# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
The U.S. Constitution does not state any right about a right to health care. Though, the Supreme Court decided right to privacy and body integrity which provides individuals right to access health care services at their own expense and from willing providers. There are legal issues against Congress about mandating health insurance. Patient Protection and Affordable Care Act, P.L. 111-148. There are government funds for Medicare, Medicaid, and CHIP.

Swendiman, Kathleen. “Health Care: Constitutional Rights and Legislative Powers.” Congressional Research Service, 5 Apr. 2010, https://www.ncsl.org/documents/health/LegPowers.pdf.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
Yes. Canada Health Act. The Canada Health Act (CHA or the Act) is Canada's federal legislation for publicly funded health care insurance. The Act sets out the primary objective of Canadian health care policy, which is "to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers."

Canada, Health. “Government of Canada.” Canada.ca, / Gouvernement Du Canada, 24 Feb. 2020, https://www.canada.ca/en/health-canada/services/health-care-system/canada-health-care-system-medicare/canada-health-act.html.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
Mexico has a Health General Act - "This law regulates the right to health protection that everyone has in the terms of Article 4. of the Political Constitution of the United Mexican States, establishes the bases and modalities for the access to health services and the concurrency of the Federation and the federative entities in the field of general health. It is applicable throughout the Republic and its provisions are of public order and social interest."

“Machine Translation of ‘Law General of Health’ (Mexico).” Global, 7 Feb. 1984, https://www.global-regulation.com/translation/mexico/560288/law-general-of-health.html.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
The current Brazilian healthcare framework was defined in 1988 upon enactment of the Federal Constitution. Brazil has developed a dynamic and complex health system based on the principle of access to health as a fundamental right of every person and a duty of the state.

“The Healthcare Law Review: Brazil.” The Law Reviews - The Healthcare Law Review, 5 Sept. 2021, https://thelawreviews.co.uk/title/the-healthcare-law-review/brazil.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
Everyone that resides in Germany are required by law to have health insurance. Everyone who has statutory health insurance in Germany is entitled to the same healthcare – regardless of how much they pay for their insurance. The premium is determined solely according to income level. People who earn more pay more and vice versa, but still get the same level of care.

Greifeneder, Stefanie. “The Healthcare Law Review: Germany.” The Law Reviews - The Healthcare Law Review, 5 Sept. 2021, https://thelawreviews.co.uk/title/the-healthcare-law-review/germany#:~:text=All%20citizens%20and%20permanent%20residents%20of%20Germany%20are%20required%20by,solely%20according%20to%20income%20level.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
From what I have read on, there is no clause in the law about health care in within France's government.

Though everyone is required to have some form of health insurance while residing in France.

“The French Healthcare System.” Expatica, 25 Jan. 2022, https://www.expatica.com/fr/healthcare/healthcare-basics/a-guide-to-the-french-healthcare-system-101166/#:~:text=Public%20healthcare%20in%20France%20is,after%20three%20months%20of%20residence.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
The Constitution of the Russian Federation has provided all citizens the right to free healthcare since 1996.

“Understanding Russia's Healthcare System.” International Citizens Insurance, 19 Jan. 2022, https://www.internationalinsurance.com/health/systems/russia.php.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
Turkey has a clause made by the Ministry of Health saying that "Every individual is entitled to social security. The State takes the necessary measures to create this confidence and organizes the organization" (Sansal 2021).

Sansal, Burak. “Health Care in Turkey.” Health Care in Turkey | All About Turkey, 2021, https://www.allaboutturkey.com/health.html#:~:text=All%20health%20care%20and%20related,confidence%20and%20organizes%20the%20organization%22.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
"Israel’s National Health Insurance (NHI) law has ensured universal coverage for citizens and permanent residents. As the law states, "Health insurance…shall be based on principles of justice, equality and mutual assistance." Under this commitment, every resident is entitled to health care services"

Authors, et al. “Israel.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/israel.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
"The Ghana Health Service (GHS) is a Public Service body established under Act 525 of 1996 as required by the 1992 constitution. It is an autonomous Executive Agency responsible for implementation of national policies under the control of the Ghana Minister for Health through its governing Council – the Ghana Health Service Council."

Ministry of Health Ghana. “Ghana Health Service.” Ministry Of Health, 7 Aug. 2019, https://www.moh.gov.gh/ghana-health-service/.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
There is not a specific clause in China's constitution about healthcare. Though, "The National Basic Public Healthcare Service Standard, promulgated in 2017, stipulates that basic public healthcare services consist of 13 types of services, including residents' health file management, vaccinations, healthcare administration for special groups (children aged under six, pregnant women, the elderly, and patients with hypertension, type 2 diabetes, severe mental disorders and tuberculosis), infectious diseases and public healthcare emergency reporting and treatment. In December 2019, the Law on Promoting Basic Medical and Health Care was promulgated to further the development of medical, hygiene, and healthcare services and ensure citizens' access to basic medical and healthcare services."

Zhu, Min. “The Healthcare Law Review: China.” The Healthcare Law Review - The Law Reviews, 2021, https://thelawreviews.co.uk/title/the-healthcare-law-review/china#:~:text=The%20National%20Basic%20Public%20Healthcare,pregnant%20women%2C%20the%20elderly%2C%20and.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
Japan has a law in its constitution that required all citizens of Japan to have health insurance coverage.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
"The constitution of India obliges the government to ensure the “right to health” for all.¹ Each state is required to provide free universal access to health care services. However, health care in India has been chronically underfunded."

Tikkanen, Roosa, et al. “India.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/india.

# data[].attributes.headline
Does this country have a clause in their constitution about health care?

# data[].attributes.subject
Does this country have a clause in their constitution about health care?

# data[].attributes.body
"There is no Commonwealth legislation explicitly enshrining the right to the enjoyment of the highest attainable standard of physical and mental health. A number of Commonwealth laws, including the following, deal with subjects relevant to the right to health."

Though people can still opt in private insurances.

Australian Government. “Right to Health.” Attorney-General's Department, 31 Aug. 2020, https://www.ag.gov.au/rights-and-protections/human-rights-and-anti-discrimination/human-rights-scrutiny/public-sector-guidance-sheets/right-health.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
Public and private, for-profit and nonprofit insurers and health care providers. Federal funding covers Medicare, Medicaid, and CHIP. States manage and pay for some local coverage and safety net. Private insurances are covered by employers mostly.

Roosa Tikkanen, et al. “United States.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/united-states.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
"Publicly funded health care is financed with general revenue raised through federal, provincial and territorial taxation, such as personal and corporate taxes, sales taxes, payroll levies and other revenue. Provinces may also charge a health premium on their residents to help pay for publicly funded health care services, but non-payment of a premium must not limit access to medically necessary health services."

Canada, Health. “Government of Canada.” Canada.ca, / Gouvernement Du Canada, 24 Feb. 2020, https://www.canada.ca/en/health-canada/services/health-care-system/canada-health-care-system-medicare/canada-health-act.html.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
The healthcare system in Mexico is part of the national social security program. It’s funded in part by employees and employers who contribute to the IMSS each month. It’s further augmented by funding from the federal government, which is raised through general taxation.

“Healthcare Systems in Mexico.” International Citizens Insurance, 5 Mar. 2021, https://www.internationalinsurance.com/health/systems/mexico.php#:~:text=The%20healthcare%20system%20in%20Mexico%20is%20part%20of%20the%20national,is%20raised%20through%20general%20taxation.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
"Brazil’s decentralized, universal public health system is funded with tax revenues and contributions from federal, state, and municipal governments. The administration and delivery of care are handled by municipalities or states."

