A very important part of the GDP of the United States that I discussed earlier is that Americans spend a lot of money on medical treatment, but the effect is not good. Moreover, many ordinary Americans have no money or dare not see doctors. Every year, 33 million Americans in the United States, that is, about 1 / 10 of Americans, do not buy any medical insurance. Every year, 1.9 million people sneak into Cuba to see doctors.
In sharp contrast, Americans spend a lot of money on medical care every year, which is also very high in developed countries. The per capita annual medical expenses are US $10000, which is 13 times that of China. However, the per capita life expectancy of the United States is the lowest among developed countries, and it was surpassed by China in 2020. By 2021, the average life expectancy in the United States will be 76 years, and that in China will be 78 years.
In a word, I am speaking ill of the American medical system, saying that the American medical system is not good.
It seems that this has angered some people. Some people call me nonsense. Some people just scolded a nonsense, and some people also added a bit of refuting material in the nonsense, saying that the United States provides free medical care.
If he just said that I was talking nonsense, I would actually laugh it off. But after his nonsense, he said that the United States is free of medical care. Instead, I thought he was talking nonsense, but I still didn’t take him seriously.
However, next, a friend said to me on wechat in a very rational and calm way: “isn’t it that 190 countries in 197 countries around the world have implemented free medical care? Isn’t it that China is one of the seven countries that have not implemented free medical care? What is this really like? Sir, can you go and verify it? It’s better to do a program.”
I paid a little attention to discussing issues with me calmly and objectively, but my reply to this friend was: “I didn’t expect that such rumors could be created to slander China.”
But to be honest, I have no plans to do another program for this matter. Because rumors are everywhere in our world, I can’t refute them every day. Rumor mongering will break one’s legs. We can’t be led by rumor.
But I still checked it online out of curiosity. I entered the keywords “197 countries in the world” on the Internet, and the results scared me. On a search website, the first four pages of the content all said that 190 countries in 197 countries in the world are free of medical care, and China is one of the seven countries that are not free. Many articles also say with certainty that Pakistan is the 190th country. This posture seems quite reliable.
This scared me out of my wits. Imagine that the first four pages of a search result on a search website are all like this. How can this mislead the public?
So I decided to do a program for this. I don’t care about the hot topics of international public opinion these days. I want to talk about this today. We can’t live in lies and rumors. When lies and rumors are only scattered, we can ignore them, but when they are overwhelming, we must talk about them.
How many countries in the world have implemented free medical care?
I think to answer this question, we must first understand the meaning of free medical care, that is, what is free medical care?
If I say this, some friends may be very impatient. You insult my IQ. Don’t I even know what free medical care is? Please forgive me, please understand, don’t worry, listen to me slowly.
What is free medical care? In short, it costs nothing to treat a disease. This should be understood by everyone without any interpretation.
Well, then I ask you weakly: if it costs money to treat a disease, is it still called free medical treatment?
At this moment, you must say: isn’t that nonsense? Do you still need to say that?
If you want to scold me in this way, I will be happy to say to you: Congratulations, you answered correctly, which is exactly what I meant.
Next, I want to ask two questions other than medical treatment.
The first question is that in many cities in China, it is free for people over 65 to take public transport. May I ask: can we say that Chinese people take buses for free? I don’t think so?
The second problem is that there are special food banks operating in the United States all year round, that is, food is distributed free of charge. People who do not have food can directly get food without paying. The name of the most famous and largest free food bank in the United States is “feed America”. I don’t want to discuss the problem of American eating today. I just want to ask: the existence of such a free American food bank means that some people in the United States eat for free. Can we say that Americans eat for free? I don’t think so?
There is no doubt that some people in China do not pay for public transport. We can not say that public transport in China is free. Some people in the United States don’t spend money on meals. We can’t and can’t say that Americans eat for free.
My friends must think I’m bored again. Today, I’m just talking nonsense.
However, friends, it’s impossible not to talk like this. I can’t explain the problem clearly. What I’m saying is that in a certain field, some people and some situations are free, so we can’t say that this matter is free on the whole.
