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Uwe Reinhardt’s important 2003 article in Health Affairs “It’s the Prices, Stupid,” concluded that the difference in healthcare costs between the US and other countries is simply because the prices are higher for healthcare goods and services in the United States. If that explanation sounds a bit weird and unsatisfying, he does go into the long explanation where he names the culprits. As an academic health economist, however, the long answers Reinhardt pens aren’t that much more revealing to the average reader looking for easy-to-talk-about answers.But I’m going to give you something that you can really understand. I’m going to add for comparison, two process diagrams for the healthcare claims adjudication process. The first one is how healthcare claims are resolved in the United States, the second one, is how they are resolved in Canada.So what is ‘claims processing’ and why is it important to the cost of US healthcare? Claims processing is the receipt and adjudication of a claim for a medical service filed by the insured member (that’s you and me) against a third-party insurer (that’s our insurance plan). Claims are accepted or rejected by a Payer (our insurance company) based on the member’s insurance policy. In the US, over 160 million people have their claims adjudicated by private Payers on behalf of millions of employers’ group plans or through individually-owned plans.The commercialization of health insurance creates an almost endless number of different contractual terms and conditions. Each different insurance company (about 4,000 different carriers) processes claims in its own unique way, usually with its own software system. Millions of claims are transacted daily in the US. Each claim can trigger hundreds of actions based on extensive rules and regulations. Insurance companies and clearinghouses designed to help manage claims process many trillions of these actions each year.This ponderous variability across multiple stakeholders (stakeholders are the insurance companies, the drug companies, the plan member/patients, the government, the hospitals, the clinics, the doctors, and other 3rd party providers) makes the US claims payment infrastructure the most complex, the most expensive, and the least efficient claims processing system anywhere in the world. It’s also the reason why the US consumes at least twice as much healthcare administration as any other comparable industrialized country.Fig 1. (below) depicts the Rube Goldberg-esque processing method we've developed in the United States to adjudicate healthcare claims. This image isn't meant entirely to be a lampoon of the system ― it's a true representation of the actual system we use. In fact, the illustration doesn't include nearly enough features; there are layers upon layers of processes and rules that sit below what is shown on top.Fig 1. US Healthcare Claims System InfrastructureNo matter how someone is insured, once they enter the Provider’s system their data must be accounted for somehow, and that’s all reflected in the claims process. Every claims processing software system on the market must attempt to accommodate every possible claims scenario. Most Providers (physicians, clinics, hospitals, etc,) need to be able to claim against each Payer, not just the ones in their ‘network.’ Many claims interact with different programs including Medicare, Medicaid, the VA, and the Affordable Care Act. In addition, different states have different rules and different public and private funding sources. The Payers within those programs all have different claims formats. Providers who send in claims on behalf of their insured patients, must format each claim differently depending on their contract with that Payer, the patient's insurance and the applicable state laws.Incredibly in the US, there is no universal, standard claims format. Some are still even paper-based. Payers struggle with providing the correct contracts to each Provider, and Providers struggle with each different claims format. Mistakes with the first claims submission in some systems are as common as 'clean claims.' Some unethical Payers deliberately make their claims process as difficult as possible, further complicating the process. A mistake at any level kicks the claim out and the process starts over again. Oftentimes, valid claims, once rejected, are not re-submitted for a variety of reasons. Days, weeks, and months may be added to the revenue cycle for Providers due to delayed payments (and unpaid debt has ballooned across every Provider sector since 2015). In many cases, up to 80% of premium costs are spent dealing with claims, not medical care. It's really the convolution of so many variables that makes claims processing in the US an administrative nightmare ― and very close to the chaos it appears to be.The medical billing process is a major driver of