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Africa Algeria Main article: Health in Algeria Health in Algeria, according to information from a March 6, 2006 United States report, does not compare well with the developed world. Algeria has inadequate numbers of physicians (one per 1,000 people) and hospital beds (2.1 per 1,000 people) and poor access to water (87 percent of the population) and sanitation (92 percent of the population). Given Algeria’s young population, policy favors preventive health care and clinics over hospitals. In keeping with this policy, the government maintains an immunization program. However, poor sanitation and unclean water still cause tuberculosis, hepatitis, measles, typhoid fever, cholera, and dysentery. In 2003 about 0.10 percent of the population aged 15–49 was living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). The poor generally receive health care aid for by the government, but the wealthy pay for care according to a sliding scale. Access to health care is enhanced by the requirement that doctors and dentists work in public health for at least five years. However, doctors are more easily found in the cities of the north than in the southern Sahara region. Cape Verde Main article: Health in Cape Verde Medical facilities in Cape Verde are limited, and some medicines are in short supply or unavailable. There are hospitals in Praia and Mindelo, with smaller medical facilities in other places. The islands of Brava and Santo Antão no longer have functioning airports so air evacuation in the event of a medical emergency is nearly impossible from these two islands. Brava also has limited inter-island ferry service.[1] Eritrea Main article: Health in Eritrea Eritrea is one of the few countries to be on target to meet its Millennium Development Goal (MDG) targets for health.[1] Researchers at the Overseas Development Institute have identified the high prioritisation of health and education both within the government and amongst Eritreans at home and abroad. Innovative multi-sectoral approaches to health were also identified with the success.[1] About one-third of the population lives in extreme poverty, and more than half survives on less than US$1 per day. Health care and welfare resources generally are believed to be poor, although reliable information about conditions is often difficult to obtain. In 2001, the most recent year for which figures are available, the Eritrean government spent 5.7 percent of gross domestic product on national health accounts. The World Health Organization (WHO) estimated that in 2004 there were only three physicians per 100,000 people in Eritrea. The two-year war with Ethiopia, coming on the heels of a 30-year struggle for independence, negatively affected the health sector and the general welfare. The rate of prevalence of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS),in Eritrea is believed to be at 0.7%(2012)which is reasonably low. In the decade since 1995,impressive results have been achieved in lowering maternal and child mortality rates and in immunizing children against childhood diseases.In 2008 average life expectancy was slightly less than 63 years, according to the WHO. Immunisation and child nutrition has been tackled by working closely with schools in a multi-sectoral approach; the number of children vaccinated against measles almost doubled in seven years, from 40.7% to 78.5% and the underweight prevalence among children decreased by 12% in 1995-2002 (severe underweight prevalence by 28%).[1] This has helped to some small extent even out rural-urban and rich-poor inequity in health.[1] Ethiopia Main article: Health in Ethiopia Throughout the 1990s, the government, as part of its reconstruction program, devoted ever-increasing amounts of funding to the social and health sectors, which brought corresponding improvements in school enrollments, adult literacy, and infant mortality rates. These expenditures stagnated or declined during the 1998–2000 war with Eritrea, but in the years since, outlays for health have grown steadily. In 2000–2001, the budget allocation for the health sector was approximately US$144 million; health expenditures per capita were estimated at US$4.50, compared with US$10 on average in sub-Saharan Africa. In 2000 the country counted one hospital bed per 4,900 population and more than 27,000 people per primary health care facility. The physician to population ratio was 1:48,000, the nurse to population ratio, 1:12,000. Overall, there were 20 trained health providers per 100,000 inhabitants. These ratios have since shown some improvement. Health care is disproportionately available in urban centers; in rural areas where the vast majority of the population resides, access to health care varies from limited to nonexistent. As of the end of 2003, the United Nations (UN) reported that 4.4 percent of adults were infected with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS); other estimates of the rate of infection ranged from a low of 7 percent to a high of 18 percent. Whatever the actual rate, the prevalence of HIV/AIDS has contributed to falling life expectancy since the early 1990s. According to the Ministry of Health, one-third of current young adult deaths are AIDS-related. Malnutrition is widespread, especially among children, as is food insecurity. Because of growing population pressure on agricultural and pastoral land, soil degradation, and severe droughts that have occurred each decade since the 1970s, per capita food production is declining. According to the UN and the World Bank, Ethiopia at present suffers from a structural food deficit such that even in the most productive years, at least 5 million Ethiopians require food relief.[2] In 2002 the government embarked on a poverty reduction program that called for outlays in education, health, sanitation, and water. A polio vaccination campaign for 14 million children has been carried out, and a program to resettle some 2 million subsistence farmers is underway. In November 2004, the government launched a five-year program to expand primary health care. In January 2005, it began distributing antiretroviral drugs, hoping to reach up to 30,000 HIV-infected adults.[2] Ghana Main article: Health in Ghana In Ghana, most health care is provided by the government, but hospitals and clinics run by religious groups also play an important role. Some for-profit clinics exist, but they provide less than 2% of health services. Health care is very variable through the country. The major urban centres are well served, but rural areas often have no modern health care. Patients in these areas either rely on traditional medicine or travel great distances for care. In 2005, Ghana spent 6.2% of GDP on health care, or US$30 per capita. Of that, approximately 34% was government expenditure.[3] Guinea See also: Guinea#Health Guinea has been reorganizing its health system since the Bamako Initiative of 1987 formally promoted community-based methods of increasing accessibility of primary health care to the population, including community ownership and local budgeting, resulting in more efficient and equitable provision of drugs and other essential health care resources.[4] In June 2011, the Guinean government announced the establishment of an air ticket solidarity levy on all flights taking off from national soil, with funds going to UNITAID to support expanded access to treatment for HIV/AIDS, tuberculosis and malaria.[5] Guinea is among the growing number of countries and development partners using market-based transactions taxes and other innovative financing mechanisms to expand financing options for health care in resource-limited settings. Mali Main article: Health in Mali Health in Mali, one of the world’s poorest nations, is greatly affected by poverty, malnutrition, and inadequate hygiene and sanitation. Mali's health and development indicators rank among the worst in the world. In 2000 only 62–65 percent of the population was estimated to have access to safe drinking water and only 69 percent to sanitation services of some kind; only 8 percent was estimated to have access to modern sanitation facilities. Only 20 percent of the nation’s villages and livestock watering holes had modern water facilities.