Applying this logic to medical treatment will lead to such a question. If the total cost of your treatment is 100 yuan, and you pay 30 yuan yourself, that is to say, you still have 70 yuan, which is free. Is this free medical treatment?
If you think that this is free medical care, then I tell you that almost all countries in the world provide free medical care, because we have not heard of any country where people pay 100% for medical treatment, that is to say, the state and society will help them to pay some money more or less.
If you think that this is not free medical care, then I tell you that all countries in the world are not free medical care. The truth is still the same. At present, there is no country in the world where people can not afford to pay for medical treatment.
Of course, this is statistically significant.
I mean, for a specific person, he may not pay for the doctor this time, but he will pay for the doctor next time. Or, this time, the registration fee is paid, the medicine fee is paid, but the diagnosis fee is not paid… Etc. in all cases, in a word, in the total cost, the individual pays a part of the money, and the state and society help him pay a part of the money. That part of the money is free for individuals. The difference between countries is that the proportion of individual contributions is different. Some countries have a high proportion and some countries have a low proportion.
Some friends will definitely say: no? I have heard that Russia, Britain, Canada, Japan, India, the United States, Spain, South Africa… These countries provide free medical care.
I want to ask you, do they say that they are free medical care, which means that individuals can’t pay a penny?
Free medical care has been interpreted by many countries in the world as free as there is a little money, so it can be said to be free medical care.
Ten years ago, in 2012, in China’s public opinion field, the voice of publicizing that foreign countries are free medical care was louder than it is now. It can be said that a huge wave was set off. The spearhead of the wave is that it is difficult and expensive to see a doctor in China, over medical treatment and over examination.
I still think that the critical Movement promoted the reform of China’s medical system. Although I didn’t work as an we media at that time, I was a real critic, and I used my actions to avoid the drawbacks of China’s medical system, think of my own way to solve my own difficulties. Because, as individuals, we can’t afford to wait. We can’t wait until the country gets better and follow suit. It takes time for the country to solve problems. When time comes, we may be old. Therefore, on the one hand, we should appeal to the country to solve the problem, and on the other hand, we should think of our own solutions.
My way is to learn traditional Chinese medicine, believe in traditional Chinese medicine, and choose traditional Chinese medicine when things happen.
The reason why I am interested in traditional Chinese medicine is only half because of my recognition of Chinese traditional culture, and the other half is to save money and time. Why? Because many Chinese herbal medicines are particularly cheap, they can cure many diseases, even serious diseases. For example, I had a serious stomach disease ten years ago. At the worst, I could only eat breakfast a day. I was hungry the rest of the day. My stomach ached when I ate. I lost a lot of weight. I also had to hang a warm water bag around my neck from getting up in the morning to going to bed at night to cover my stomach. Later, a Chinese medicine Professor solved my problem with Baihu Decoction, a traditional Chinese medicine prescription. I buy my own medicine and decoct it at home. The daily cost of medicine is only a few yuan. During the whole treatment process, I didn’t care about the money at all. I didn’t even have the idea to solve the drug cost. I paid for it voluntarily. In addition, in this way, you can not go to the hospital, and you can take care of your normal work and life. However, no matter how much money is saved, drinking white tiger soup still costs a few yuan every day. A few yuan is also money. Interestingly, TCM’s meridian theory, sentiment thought, four seasons health preservation, and even the “benevolent longevity” idea of health preservation and treatment by improving moral sentiments do not cost a penny, nor do they need to spend time on treatment, so they can live a normal life to maintain health and treat diseases. Therefore, my understanding is that it is very reliable to learn Chinese medicine to maintain health and treat diseases with less money and time. This opinion is only for friends’ reference. I am not a doctor. I am just a former patient. I just want to talk about the treatment experience of a former patient.
In short, in China 10 years ago, I really dared not get sick and go to the hospital! Because of lack of money and time! I can’t afford to be ill!
Today, this situation has not been fundamentally changed, so we need to continue to criticize the shortcomings of China’s existing medical system, and at the same time, we should choose a suitable way to save money for medical treatment.