Tikkanen, Roosa, et al. “Brazil.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/brazil#:~:text=Brazil's%20decentralized%2C%20universal%20public%20health,handled%20by%20municipalities%20or%20states.&text=There%20is%20no%20cost%2Dsharing%20for%20health%20care%20services.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
Healthcare in Germany is funded by statutory contributions, ensuring free healthcare for all.

“The German Healthcare System.” Expatica, 24 Jan. 2022, https://www.expatica.com/de/healthcare/healthcare-basics/german-healthcare-system-103359/#:~:text=Healthcare%20in%20Germany%20is%20funded,(gesetzliche%20Krankenkasse%20or%20GKV).&text=Germany%20ranked%2012th%20on%20the%202018%20Euro%20Health%20Consumer%20Index.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
The French government sets the national health strategy and allocates budgeted expenditures to regional health agencies, which are responsible for planning and service delivery. Enrollment in France’s statutory health insurance system is mandatory. The insurance system is funded primarily by payroll taxes (paid by employers and employees), a national income tax, and tax levies on certain industries and products.

Tikkanen, Roosa, et al. “France.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/france.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
The Russian Ministry of Health (министерство здравоохранения in Russian) oversees the Russian public healthcare system, and the sector employs more than two million people. Federal regions also have their own departments of health (e.g., Moscow Department of Health) that oversee local administration. This is provided by the state through the Federal Compulsory Medical Insurance Fund (also called the OMI or Obligatory Medical Insurance). It is funded through payroll and employer contributions.

“Understanding Russia's Healthcare System.” International Citizens Insurance, 19 Jan. 2022, https://www.internationalinsurance.com/health/systems/russia.php.

“The Healthcare System in Russia.” Expatica, 25 Jan. 2022, https://www.expatica.com/ru/healthcare/healthcare-basics/healthcare-in-russia-104030/.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
The health care system is financed by "taxes (41%), insurance premiums (31%), and out-of-pocket payments (28%)" (Kisa 2006)

Kisa, Adnan, and Mustafa Z Younis. “Financing health care for the poor in Turkey: is a temporary solution becoming a permanent scheme?.” Public health reports (Washington, D.C. : 1974) vol. 121,6 (2006): 764-8. doi:10.1177/003335490612100617

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
"The overall NHI system is financed primarily by a health tax and general tax revenue. Over a third of Israel’s national health expenditures are covered by households, through a mix of out-of-pocket payments and supplemental insurance packages."

Johnson, James A., et al. Comparative Health Systems: A
Global Perspective. Second ed., Jones & Bartlett Learning, 2018.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
"Apart from allocations from tax revenue, the Ghanaian health system is financed by direct out-of-pocket (OOP) payments (accounting for nearly half of all health care expenditure) and health insurance (composing of premiums and payroll deductions)."

Akazili, J., Gyapong, J. & McIntyre, D. Who pays for health care in Ghana?. Int J Equity Health 10, 26 (2011). https://doi.org/10.1186/1475-9276-10-26

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
"China achieves near-universal coverage through the provision of publicly funded basic medical insurance. The urban employed are required to enroll in an employment-based program, which is funded primarily via employer and employee payroll taxes."

Authors Roosa Tikkanen, et al. “China.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/china#:~:text=China%20achieves%20near%2Duniversal%20coverage,employer%20and%20employee%20payroll%20taxes.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
"Japan’s prefectures implement national regulations, manage residence-based regional insurance (for example, by setting contributions and pool funds), and develop regional health care delivery networks with their own budgets and funds allocated by the national government. The more than 1,700 municipalities are responsible for organizing health promotion activities for their residents and assisting prefectures with the implementation of residence-based Citizen Health Insurance plans, for example, by collecting contributions and registering beneficiaries."

Tikkanen, Roosa, et al. “Japan.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/japan.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
"India's healthcare system is funded through government taxation. In 2019, the government was spending $36 billion on healthcare annually, or roughly 1.23% of its GDP. When out-of-pocket costs that patients spend for private healthcare are taken into account, the country's total healthcare GDP equals 3.6%."

“Understanding India's Healthcare System.” International Citizens Insurance, 2021, https://www.internationalinsurance.com/health/systems/india.php#:~:text=India's%20healthcare%20system%20is%20funded,total%20healthcare%20GDP%20equals%203.6%25.

# data[].attributes.headline
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.subject
How is the health care system financed? [meaning how is it paid for]

# data[].attributes.body
"Funding and responsibility for Australia’s health system is a complex blend of purchasers and providers and is funded predominantly from taxation sources with federal, state, and territory governments, contributing close to 70% of all health spending.  Nongovernment funding is drawn mainly from out-of-pocket payment by individuals and health insurance funds, which help to cover the cost of treatment in private hospitals and a range of other medical and ancillary health services."

Johnson, James A., et al. Comparative Health Systems: A
Global Perspective. Second ed., Jones & Bartlett Learning, 2018.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Both. There is no universal health care. USA health care system are ran by private, for-profit and nonprofit providers. Though federal funds public insurances.

Ridic, Goran et al. “Comparisons of health care systems in the United States, Germany and Canada.” Materia socio-medica vol. 24,2 (2012): 112-20. doi:10.5455/msm.2012.24.112-120

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Public health care system. Canada has a decentralized, universal, publicly funded health system called Canadian Medicare.

Canada, Health. “Government of Canada.” Canada.ca, / Gouvernement Du Canada, 24 Feb. 2020, https://www.canada.ca/en/health-canada/services/health-care-system/canada-health-care-system-medicare/canada-health-act.html.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Mexico has a public and private health care systems.
Though it is mostly ran by The Ministry of Health, the Mexican Social Security Institute (IMSS), and the Mexican Children’s Hospital.

“Mexico: Summary.” Columbia Public Health, 2021, https://www.publichealth.columbia.edu/research/comparative-health-policy-library/mexico-summary.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Brazil has a decentralized, universal public health system

Tikkanen, Roosa, et al. “Brazil.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/brazil#:~:text=Brazil's%20decentralized%2C%20universal%20public%20health,handled%20by%20municipalities%20or%20states.&text=There%20is%20no%20cost%2Dsharing%20for%20health%20care%20services.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
It is a universal health network with dual public-private system. It is funded by contributions and also have private health insurances that people can pay for.

Tikkanen, Roosa, et al. “Germany.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/germany.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
France has a universal health care system. They have public and private practices.

Tikkanen, Roosa, et al. “France.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/france.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Russia has both a public and private health care system. Since public health is free to all residents through the government, it lacks funds. Most go through the private health care system.

“The Healthcare System in Russia.” Expatica, 25 Jan. 2022, https://www.expatica.com/ru/healthcare/healthcare-basics/healthcare-in-russia-104030/.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Turkey has both public and private institutions. The public healthcare "is not well equipped, suffering from a lack of funding and over capacity, but services are subsidised; providing prescriptions, hospitalisation, pregnancy, rehabilitation and specialist treatments.

Payment is made either out of pocket or through compulsory contributions to the Social Insurance Organisation for Health, with the amount usually deducted by employers from your income at the end of every month"

"Expats in Turkey tend to seek treatment at private hospitals where they can access superior facilities and well-trained staff who are more likely to speak English. While more expensive than public healthcare, it remains quite affordable. By using private healthcare, expats also skip the long queues so often prevalent in state-run institutions.

Those staying in Turkey long-term or those who suffer from chronic illnesses should consider investing in health insurance. The European Health Insurance Card isn’t valid in Turkey so health insurance is advised if you want to be treated in private facilities."