[6] Mali is dependent on international development organizations and foreign missionary groups for much of its health care. In 2001 general government expenditures on health constituted 6.8 percent of total general government expenditures and 4.3 percent of gross domestic product (GDP), totaling only about US$4 per capita at an average exchange rate. Medical facilities in Mali are very limited, especially outside of Bamako, and medicines are in short supply. There were only 5 physicians per 100,000 inhabitants in the 1990s and 24 hospital beds per 100,000 in 1998. In 1999 only 36 percent of Malians were estimated to have access to health services within a five-kilometer radius.[2] Morocco Main article: Health in Morocco According to the United States government, Morocco has inadequate numbers of physicians (0.5 per 1,000 people) and hospital beds (1.0 per 1,000 people) and poor access to water (82 percent of the population) and sanitation (75 percent of the population). The health care system includes 122 hospitals, 2,400 health centers, and 4 university clinics, but they are poorly maintained and lack adequate capacity to meet the demand for medical care. Only 24,000 beds are available for 6 million patients seeking care each year, including 3 million emergency cases. The health budget corresponds to 1.1 percent of gross domestic product and 5.5 percent of the central government budget.[7] Niger Main article: Health in Niger Health care system of Niger suffers from a chronic lack of resources and a small number of health providers relative to population. Some medicines are in short supply or unavailable. There are government hospitals in Niamey (with three main hospitals in Niamey, including the Hôpital National de Niamey and the Hôpital National De Lamordé), Maradi, Tahoua, Zinder and other large cities, with smaller medical clinics in most towns.[8] Medical facilities are limited in both supplies and staff, with a small government health care system supplemented by private, charitable, religious, and Non-government organisation operated clinics and public health programs (such as Galmi Hospital near Birnin Konni and Maradi). Government hospitals, as well as public health programmes, fall under the control of the Nigerien Ministry of Health. A number of private for profit clinics ("Cabinets Médical Privé") operate in Niamey. The total expenditure on health per capita in 2005 was Intl $25. There were 377 Physicians in Niger in 2004, a ratio of 0.03 per 10,000 population. In 2003, 89.2 percent of individual expenditures on health care were "out-of-pocket" (paid by the patient).[9] Nigeria Main article: Health in Nigeria Health care provision in Nigeria is a concurrent responsibility of the three tiers of government in the country.[10] However, because Nigeria operates a mixed economy, private providers of health care have a visible role to play in health care delivery. The federal government's role is mostly limited to coordinating the affairs of the university teaching hospitals, while the state government manages the various general hospitals and the local government focus on dispensaries. The total expenditure on health care as % of GDP is 4.6, while the percentage of federal government expenditure on health care is about 1.5%.[11] A long run indicator of the ability of the country to provide food sustenance and avoid malnutrition is the rate of growth of per capita food production; from 1970–1990, the rate for Nigeria was 0.25%.[12] Though small, the positive rate of per capita may be due to Nigeria's importation of food products. Historically, health insurance in Nigeria can be applied to a few instances: government-paid health care provided and financed for all citizens, health care provided by government through a special health insurance scheme for government employees and private firms entering contracts with private health care providers.[13] However, there are few people who fall within the three instances. In May 1999, the government created the National Health Insurance Scheme, the scheme encompasses government employees, the organized private sector and the informal sector. Legislative wise, the scheme also covers children under five, permanently disabled persons and prison inmates. In 2004, the administration of Obasanjo further gave more legislative powers to the scheme with positive amendments to the original 1999 legislative act.[14] Senegal Main article: Health in Senegal The health budget in Senegal has tripled between 1980 and 2000, leading to the Senegalese people leading healthier and longer lives - the life expectancy at birth is approximately 55.34 years for men, 58.09 years for women, and 56.69 years for the entire population. Also, the prevalence rate of AIDS in Senegal is one of the lowest in Africa, at 0.9%. However, large disparities still exist in Senegal's health coverage, with 70% of doctors, and 80% of pharmacists and dentists, living in the nation's capital city, Dakar. South Africa Main article: Health in South Africa In South Africa, parallel private and public systems exist. The public system serves the vast majority of the population, but is chronically underfunded and understaffed. The wealthiest 20% of the population uses the private system and are far better served. This division in substantial ways perpetuates racial inequalities created in the pre-apartheid segregation era and apartheid era of the 20th century. In 2005, South Africa spent 8.7% of GDP on health care, or US$437 per capita. Of that, approximately 42% was government expenditure.[3] Sudan Main article: Health in Sudan Outside urban areas, little health care is available in Sudan, helping account for a relatively low average life expectancy of 57 years and an infant mortality rate of 69 deaths per 1,000 live births, low by standards in Middle Eastern but not African countries. For most of the period since independence in 1956, Sudan has experienced civil war, which has diverted resources to military use that otherwise might have gone into health care and training of professionals, many of whom have migrated in search of more gainful employment. In 1996 the World Health Organization estimated that there were only 9 doctors per 100,000 people, most of them in regions other than the South. Substantial percentages of the population lack access to safe water and sanitary facilities. Malnutrition is widespread outside the central Nile corridor because of population displacement from war and from recurrent droughts; these same factors together with a scarcity of medicines make diseases difficult to control. Child immunization against most major childhood diseases, however, had risen to approximately 60 percent by the late 1990s from very low rates in earlier decades. Spending on health care is quite low—only 1 percent of gross domestic product (GDP) in 1998 (latest data). The United Nations placed the rate of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) infection in late 2003 at 2.3 percent for adults, quite low by regional standards. The United Nations suggested, however, that the rate could be as high as 7.2 percent. Between 400,000 and 1.3 million adults and children were living with HIV, and AIDS deaths numbered 23,000. As of late 2004, some 4 million persons in the South had been internally displaced and more than 2 million had died or been killed as a result of two decades of war. Comparable figures for Darfur were 1.6 million displaced and 70,000 dead since fighting began there in early 2003.[15] Zimbabwe Main article: Health in Zimbabwe Zimbabwe now has one of the lowest life expectancies on Earth - 44 for men and 43 for women,[16] down from 60 in 1990. The rapid drop has been ascribed mainly to the HIV/AIDS pandemic. Infant mortality has risen from 59 per thousand in the late 1990s to 123 per 1000 by 2004.