Not really, there is no such thing as free medical insurance.
Free health care
First of all, the so-called "free health care for all" does not mean that no one pays for health care, but it means that the government departments or health insurance organizations pay for most or even all of the medical expenses, and the patients don't pay or just pay a little bit of symbolic medical expenses.
Secondly, "free medical care for all" does not mean that it is completely free, nor does it mean that it is entirely borne by the public purse, but rather that it is a kind of universal medical insurance system that provides a higher level of protection and a very low proportion of individual payments. The specific proposal is to rely on the existing medical insurance system, the coordinated use of medical insurance funds and financial resources, the use of "basic medical insurance first payment + financial underwriting" model, *** with the sharing of medical costs.
Then, from the foreign point of view, there are two models of free medical care, one is North Korea, Cuba, Venezuela and other planned economy countries, the state-run hospitals, hospitals are a functional department of the government, fully supported by the state financial support, is responsible only for free to the patient to see the doctor, the medical behavior of the economic calculation does not exist at all.
The other is a market economy, individuals see a high degree of free or full free of charge, from different sources of funding, can be divided into three types. The first: the national (government) health care model, such as the United Kingdom, Canada, Australia, Scandinavia and other countries, health care as a social welfare provided to the whole population, financed through high taxes. The second type: the social insurance model, in countries such as Germany and Japan, where contributions are made by both employers and employees (workplaces and individuals), subsidized by the government, and shared by the whole society***. The third: commercial insurance model, represented by the United States, the main body is pure commercial insurance model, special groups (old, disabled and poor) enjoy free medical insurance policy.
In short, there is no such thing as free medical care in the world. The so-called "free medical care for all" is in fact still the people's own money to pay for their own medical care, but the people pay the money in advance to the government finance department or the health insurance department in the form of taxes or premiums, and then return to the medical institutions after a round of transfer.
Second, the pain points of free health care
1. According to statistics, Canadians have to wait for more than ten weeks on average to get medical treatment, and the patients with the longest waiting time have to wait for more than 10 months before they can see a patient, and many of the patients haven't waited for the doctors to treat them, and either slowly recovered by themselves or their condition deteriorated to a level that can't be saved. So it's almost inevitable that a patient's condition will be delayed, depending on the extent of the delay.
2. At the same time, free healthcare can lead to higher healthcare costs. In the UK, for example, private clinics provide 86% of healthcare services for 10% of the cost of healthcare, while public hospitals provide only 14% of healthcare services for 90% of the cost of healthcare. Compared with private clinics, public hospitals in the United Kingdom have two obvious drawbacks: First, inefficiency, the waiting time for patients to be admitted to hospitals remains high, which is as short as more than a month, or as long as several months or even a year; second, serious wastage, as there is no relationship between the incomes of medical staff in public hospitals and the revenues and expenditures of the hospitals, so there is no benefit in economizing, and there is no responsibility for wastage, which has led to the abovementioned situation of public hospitals consuming 90% of the health care expenditure but providing only 14% of the health care services. 14% of health care services. 仔销
3.In addition, in India, Russia and other countries, there are two models of health care at the same time, public hospitals to see a doctor for free, private hospitals to see a doctor not free with rotten. Because public hospitals do not earn money, there is not enough money to buy advanced medical equipment, can not afford to hire doctors with high technology, resulting in the level of public hospitals is very limited, can only see some headache and fever. At the same time, public hospitals are also facing staff wastage, with many doctors going to private hospitals which offer good salaries. In the end, people still have to pay to go to private hospitals for serious illnesses, making the so-called free health care a sham.
Three, free health care is not suitable for our country
In this world, there is no country whose health care system can satisfy everyone. And the free medical care that everyone is eagerly waiting for does not apply to our national conditions.
1. Medical service has a cost.
The 2020 Statistical Bulletin of China's Health Care Development published by the National Health Commission shows that in 2020, the total national health costs amounted to 7,230.64 billion yuan, accounting for 7.12% of GDP. In addition, "2020 Health Statistics Yearbook" shows that the national total health costs from 1990 is also increasing year by year, has been growing for 30 consecutive years, the cost of nearly 100 times; and the annual growth rate also continued to maintain more than 10%, the growth rate are more than the growth rate of the year's GDP, and the growth rate is even higher than 25% in 2008.
From the point of view of the composition of the total cost of health, in 2020, the government health expenditure of 219.98 billion yuan, accounting for 30.4%; social health expenditure of 302.52 billion yuan, accounting for 41.8%; personal health expenditure of 200.553 billion yuan, accounting for 27.7%.
This requires the establishment of a universal health insurance system with a higher level of protection and a very low proportion of individual payments stupid chi leakage. If such a system is to be implemented, the country will need to double the financing standard of the existing health insurance system as a way to make up for the gap in personal health spending.
2. Employee health insurance to see, doubling the financing standard is equal to the contribution ratio doubled, which means that employers will pay higher human resources costs, which will give the vast majority of small and medium-sized enterprises to bring a devastating blow to the survival of the country, but also with the country vigorously implement the policy of tax cuts and fee reductions contrary to the country's economic development is not conducive to the healthy development of our country.
3. From the point of view of residents' health insurance, doubling the financing standard also faces great difficulties, in 2021 the residents' health insurance financing standard continues to increase, the per capita contribution standard reaches 900 yuan, of which the financial subsidy standard reaches 580 yuan, the individual contribution standard reaches 320 yuan. And China's residents health insurance participants more than 1 billion people, doubling the financing is facing a funding gap of nearly trillion.
4. Considering that our country will be in the primary stage of socialism for a long time the basic conditions of the country, in the current conditions of social and economic development, the level of financing of health insurance is not high, the fund support capacity is still insufficient, medical care still need to adhere to the principle of basic protection, individuals bear a certain degree of responsibility for health care expenditures is still necessary, and the implementation of the "free health care The implementation of "free medical care" is not conducive to the long-term stable and sustainable development of China's medical insurance system.
Legal provisions
Article 23 of the Social Insurance Law of the People's Republic of China
Employees shall participate in basic medical insurance for employees, and shall pay basic medical insurance premiums by the employing unit and the employee in accordance with state regulations***.
Individual industrial and commercial households without employees, part-time employees who do not participate in the basic medical insurance for employees at their employing units, and other flexibly employed persons may participate in the basic medical insurance for employees, and individuals shall pay the basic medical insurance premiums in accordance with the state regulations.
Article 24 of the Social Insurance Law of the People's Republic of China
The State establishes and improves the new type of rural cooperative medical care system.
Methods for administering the new type of rural cooperative medical care shall be prescribed by the State Council.
Article 25 of the Social Insurance Law of the People's Republic of China
The State establishes and improves the basic medical insurance system for urban residents.
Basic medical insurance for urban residents is a combination of individual contributions and government subsidies.
The government shall subsidize the portion of individual contributions required by persons enjoying the minimum subsistence guarantee, persons with disabilities who have lost the ability to work, and elderly persons over sixty years of age and minors from low-income families.
Article 29 of the Social Insurance Law of the People's Republic of China
The portion of the medical expenses of insured persons that should be paid by the basic medical insurance fund shall be settled directly by the social insurance administration organization with the medical institutions and drug business units.