“Guide Healthcare in Turkey: Allianz Care.” Allianzcare.com, 2022, https://www.allianzcare.com/en/support/health-and-wellness/national-healthcare-systems/healthcare-in-turkey.html.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Israel has a universal health care system, meaning all Israel's citizens can have insurance.
"Residents are free to choose one of four competing nonprofit health plans that must cover anyone who applies. Every resident has a right to receive all services included in the benefit basket that is mandated by the government, subject to medical discretion. While residents also have the right to receive services at a reasonable quality level, within a reasonable period of time, and at a reasonable distance from their home, no formal definition of “reasonable” exists, and there is no penalty for health plans that fail to comply."

Authors, et al. “Israel.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/israel.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
"There are four main categories of healthcare delivery systems in Ghana: the public, private for profit, private not for profit, and traditional systems.19 The public health system, centered around the Ministry of Health (MoH), has a hierarchical organizational structure disseminating from the central headquarters in Accra to the regions, districts, and subdistricts. Services are delivered through a network of facilities, with health centers and district hospitals providing primary healthcare services, regional hospitals providing secondary health care, and four teaching hospitals—the Korle Bu Hospital, the Komfo Anokye Teaching Hospital (KATH), the Tamale Teaching Hospital (TTH), and the Cape Coast Teaching Hospital—at the apex providing tertiary services. The four teaching hospitals play a key role in teaching and research, offering facilities for the training of doctors and other health professionals and for medical and public health research. KATH and TTH serve about half of the people of Ghana and serve as the main tertiary referral center for neighboring Burkina Faso and Côte d’Ivoire."

Johnson, James A., et al. Comparative Health Systems: A
Global Perspective. Second ed., Jones & Bartlett Learning, 2018.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
China has both public and private health care available for its residents.
"The urban employed are required to enroll in an employment-based program, which is funded primarily via employer and employee payroll taxes. Other residents can voluntarily enroll in Urban-Rural Resident Basic Medical Insurance, financed primarily by central and local governments through individual premium subsidies. Local health commissions organize public and private health care organizations to deliver services. The basic medical insurance plans cover primary, specialty, hospital, and mental health care, as well as prescription drugs and traditional Chinese medicine. Deductibles, copayments, and reimbursement ceilings apply. There is no annual cap on out-of-pocket spending. Complementary private health insurance helps cover cost-sharing and coverage gaps."

Roosa Tikkanen, et al. “China.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/china#:~:text=China%20achieves%20near%2Duniversal%20coverage,employer%20and%20employee%20payroll%20taxes.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Japan has a universal health coverage.
"Japan’s statutory health insurance system (SHIS) covers 98.3 percent of the population, while the separate Public Social Assistance Program, for impoverished people, covers the remaining 1.7 percent.1,2 Citizens and resident noncitizens are required to enroll in an SHIS plan; undocumented immigrants and visitors are not covered."

Tikkanen, Roosa, et al. “Japan.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/japan.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
India has both public and private health care systems.
"The vast majority of expats opt to carry private international health insurance in India and be treated in private facilities. This isn’t just because public facilities are very basic in nature. It’s also because there are limited resources. An expat who receives care in a public facility is just one more person causing delays and congestion.

For those who do opt to use public facilities (or who no other choice based on their location), you can expect a registration fee in addition to the treatment cost. Those admitted overnight also pay room charges. Most public hospitals offer different levels of accommodations (common classifications include “deluxe,” “deluxe with AC,” or “super deluxe”.) Generally, the better the room, the happier the patient. Expats who find themselves in this situation should request the best room classification that they can afford."

“Understanding India's Healthcare System.” International Citizens Insurance, 2021, https://www.internationalinsurance.com/health/systems/india.php#:~:text=India's%20healthcare%20system%20is%20funded,total%20healthcare%20GDP%20equals%203.6%25.

# data[].attributes.headline
Is this a public or private health care system?

# data[].attributes.subject
Is this a public or private health care system?

# data[].attributes.body
Australia has a universal public health insurance program - Medicare.

# data[].attributes.body
Multiple ways. People can apply for public insurance such as Medicare, Medicaid, and CHIP. There is an Affordable Care Act, buy Private Health Insurance Plans personally and from employers, COBRA.

“Finding Health Insurance.” USAGov, 2022, https://www.usa.gov/finding-health-insurance#item-36412.

# data[].attributes.body
Since Canada has a universal health care system, any Canadian citizen and permanent resident in the country can apply for public health insurance. "Each province and territory has a different health plan that covers different services and products."

Canada, Health. “Government of Canada.” Canada.ca, / Gouvernement Du Canada, 24 Feb. 2020, https://www.canada.ca/en/health-canada/services/health-care-system/canada-health-care-system-medicare/canada-health-act.html.

# data[].attributes.body
In Mexico, you will have good private and public health insurance options. Public health care is usually provided by the IMSS through employment or voluntary enrollment. The INSABI provides health care to individuals who are not covered by IMSS or who do not have private insurance.

“Healthcare in Mexico.” InterNations, 2021, https://www.internations.org/go/moving-to-mexico/healthcare#:~:text=In%20Mexico%2C%20you%20will%20have,do%20not%20have%20private%20insurance.

# data[].attributes.body
All residents and visitors, including undocumented individuals, can access free, comprehensive services, including primary, outpatient specialty, mental health, and hospital care, as well as prescription drug coverage. No application process is necessary. There is no cost-sharing for health care services.

Tikkanen, Roosa, et al. “Brazil.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/brazil#:~:text=Brazil's%20decentralized%2C%20universal%20public%20health,handled%20by%20municipalities%20or%20states.&text=There%20is%20no%20cost%2Dsharing%20for%20health%20care%20services.

# data[].attributes.body
All German residents can access the healthcare system through public health insurance in Germany. Non-residents need to have private insurance coverage to access healthcare. Temporary visitors will typically need to pay for treatment and claim reimbursement later.

“The German Healthcare System.” Expatica, 24 Jan. 2022, https://www.expatica.com/de/healthcare/healthcare-basics/german-healthcare-system-103359/#:~:text=Healthcare%20in%20Germany%20is%20funded,(gesetzliche%20Krankenkasse%20or%20GKV).&text=Germany%20ranked%2012th%20on%20the%202018%20Euro%20Health%20Consumer%20Index.

# data[].attributes.body
Public healthcare can be accessed by all residents through the French health insurance contributions. By law, all residents must have some type of health insurance by applying through the government or through private insurances.

“The French Healthcare System.” Expatica, 25 Jan. 2022, https://www.expatica.com/fr/healthcare/healthcare-basics/a-guide-to-the-french-healthcare-system-101166/#:~:text=Public%20healthcare%20in%20France%20is,after%20three%20months%20of%20residence.

# data[].attributes.body
Healthcare in Russia is free to all residents through a compulsory state health insurance program. However, the public healthcare system has faced much criticism due to poor organizational structure, lack of government funds, outdated medical equipment, and poorly paid staff. Every Russian citizen and resident receives free public healthcare under the Russian healthcare system via Obligatory Medical Insurance (OMI). Foreign residents in Russia, both permanent and temporary, can access public healthcare through OMI. Many expat residents are also covered by voluntary healthcare insurance (VHI) which is supplementary insurance usually offered through employers. Unemployed foreign citizens with a residence permit may eligible for an OMI policy under certain conditions; you will need to check via a medical insurance company that is subscribed to the Russian healthcare system.

“The Healthcare System in Russia.” Expatica, 25 Jan. 2022, https://www.expatica.com/ru/healthcare/healthcare-basics/healthcare-in-russia-104030/.

