Costs are also ballooning in Thailand, which reformed the way it finances its public health system in 2002. Famously inexpensive compared with other places in the region - it is common, for example, for people in Hong Kong to travel to Thailand for minor surgery or dental treatment. Costs are rising there too. A heart bypass which can cost as much as $130,000 in the US or $18,500 in Singapore, can be carried out for $11,000 in Thailand.

The National Health Security Office is working to reduce costs, according to WHO. Still, Thailand spends about 1 percent of its GDP on private healthcare expenditure compared with 4.5 percent in Cambodia, 1.5 percent in Indonesia and more than 2 percent in China.

The real cost of healthcare

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Ballooning costs, driven by overtreatment, may be most visible in China, where the problem is also emerging as a key constraint.

Beijing is working to extend healthcare coverage to 90 percent of the population or more and that is pushing costs up.

McKinsey anticipates that China will spend as much as $1 trillion by 2020 on healthcare, almost three times as much as today. That will lift total healthcare spending to 7 percent of GDP, up from 5.5 percent in 2010.

"Overtreatment is very common in China. It happens basically in every hospital," says John Cai, director of the Center for Health Care Management and Policy with the China Europe International Business School.

The best examples are the overuse of antibiotics and intravenous therapy. Hospitals are constantly packed with patients taking or waiting to take intravenous therapy.

Deng Haihua, vice-director of communications with the National Health and Family Planning Commission, last year said that although the overuse of medicine was a common concern, reports of overuse of intravenous fluids were exaggerated. The commission is now working to improve regulations and improve training.

The problem is not just with the use of drugs. Unnecessary surgical procedures are frequent. Heart patients, for example, are often encouraged to have heart stents implanted regardless of their condition. In China, there are about 15 stents implanted for every single bypass surgery.

In most other countries the rate is about half that, said Wang Hufeng, director of the Healthcare Reform Center of Renmin University of China, Beijing, during an interview with CCTV. With a large population and an unbalanced distribution of healthcare resources, China faces a difficult problem.

 

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