[17] The health system has more or less collapsed: By the end of November 2008, three of Zimbabwe's four major hospitals had shut down, along with the Zimbabwe Medical School and the fourth major hospital had two wards and no operating theatres working.[18] Due to hyperinflation, those hospitals still open are not able to obtain basic drugs and medicines.[19] The ongoing political and economic crisis also contributed to the emigration of the doctors and people with medical knowledge.[20] In August 2008, large areas of Zimbabwe were struck by the ongoing cholera epidemic. Asia Afghanistan Main article: Health in Afghanistan Beginning in 1979, military conflict destroyed the health system of Afghanistan. Most medical professionals left the country in the 1980s and 1990s, and all medical training programmes ceased.[2] In 2004 Afghanistan had one medical facility for every 27,000 people, and some centers were responsible for as many as 300,000 people.[2] In 2004 international organizations provided a large share of medical care.[2] An estimated one-quarter of the population had no access to health care.[2] In 2003 there were 11 physicians and 18 nurses per 100,000 population, and the per capita health expenditure was US$28.[2] Bhutan Main article: Health in Bhutan Bhutan's health care system development accelerated in the early 1960s with the establishment of the Department of Public Health and the opening of new hospitals and dispensaries throughout the country. By the early 1990s, health care was provided through twenty-nine general hospitals (including five leprosy hospitals, three army hospitals, and one mobile hospital), forty-six dispensaries, sixty-seven basic health units, four indigenous-medicine dispensaries, and fifteen malaria eradication centers. The major hospitals were the National Referral Hospital in Thimphu, and other hospitals in Geylegphug, and Tashigang. Hospital beds in 1988 totaled 932. There was a severe shortage of health-care personnel with official statistics reporting only 142 physicians and 678 paramedics, about one health-care professional for every 2,000 people, or only one physician for almost 10,000 people. Training for health-care assistants, nurses' aides, midwives, and primary health-care workers was provided at the Royal Institute of Health Sciences, associated with Thimphu General Hospital, which was established in 1974. Graduates of the school were the core of the national public health system and helped staff the primary care basic health units throughout the country. Additional health-care workers were recruited from among volunteers in villages to supplement primary health care.[21] The Institute of Traditional Medicine Services supports indigenous medical centers associated with the district hospitals. China, P.R. Main article: Health in the People's Republic of China See also: Health in Hong Kong and Health in Macau The effective public health work in controlling epidemic disease during the early years of the PRC and, after reform began in 1978, the dramatic improvements in nutrition greatly improved the health and life expectancy of the Chinese people. The 2000 WHO World Health Report - Health systems: improving performance found that China's health care system before 1980 performed far better than countries at a comparable level of development, since 1980 ranks much lower than comparable countries.[22] The end of the famed "barefoot doctor" system was abolished in 1981. China is undertaking a reform on its health care system. The New Rural Co-operative Medical Care System (NRCMCS) is a new 2005 initiative to overhaul the health care system, particularly intended to make it more affordable for the rural poor. Under the NRCMCS, the annual cost of medical cover is 50 yuan (US$7) per person. Of that, 20 yuan is paid in by the central government, 20 yuan by the provincial government and a contribution of 10 yuan is made by the patient. As of September 2007, around 80% of the whole rural population of China had signed up (about 685 million people). The system is tiered, depending on the location. If patients go to a small hospital or clinic in their local town, the scheme will cover from 70-80% of their bill. If they go to a county one, the percentage of the cost being covered falls to about 60%. And if they need specialist help in a large modern city hospital, they have to bear most of the cost themselves, the scheme would cover about 30% of the bill.[23] Health care was provided in both rural and urban areas through a three-tiered system. In rural areas the first tier was made up of barefoot doctors working out of village medical centers. They provided preventive and primary-care services, with an average of two doctors per 1,000 people. At the next level were the township health centers, which functioned primarily as out-patient clinics for about 10,000 to 30,000 people each. These centers had about ten to thirty beds each, and the most qualified members of the staff were assistant doctors. The two lower-level tiers made up the "rural collective health system" that provided most of the country's medical care. Only the most seriously ill patients were referred to the third and final tier, the county hospitals, which served 200,000 to 600,000 people each and were staffed by senior doctors who held degrees from 5-year medical schools. Health care in urban areas was provided by paramedical personnel assigned to factories and neighborhood health stations. If more professional care was necessary the patient was sent to a district hospital, and the most serious cases were handled by municipal hospitals. To ensure a higher level of care, a number of state enterprises and government agencies sent their employees directly to district or municipal hospitals, circumventing the paramedical, or barefoot doctor, stage. India Main article: Health in India In India, the hospitals are run by government, charitable trusts and by private organizations. The government hospitals in rural areas are called Primary Health Centres (PHCs). Major hospitals are located in district headquarters or major cities. Apart from the modern system of medicine, traditional and indigenous medicinal systems like Ayurvedic and Unani systems are in practice throughout the country. The Modern System of Medicine is regulated by the Medical Council of India, whereas the Alternative systems recognised by Government of India are regulated by the Department of AYUSH (an acronym for Ayurveda, Yoga, Unani, Siddha & Homeopathy) under the Ministry of Health, Government of India. PHCs are non-existent in most places, due to poor pay and scarcity of resources. Patients generally prefer private health clinics. These days some of the major corporate hospitals are attracting patients from neighboring countries such as Pakistan, countries in the Middle East and some European countries by providing quality treatment at low cost. In 2005, India spent 5% of GDP on health care, or US$36 per capita. Of that, approximately 19% was government expenditure.,.[3] Indonesia Main article: Health in Indonesia Indonesia had a three-tiered system of community health centers in the late 1990s, with 0.66 hospital beds per 1,000 population, the lowest rate among members of the Association of Southeast Asian Nations (ASEAN).[24] In the mid-1990s, according to the World Health Organization (WHO), there were 16 physicians per 100,000 population in Indonesia, 50 nurses per 100,000, and 26 midwives per 100,000.[2] Both traditional and modern health practices are employed. Government health expenditures are about 3.7 percent of the gross domestic product (GDP).[2] There is about a 75:25 percent ratio of public to private health-care expenditures. Israel Main article: Health care in Israel In Israel, the publicly funded medical system is universal and compulsory. In 2005, Israel spent 7.8% of GDP on health care, or US$1,533 per capita. Of that, approximately 66% was government expenditure.