# data[].attributes.body
Since people can get healthcare through public and private institutions, people can use "the state budget, the social security organizations’ budget, and personal expenses. The general state budget is financed from tax revenues, which is the major source for health services finance in the country" (Johnson 2018). They have a problem with access to healthcare as not everyone everyone has this opportunity. Turkey is working on transforming health care to a universal healthcare coverage.

Johnson, James A., et al. Comparative Health Systems: A Global Perspective. Second ed., Jones & Bartlett Learning, 2018.

# data[].attributes.body
"Residents are free to choose one of four competing nonprofit health plans that must cover anyone who applies. Every resident has a right to receive all services included in the benefit basket that is mandated by the government, subject to medical discretion. While residents also have the right to receive services at a reasonable quality level, within a reasonable period of time, and at a reasonable distance from their home, no formal definition of “reasonable” exists, and there is no penalty for health plans that fail to comply."

Authors, et al. “Israel.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/israel.

# data[].attributes.body
"Healthcare is variable throughout Ghana. Urban centers are well served, and are where most hospitals, clinics, and pharmacies in the country can be found. Rural areas often have no modern healthcare services. Patients in these areas either rely on traditional African medicine or travel great distances for healthcare. Most healthcare is provided by the government and is largely administered by the Ministry of Health and Ghana Health Services. The healthcare system has five levels of providers: health posts, health centers and clinics, district hospitals, regional hospitals and tertiary hospitals. Health posts are the first level of primary care for rural areas."

International Trade Administration. “Ghana - Healthcare.” International Trade Administration | Trade.gov, https://www.trade.gov/country-commercial-guides/ghana-healthcare#:~:text=Healthcare%20is%20variable%20throughout%20Ghana,travel%20great%20distances%20for%20healthcare.

# data[].attributes.body
China residents can enroll through employers or can enroll in Urban Rural Resident Basic Medical Insurance from central and local governments.

# data[].attributes.body
"The SHIS consists of two types of mandatory insurance:

1. employment-based plans, which cover about 59 percent of the population

2. residence-based insurance plans, which include Citizen Health Insurance plans for nonemployed individuals age 74 and under (27% of the population) and Health Insurance for the Elderly plans, which automatically cover all adults age 75 and older (12.7% of the population).

Each of Japan’s 47 prefectures, or regions, has its own residence-based insurance plan, and there are more than 1,400 employment-based plans."

Tikkanen, Roosa, et al. “Japan.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/japan.

# data[].attributes.body
"Historically, there have been several government-funded health insurance schemes intended to improve coverage for specific population groups, with variations across states. One important scheme aimed at reducing financial catastrophe and vulnerability for lower-income populations is the National Health Insurance Program (Rashtriya Swasthya Bima Yojana, or RSBY), launched in 2008. As of 2016, some 41 million families were enrolled in RSBY.² However, evidence indicates that the scheme has not significantly reduced out-of-pocket spending. It is now being subsumed under the PM-JAY.

With ineffective public insurance schemes and the low uptake of commercial insurance, only around 37 percent of the population were covered by any form of health coverage in 2017–2018.³ Further systemic barriers to access include long wait times in hospitals, the perceived low quality of public health services, and substantial workforce and infrastructure shortfalls.⁴

In March 2018, the central government approved the implementation of PM-JAY. This flagship public health initiative has been internationally recognized as a significant step toward achieving universal coverage in India.⁵ The initiative offers hospital coverage for the 40 percent of the country’s population that is poor or low-income. The other important initiative is to bolster preventive and promotive health care services by revamping existing primary health facilities into Health and Wellness Centres."

Tikkanen, Roosa, et al. “India.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/india.

# data[].attributes.body
"Under Medicare, patients are entitled to access public hospital care at no charge. This includes free medical and surgical care from physicians and surgeons, accommodation, meals, and other health services while in the hospital if they are admitted as public patients. In addition to having a publicly funded social health insurance scheme (Medicare), Australians can also subscribe to private health insurance. If privately insured patients choose to be admitted as private patients, then additional fees and charges are likely. In these instances, the patient can choose their own physician/surgeon. When in private hospitals, patients are charged fees for accommodation, nursing care, and other hospital care. They are also charged separately for any medical and surgical treatment. Private health insurance is available to cover such expenses (and ancillaries, such as optical, dental and allied health) if people wish to subscribe. Any premiums are additional to the Medicare levy (2.0% of income, with some reductions and exclusions), which all Australian taxpayers are obliged to pay.17 In recent years, the government has introduced a number of policies to reduce the pressure on the public health system penalizing higher earning taxpayers with an additional Medicare surcharge if they do not take out private insurance."

Johnson, James A., et al. Comparative Health Systems: A
Global Perspective. Second ed., Jones & Bartlett Learning, 2018.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
Yes. Deductibles, coinsurance, copayments, premiums, and cost of services if not covered by the insurance an individual has.

“Out-of-Pocket Costs - Healthcare.gov Glossary.” HealthCare.gov, 2022, https://www.healthcare.gov/glossary/out-of-pocket-costs/.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
Canada does have out of pocket fees. There are still premiums. Canada pays up to 50% more in taxes than USA. Though, "supplementary services, or those not covered under Canadian Medicare, are largely privately financed, either from patient out-of-pocket payments or through employer-based or private insurance." There is no cost-sharing for public physicians. Drug plans are provided by provinces and territories.

Tikkanen, Roosa, et al. “Canada.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/canada.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
Mexico has private and public insurances that require out of pocket and additional fees. There are reports that suggest that, in some hospitals, medications and medical supplies (e.g. gauze, ointments) are not readily available and patients must pay out of pocket.

Murray, Don. “Healthcare in Mexico: Overview of Costs and Plans Available.” International Living, 13 Oct. 2021, https://internationalliving.com/countries/mexico/health-care/.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
There is no cost sharing in Brazil though "Out-of-pocket expenditures account for a little more than 27 percent of total health expenditures.⁸ However, they represent a considerable financial burden for households, and disproportionately affect the poor."

Tikkanen, Roosa, et al. “Brazil.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/brazil#:~:text=Brazil's%20decentralized%2C%20universal%20public%20health,handled%20by%20municipalities%20or%20states.&text=There%20is%20no%20cost%2Dsharing%20for%20health%20care%20services.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
Out-of-pocket spending accounted for 13.5 percent of total health spending in 2017, and most individual spending went to nursing homes, pharmaceuticals, and medical aids.⁸

Copayments are determined by federal legislation and apply at the national level.

To compete for patients, sickness funds offer a range of deductibles and no-claims bonuses. Preventive services do not count toward the deductible, and there are no copayments for recommended preventive services (such as cancer screenings at certain ages).

Physicians who contract with sickness funds are not allowed to charge above the fee schedule for services in the SHI benefit catalogue. However, a list of individual health services outside the comprehensive range of coverage may be offered for a fee to patients paying out of pocket.

Tikkanen, Roosa, et al. “Germany.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/germany.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
There are no deductibles. Cost-sharing for primary and specialist care takes three forms: coinsurance, copayments, and balance billing. Some physicians are allowed to balance-bill above the national fee schedule; authorization is based upon the duration of their hospital residency. These out of pocket fees are for dental and vision services, as well as for prescription drugs.

Tikkanen, Roosa, et al. “France.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/france.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
22.2% of patients pay for outpatient services, 37.5% pay for inpatient services and 91.5% pay for outpatient medicinal treatment. The informal payments are almost equally met in both outpatient (13.4%) and inpatient (12.2%) care; while the official payments are more common in inpatient care (25.2%), compared to outpatient care (8.8%). The main reasons for informal payment include: improvements in the quality of care and gratitude for medical staff. The official payments are more frequently motivated by an inability to receive a certain treatment free of charge.