healthcare spending in the US. Technology has streamlined many other consumer/industrial sectors; everything from banking, to online purchasing, to media distribution, to ride sharing. But that’s not true for the healthcare claims process. The complexity of the process with its multiplicity of plans and contracts, medical codes, share of government and private funding, multiple accounts to draw from for the same claim, inconsistent deductibles and reimbursement levels, even within the same plan, make it impractical to apply algorithms. Algorithms are computations that deal with finite numbers of precisely defined successive states, eventually producing a final outcome. Algorithms have made consumer-facing companies like Amazon, Facebook, Snapchat, and Uber successful. But health insurance claims are more like snowflakes—no two are exactly the same, making algorithms that depend on ‘sameness’ difficult to adapt. No matter how many feedback loops you build into the process, there continue to be so many computational failures along the algorithmic flow that real humans must intervene every so often to resolve problems and move the claim forward. But human touches are expensive and time consuming — and so far, no application of even the most advanced technology has been able to arrest the continual need to hire more and more administrators.Now let’s look at the same claim adjudication flow for a healthcare system like Canada’s (represented by Fig 2), where every person is covered. Keep in mind that claims for exactly the same medical tests and procedures occur in Canada as the US. On their authority as accredited Providers, Canadian physicians make claims submitted electronically to the provincial health Payer. Adjudication between Provider and Payer happens much the same way as it does in the US. But that’s where the similarity ends because there’s only one plan and one Payer ― no redundant middlemen. In Canada, there's only need for one secure interface between Provider and Payer. To put it into American terms, Canadians are all members of the same plan with the same coverage. The single Payer represents the Insurer, who is dedicated to providing all services to every citizen on an equitable basis.To make a claim for a service provided to a patient, a doctor or his office staff simply enters the provincial tariff codes into a secure electronic database hosted by the Payer. For Providers, there is only one set of prices for each province based on a fee-for-service payment structure. These prices are maintained for years with an annual inflation factor added. For patients, there is nothing to do; no paperwork, no bills. Everyone receives the same comprehensive coverage through their provincial plan based on a system that covers all basic medical services. Because the provincial plan pays, no Canadian has ever been denied care or accumulated personal debt for a medical reason.One Canadian clinic administrator can take care of all of the billing for a group of 10 to 20 doctors along with performing additional office tasks. That's a far cry from the US where it takes 7 administrators to handle the paperwork burden for every 10 physicians. A comparison of hospitals is the best example. It takes about 8 billing clerks to enter billing data for a large ~900-bed Canadian hospital. Contrast that to Duke University where their 957-bed hospital requires the employment of 1,600 billing clerks and an additional unknown number of billing consultants.The administration function is made easier because there’s no such thing as pre-authorization on the front end and the adjudication process for claims is infinitely simpler. Depending on area of practice, 95-100% of claims are paid by the provincial Payer every 15 days. That’s the length of the revenue cycle in Canada — two weeks. The flow chart for the Canadian healthcare system looks like Fig. 2. It's clean, simple, and precise, with no need for any of the billion dollar technology features and onerous government regulations that must be applied to the same adjudication process in the US. And fraud? According to the FBI about $272 Billion worth of medical and billing fraud occurs each year in the US. By comparison, the Canadian system is so simple that fraud is unheard of.Fig. 2 Healthcare Claim Payment Infrastructure in Single Payer SystemThe Canadians have created a plan benefit design that is comprehensive and their laws have given provincial governments the regulatory teeth to make it work. They understand that the more players who are allowed to represent more variable and alterable plans, the more administrative problems it creates for Providers and patients alike. The more Payers and plans ― what we like to call ‘choice,’ in America ― the greater the reduction in cost-effectiveness. Although opponents of 'socialized medicine' typecast it as 'Americans under the thumb of Big Government,' it's impossible to