Too big to be free

The news that in Russia medical services will continue to be provided free of charge has sparked a heated discussion in China about the possibility of realizing free medical care in China. However, China's huge population means the government and individuals should continue to share the costs of medical care, says an article in People's Daily. Excerpts:

With the establishment of a social security net that covers the largest population in the world, Chinese people understandably have high expectations of the country's medical care, and universal access to basic medical care and health services has become a key objective in the ongoing medical reforms.

 

A staff member (right) at a village clinic in Shandong province explains the rural cooperative medical program to a resident. The program now covers 900 million people across the country. [ZHANG CHUNLEI / FOR CHINA DAILY]

However, there is no such thing as a free lunch. Even under the so-called free medical care system in Russia, people still have to pay for their medications, and due to insufficient public medical resources, the quality of services in a Russian hospital often ranges from uncomfortable to unacceptable.

As one of the most prosperous countries in the world, the United States spends about 18 percent of its GDP on healthcare, and the financial burden of medical care has already taken a toll on the country's economy, which is a concern shared by many other developed countries.

Free access to a resource like medical care will lead to a "tragedy of the commons", to borrow an term from economics, which refers to the depletion of a shared resource by individuals acting upon their self-interests. In the context of China, the lack of a well established medical supervision system would probably result in doctor-patient collusion and thus the overexploitation of medical resources, if free medical care were to become a reality.

As a developing country with a population of 1.3 billion, China has a wide gap in the welfare provided in rural and urban areas, so the priority should be to put in place basic medical and healthcare systems that cover both urban and rural residents.

(China Daily 11/08/2013 page9)