[3] Japan Main article: Health in Japan In Japan, services are provided either through regional/national public hospitals or through private hospitals/clinics, and patients have universal access to any facility, though hospitals tend to charge higher for those without a referral. Public health insurance covers most citizens/residents and pays 70% or more cost for each care and each prescribed drug. Patients are responsible for the remainder (upper limits apply). The monthly insurance premium is 0-50,000 JPY per household (scaled to annual income). Supplementary private health insurance is available only to cover the co-payments or non-covered costs, and usually makes a fixed payment per days in hospital or per surgery performed, rather than per actual expenditure. In 2005, Japan spent 8.2% of GDP on health care, or US$2,908 per capita. Of that, approximately 83% was government expenditure.[3] Jordan Main article: Health in Jordan In comparison to most of its neighbors, Jordan has quite an advanced health care system, although services remain highly concentrated in Amman. Government figures have put total health spending in 2002 at some 7.5 percent of Gross domestic product (GDP), while international health organizations place the figure even higher, at approximately 9.3 percent of GDP. The country’s health care system is divided between public and private institutions. In the public sector, the Ministry of Health operates 1,245 primary health-care centers and 27 hospitals, accounting for 37 percent of all hospital beds in the country; the military’s Royal Medical Services runs 11 hospitals, providing 24 percent of all beds; and the Jordan University Hospital accounts for 3 percent of total beds in the country. The private sector provides 36 percent of all hospital beds, distributed among 56 hospitals. In 1 June 2007, Jordan Hospital (as the biggest private hospital) was the first general specialty hospital who gets the international accreditation (JCI).Treatment cost in Jordan hospitals is less than in other countries. [25] Kazakhstan Main article: Health in Kazakhstan In principle, health care is paid for by the government. However, bribes often are necessary to obtain needed care. The quality of health care, which remained entirely under state control in 2006, has declined in the post-Soviet era because of insufficient funding and the loss of technical experts through emigration. Between 1989 and 2001, the ratio of doctors per 10,000 inhabitants fell by 15 percent, to 34.6, and the ratio of hospital beds per 10,000 inhabitants fell by 46 percent, to 74. By 2005 those indicators had recovered somewhat, to 55 and 77, respectively. Since 1991, health care has consistently lacked adequate government funding; in 2005 only 2.5 percent of gross domestic product went for that purpose. A government health reform program aims to increase that figure to 4 percent in 2010. A compulsory health insurance system has been in the planning stages for several years. Wages for health workers are extremely low, and equipment is in critically short supply. The main foreign source of medical equipment is Japan. Because of cost, the emphasis of treatment increasingly is on outpatient care instead of the hospital care preferred under the Soviet system. The health system is in crisis in rural areas such as the Aral Sea region, where health is most affected by pollution.[26] Malaysia Main article: Health in Malaysia Health care in Malaysia is divided into private and public sectors. Doctors are required to undergo a 2 year internship and perform 3 years of service with public hospitals throughout the nation, ensuring adequate coverage of medical needs for the general population. Foreign doctors are encouraged to apply for employment in Malaysia, especially if they are qualified to a higher level. Malaysian society places importance on the expansion and development of health care, putting 5% of the government social sector development budget into public health care — an increase of more than 47% over the previous figure. This has meant an overall increase of more than RM 2 billion. With a rising and ageing population, the Government wishes to improve in many areas including the refurbishment of existing hospitals, building and equipping new hospitals, expansion of the number of polyclinics, and improvements in training and expansion of telehealth. Over the last couple of years they have increased their efforts to overhaul the systems and attract more foreign investment. There is still a shortage in the medical workforce, especially of highly trained specialists. As a result certain medical care and treatment is available only in large cities. Recent efforts to bring many facilities to other towns have been hampered by lack of expertise to run the available equipment made ready by investments. The majority of private hospital facilities are in urban areas and, unlike many of the public hospitals, are equipped with the latest diagnostic and imaging facilities. North Korea Main article: Health in North Korea North Korea has a national medical service and health insurance system.[2] As of 2000, some 99 percent of the population had access to sanitation, and 100 percent had access to water, but water was not always potable.[2] Medical treatment is paid for by the state.[2] In the past, there reportedly has been one doctor for every 700 inhabitants and one hospital bed for every 350 inhabitants.[2] Health expenditures in 2001 were 2.5 percent of gross domestic product, and 73 percent of health expenditures were made in the public sector.[2] There were no reported human immuno-deficiency virus/acquired immune deficiency syndrome (HIV/AIDS) cases as of 2007.[2] However, it is estimated that between 500,000 and 3 million people died from famine in the 1990s, and a 1998 United Nations (UN) World Food Program report revealed that 60 percent of children suffered from malnutrition, and 16 percent were acutely malnourished.[2] UN statistics for the period 1999–2001 reveal that North Korea’s daily per capita food supply was one of the lowest in Asia, exceeding only that of Cambodia, Laos, and Tajikistan, and one of the lowest worldwide.[2] Because of continuing economic problems, food shortages and chronic malnutrition prevail in the 2000s.[27] Oman Main article: Health in Oman Oman's healthcare system was ranked at number 8 by the WHO health systems ranking in 2000.[22] Universal healthcare (including prescriptions and dental care) is provided automatically to all citizens and also to expatriates working in the public sector by the Ministry of Health. Non-eligible individuals such as expatriates working in the private sector and foreign visitors can be treated in the government hospitals and clinics for a reasonable fee or they can opt for the more expensive private clinics and medical centres. The Ministry of Health also finances the treatment of citizens abroad if the required treatment is not available in Oman. The life expectancy in Oman as of 2007 was 71.6. It had 1.81 doctors per 1000 pop., 1.9 beds per 1000 pop. and an infant mortality rate of 9 per 1000 live births. Health expenditure accounts for 4.5% of government revenue.