conceive of a system that's more bureaucratic, wasteful and corrupt than what we have now.That bureaucracy means that here in the US, all stakeholders are continually hiring more low-level clerks and administrators to manage the choke-points. (Fig 3. below) In this scenario there is no need for more physicians who would only generate more paperwork ― best to curtail the care to lessen the admin burden, and raise prices to pay for the new hires. Healthcare stakeholders have placed higher value on a good revenue cycle strategy than the delivery of healthcare itself. The result? Higher healthcare premiums, higher co-pays, more high-deductible plans, a high rate of inflation that guarantees significantly higher insurance plan costs each year, and far less coverage than ever before. The other result that’s perversely and indefensibly higher is insurance company profitability along with the billions of dollars in performance bonuses ‘taken’ by CEOs who somehow believe they deserve them. It doesn't matter that the insurers have failed spectacularly in their mission to provide affordable and comprehensive plans to Americans. It only means that ‘whoever has the gold makes the rules.’Fig. 3 Growth in Physicians and Administrators US Healthcare System 1970-2017According to a Harvard study, we put up with $60 billion in overpayments (Americans being charged and paying more than they should have been billed) Annual care for the uninsured and under-insured generates $85 billion in uncompensated costs covered by us, the taxpayers. There are $272 billion in medical billing fraud each year. That means the American system 'absorbs' more in unrecoverable costs due to fraud each year than the entire Canadian healthcare system costs to run! (absorbs = recovered out of higher premiums we all pay) There are also $262 billion in medical claims that are denied, leaving patients to scramble to either get the denial decision reversed or find an alternate means of financing their care. Physicians give away $125 billion in free services for rejected claims each year. Uncompensated care provided by American hospitals is over $38 billion per year. All told, the ‘waste, fraud, and abuse’ measure has been accurately authenticated at around $1.1 trillion of our $3.6 trillion healthcare system.Attempts to reclaim these losses add untold billions in administrative costs, not to mention the millions of hours of unpaid time spent by patients’ families attempting to get the medical care they need. In fact, every pointless and unnecessary cost in the system is recovered on the backs of Americans ― you and me. That’s because insurers don’t endure the cost; they simply recoup losses by increasing premiums, raising deductibles and decreasing coverage.Through all of this, it's key to remember that the number of uninsured Canadians is zero, and the personal debt accumulated for insured medical care is zero. Because the provincial plan pays, no Canadian has ever been denied care. Canada can offer this to everyone because they've wrestled their costs to the ground. Canada and Scotland have the lowest hospital administration costs in the world. There is much to be said about the simplicity and practicality of viewing healthcare as a right, and not a commodity.If a picture is worth a thousand words, then the two comparative process diagrams I’ve illustrated surely provide an eloquent answer to our healthcare problems. But the gains found by eliminating the tortuous claims process only occurs by moving to a simpler system. It’s time to take a serious look at how other countries deliver healthcare for half of what we pay before the harm the current system inflicts upon the country becomes an unrecoverable condition.

Countries Where Bitcoin is Legal and not LegalThe peer-to-peer digital currency Bitcoin made its debut in 2009 and with it ushered in a new era of cryptocurrency. While tax authorities, enforcement agencies and regulators worldwide are still debating best practices, one pertinent question: is Bitcoin legal or illegal? The answer – it depends on the location and activity of the user.Bitcoins are not issued, endorsed, or regulated by any central bank. Instead, they are created through a computer-generated process known as mining. In addition to being a cryptocurrency unrelated to any government, Bitcoin is a peer-to-peer payment system since it does not exist in a physical form. As such, it offers a convenient way to conduct cross-border transactions with no exchange rate fees. It also allows users to remain anonymous.Consumers have greater ability to purchase goods and services with Bitcoin directly at online retailers, pull cash out of Bitcoin ATMs and use Bitcoin at some brick-and-mortar stores. The currency is being traded on exchanges, and virtual currency-related ventures and ICOs draw interest from across the investment spectrum. While Bitcoin appears at glance to be a