Zasimova L. The use of medical care and out-of-pocket payments in Russia. Scand J Public Health. 2016 Jul;44(5):440-5. doi: 10.1177/1403494816638193. Epub 2016 Mar 15. PMID: 26980731.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
"Out-of-pocket payments on health care constitute a substantial portion of the household expenditure in many developing countries. These payments become catastrophic when a household is not able to pay and has to reduce other spending, including food, clothing and education, to compensate for the health expenditures"

Out of pocket stands at 17.38%.

Giovanis, Eleftherios. The Effects of Policy Reforms on out-of-Pocket Health ... 2017, https://erf.org.eg/publications/the-effects-of-policy-reforms-on-out-of-pocket-health-expenditures-evidence-from-turkey/.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
"In 2016, out-of-pocket spending accounted for 22 percent of national health expenditures.⁷ Most of this was for voluntary health insurance (38%), adult dental care (22.5%), and pharmaceuticals (15%). The remainder was for other services not included in the NHI benefit package, including vision care and medical equipment, as well as cost-sharing for NHI-covered services."

Authors, et al. “Israel.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/israel.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
"Close to 49.7% (1027) of all patients reported paying for health care at the health facility they visited. Sixty-four percent (657) paid consultation fee and 34.2% (326) paid for drugs (Table 5). Whereas some patients incurred cost that otherwise should have been paid for by the NHIS, other costs were co-payments. Of those who paid for these services, 42.5% (441) did not get a receipt for the services paid for. Patients reported ever paying for services at the same health facilities. Close to 48 % (456) reported ever paying for these services in previous visits to the health facilities. For the most recent payments, 77.4% (322) paid weeks ago before this survey (Table 5).

Out-of-pocket payment for health care services occurred at all level of health facilities. On average close to 41% (441) of patients who visited the CHPS and 43%(881) health centres paid for health care while an average of 53% of those who visited district, regional and tertiary (teaching training hospitals) health facilities also paid out-of-pocket for health care.

Out-of-pocket payments at district and regional hospitals were slightly higher than those of tertiary hospitals but the differences were not statistically significant (P > 0.05).

Of all drugs prescribed, 34.9% (717) were purchased outside the health facility visited (Table 5). The main reasons why the drugs were not supplied by the health facilities patients visited were: unavailability of the drug 67.9% (487) and the drugs prescribed not being covered by the NHIS 20.8% (142).

Most patients (66.5%) paid between GHS1.00 (USD0.20) and GHS20.00 (USD4.00) for consultation and drugs (Table 5).

Out-of-pocket payment for health services by insured clients

Ninety percent of patients (1722) who accessed health care at all health facilities in the regions had a valid NHIS card and 8% (153) had a valid NHIS card but could not show it at the time of the survey (Table 6).

Insured clients who paid for health care were 46.9% (803) compared to 49.7% (89) of those who reported not having enrolled with the NHIS. This difference was not statistically significant .

Of those who held a valid NHIS card that was seen, 75.3% (1295) paid for consultation and 63.2% (1079) paid out of pocket for drugs, and 26% paid for both consultation and drugs (Table 6). Of those with valid NHIS cards who could not present them, 68.5% (102) paid for consultation and 75% (111) paid for drugs (Table 6).

The proportion of NHIS clients in this study earning income was 56% (998). The median monthly income of NHIS clients was GHS300.00 (USD60.00) while the mean income was GHS574.72 (USD114.94). However, over 55.6% of NHIS members earned in the range of GHS8.00 to GHS300.00 (Table 6). The average monthly health care costs paid per client was GHS33.1 representing 11% of the median income of GHS300.00 (USD60.00) of patients.

NHIS clients paying-out-of-pocket for health care varied by region with 62.4% (431) of those from the Ashanti region paying out of pocket with much lower payments observed in the Central 48.2% (335) and Northern regions 35.2% (238) and these differences were statistically significant (P < 0.001) as shown in Fig. 2."

Akweongo, P., Aikins, M., Wyss, K. et al. Insured clients out-of-pocket payments for health care under the national health insurance scheme in Ghana. BMC Health Serv Res 21, 440 (2021). https://doi.org/10.1186/s12913-021-06401-8

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
"

Copayments for outpatient physician visits are often small (CNY 5–10, or USD 2–3), although physicians with professor titles have much higher copayments.

Prescription drug copayments vary; they were about 50 percent to 80 percent of the cost of the drug in Beijing in 2018, depending on the hospital type.

Copayments for inpatient admissions are much higher than for outpatient services.

There are no annual caps on out-of-pocket spending. In 2018, out-of-pocket spending per capita was CNY 1,186 (USD 262)—representing about 28 percent of total health expenditures.⁸ A fairly high percentage of out-of-pocket spending is for prescription drugs."

Authors Roosa Tikkanen, et al. “China.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/china#:~:text=China%20achieves%20near%2Duniversal%20coverage,employer%20and%20employee%20payroll%20taxes.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
"In 2015, out-of-pocket payments accounted for 14 percent of current health expenditures. There are no deductibles, but SHIS enrollees pay coinsurance and copayments.

SHIS enrollees have to pay 30 percent coinsurance for all health services and pharmaceuticals; young children and adults age 70 and older with lower incomes are exempt from coinsurance.

Small copayments are charged for primary care and specialty visits (see table). Residents also pay user charges for preventive services, such as cancer screenings, delivered by municipalities.

Providers are prohibited from balance billing or charging fees above the national fee schedule, except for some services specified by the Ministry of Health, Labor and Welfare, including experimental treatments, outpatient services of large multispecialty hospitals, after-hours services, and hospitalizations of 180 days or more."

Tikkanen, Roosa, et al. “Japan.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/japan.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
"Citizens can get free care in public health facilities with no deductibles, co-payments, or coinsurance.

However, because government funding for health care is limited and there are accessibility issues at the existing facilities, a significant portion of outpatient and inpatient care is delivered at private, high-priced facilities, with costs typically paid out-of-pocket.²⁰ As a result, out-of-pocket payments have been the primary means of funding health care, accounting for 65 percent of total health expenditures in 2015–2016."

Tikkanen, Roosa, et al. “India.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/india.

# data[].attributes.headline
Are there out of pocket or additional user fees?

# data[].attributes.subject
Are there out of pocket or additional user fees?

# data[].attributes.body
"Out-of-pocket payments accounted for 16.5 percent of total health expenditures in 2016–2017. The largest share (68%) was for primary care, of which one-third (37%) was for medications, followed by hospital care (11%).¹¹

Under Medicare, there are no deductibles or out-of-pocket costs for public patients receiving public hospital services. Cost-sharing for outpatient care varies. The federal government sets Medical Benefits Schedule (MBS) fees for general practitioner (GP) and specialty visits; it pays GPs 100 percent of the fee and specialists 85 percent. Patients pay the remaining 15 percent of specialist fees, as well as any surcharges. GPs and specialists can choose to charge above the MBS fees, although there is a maximum patient out-of-pocket fee of AUD 83.40 (USD 57.00) per service. About 86 percent of GP visits were provided without an additional charge to patients in 2016–2017.¹² Patients who were charged paid an average of AUD 31 (USD 22).

Out-of-pocket outpatient pharmaceutical expenditures are capped under the PBS (see table). Consumers pay the full price of medicines not listed on the PBS. Pharmaceuticals provided to inpatients in public hospitals are generally free."

Tikkanen, Roosa, et al. “Australia.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/australia#:~:text=Australia%20has%20a%20regionally%20administered,revenue%20and%20a%20government%20levy.

# data[].attributes.body
It's different for every insurance that an individual pays for.

Typically, most insurances cover:
Doctor and hospital visits
Prescriptions
Wellness visits
Medical devices

Some procedures need to be appealed and approved to prove that it is medically necessary.