[28] Pakistan Main article: Health in Pakistan Pakistan's health indicators, health funding, and health and sanitation infrastructure are generally poor, particularly in rural areas. About 19 percent of the population is malnourished—a higher rate than the 17 percent average for developing countries—and 30 percent of children under age five are malnourished. Leading causes of sickness and death include gastroenteritis, respiratory infections, congenital abnormalities, tuberculosis, malaria, and typhoid fever. The United Nations estimates that in 2003 Pakistan’s human immunodeficiency virus (HIV) prevalence rate was 0.1 percent among those 15–49, with an estimated 4,900 deaths from acquired immune deficiency syndrome (AIDS). AIDS is a major health concern, and both the government and religious community are engaging in efforts to reduce its spread. In 2003 there were 68 physicians for every 100,000 persons in Pakistan. According to 2002 government statistics, there were 12,501 health institutions nationwide, including 4,590 dispensaries, 906 hospitals with a total of 80,665 hospital beds, and 550 rural health centers with a total of 8,840 beds. According to the World Health Organization, Pakistan’s total health expenditures amounted to 3.9 percent of gross domestic product (GDP) in 2001, and per capita health expenditures were US$16. The government provided 24.4 percent of total health expenditures, with the remainder being entirely private, out-of-pocket expenses. Philippines Main article: Health in the Philippines In 2000 the Philippines had about 95,000 physicians, or about 1 per 800 people. In 2001 there were about 1,700 hospitals, of which about 40 percent were government-run and 60 percent private, with a total of about 85,000 beds, or about one bed per 900 people. The leading causes of morbidity as of 2002 were diarrhea, bronchitis, pneumonia, influenza, hypertension, tuberculosis, heart disease, malaria, chickenpox, and measles. Cardiovascular diseases account for more than 25 percent of all deaths. According to official estimates, 1,965 cases of human immunodeficiency virus (HIV) were reported in 2003, of which 636 had developed acquired immune deficiency syndrome (AIDS). Other estimates state that there may have been as many as 9,400 people living with HIV/AIDS in 2001.[29] Singapore Main article: Health in Singapore Health care in Singapore is mainly under the responsibility of the Singapore Government's Ministry of Health. Singapore generally has an efficient and widespread system of health care. It implements a universal health care system, and co-exists with private health care system. Infant mortality rate: in 2006 the crude birth rate stood at 10.1 per 1000, and the crude death rate was also one of the lowest in the world at 4.3 per 1000. In 2006, the total fertility rate was only 1.26 children per woman, the 3rd lowest in the world and well below the 2.10 needed to replace the population. Singapore was ranked 6th in the World Health Organization's ranking of the world's health systems in the year 2000. Singapore has a universal health care system where government ensures affordability, largely through compulsory savings and price controls, while the private sector provides most care. Overall spending on health care amounts to only 3% of annual GDP. Of that, 66% comes from private sources.[30] Singapore currently has the lowest infant mortality rate in the world (equaled only by Iceland) and among the highest life expectancies from birth, according to the World Health Organization.[31] Singapore has "one of the most successful health care systems in the world, in terms of both efficiency in financing and the results achieved in community health outcomes," according to an analysis by global consulting firm Watson Wyatt.[32] Singapore's system uses a combination of compulsory savings from payroll deductions (funded by both employers and workers) a nationalized catastrophic health insurance plan, and government subsidies, as well as "actively regulating the supply and prices of health care services in the country" to keep costs in check; the specific features have been described as potentially a "very difficult system to replicate in many other countries." Many Singaporeans also have supplemental private health insurance (often provided by employers) for services not covered by the government's programs.[32] Singapore’s well-established health care system comprises a total of 13 private hospitals, 10 public (government) hospitals and several specialist clinics, each specializing in and catering to different patient needs, at varying costs. Patients are free to choose the providers within the government or private health care delivery system and can walk in for a consultation at any private clinic or any government polyclinic. For emergency services, patients can go at any time to the 24-hour Accident & Emergency Departments located in the government hospitals. Singapore's medical facilities are among the finest in the world, with well qualified doctors and dentists, many trained overseas. Singapore has medical savings account system known as Medisave. Syria Main article: Health in Syria The Baath Party has placed an emphasis on health care, but funding levels have not been able to keep up with demand or maintain quality. Health expenditures reportedly accounted for 2.5 percent of the gross domestic product (GDP) in 2001. Syria’s health system is relatively decentralized and focuses on offering primary health care at three levels: village, district, and provincial. According to the World Health Organization (WHO), in 1990 Syria had 41 general hospitals (33 public, 8 private), 152 specialized hospitals (16 public, 136 private), 391 rural health centers, 151 urban health centers, 79 rural health units, and 49 specialized health centers; hospital beds totaled 13,164 (77 percent public, 23 percent private), or 11 beds per 10,000 inhabitants. The number of state hospital beds reportedly fell between 1995 and 2001, while the population had an 18 percent increase, but the opening of new hospitals in 2002 caused the number of hospital beds to double. WHO reported that in 1989 Syria had a total of 10,114 physicians, 3,362 dentists, and 14,816 nurses and midwives; in 1995 the rate of health professionals per 10,000 inhabitants was 10.9 physicians, 5.6 dentists, and 21.2 nurses and midwives. Despite overall improvements, Syria’s health system exhibits significant regional disparities in the availability of health care, especially between urban and rural areas. The number of private hospitals and doctors increased by 41 percent between 1995 and 2001 as a result of growing demand and growing wealth in a small sector of society. Almost all private health facilities are located in large urban areas such as Damascus, Aleppo, Tartus, and Latakia.[33] Taiwan Main article: Health in Taiwan The current health care system in Taiwan, known as National Health Insurance (NHI), was instituted in 1995. NHI is a single-payer compulsory social insurance plan which centralizes the disbursement of health care dollars. The system promises equal access to health care for all citizens, and the population coverage had reached 99% by the end of 2004.[34] NHI is mainly financed through premiums, which are based on the payroll tax, and is supplemented with out-of-pocket payments and direct government funding. In the initial stage, fee-for-service predominated for both public and private providers. Most health providers operate in the private sector and form a competitive market on the health delivery side. However, many health care providers took advantage of the system by offering unnecessary services to a larger number of patients and then billing the government. In the face of increasing loss and the need for cost containment, NHI changed the payment system from fee-for-service to a global budget, a kind of prospective payment system, in 2002. According to T.R. Reid, Taiwan achieves "remarkable efficiency", costing ~6 percent of GDP universal coverage; however, this underestimates the cost as it is not fully funded and the government is forced to borrow to make up the difference. "And frankly, the solution is fairly obvious: increase the spending a little, to maybe 8 percent of GDP. Of course, if Taiwan did that, it would still be spending less than half of what America spends."