well-established virtual currency system, there are still no uniform international laws that regulate Bitcoin.Countries that Say Yes to BitcoinBitcoin can be used anonymously to conduct transactions between any account holders, anywhere and anytime across the globe, which makes it attractive to criminals and terror organizations. They may use Bitcoin to buy or sell illegal goods like drugs or weapons. Most countries have not clearly determined the legality of Bitcoin, preferring instead to take a wait-and-see approach. Some countries have indirectly assented to the legal use of Bitcoin by enacting some regulatory oversight. However, Bitcoin is never legally acceptable as a substitute for a country’s legal tender.The United StatesThe United States has taken a generally positive stance toward Bitcoin, though several government agencies work to prevent or reduce Bitcoin use for illegal transactions. Prominent businesses like Dish Network (DISH), the Microsoft Store, sandwich retailer Subway and Bedding, Furniture, Electronics, Jewelry, Clothing & more (OSTK) welcome payment in Bitcoin. The digital currency has also made its way to the U.S. derivatives markets, which speaks about its increasingly legitimate presence.The U.S. Department of Treasury’s Financial Crimes Enforcement Network (FinCEN) has been issuing guidance on Bitcoin since 2013. The Treasury has defined Bitcoin not as currency, but as a money services business (MSB). This places it under the Bank Secrecy Act which requires exchanges and payment processors to adhere to certain responsibilities like reporting, registration, and record keeping. In addition, Bitcoin is categorized as property for taxation purposes by the Internal Revenue Service (IRS).CanadaLike its southern neighbor the United States, Canada maintains a generally Bitcoin-friendly stance while also ensuring the cryptocurrency is not used for money laundering. Bitcoin is viewed as a commodity by the Canada Revenue Agency (CRA). This means that Bitcoin transactions are viewed as barter transactions, and the income generated is considered as business income. The taxation also depends whether the individual has a buying-selling business or is only concerned with investing.Canada considers Bitcoin exchanges to be money service businesses. This brings them under the purview of the anti-money laundering (AML) laws. Bitcoin exchanges need to register with Financial Transactions and Reports Analysis Centre of Canada (FINTRAC), report any suspicious transactions, abide by the compliance plans, and even keep certain records. In addition, some major Canadian banks have banned the use of their credit or debit cards for Bitcoin transactions.AustraliaAustralia considers Bitcoin a currency like any other and allows entities to trade, mine, or buy it.The European UnionThough the European Union (EU) has followed developments in cryptocurrency, it has not issued any official decision on legality, acceptance or regulation. In the absence of central guidance, individual EU countries have developed their own Bitcoin stances.In Finland, the Central Board of Taxes (CBT) has given Bitcoin a value-added tax exempt status by classifying it as a financial service. Bitcoin is treated as a commodity in Finland and not as a currency. The Federal Public Service Finance of Belgium has also made Bitcoin exempt from value added tax (VAT). In Cyprus, Bitcoin are not controlled or regulated either. The Financial Conduct Authority (FCA) in the United Kingdom (U.K.) has a pro-Bitcoin stance and wants the regulatory environment to be supportive of the digital currency. Bitcoin is under certain tax regulations in the U.K. The National Revenue Agency (NRA) of Bulgaria has also brought Bitcoin under its existing taw laws. Germany is open to Bitcoin; it is considered legal but taxed differently depending upon whether the authorities are dealing with exchanges, miners, enterprises or users.Ukraine - LegalThe use of bitcoins is not regulated in Ukraine. Mining is legal type of entrepreneurship.Belarus - LegalThe Decree On the Development of Digital Economy — the decree of Alexander Lukashenko, the President of the Republic of Belarus, which includes measures to liberalize the conditions for conducting business in the sphere of high technologies.The provisions of the decree "On the Development of Digital Economy" create of a legal basis for the circulation of digital currencies and tokens based on blockchain technology, so that resident companies of the High-Tech Park can provide the services of stock markets and exchange offices with cryptocurrencies and attract financing through the ICO. For legal entities, the Decree confers the rights to create and place their own tokens, carry out transactions through stock markets and exchange operators; to individuals the Decree gives the right to engage in mining, to own tokens, to acquire and change them for Belarusian