When I say this to my friends today, I want to say that the Chinese attack on China’s medical system began in this century. I am also a radical critic. I also resist these abuses with practical actions. This kind of attack and resistance reached a climax around 2012, 10 years ago. At that time, there was a saying that there were experts (please note, experts), saying that only more than 20 countries in the world did not implement free medical care (of course, today, the saying of more than 20 countries has become seven). In 2012, in response to this situation, the people’s daily arranged foreign correspondents all over the world to investigate and understand more than 70 countries in the world, including China, and finally wrote articles about the results of the investigation and published them in the people’s daily.
In that article, there is a general manager’s sentence. The original sentence of this sentence is like this. I read it again:
“According to the 2010 China Satellite
According to the data of the health statistics yearbook, among the health expenditure of 193 countries in the world, there is no country with zero personal health expenditure, that is to say, no country spends no money to see a doctor. “
I believe that many friends will not believe this sentence when they hear me reread this article in people’s daily 10 years ago today, and this sentence is a judgment based on the data in China’s 2010 Health Statistics Yearbook. To be honest, I feel a little guilty when I say it so absolutely.
However, fortunately, people’s daily is people’s daily after all. It is not an irresponsible we media. It provides data to support this judgment.
In that article, the people’s Daily cited the health expenditure of various countries in 2007 released by the World Health Organization in 2010, listing the percentage of private health expenditure in total expenditure in more than 70 countries in the world, that is, how much does an individual spend for every 100 yuan spent on medical expenses?
Let’s take a look at the percentage of personal health expenditure in the total health expenditure in the so-called free medical care countries with high popularity that have been hyped in public opinion.
Let’s talk about America first. Because some people say that I am nonsense and that the United States is free of medical care, we will first talk about the United States. Sorry, the figures in the United States are particularly ugly. The private health expenditure in the United States accounts for 54.5% of the total expenditure. That is to say, Americans actually pay more than half of their own money for medical treatment, which is very high among the more than 70 countries surveyed, because among the more than 70 countries surveyed, only 4 countries, including the United States, account for more than 50%.
Let’s talk about Russia. The online hype about free medical care in Russia is also very strong. What is the percentage of private health expenditure in Russia in the total health expenditure? The answer was 35.8%.
In Britain, the figure is 18.3%.
In Japan, the figure is 18.7%.
Let’s talk about India. Some people say that India is so poor and so many people have implemented free medical care. The implication is that India is good and China is bad. Let’s look at the percentage of India’s private health expenditure in total expenditure. The answer is 73.8%, which belongs to a country with a very high proportion.
Next, let’s speed up the pace a bit. I’ll read the proportion of countries with high reputation for free medical care here. Canada is 30%, Belgium is 25.9%, Germany is 23.1%, Spain is 28.2%, Sweden is 18.3%, Argentina is 49.2%, Poland is 29.1%, Ukraine is 42.4%, Belarus is 25.1%, Latvia is 42.1%, Lithuania is 27%, Estonia is 23.5%, Georgia is 81.6%, South Africa is 58.6%, Mexico is 54.6%, and Indonesia is 45.5%.
These countries are the so-called countries with high reputation and so-called free medical care, and their free medical care is exempted to this extent. You can’t say that he is free of any money, because in none of these countries, the people pay 100% of their own money for medical treatment. The state and society give them some money more or less. You can say that he is free, because after all, he is free of some fees. But if you want to say that this is also free, then all countries in the world are free.
Some friends may be a little puzzled after listening to these figures I shared today. No, I have read many articles saying that they are free. It sounds like they are all free. What is the matter with their free?
What I want to tell my friends is that they said they were free, and they didn’t lie. As I said earlier, it may be free to see this disease today, but it will not be free to see that disease tomorrow. Or, if you go to see a doctor today, the fees in this area are free, and the fees in that area are not free. This means free.
Let me cite a few examples.
In Canada, the outpatient service, examination and hospitalization are all free, but the drugs prescribed by the outpatient department must be purchased at their own expense.
In Japan, individuals bear part of the medical expenses, including 20% for children under 6 years old, 30% for those between 6 and 70 years old, 20% for those between 70 and 74 years old, and 10% for those over 75 years old.
In Germany, the treatment fee, hospitalization fee and medical fee are free, but the registration fee is paid by oneself.