[35] Thailand Main article: Health in Thailand The majority of health care services in Thailand is delivered by the public sector, which includes 1,002 hospitals and 9,765 health stations. Universal health care is provided through three programs: the civil service welfare system for civil servants and their families, Social Security for private employees, and the Universal Coverage scheme theoretically available to all other Thai nationals. Some private hospitals are participants in these programs, though most are financed by patient self-payment and private insurance. The Ministry of Public Health (MOPH) oversees national health policy and also operates most government health facilities. The National Health Security Office (NHSO) allocates funding through the Universal Coverage program. Other health-related government agencies include the Health System Research Institute (HSRI), Thai Health Promotion Foundation ("ThaiHealth"), National Health Commission Office (NHCO), and the Emergency Medical Institute of Thailand (EMIT). Although there have been national policies for decentralization, there has been resistance in implementing such changes and the MOPH still directly controls most aspects of health care. Turkmenistan Main article: Health in Turkmenistan In the post-Soviet era, reduced funding has put the health system in poor condition. In 2002 Turkmenistan had 50 hospital beds per 10,000 population, less than half the number in 1996. Overall policy has targeted specialized inpatient facilities to the detriment of basic, outpatient care. Since the late 1990s, many rural facilities have closed, making care available principally in urban areas. President Niyazov’s 2005 proposal to close all hospitals outside Ashgabat intensified this trend. Physicians are poorly trained, modern medical techniques are rarely used, and medications are in short supply. In 2004 Niyazov dismissed 15,000 medical professionals, exacerbating the shortage of personnel. In some cases, professionals have been replaced by military conscripts. Private health care is rare, as the state maintains a near monopoly. Government-paid public health care was abolished in 2004.[36] United Arab Emirates Main article: Health in the United Arab Emirates Standards of health care are considered to be generally high in the United Arab Emirates, resulting from increased government spending during strong economic years. According to the UAE government, total expenditures on health care from 1996 to 2003 were US$436 million. According to the World Health Organization, in 2004 total expenditures on health care constituted 2.9 percent of gross domestic product (GDP), and the per capita expenditure for health care was US$497. Health care currently is government-paid only for UAE citizens. Effective January 2006, all residents of Abu Dhabi are covered by a new comprehensive health insurance program; costs will be shared between employers and employees. The number of doctors per 100,000 (annual average, 1990–99) is 181. The UAE now has 40 public hospitals, compared with only seven in 1970. The Ministry of Health is undertaking a multimillion-dollar program to expand health facilities—hospitals, medical centers, and a trauma center—in the seven emirates. A state-of-the-art general hospital has opened in Abu Dhabi with a projected bed capacity of 143, a trauma unit, and the first home health care program in the UAE. To attract wealthy UAE nationals and expatriates who traditionally have traveled abroad for serious medical care, Dubai is developing Dubai Healthcare City, a hospital free zone that will offer international-standard advanced private health care and provide an academic medical training center; completion is scheduled for 2010.[37] Uzbekistan Main article: Health in Uzbekistan In the post-Soviet era, the quality of Uzbekistan’s health care has declined. Between 1992 and 2003, spending on health care and the ratio of hospital beds to population both decreased by nearly 50 percent, and Russian emigration in that decade deprived the health system of many practitioners. In 2004 Uzbekistan had 53 hospital beds per 10,000 population. Basic medical supplies such as disposable needles, anesthetics, and antibiotics are in very short supply. Although all citizens nominally are entitled to free health care, in the post-Soviet era bribery has become a common way to bypass the slow and limited service of the state system. In the early 2000s, policy has focused on improving primary health care facilities and cutting the cost of inpatient facilities. The state budget for 2006 allotted 11.1 percent to health expenditures, compared with 10.9 percent in 2005.[38] Vietnam Main article: Health in Vietnam The overall quality of health in Vietnam is regarded as good, as reflected by 2005 estimates of life expectancy (70.61 years) and infant mortality (25.95 per 1,000 live births). However, malnutrition is still common in the provinces, and the life expectancy and infant mortality rates are stagnating. In 2001 government spending on health care corresponded to just 0.9 percent of gross domestic product (GDP). Government subsidies covered only about 20 percent of health care expenses, with the remaining 80 percent coming out of individuals’ own pockets.[39] In 1954 the government in the North established a public health system that reached down to the hamlet level. After reunification in 1976, this system was extended to the South. Beginning in the late 1980s, the quality of health care began to decline as a result of budgetary constraints, a shift of responsibility to the provinces, and the introduction of charges. Inadequate funding has led to delays in planned upgrades to water supply and sewage systems. As a result, almost half the population has no access to clean water, a deficiency that promotes such infectious diseases as malaria, dengue fever, typhoid, and cholera. Inadequate funding also has contributed to a shortage of nurses, midwives, and hospital beds. In 2000 Vietnam had only 250,000 hospital beds, or 14.8 beds per 10,000 people, a very low ratio among Asian nations, according to the World Bank.[2] Yemen Main article: Health in Yemen Despite the significant progress Yemen has made to expand and improve its health care system over the past decade, the system remains severely underdeveloped. Total expenditures on health care in 2002 constituted 3.7 percent of gross domestic product. In that same year, the per capita expenditure for health care was very low, as compared with other Middle Eastern countries—US$58 according to United Nations statistics and US$23 according to the World Health Organization. According to the World Bank, the number of doctors in Yemen rose by an average of more than 7 percent between 1995 and 2000, but as of 2004 there were still only three doctors per 10,000 persons. In 2003 Yemen had only 0.6 hospital beds available per 1,000 persons.[40] Health care services are particularly scarce in rural areas; only 25 percent of rural areas are covered by health services, as compared with 80 percent of urban areas. Emergency services, such as ambulance service and blood banks, are non-existent. Most childhood deaths are caused by illnesses for which vaccines exist or that are otherwise preventable. According to the Joint United Nations Programme on HIV/AIDS, in 2003 an estimated 12,000 people in Yemen were living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS).[2] Europe Belgium Main article: Healthcare in Belgium As in most countries, the Belgian system divides itself into state and private, though fees are payable in both. A person must have adequate coverage through either the state or private insurance. In the state mutuelle/mutualiteit scheme a person has the ability to choose any doctor, clinic or hospital in any location without referral, according to the patient's needs in much the same way as with private insurance. Doctors General practitioners can be found in private practices or attached to clinics and hospitals. A person is free to consult or register with any of their own choosing. Similarly with specialist consultants. Reimbursements are available for those with insurance, either private or public. If a patient is on a private scheme, or is uninsured, the fee is payable in full at the time of the appointment. The patient then brings, mails or deposits the receipt to his insurance mutuality which then immediately repays the amount. The majority of dentists in Belgium are private, though there are those who accept part-payment on state insurance.