rubles, foreign currency and electronic money, and to bequeath them. Up to 1 Jan In 2023, the Decree excludes revenue and profits from operations with tokens from the taxable base. In relation to individuals, the acquisition and sale of tokens is not considered entrepreneurial activity, and the tokens themselves and income from transactions with them are not subject to declaration. The peculiarity of the introduced regulation is that all operations will have to be carried out through the resident companies of the High Technology Park.In addition, the decree includes:Extension of the validity period of the special legal regime of the High-Tech Park until January 1, 2049, and expansion of the list of activities of resident companies. Under the new rules, developers of blockchain-based solutions, developers of machine learning systems based on artificial neural networks, companies from the medical and biotechnological industries, developers of unmanned vehicles, as well as software developers and publishers can become residents. The list of promising areas is unlimited and can be expanded by the decision of the High-Tech Park supervisory board.Preservation of existing benefits for resident companies in the High-Tech Park, including the cancellation of the profit tax (instead of which a contribution of 1% of the gross revenues proceeding to the administration of the park is applied), reduced to 9% of the personal income tax rate for employees, and the right to contribute to the Social Protection Fund according to the national average figures, and not the actual salaries.Exemption of foreign companies providing marketing, advertising, consulting and other services to the residents of the High-Tech Park from paying value-added tax, as well as paying income tax, which allows to promote IT products of Belarusian companies in foreign markets. To encourage investments, the Decree also exempts foreign companies from the tax on income from the alienation of shares, stakes in the authorized capital and shares in the property of residents of the High-Tech Park (under condition of continuous possession of at least 365 days).Introduction of individual English law institutions for residents of the High-Tech Park, which will make it possible to conclude option contracts, convertible loan agreements, non-competition agreements with employees, agreements with responsibility for enticing employees, irrevocable powers of attorney and other documents common in international practice. This measure is aimed at simplifying the structuring of transactions with foreign capital.Simplification of the regime of currency transactions for residents of the High-Tech Park, including the introduction of a notification procedure for currency transactions, the cancellation of the mandatory written form of foreign trade transactions, the introduction of confirmation of the conducted operations by primary documents drawn up unilaterally. Also, the decree removes restrictions on resident companies for transactions with electronic money and allows opening accounts in foreign banks and credit and financial organizations without obtaining permission from the National Bank of the Republic of Belarus.Simplification of the procedure for recruiting qualified foreign specialists by resident companies of the High-Tech Park, including the abolition of the recruitment permit, the simplified procedure for obtaining a work permit, and the visa-free regime for the founders and employees of resident companies with a term of continuous stay of up to 180 days.Japan - LegalOn 7 March 2014, the Japanese government, in response to a series of questions asked in the National Diet, made a cabinet decision on the legal treatment of bitcoins in the form of answers to the questions. The decision did not see bitcoin as currency nor bond under the current Banking Act and Financial Instruments and Exchange Law, prohibiting banks and securities companies from dealing in bitcoins. The decision also acknowledges that there are no laws to unconditionally prohibit individuals or legal entities from receiving bitcoins in exchange for goods or services. Taxes may be applicable to bitcoins.Do you think of how to make fast profits with your cryptos..? It’s so possible atcenturycoingroup.us because at Century Coin Group USA , you will be able to make double of your bitcoin investment within just seven days..South Korea it is LegalMinors and all foreigners are prohibited from trading cryptocurrencies. Adult South Koreans may trade on registered exchanges using real name accounts at a bank where the exchange also has an account. Both the bank and the exchange are responsible for verifying the customer's identity and enforcing other anti-money-laundering provisions.As of April 2017, cryptocurrency exchange businesses operating in Japan have been regulated by the Payment Services Act. Cryptocurrency exchange businesses have to