Most cosmetic procedures, fertility treatments, new drugs, new technology, and off-label prescriptions are not covered.

Zucchi, Kristina. “Services That Health Insurers Often Decline.” Investopedia, Investopedia, 21 Jan. 2022, https://www.investopedia.com/articles/insurance/09/services-health-insurers-do-not-cover.asp.

# data[].attributes.body
"In general, with public health insurance you won’t have to pay for

most health care services

emergency medical services, even if you don’t have a health card (there may be some restrictions depending on your immigration status)"

"In most cases, public health insurance won’t cover prescription medication. Many Canadians have other insurance coverage that pays for part of the cost of their prescriptions.

This coverage can come from

provincial and territorial medication programs (you need to be eligible for these programs)

employers that have private insurance plans for their employees"

"In Canada, our public health insurance doesn’t cover the cost of most dental services. To know what’s covered, check with

your public health authority

your private health care provider"

"The provinces and territories provide coverage to certain people (e.g., seniors, children and low-income residents) for health services that are not generally covered under the publicly funded health care system. These supplementary health benefits often include prescription drugs outside hospitals, dental care, vision care, medical equipment and appliances (prostheses, wheelchairs, etc.), and the services of other health professionals such as physiotherapists. The level of coverage varies across the country."

Canada, Health. “Government of Canada.” Canada.ca, / Gouvernement Du Canada, 17 Sept. 2019, https://www.canada.ca/en/health-canada/services/health-care-system/reports-publications/health-care-system/canada.html.
Immigration, Refugees and Citizenship Canada. “Government of Canada.” Canada.ca, / Gouvernement Du Canada, 3 Dec. 2021, https://www.canada.ca/en/immigration-refugees-citizenship/services/new-immigrants/new-life-canada/health-care/universal-system.html.

# data[].attributes.body
Mexico’s public healthcare operates through the Instituto Mexicano de Seguro Social (IMSS)  and Seguro Popular systems. These cover  patients for most medical services and prescription drugs.

“Guide Healthcare in Mexico: Allianz Care.” Allianzcare.com, 2021, https://www.allianzcare.com/en/support/health-and-wellness/national-healthcare-systems/healthcare-in-mexico.html.

The insurance program is funded by the federal government as well as employer and employee fees. All employers must register with the IMSS which provides full government medical coverage, including outpatient care, inpatient care, maternity care, and disability and injury benefits.

“Mexico: Summary.” Columbia Public Health, 2021, https://www.publichealth.columbia.edu/research/comparative-health-policy-library/mexico-summary.

# data[].attributes.body
SUS offers a broad spectrum of health services free of charge, including⁷:

preventive services, including immunizations

primary health care

outpatient specialty care

hospital care

maternity care

mental health services

pharmaceuticals

physical therapy

dental care

optometry and other vision care

durable medical equipment, including wheelchairs

hearing aids

home care

organ transplant

oncology services

renal dialysis

blood therapy.

Tikkanen, Roosa, et al. “Brazil.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/brazil#:~:text=Brazil's%20decentralized%2C%20universal%20public%20health,handled%20by%20municipalities%20or%20states.&text=There%20is%20no%20cost%2Dsharing%20for%20health%20care%20services.

# data[].attributes.body
Preventive services, including regular dental checkups, child checkups, basic immunizations, chronic disease checkups, and cancer screenings at certain ages

Inpatient and outpatient hospital care

Physician services

Mental health care

Dental care

Optometry

Physical therapy

Prescription drugs, except for those explicitly excluded by law (mainly so-called lifestyle drugs like appetite suppressants) and those excluded following an unfavorable benefit-risk assessment

Medical aids

Rehabilitation

Hospice and palliative care

Maternity care

Sick leave compensation.

Tikkanen, Roosa, et al. “Germany.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/germany.

# data[].attributes.body
SHI covers the following:

hospital care

treatment in public or private rehabilitation or physiotherapy institutions

outpatient care provided by general practitioners, specialists, dentists, physical therapists, and midwives

all maternity care services, from the 12th week of pregnancy through six months after delivery

newborn care and children’s preventive health care up to age 4

diagnostic services prescribed by doctors and carried out by laboratories and paramedical professionals

prescription drugs

medical appliances, including durable equipment such as wheelchairs and prostheses, that have been approved for reimbursement

prescribed health care–related transportation and home care.

Tikkanen, Roosa, et al. “France.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/france.

# data[].attributes.body
Overall, OMI based care is comprehensive. It covers the cost of inpatient care, all procedures that require an overnight stay at the hospital, chronic conditions, maternal and newborn care, vaccinations, and more.

“Understanding Russia's Healthcare System.” International Citizens Insurance, 19 Jan. 2022, https://www.internationalinsurance.com/health/systems/russia.php.

# data[].attributes.body
SGK covers
Inpatient and outpatient services across all public hospitals and clinics
Pregnancy and related expenses
Occupational injuries and diseases
Discounts in private hospitals and clinics

SKG does not cover pre-existing or current conditions such as cancer and diabetes.

“Turkey Expatriate Health Insurance - Everything You Need to Know about Expat Health Insurance in Turkey.” Insubuy, 2022, https://www.insubuy.com/turkey-expatriate-health-insurance/.

# data[].attributes.body
Services covered: The mandated NHI benefit package includes the following:

hospital care

primary and specialty care

prescription drugs

certain preventive services

mental health care

dental care for children and the elderly aged 75+

diagnostic exams

maternity care

allied medical care (physiotherapy, occupational therapy, nutrition, speech therapy)

some durable medical equipment (wheelchairs, orthopedic aids)

limited coverage of palliative and hospice services.⁶

Dental care for adults, optometry, and hearing aids are excluded.

Means-tested institutional long-term care, infant developmental screenings and vaccinations, and postpartum care like breastfeeding guidance are covered by the Ministry of Health, but separately from NHI.

Authors, et al. “Israel.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/israel.

# data[].attributes.body
"The NHIS covers outpatient services, including diagnostic testing and operations such as hernia repair; most in-patient services, including specialist care, most surgeries, and hospital accommodation (general ward); oral health treatments; all maternity care services, including Caesarean deliveries; emergency care; and, finally, all drugs on the centrally-established NHIA Medicines List.

The NHIS package excludes some very expensive procedures such as certain surgeries, cancer treatments (other than breast and cervical cancer), organ transplants, and dialysis; non-vital services such as cosmetic surgery; and some high profile items such as HIV antiretroviral drugs (which are heavily subsidized by the separate National AIDS Program). Other than the excluded services, there are few formal limits placed on NHIS members' consumption of benefits—there is no cost-sharing beyond premiums (i.e., no co-payments, coinsurance, or deductibles), no annual or lifetime limits and little effective gate-keeping. Benefits were intended to be “portable” from district to district, but actual portability has been mixed and is one reason for the recent introduction of a single, national NHIS identification card to replace district-level cards."

Blanchet, N J et al. “The effect of Ghana's National Health Insurance Scheme on health care utilisation.” Ghana medical journal vol. 46,2 (2012): 76-84.

# data[].attributes.body
"
Services covered: The benefit package is often defined by the local governments. Publicly financed basic medical insurance typically covers:

inpatient hospital care (selected provinces and cities)

primary and specialist care

prescription drugs

mental health care

physical therapy

emergency care

traditional Chinese medicine.

A few dental services (such as tooth extraction, but not cleaning) and optometry services are covered, but most are paid out-of-pocket. Home care and hospice care are often not included either. Durable medical equipment, such as wheelchairs and hearing aids, is often not covered.

