists are still paying student loans from dental school.'

http://www.cbsnews.com/news/why-your-dentist-costs-so-much/

Dear friends, some facts on Social Security in Serbia are given on the following web page! How about these parameters in your countries?!

http://www.capitaltaxconsulting.com/international-tax/serbia/serbian-social-security/

Thanks Prof Ljubomir for the link.  Here is some on Malaysia:

'Service delivery-wise, there is a need to enhance financing capacity to expand preventive care, in better managing escalating healthcare costs associated with the increasing trend of non-communicable diseases. In tandem, health financing policies need to infuse the element of cost-effectiveness to better manage the purchasing of new medical supplies and equipment. Ultimately, good governance and leadership are needed to ensure adequate public spending on health...'

http://www.biomedcentral.com/content/pdf/1471-2458-12-S1-S7.pdf

'If you want to be healthy- you have to pay money"http://www.healthcare.siemens.com/siemens_hwem-hwem_ssxa_websites-context-root/wcm/idc/siemens_hwem-hwem_ssxa_websites-context-root/wcm/idc/groups/public/@global/documents/download/mdaw/mtqz/~edisp/essay_russia-00068240.pdf

It's ineffective.

Thanks dear Irina, for the info on consumer satisfaction with healthcare and on the situation in Russia.

Today I came across this paper: 'Making Health Care Universally Accessible: The Emergence of Telemedicine as a Core Necessity'.  t's certainly related to this thread.  (Let's read it as soon as we find some time; I can only hope for some public holiday.)

Article Making Health Care Universally Accessible: The Emergence of ...

Dear @Miranda, the objective of the Additional Financing for the Health Project for Serbia is to build capacity to develop a sustainable, performance oriented health care system where providers are rewarded for quality and efficiency and where health insurance coverage ensures access to affordable and effective care. 

Would it be feasible!?

http://www.worldbank.org/projects/P077675/health-project-serbia?lang=en

The US Medicaid Expansion and Apple Health

The Affordable Care Act raised the income limit on eligibility for Medicaid. It also simplified qualifying procedures, by the way, changing the name of Medicaid to Apple Health.

Eligiblity for Medicaid/Apple Health :

• U.S. citizen or a documented immigrant living in Washington who has been in the U.S. for at least five years,
• Not incarcerated,
• Annual income is at or below 138 percent of the federal poverty level.
• For single income is $15,856 or less,
• Different amounts are designated for different-sized families.

http://www.hca.wa.gov/hcr/Pages/default.aspx

Thanks @Umachandran for a great link.  All of us know that healthcare is expensive in many places.  So this is great news.  (I am extremely busy these few days, but I hope to be back to normal, to interact meaningfully with all of you...in the next few days.)

'The Affordable Care Act

The Affordable Care Act (ACA) is the law that is commonly referred to as health care reform. It became law in 2010 and brings major improvements to our health care system. Quality health care coverage will now be available to millions of Americans who have been unable to purchase health insurance on their own.'

http://www.hca.wa.gov/hcr/Pages/default.aspx

https://www.researchgate.net/publication/276121947_Mobile_Health_Services_A_New_Paradigm_for_Health_Care_Systems?ev=prf_pub

Article Mobile Health Services: A New Paradigm for Health Care Systems