be registered, keep records, take security measures, and take measures to protect customers. Financial Services Agency (FSA) was established in 2014 for the purpose of establishing a registration platform for cryptocurrency exchange businesses. the law on cryptocurrency transactions must comply with the anti-money laundering law; and measures to protect users investors. The Payment Services Act defines “cryptocurrency” as a property value. The Act also states that cryptocurrency is limited to property values that are stored electronically on electronic devices, not a legal tender.Taiwan - Legal /Banking banFinancial institutions are not allowed to facilitate bitcoin transactions. Regulators have warned the public that bitcoin does not have legal protection, "as the currency is not issued by any monetary authority and is therefore not entitled to legal claims or guarantee of conversion".Financial institutions have been warned by regulators that necessary regulatory actions may be taken if they use bitcoin. TaiwanOn 31 December 2013, Financial Supervisory Commission (Republic of China) (FSC) and CBC issued a joint statement which warns against the use of bitcoins. It is stated that bitcoins remains highly volatile, highly speculative, and is not entitled to legal claims or guarantee of conversion.On 5 January 2014, FSC chairman Tseng Ming-chung stated that FSC will not allow the installation of bitcoin ATM in Taiwan because bitcoin is not a currency and it should not be accepted by individuals and banks as payment.South Africa - LegalIn December 2014 the Reserve Bank of South Africa issued a position paper on virtual currencies whereby it declared that virtual currency had ‘no legal status or regulatory framework’. The South African Revenue Service classified bitcoin as an intangible asset.Namibia-LegalIn September 2017 the Bank of Namibia issued a position paper on virtual currencies entitled[20] wherein it declared cryptocurrency exchanges are not allowed and cryptocurrency cannot be accepted as payment for goods and services.Zimbabwe - LegalThe Reserve Bank Of Zimbabwe is sceptical about bitcoin and has not officially permitted its use. On 5 April 2017 however, BitMari, a Pan-African Blockchain platform got licensed, through its banking partner, AgriBank, to operate in the country.Nigeria - LegalAs of 17 January 2017, The Central Bank of Nigeria (CBN) has passed a circular to inform all Nigerian banks that bank transactions in bitcoin and other virtual currencies have been banned in Nigeria.However, during the year, the CBN (through its Deputy Director on Banking and Payments System, Musa Itopa-Jimoh) clarified the circular and its stance on bitcoin, citing that a lot of people misinterpret the central bank’s recent warning. It noted that "Central bank cannot control or regulate bitcoin. Central bank cannot control or regulate blockchain. Just the same way no one is going to control or regulate the Internet. We don’t own it".Later on, a committee was set up by the Central Bank of Nigeria (CBN) and the Nigeria Deposit Insurance Corporation (NDIC) to look into the possibility of the country adopting the technology driving bitcoin and other digital currencies – blockchain. The committee has submitted its report but "several sub-committees are still working on the issue" according to the Director, Banking & Payments System Department at CBN, Mr. ‘Dipo Fatokun.Israel- Yes- LegalAs of 2017, the Israel Tax Authorities issued a statement saying that bitcoin and other cryptocurrencies would not fall under the legal definition of currency, and neither of that of a financial security, but of a taxable asset.[55] Each time a bitcoin is sold, the seller would have to pay a capital gains tax of 25%. Miners, traders of bitcoins would be treated as businesses and would have to pay corporate income tax as well as charge a 17% VATSaudi Arabia - Legal - Banking banFinancial institutions are warned from using bitcoin. The Saudi Arabian Monetary Authority (SAMA) has warned from using bitcoin as it is high risk and its dealers will not be guaranteed any protection or rights.Jordan-Legal- Banking banThe government of Jordan has issued a warning discouraging the use of bitcoin and other similar systems.The Central Bank of Jordan prohibits banks, currency exchanges, financial companies, and payment service companies from dealing in bitcoins or other digital currencies. While it warned the public of risks of bitcoins, and that they are not legal tender, bitcoins are still accepted by small businesses and merchants.Lebanon-LegalThe government of Lebanon has issued a warning discouraging the use of bitcoin and other similar systems.Turkey-LegalBitcoin is not regulated as it is not considered to be electronic money according to the law.Iran-Legal-Banking banFinancial institutions are not allowed by central bank to facilitate bitcoin transactions. In April 2018, Central