Preventive services, such as immunization and disease screening, are included in a separate public-health benefit package funded by the central and local governments; every resident is entitled to these without copayments or deductibles. Coverage is person-specific; there are no family or household benefit arrangements.

Maternity care is also covered by a separate insurance program; it is currently being merged into the basic medical insurance plan."

Authors Roosa Tikkanen, et al. “China.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/china#:~:text=China%20achieves%20near%2Duniversal%20coverage,employer%20and%20employee%20payroll%20taxes.

# data[].attributes.body
"Services covered: All SHIS plans provide the same benefits package, which is determined by the national government:

hospital visits

primary and specialty care

mental health care

approved prescription drugs

home care services provided by medical institutions

hospice care

physical therapy

most dental care.

The SHIS does not cover corrective lenses unless they’re prescribed by physicians for children up to age 9. Optometry services provided by nonphysicians also are not covered.

Although maternity care is generally not covered, the SHIS provides medical institutions with a lump-sum payment for childbirth services. In addition, local governments subsidize medical checkups for pregnant women.

Home care services provided by nonmedical institutions are covered by long-term care insurance (LTCI) (see “Long-term care and social supports” below).

Durable medical equipment prescribed by physicians (such as oxygen therapy equipment) is covered by SHIS plans. People with disabilities who need other equipment like hearing aids or wheelchairs receive government subsidies to help cover the cost.

Select preventive services, including some screenings and health education, are covered by SHIS plans, while cancer screenings are delivered by municipalities."

Tikkanen, Roosa, et al. “Japan.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/japan.

# data[].attributes.body
"Services covered depend on the insurance scheme. Under the National Health Protection Scheme, secondary and tertiary care are covered, but not outpatient care. The Central Government Health Scheme and Employees’ State Insurance Corporation cover all types of care, including outpatient care and drugs. Under other publicly subsidized insurance coverage, all secondary, tertiary, pre-hospital, and post-hospitalization treatment are covered."

Tikkanen, Roosa, et al. “India.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/india.

# data[].attributes.body
"The federal government defines and funds MBS benefits, which cover hospital care and medical services, including mental health and maternity care. MBS also provides for limited optometry and children’s dental care.

Pharmaceutical subsidies are provided by the government through the PBS. To be listed, pharmaceuticals need to be approved for cost-effectiveness by the Pharmaceutical Benefits Advisory Committee.

The federal government also funds cancer screening and immunization programs that are provided free to targeted population groups.

States are responsible for the delivery of free public hospital services, preventive care, chronic disease management, and supplementary mental health care not covered by Medicare. States also provide means-tested access to medical equipment such as wheelchairs.

Home care for the elderly and hospice care coverage are funded separately by Medicare."

Tikkanen, Roosa, et al. “Australia.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/australia#:~:text=Australia%20has%20a%20regionally%20administered,revenue%20and%20a%20government%20levy.

# data[].attributes.body
Salary varies by practice setting and medical specialty.
"On average, a bit more than half (52.5 percent) of physician compensation came from salary in 2016, almost a third (31.8 percent) came from personal productivity, 9 percent came from practice financial performance, 4.1 percent came from bonuses, and 2.5 percent came from other sources."
Compensation is linked to productivity and practice.

Robeznieks Senior News Writer .cls-1{fill:none;}.cls-2{fill:#1da1f2;}Twitter logo, Andis. “This Is How Physicians Get Paid. See Where You Fit.” American Medical Association, 24 Apr. 2018, https://www.ama-assn.org/about/research/how-physicians-get-paid-see-where-you-fit.

# data[].attributes.body
Most physicians are self-employed in private practices. Fee-for-service is their primary payment.

Tikkanen, Roosa, et al. “Canada.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/canada.

# data[].attributes.body
Both public and private healthcare systems have their own doctors, pharmacies, physicians, and healthcare These operate in independent networks. People are usually only allowed to use the services within their network.

“Healthcare in Mexico.” InterNations, 2021, https://www.internations.org/go/moving-to-mexico/healthcare#:~:text=In%20Mexico%2C%20you%20will%20have,do%20not%20have%20private%20insurance.

# data[].attributes.body
Physicians tend to work in more urban and wealthy areas, making it skewed for the country, especially for the poorer population. The federal government is responsible for financing and delivery of services in federal hospitals. Specialists who work in the public sector have the freedom to undertake private work and see private patients. The federal government reimburses states or municipalities according to the volume of specialist services provided. States and municipalities pay for specialist services predominantly on a fee-for-service basis. The fees follow the national list of SUS procedures (tabela SUS), which are usually well below actual costs. For example, the fee schedule for a specialist consultation is less than BRL 10 (USD 2.33).

Tikkanen, Roosa, et al. “Brazil.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/brazil#:~:text=Brazil's%20decentralized%2C%20universal%20public%20health,handled%20by%20municipalities%20or%20states.&text=There%20is%20no%20cost%2Dsharing%20for%20health%20care%20services.

# data[].attributes.body
Most practitioners and specialists have their own practices (56% in solo practice and 33% in dual practice). They can also be working in clinics and are earn salary. Specialized outpatient care is provided by hospital specialists.

Tikkanen, Roosa, et al. “Germany.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/germany.

# data[].attributes.body
Outpatient physicians can enter into contractual agreements that guarantee a monthly salary of EUR 6,900 (USD 8,734) if they practice in a region with insufficient physician supply and agree to limit extra billing. For physicians who work full-time in medical centers in underserved areas, the guaranteed salary is approximately EUR 50,000 (USD 63,290) per year.

Tikkanen, Roosa, et al. “France.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/france.

# data[].attributes.body
Physicians are paid by the government if working for public agencies, with over two million employees. Since most work in private sectors, they are paid through their own practices.

“Understanding Russia's Healthcare System.” International Citizens Insurance, 19 Jan. 2022, https://www.internationalinsurance.com/health/systems/russia.php.

# data[].attributes.body
"According to 2015 data, there were 141,259 physicians in Turkey. Some 54.5% of all physicians were specialists, 30.0% general practitioners, and 15.5% residents. Employed by the MoH were 50.0% of all specialist and 85.7% of all general practitioners; 29.2% of specialists worked in the private sector.  In 2014, While 94.0% of specialist physicians in the MoH work in hospitals, 62.1% of general practitioners work in FHUs. Nearly half of nurses and midwives work in hospitals.15 In general, there were 179 physicians, 99 specialist physicians, 53 general practitioners, 32 dentists, 35 pharmacists, and 261 nurses and midwives per 100,000 population in 2015. There is a regional disparity in the distribution of health professionals; for example, in 2015, western Anatolia, there were 273 physicians per 100,000 population, while this figure was 131 in southeastern Anatolia." (Johnson 2018).

Johnson, James A., et al. Comparative Health Systems: A Global Perspective. Second ed., Jones & Bartlett Learning, 2018.

# data[].attributes.body
"Specialty physicians employed by the hospitals are salaried members of the hospital staff and are prohibited from billing patients or health plans for additional services. This system of physician employment by hospitals is similar to what is currently in place in the United States, given the substantial growth of physician-hospital organizations (PHOs"

Johnson, James A., et al. Comparative Health Systems: A
Global Perspective. Second ed., Jones & Bartlett Learning, 2018.

# data[].attributes.body
"THE PRIVATE HEALTH SECTOR IN GHANA

This is not the case for the private hospital managers, whose stay as managers depends, to a large extent, on the profitability of such hospitals.

Informed by that character of purpose, doctors are more financially rewarded on account of their professional services to clients in private hospitals. In the long run, private ghanaian doctors end up getting more pay than their counterparts in the public sector.

