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. 

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. 

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. 

The federal government provides funding and indirect support for inpatient and outpatient care through the Medicare Benefits Scheme (MBS) and for outpatient prescription medicine through the Pharmaceutical Benefits Scheme (PBS). The federal government is also responsible for regulating private health insurance, pharmaceuticals, and therapeutic goods; however, it has a limited role in direct service delivery.

States own and manage service delivery for public hospitals, ambulances, public dental care, community health (primary and preventive care), and mental health care. They contribute their own funding in addition to that provided by federal government. States are also responsible for regulating private hospitals, the location of pharmacies, and the health care workforce.

Local governments play a role in the delivery of community health and preventive health programs, such as immunizations and the regulation of food standards.³

At the federal level, intergovernmental collaboration and decision-making occur through the Council of Australian Governments (COAG), with representation from the prime minister and the first ministers of each state. The COAG focuses on the highest-priority issues, such as major funding discussions and the interchange of roles and responsibilities among governments. The COAG Health Council is responsible for more detailed policy issues and is supported by the Australian Health Minister’s Advisory Council.

The federal Department of Health oversees national policies and programs, including the MBS and PBS. Payments through these schemes are administered by the Department of Human Services.

Other federal agencies involved in health care include the following:

The state governments operate their own departments of health and have delegated the management of hospitals to Local Hospital Networks. These hospital networks are responsible for working collaboratively with federally funded Primary Health Networks, which were established in 2015 to improve the efficiency, effectiveness, and coordination of care. Primary Health Networks have boards comprising medical professionals and community advisory committees."

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. 

The Australian Commission on Safety and Quality in Health Care (ACSQHC) is the main body responsible for safety and quality improvement in health care. The ACSQH has developed service standards that have been endorsed by health ministers. These include standards for conducting patient surveys, which must be met by hospitals and day surgery centers to ensure accreditation. The Australian Bureau of Statistics, the national government statistical body, also undertakes an annual patient experience survey.

The Australian Council on Healthcare Standards is the (nongovernment) agency authorized to accredit provider institutions. States license and register private hospitals and the health workforce, legislate on the operation of public hospitals, and work collaboratively through the National Registration and Accreditation Scheme to facilitate workforce mobility across jurisdictions while maintaining patient protections. States also ensure that the workforce maintains minimum hours and standards of continuing education to maintain accreditation.

The Royal Australian College of General Practitioners has responsibility for accrediting GPs. To be eligible for government subsidies, aged-care services must be accredited by the government-owned Aged Care Standards and Accreditation Agency. Beginning in January 2019, the new Aged Care Quality and Safety Commission will be responsible for regulation, compliance, and complaints for aged care.

There are a number of disease and device registries. Government-funded registries are housed in universities and nongovernmental organizations, as well as within state governments. The ACSQH has developed a national framework to support consistent registries.

The National Health Performance Authority reports on the comparable performance of Local Hospital Networks, public and private hospitals, and other key health service providers, but not nursing homes or home care agencies. The reporting framework, agreed to by the Council of Australian Governments, includes measures of equity, effectiveness, and efficiency.

The federal government has regulatory oversight of quarantine, blood supply, pharmaceuticals, and therapeutic goods and appliances.³⁰ In addition, there are a number of national bodies that promote quality and safety of care through evidence-based clinical guidelines and best-practice advice. They include the National Health and Medical Research Council and Cancer Australia."

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. 

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. 

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. 

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. 

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. 

The research hospitals and education centers funded by the central and state governments offer specialized care in a variety of disciplines, such as ophthalmology, cardiothoracic surgery, neurosciences, trauma, cancer, and drug dependence.^34,35 Under the National Health Protection Scheme, some district hospitals will be upgraded to tertiary care facilities to improve access to specialized services and strengthen physician workforce capacity.³⁶

Public hospitals account for only approximately 10 percent of the total number of hospitals throughout the country.^37,38 The remainder are operated almost entirely by the private for-profit sector, and a small number by charitable organizations. There has been significant growth in the number of private sector hospitals as a result of perceived poor-quality care in public facilities and the rise of medical tourism.³⁹

In most public hospitals, prices are set administratively. Public district and tertiary hospitals are paid through an annual budgetary mechanism funded by either the state or central government. All private hospitals operate on a fee-for-service basis, with no standardization of service price."

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

Currently, there is no single entity that is responsible for measuring all aspects of quality of care at health care facilities. Most efforts have been focused on structural elements, such as tracking the availability of health care resources.⁴⁹ Over the years, several regulations have been enacted and authorities created at the state and national levels with the aim of protecting patients and improving quality of care."

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

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. 

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. 

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. 

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. 

Acute-care hospitals, both public and private, choose whether to be paid strictly under traditional fee-for-service or under a diagnosis-procedure combination (DPC) payment approach, which is a case-mix classification similar to diagnosis-related groups.²⁴ The DPC payment consists of a per-diem payment for basic hospital services and less-expensive treatments and a fee-for-service payment for specified expensive services, such as surgical procedures or radiation therapy.²⁵ Most acute-care hospitals choose the DPC approach. Episode-based payments involving both inpatient and outpatient care are not used."

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

Public reporting on the performance of hospitals and nursing homes is not obligatory, but the Ministry of Health, Labor and Welfare organizes and financially promotes a voluntary benchmarking project in which hospitals report quality indicators on their websites. National and local government facilitate mandatory third-party evaluations of welfare institutions, including nursing homes and group homes for people with dementia, to improve care.