[citation needed] As with general practitioners, patients can arrange to see a specialist of their choice at any hospital. Those going into hospital for a planned stay need to take personal care items (such as a towel, soap etc.) with them.[41] In Brussels, the eleven big public hospitals are organized under the Iris association.[42] Alternative health care The Ministry of Health recognizes homeopathy, acupuncture, osteopathy and chiropractic as reimbursable alternative treatments. Reimbursement is possible only if the practitioner is registered as a qualified doctor. Emergency treatment If a call is made to the Emergency services using the old emergency number (100) or the European telephone number (112), an ambulance will transport the patient to the nearest hospital or the best centre suited according to the needs of the patient, for example, a Specialist Burns Unit. Pharmacies Pharmacies are common in Belgium and are marked with a green cross on the street. There is a rota system for pharmacists to open outside of usual hours through the night.[43] Health Insurance Health care insurance is a part of the Belgian social security system. To enroll, a person must first join a health insurance fund mutuelle (mutualité) or ziekenfonds (mutualiteit) for which an employer's certificate is required if the employer is to contribute to the cost. If employed a person's contributions is automatically deducted from salary. The employer will also pay a contribution. Health insurance funds will reimburse medical costs. The choice of mutual insurer is up to the individual. Most of them are affiliated to a religious or political institution but there is no real difference between them because reimbursement rates are fixed by the Belgian government.[44] Insurance funds do not always cover the full costs of treatment and typical reimbursement is between half to three-quarters of a typical doctors or specialists visit. A deciding factor here depends on one's job. From people who are unemployed or disabled, receiving other benefits or business-owners receive somewhat less. There is also a "yearly maximum bill" meaning that someone who has paid a certain amount to their doctor/hospital within the year does not have to make any further payment. From this point, any extra is returned from the patient's insurance. In general, the poor, even without reaching the necessary sum, do not pay anything.[45] Insured persons have a standardized credit card style SIS-card[46] which is needed in pharmacies and hospitals.[47] Bulgaria Main article: Health in Bulgaria Bulgaria began overall reform of its antiquated health system, inherited from the communist era, only in 1999. In the 1990s, private medical practices expanded somewhat, but most Bulgarians relied on communist-era public clinics while paying high prices for special care. During that period, national health indicators generally worsened as economic crises substantially decreased health funding. The subsequent health reform program has introduced mandatory employee health insurance through the National Health Insurance Fund (NHIF), which since 2000 has paid a gradually increasing portion of primary health-care costs. Employees and employers pay an increasing, mandatory percentage of salaries, with the goal of gradually reducing state support of health care. Private health insurance plays only a supplementary role. The system also has been decentralized by making municipalities responsible for their own health-care facilities, and by 2005 most primary care came from private physicians. Pharmaceutical distribution also was decentralized.[48] In the early 2000s, the hospital system was reduced substantially to limit reliance on hospitals for routine care. Anticipated membership in the European Union (2007) was a major motivation for this trend. Between 2002 and 2003, the number of hospital beds was reduced by 56 percent to 24,300. However, the pace of reduction slowed in the early 2000s; in 2004 some 258 hospitals were in operation, compared with the estimated optimal number of 140. Between 2002 and 2004, health-care expenditures in the national budget increased from 3.8 percent to 4.3 percent, with the NHIF accounting for more than 60 percent of annual expenditures.[2] In the 1990s, the quality of medical research and training decreased seriously because of low funding. In the early 2000s, the emphasis of medical and paramedical training, which was conducted in five medical schools, was preparation of primary-care personnel to overcome shortages resulting from the communist system’s long-term emphasis on training specialists. Experts considered that Bulgaria had an adequate supply of doctors but a shortage of other medical personnel. In 2000 Bulgaria had 3.4 doctors, 3.9 nurses, and 0.5 midwives per 1,000 population.[2] Denmark Main article: Health care in Denmark Denmark's health care system has retained the same basic structure since the early 1970s. The administration of hospitals and personnel is dealt with by the Ministry of the Interior, while primary care facilities, health insurance, and community care are the responsibility of the Ministry of Social Affairs. Anyone can go to a physician for no fee and the public health system entitles each Dane to his/her own doctor. Expert medical/surgical aid is available, with a qualified nursing staff. Costs are borne by public authorities, but high taxes contribute to these costs. As of 1999, there were an estimated 3.4 physicians and 4.5 hospital beds per 1,000 people. The number of hospital beds, like that in other EU countries, has undergone a major decline since 1980, from around 40,000 to about 23,000 in 1998/99. Deinstitutionalization of psychiatric patients has contributed significantly to this trend. The ratio of doctors to population, by contrast, has increased during this period. The total fertility rate in 2000 was 1.7, while the maternal mortality rate was 10 per 100,000 live births as of 1998. Studies show that between 1980 and 1993, 63% of married women (ages 15 to 49) used contraception. As of 2002 cardiovascular diseases and cancer were the leading causes of death. Denmark's cancer rates were the highest in the European Union. In 1999, there were only 12 reported cases of tuberculosis per 100,000 people. As of 1999, the number of people living with HIV/AIDS was estimated at 4,300 and deaths from AIDS that year were estimated at less than 100. HIV prevalence was 0.17 per 100 adults. Danish citizens may choose between two systems of primary health care: medical care paid for by the government provided by a doctor whom the individual chooses for a year and by those specialists to whom the doctor refers the patient; or complete freedom of choice of any physician or specialist at any time, with state reimbursement of about two-thirds of the cost for medical bills paid directly by the patient. Most Danes opt for the former. All patients receive subsidies on pharmaceuticals and vital drugs; everyone must pay a share of dental bills. As of 1999, total health care expenditure was estimated at 8.4% of GDP. Responsibility for the public hospital service rests with county authorities. Counties form public hospital regions, each of which is allotted one or two larger hospitals with specialists and two to four smaller hospitals where medical treatment is practically totally paid for by the government. State-appointed medical health officers, responsible to the National Board of Health, are employed to advise local governments on health matters. Public health authorities have waged large-scale campaigns against tuberculosis, venereal diseases, diphtheria, and poliomyelitis. The government-paid guidance and assistance given to mothers of newborn children by public health nurses have resulted in a low infant mortality rate of 4 per 1,000 live births (2000). Medical treatment is government-paid up to school age, when government-paid school medical inspections begin. As