Bank of the Islamic Republic of Iran issued a statement banning the country’s banks and financial institutions from dealing with cryptocurrencies, citing money laundering and terrorism financing risks.Bangladesh - Legal/Banking banFinancial institutions are not allowed to facilitate bitcoin transactions. In September 2014, Bangladesh Bank said that "anybody caught using the virtual currency could be jailed under the country's strict anti-money laundering laws".India -Legal /Banking banFinance minister Arun Jaitley, in his budget speech on 1 February 2018, stated that the government will do everything to discontinue the use of bitcoin and other virtual currencies in India for criminal uses. He reiterated that India does not recognise them as legal tender and will instead encourage blockchain technology in payment systems."The government does not recognise cryptocurrency as legal tender or coin and will take all measures to eliminate the use of these cryptoassets in financing illegitimate activities or as part of the payments system," Jaitley said.In early 2018 India's central bank, the Reserve Bank of India (RBI) announced a ban on the sale or purchase of cryptocurrency for entities regulated by RBI.In 2019, a petition has been filed[by whom?] with the Supreme Court of India challenging the legality of cryptocurrencies and seeking a direction or order restraining their transaction.Countries That Say No to BitcoinWhile Bitcoin is welcomed in many parts of the world, a few countries are wary because of its volatility, decentralized nature, perceived threat to current monetary systems and links to illicit activities like drug trafficking and money laundering. Some nations have outright banned the digital currency while others have tried to cut off any support from the banking and financial system essential for its trading and use.List of some of the Countries Bitcoin-Cryptos are illegalChina - IllegalBitcoin is essentially banned in China. All banks and other financial institutions like payment processors are prohibited from transacting or dealing in Bitcoin. Cryptocurrency exchanges are banned. The government has cracked down on miners. (Related reading How Bitcoin Can Change The World)Russia - RegulatedBitcoin is not regulated in Russia, though its use as payment for goods or services is illegal. As of November 2016 declared, bitcoins are "not illegal" according to the Federal Tax Service of Russia.[50] Deputy Finance Minister of the Russian Federation Alexei Moiseev said in September 2017 it's "probably illegal" to accept cryptocurrencies payments.[51] However bitcoin market sites are blocked and in court decisions stated that bitcoin is a currency surrogate which is outlawed on the territory of Russian Federation.Vietnam - IllegalVietnam’s government and its state bank maintain that Bitcoin is a not a legitimate payment method, though it is not regulated as an investment.Bolivia, Columbia and Ecuador not legalEl Banco Central de Bolivia has banned the use of Bitcoin and other cryptocurrencies. Columbia does not allow Bitcoin use or investment. Bitcoin and other cryptocurrencies were banned in Ecuador by a majority vote in the national assembly.Algeria it is illegalAccording to the "Journal Officiel" (28 December 2017)The purchase, sale, use, and holding of so-called virtual currency is prohibited. Virtual currency is that used by internet users via the web. It is characterized by the absence of physical support such as coins, notes, payments by cheque or credit card. Any breach of this provision is punishable in accordance with the laws and regulations in force.Egypt it is illegal"Egypt’s Dar al-Ifta, the primary Islamic legislator in Egypt, has issued a religious decree classifying commercial transactions in bitcoin as haram (prohibited under Islamic law).Morocco it is illegalOn 20 November 2017 the exchange office issued a public statement in which it declared, "The Office des Changes wishes to inform the general public that the transactions via virtual currencies constitute an infringement of the exchange regulations, liable to penalties and fines provided for by [existing laws] in force."The following day, the monetary authorities also reacted in a statement issued jointly by the Ministry of Economy and Finance, Bank Al-Maghrib and the Moroccan Capital Market Authority (AMMC), warning against risks associated with bitcoin, which may be used "for illicit or criminal purposes, including money laundering and terrorist financing"On 19 December 2017, Abdellatif Jouahri, governor of Bank Al-Maghrib, said at a press conference held in Rabat during the last quarterly meeting of the Bank Al-Maghrib's Board of 2017 that bitcoin is not a currency but a "financial asset". He also warned of its dangers and called for a framework to be put in place for consumer protectionUnited Arab Emirates - Contradictory informationAbsolute ban. According to the Library of Congress "Under article D.7.3 of the Regulatory Framework for Stored Values and an Electronic Payment System, issued by the Central Bank of the United Arab Emirates in January 2017, all transactions in “virtual currencies” (encompassing cryptocurrencies in Arabic) are prohibited."Nevertheless, on 13 February 2018 Dubai gold trader Regal RA DMCC became the first company in the Middle East to get a license to trade cryptocurrencies, the Dubai Multi Commodities Centre said.