To practice, physicians are required to obtain a license by passing a national exam. Although physicians are not subject to revalidation, specialist societies have introduced revalidation for qualified specialists. Some physician fees are paid on the condition that physicians have completed continuing medical education credits. Public reporting on physician performance is voluntary."

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

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. 

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. 

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. 

To be accredited, hospitals must obtain a license from the local health authority. Physicians get their practice licenses through hospitals; licenses are subject to renewal. Local health authorities are responsible for physician recertification and revalidation and for hospital accreditation to ensure competency. Several national rankings of hospitals are published by third parties, although there are no financial incentives for hospitals to meet quality targets.¹⁸ No public information about individual doctors, nursing homes, or home care agencies is made available.

Following release of the “Temporary Directing Principles of Clinical Pathway Management” by the former Ministry of Health in 2009, clinical pathways are now regulated nationally and used similarly to clinical guidelines in Western countries. Previously, pathways were created at the hospital, rather than the national, level."

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. 

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

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.

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

The above is the total monthly salary including bonuses.

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

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/. 

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. 

Most GPs contract with one of the four competing nonprofit NHI health plans. Only 5 percent have contracts with more than one health plan.¹⁰

The four NHI health plans (Clalit, Maccabi, Meuhedet, and Leumit) have different approaches to organizing care. Clalit, the largest health plan, provides most primary care in clinics that it owns and operates, and GPs are salaried employees. The typical clinic is multidisciplinary, with three-to-six GPs and several nurses, pharmacists, and other professionals. Clalit also contracts with independent physicians who tend to work in solo practices, with some access to administrative and nonphysician services at Clalit district clinics.

The other three health plans also use a mix of multidisciplinary clinics and independent primary care practices. In Maccabi (the second-largest plan) and Meuhedet, almost all of the primary care is provided by independent physicians, while in Leumit the clinic model predominates."

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

The Ministry of Health publishes comparative, hospital-specific quality data. The number of quality indicators and of the types of services covered has been growing rapidly. Currently, explicit financial incentives for hospitals to improve quality exist only for timely care of hip fractures or stroke.

The Ministry of Health also has a well-developed system for monitoring the quality of care in nursing homes and mother-and-child clinics, and is sharing this performance information with the public. There is no parallel system for home care services.

Practice guidelines exist for some clinical areas. These have been developed by professional medical associations, often in collaboration with the Ministry of Health.

All Israeli general hospitals are required to have received, or to be working toward, accreditation by Joint Commission International. As of June 2018, almost all of the general hospitals were accredited."

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

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. 
 

This put the Eurasian country 37 places below the UK, and lower than comparatively poorer countries like Macedonia, Lithuania, and Bermuda.

Turkey still has some way to go in several areas, for instance in raising the number of physicians in the country. There are currently 18 doctors per 10,000 people, according to the World Bank – less than nearby Cyprus, or war-torn Libya.

6.9% of people over the age of 15 in Turkey also have unmet health needs, according to Eurostat, which is a fifth higher than the UK’s 5.8%.

This shortfall in quality can be largely explained by the fact that Turkey spends just 4.22% of its GDP on healthcare, according to the World Bank.

This is far below the UK’s 9.63%, and lower even than developing countries like Yemen, Zambia, and Chad.

Three-quarters of that figure comes from government spending, with the rest funded by the public – and public spending is on the rise, increasing 19.4% in 2018, according to the TSI.

However, out-of-pocket expenditure still isn’t scandalously high, currently standing at 17.38%, according to the World Bank. This is only slightly higher than the UK, and below many nations with a higher GDP, including Australia, China, and Italy.

Turkey also has 2.81 hospital beds per 1,000 people, which is very respectable. It’s more than the UK, US, or New Zealand.

And individuals spend an average of ₺2,030 (£190) on healthcare each year, according to the TSI, which employed expats should be able to easily afford.

This may all explain why patient satisfaction is 90%, according to the Ministry of Health – though take that figure with a pinch of salt.

Much of Turkish news reporting is fabricated to reflect well on the government, whose leader Recep Tayyip Erdoğan – “a dictator in all but name”, according to The Guardian – has been in power since 2003.

57% of people in the country believe they are in good health, according to Statista – and that is likely a truer reflection of the state of Turkish healthcare."

Jackman, Josh. “Healthcare for Expats in Turkey: How Does It Work?” MoveHub, 25 Oct. 2021, https://www.movehub.com/uk/moving-abroad/turkey/healthcare-for-expats/#:~:text=Quality%20of%20healthcare%20in%20Turkey%20vs%20the%20world,-Turkey's%20health%20system&text=A%202018%20study%20published%20in,Macedonia%2C%20Lithuania%2C%20and%20Bermuda. 

In the private sector, there are many health centers and medical centers that provide both inpatient and outpatient care. What facilities you have access to will depend on your location and what is available in your area.

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

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

They are currently ranked 28th in the World Index of Healthcare Innovation.

Girvan, Gregg. “France: #28 in the 2020 World Index of Healthcare Innovation.” Medium, FREOPP.org, 25 June 2021, https://freopp.org/france-health-system-profile-28-in-the-world-index-of-healthcare-innovation-86f366782e1#:~:text=Introduction,the%20United%20States%20(%2330).

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

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. 

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

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. 

“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. 

"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

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

"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. 

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