of 1999, children up to one year of age were vaccinated against diphtheria, pertussis, and tetanus (99%) and measles (92%). In 2000, life expectancy at birth was 76 years for males and females. The overall death rate was 11 per 1,000 people in 1999. Estonia Main article: Healthcare in Estonia Healthcare in Estonia is supervised by the Ministry of Social Affairs and funded by general taxation through the National Health Service. Finland Main article: Health in Finland In Finland, public medical services at clinics and hospitals are run by the municipalities (local government) and are funded 78% by taxation, 20% by patients through access charges, and by others 2%. Patient access charges are subject to annual caps. For example GP visits are (€11 per visit with annual €33 cap), hospital outpatient treatment (€22 per visit), a hospital stay, including food, medical care and medicines (€26 per 24 hours, or €12 if in a psychiatric hospital). After a patient has spent €590 per year on public medical services, all treatment and medications thereafter are paid for by the government. Taxation funding is partly local and partly nationally based. Patients can claim re-imbursement of part of their prescription costs from KELA. Finland also has a much smaller private medical sector which accounts for about 14 percent of total health care spending. Only 8% of doctors choose to work in private practice, and some of these also choose to do some work in the public sector. Private sector patients can claim a contribution from KELA towards their private medical costs (including dentistry) if they choose to be treated in the more expensive private sector, or they can join private insurance funds. However, private sector health care is mainly in the primary care sector. There are virtually no private hospitals, the main hospitals being either municipally owned (funded from local taxes) or run by the teaching universities (funded jointly by the municipalities and the national government). In 2005, Finland spent 7.5% of GDP on health care, or US$2,824 per capita. Of that, approximately 78% was government expenditure.[3] France Main article: Health care in France In its 2000 assessment of world health systems, the World Health Organization found that France provided the "best overall health care" in the world.[22] In 2005, France spent 11.2% of GDP on health care, or US$3,926 per capita. Of that, approximately 80% was government expenditure.[3] In France, most doctors remain in private practice; there are both private and public hospitals. Social Security consists of several public organizations, distinct from the state government, with separate budgets that refunds patients for care in both private and public facilities. It generally refunds patients 70% of most health care costs, and 100% in case of costly or long-term ailments. Supplemental coverage may be bought from private insurers, most of them nonprofit, mutual insurers, to the point that the word "mutuelle" (mutual) has come to be a synonym of supplemental private insurer in common language. Until recently, social security coverage was restricted to those who contributed to social security (generally, workers, unemployed or retirees), excluding some few poor segments of the population; the government of Lionel Jospin put into place the "universal health coverage" allowing the entire French population to benefit from Health care. In some systems, patients can also take private health insurance but choose to receive care at public hospitals, if allowed by the private insurer. For serious illness, regardless of the insurance regime, the national health system will assume the cost of long-term remedial treatment. Germany Main article: Health in Germany The University Medical Center Freiburg in Germany Germany has a universal multi-payer system with two main types of health insurance: "Law-enforced health insurance" (Gesetzliche Krankenversicherung) known as sickness funds and "Private" (Private Krankenversicherung).[49][50][51] Compulsory insurance applies to those below a set income level and is provided through private non-profit "sickness funds" at common rates for all members, and is paid for with joint employer-employee contributions. Provider compensation rates are negotiated in complex corporatist social bargaining among specified autonomously organized interest groups (e.g. physicians' associations) at the level of federal states (Länder). The sickness funds are mandated to provide a wide range of coverages and cannot refuse membership or otherwise discriminate on an actuarial basis. Small numbers of persons are covered by tax-funded government employee insurance or social welfare insurance. Persons with incomes above the prescribed compulsory insurance level may opt into the sickness fund system, which a majority do, or purchase private insurance. Private supplementary insurance to the sickness funds of various sorts is available. In 2005, Germany spent 10.7% of GDP on health care, or US$3,628 per capita. Of that, approximately 77% was government expenditure.[3] Greece Main article: Health care in Greece The Greek healthcare system is universal and is ranked as one of the best in the world. In a 2000 World Health Organization report it was ranked 14th in the overall assessment and 11th at quality of service, surpassing countries such as the United Kingdom (18th) and Germany (25th).[52] In 2010 there were 131 hospitals with 35,000 beds in the country, but on 1 July 2011 the Ministry for Health and Social Solidarity announced its proposal to shorten the number to 83 hospitals with 33,000 beds.[53] Greece's healthcare expenditures as a percentage of GDP were 9.6% in 2007 according to a 2011 OECD report, just above the OECD average of 9.5%.[54] The country has the largest number of doctors-to-population ratio of any OECD country.[54] Life expectancy in Greece is 80.3 years, above the OECD average of 79.5.[54] and among the highest in the world. The same OECD report showed that Greece had the largest percentage of adult daily smokers of any of the 34 OECD members.[54] The country's obesity rate is 18.1%, which is above the OECD average of 15.1% but considerably below the American rate of 27.7%.[54] In 2008 Greece had the highest rate of perceived good health in the OECD, at 98.5%.[55] Infant mortality is one of the lowest in the developed world with a rate of 3.1 deaths/1000 live births.[56] Iceland Main article: Healthcare in Iceland Healthcare in Iceland is universal. The healthcare system is largely paid for by taxes (85%) and to some extent by service fees (15%) and is administrated by the Ministry of Welfare. A considerable portion of government spending is assigned to healthcare. There is almost no private health insurance in Iceland and no private hospitals. Ireland Main article: Healthcare in the Republic of Ireland All persons resident in the Republic of Ireland are entitled to health care through the public health care system, which is managed by the Health Service Executive and funded by general taxation. A person may be required to pay a subsidised fee for certain health care received; this depends on income, age, illness or disability. All maternity services are however paid for by the government, as well as health care of infants under 6 months of age. Emergency care is provided at a cost of €120 for a visit to a hospital Emergency Department. Italy Main article: Healthcare in Italy According to WHO in 2000, Italy had the world's "second overall best" healthcare system in the world, coming after France, and surpassing Spain, Oman and Japan.[57] In 1978 Italy adopted a tax-funded universal health care system called "National Health Service" (in Italian: Servizio Sanitario Nazionale), which was closely modeled on the British system. The SSN covers general practice (distinct between adult and pediatric practice), outpatient and inpatient treatments, and the cost of most (but not all) drugs and sanitary ware |
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