GHANAIAN DOCTORS AND THEIR SALARY IN PUBLIC HOSPITAL (LATEST)

The salary range for doctors working in Ghana’s Public Health Sector is typically from:

893.00 GHC (minimum salary) to 2,806.00 GHC (maximum salary) per month. (Fresh Doctors)

1,596 GHC (minimum salary) to 5,158 GHC (maximum salary) per month. (Senior Doctors)

The above is the total monthly salary including bonuses.

GHANAIAN DOCTORS AND THEIR SALARY IN PRIVATE HOSPITAL (LATEST)

The salary range for doctors working in Ghana’s Private Health Sector is typically from:

11,900 GHC per month

4,370 GHC (lowest average) to 20,100 GHC (highest average)

This is the average monthly salary including housing, transport, and other benefits.

Since doctors are the sole guardians of any nation’s health and wealth, it is pertinent upon the Ghanaian government to painstakingly overhaul the public health sector of the country as this will not only improve the doctors’ standard of living in terms of finances, but will also positively affect the life of average Ghanaian on the street."

Samuel, Afolabi, et al. “Ghanaian Doctors and Their Salary in Public and Private Hospitals (Latest).” School Drillers, 25 Dec. 2020, https://www.schooldrillers.com/ghanaian-doctors-and-their-salary/.

# data[].attributes.body
"The number of physicians is not regulated at the national level, and the government is trying to encourage more people to complete medical school. All the medical schools are public. Tuition varies by region, ranging from CNY 5,000 (USD 1,408) to CNY 10,000 (USD 2,816) per year. Tuition is heavily subsidized by the government.

To ensure a supply of medical providers in rural or remote areas, China waives tuition and lowers entrance qualifications for some medical students. Medical students who attend these education programs must work in rural or remote areas for at least six years after graduation."

"Fee schedules for primary care in government-funded health institutions are regulated by local health authorities and the Bureaus of Commodity Prices. Primary care doctors in public hospitals and clinics cannot bill above the fee schedule. To encourage nongovernmental investment in health care, China began allowing nonpublic clinics and hospitals to charge above the fee schedule in 2014.

Village doctors and health workers in village clinics earn income through reimbursements for clinical services and public health services like immunizations and chronic disease screening; government subsidies are also available. Incomes vary substantially by region. GPs at hospitals receive a base salary along with activity-based payments, such as patient registration fees. With fee-for-service still the dominant payment mechanism for hospitals (see below), hospital-based physicians have strong financial incentives to induce demand. It is estimated that wages constitute only one-quarter of physician incomes; the rest is thought to be derived from practice activities. No official income statistics are reported for doctors."

Authors Roosa Tikkanen, et al. “China.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/china#:~:text=China%20achieves%20near%2Duniversal%20coverage,employer%20and%20employee%20payroll%20taxes.

# data[].attributes.body
"Historically, there has been no institutional or financial distinction between primary care and specialty care in Japan. The idea of “general practice” has only recently developed.

Primary care is provided mainly at clinics, with some provided in hospital outpatient departments. Most clinics (83% in 2015) are privately owned and managed by physicians or by medical corporations (health care management entities usually controlled by physicians). A smaller proportion are owned by local governments, public agencies, and not-for-profit organizations.

Primary care practices typically include teams with a physician and a few employed nurses. In 2014, the average clinic had 6.8 full-time-equivalent workers, including 1.3 physicians, 2.0 nurses, and 1.8 clerks.¹⁸ Nurses and other staff are usually salaried employees. In some places, nurses serve as case managers and coordinate care for complex patients, but duties vary by setting."

Tikkanen, Roosa, et al. “Japan.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/japan.

# data[].attributes.body
"All medical personnel, including primary and specialty physicians, working at public outpatient or inpatient facilities are paid fixed salaries, which vary based on area of work and level of specialization. Currently, there are no performance-based payment incentives. However, the prime minister announced recently that all accredited social health activists will be enrolled in one of the social security schemes and provided free insurance coverage.

Physicians are allowed to operate private clinics in some states in accordance with regulations determined by the state in which they live and practice. Doctors in states where this is disallowed receive an additional non-practicing allowance payment.²⁶ Some government doctors violate service rules by resorting to private practice during office hours. There is also some evidence that patients have made informal payments to their physicians for services that are supposed to be provided for free, in a bid to improve the quality of their care."

Tikkanen, Roosa, et al. “India.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/india.

# data[].attributes.body
"GPs are paid primarily on a fee-for-service basis through the MBS model, although they can also receive funding from a performance-based initiative called the Practice Incentives Program. The Practice Incentives Program accounts for 5.5 percent of federal expenditures on GPs.¹⁹

The federal government also encourages multidisciplinary care coordination by funding large multidisciplinary GP clinics, known as Super Clinics, and through the establishment of Primary Health Networks, which support more efficient, effective, and coordinated primary care.

In 2015, there were 11,040 nurses or midwives working in a general practice setting.²⁰ Their role has been expanding with the addition of a practice nurse payment in the Practice Incentives Program. Nurses in general practice settings provide chronic disease management and care coordination, preventive health education, and oversight of patient follow-up and reminder systems" (Tikkanen 2020).

"Under Medicare, the government pays a flat rate per physician consultation. A physician can choose to charge the patient either that amount or more. A patient pays any difference. Other services funded through Medicare include services from participating optometrists and services delivered by a practice nurse on behalf of a general practitioner and for certain services from eligible dentists and allied health practitioners. Claims can be made by post or over the counter at Medicare offices, or the physician can “bulk bill” patients. In this case, physicians send accounts directly to Medicare and accept the Medicare rebate as full payment for the service. There is no cost to the patient. Just over 8 of 10 physicians “bulk billed” the government for their patient consultations in 2013–2014" (Johnson 2018).

Johnson, James A., et al. Comparative Health Systems: A
Global Perspective. Second ed., Jones & Bartlett Learning, 2018.

Tikkanen, Roosa, et al. “Australia.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/australia#:~:text=Australia%20has%20a%20regionally%20administered,revenue%20and%20a%20government%20levy.

# data[].attributes.headline
Who owns the hospitals and how are they arranged?

# data[].attributes.subject
Who owns the hospitals and how are they arranged?

# data[].attributes.body
Hospitals are owned privately or by the government.
"In 2018, 57 percent of the 5,198 short-term acute care hospitals in the U.S. were nonprofit; 25 percent were for-profit; and 19 percent were public (state or local government–owned).²⁷ In addition, there were 209 federal government hospitals. Hospitals are free to choose which insurance they accept; most accept Medicare and Medicaid."

Medicare pays hospitals through prospective diagnosis-related group (DRG) rates, which do not include physician payments.

Medicaid pays hospitals on a DRG, per diem, or cost-reimbursement basis,²⁸ and states have considerable discretion in setting hospital payment rates.

Private insurers pay hospitals usually on a per diem basis, typically negotiated between each hospital and its insurers on an annual basis.

Roosa Tikkanen, et al. “United States.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/united-states.

# data[].attributes.headline
Who owns the hospitals and how are they arranged?

# data[].attributes.subject
Who owns the hospitals and how are they arranged?

# data[].attributes.body
"Hospitals are a mix of public and private, predominantly not-for-profit, organizations. They are often managed by delegated health authorities or hospital boards representing the community. In most provinces and territories, many hospitals are publicly owned,²⁴ whereas in Ontario they are predominantly private not-for-profit corporations."
Hospitals operate under global budgets with the federal government.

Tikkanen, Roosa, et al. “Canada.” Home, 5 June 2020, https://www.commonwealthfund.org/international-health-policy-center/countries/canada.