[53] DMCC's website emphasizes the "cold storage" of cryptocurrencies and states "DMCC’s Crypto-commodities license is for Proprietary Trading in Crypto-commodities only. No initial coin offerings are permitted and no establishment of an exchange is permitted under this license."Nepal it is IllegalAbsolute ban. On 13 August 2017 Nepal Rastra Bank declared bitcoin as illegal.Pakistan it is IllegalAs of 7 April 2018, State Bank of Pakistan [SBP] has announced that bitcoin and other virtual currencies/tokens/ coins are banned in Pakistan. This news was followed right after India's restriction of converting bitcoin and cryptocurrencies into fiat currency. For organizations and institutions it is banned by State Bank of Pakistan. Bank will not get involved if there is any dispute. They will not facilitate any transaction for it.The bank has issued an official notice on its website and has also posted the news on its official Twitter account.The Bottom LineAlthough Bitcoin is now almost 10 years old, many countries still do not have explicit systems that restrict, regulate or ban the cryptocurrency. The decentralized and anonymous nature of Bitcoin has challenged many governments on how to allow legal use while preventing criminal transactions. Many countries are still analyzing ways to regulate the the cryptocurrency. Overall, Bitcoin remains in a legal gray area for much of the world.Thank you!

Here are 5 startups focusing on blockchain that have caught my eye, with the potential to revolutionise industries globally:Provenance: Founder Jessi Baker has been looking into developing more transparent supply chains for almost a decade.Her and Dr Julia Steiner developed Provenance to try and think of a grassroots approach to supply chain transparency. They recognised that the difficulty of creating end-to-end supply chain transparency without compromising what happens within the supply chain itself and revealing identity.Provenance aims to create a more transparent system to try to reduce exploitation within supply chains, from social impacts that supply chains have to environmental devastation.Provenance doesn’t sell any products and they don’t intend to be a retailer of goods, what’s important to them is brokering the information and being a way that information can flow between different consumers and stakeholders by tracing the origins and histories of products.Enigma: Enigma is a decentralized cloud platform that guarantees privacy to solve two of the main obstacles in technology: privacy and security.Enigma will store, analyse and share private data without revealing it to any party, whilst providing multi-party computation powered by blockchain.Enigma will provide the finance, health and civil service industries with fundamental trust and security to help them take advantage of the potential of next generation mobile applications.Funderbeam: Funderbeam has created a blockchain-based “stock exchange” for the funding of early-stage and growth-stage companies and the subsequent trading of equity.Funderbeam’s secondary market uses blockchain technology to offer smart contracts to shareholders and allows for cross-border transactions on the exchange.They’ve raised $5.07M in funding from investors such as 3TS Capital Partners, Draper Associates, IQ Capital Partners.Hashed Health: Trying to disrupt industries is a main aim of startups that use blockchain.Hashed Health is a blockchain health consortium that is looking to disrupt and improve the healthcare industry by using blockchain technology for various healthcare use-cases.They focus on revenue-cycle management, electronic medical records, insurance and pharmaceutical supply chain logistics to make these areas within the industry more efficient and streamlined with blockchain technology.Tallysticks: This startup targets the finance industry having developed an industry-disrupting supply chain finance solution.They use blockchain technology to drive automation and enable lenders with the ability to cost-effectively offer credit. Tallysticks uses disrupted ledger technology to provide immutable record keeping, enhanced data security and smart contracts.They also use digital signatures to prevent fraud and utilise strong encryption to ensure data privacy. All this makes it easier to automate the supply chain documentation and financing processes, to make it easier, more cost-effective, more efficient and more transparent.