In Sweden, the laboratory fee and examination fee are free, but the registration fee and drug fee are borne by the individual, and the hospitalized individual pays 80 kroner every day.
In the UK, appointments and treatment fees in public hospitals are free, 85% of prescription drugs are free, and the remaining 15% are self funded.
In Russia, it is free to see a doctor in a hospital, that is, free to diagnose, but to buy drugs at one’s own expense. Of course, the cost during hospitalization is free.
In the three Baltic countries of Latvia, Lithuania and Estonia, public clinics provide free diagnosis in hospitals, but individuals bear part of the drug and surgery costs, and the rest is free.
In India, public hospitals are free of registration fees, examination fees and a few drug fees, while other individuals pay at their own expense.
I won’t talk about it one by one. It’s a big story. Friends only need to have a little impression. In the final analysis, some content is free, and some content is self funded. Another common feature is that free generally refers to going to public hospitals. If you go to private hospitals, you will most likely pay at your own expense.
It should also be noted that there are two situations of self payment:
One situation is that you have to pay on the spot when you see a doctor. Another situation is that when you see a doctor, you don’t pay at the scene, but in fact you still pay at your own expense. Why? Because you need to buy insurance in advance, you need to pay the premium.
This is a bit like when you eat in the canteen of the company or the cafeteria of some hotels. You don’t need to pay when you actually pay. You just need to swipe your card. However, before you go to the restaurant, you need to recharge your card. When you recharge, you may pay 100% of it yourself, or you may pay a part of it yourself. The company may subsidize a part of it.
First charge the card, and then you only need to swipe the card when you actually pay. Do you pay at your own expense or free?
To tell the truth, do you think it’s a little messy for friends to say this? I can’t use my brain. You’re right! So let’s keep it simple. Let’s just look at one thing. Does the private sector pay tens of percent of a country’s total health expenditure? So we still need to return to the percentage I mentioned earlier, so that we can talk about things.
In terms of percentage, as the data provided in the 2010 Health Statistics Yearbook shows, among the 193 countries in the world, none have zero personal health expenditure.
This statement is compiled by the Chinese health department, while the specific figures above are compiled by the World Health Organization.
I think the sources of these two statements are reliable.
In short, I believe in the World Health Organization and China’s health sector. If you insist on arguing with me, saying that the World Health Organization’s statement may not be accurate, and the Chinese health department’s statement may not be accurate, I can’t help it, because there is nothing absolutely accurate in the world. If you don’t believe in the World Health Organization and China’s health department, then I want to ask you: who do you believe? Do you believe in those nonsense we media? Or do you believe some so-called experts who are full of nonsense?
If you don’t believe in the World Health Organization, people’s daily, and China’s health department, you believe in those nonsense we media and a few experts who are full of nonsense, then we can’t talk about this topic. Because it is impossible for us to investigate the health care expenditure of 197 countries, we have no ability, ability and condition. Further, even if you have the ability and conditions to investigate, will your final investigation result be reliable?
So when discussing this issue, who do you believe is a very important issue.
After such a big circle, we can come to a conclusion: the so-called free is relative. Don’t listen to some people. From a relative perspective, all countries in the world have free medical care. But if you have to think that this is absolutely free, then I tell you that there is no country in the world where medical care is absolutely free.
So, after all, we look at the proportion.
Having said so much, I haven’t told my friends what the proportion of China is. In the article in people’s daily in 2012, it was mentioned that according to the data released by the World Health Organization in 2007, China’s proportion is also very high, specifically 55.3%, which is one of the few countries with more than 50%, so China’s situation is not very good.
I think this is also the source of dissatisfaction with China’s medical system on the Internet. I even want to say that because the public is not satisfied with this matter, the so-called “190 out of 197 countries in the world implement free medical care” rumor has arisen. Conversely, if we do a good job in this matter, these rumors may not appear.
But I want to say that China’s figure is on the high side, which is the figure of 2007. By 2021, China’s figure will drop to 27.7%. On July 22, 2022, MI Feng, spokesman of the National Health Commission, introduced that the proportion of personal health expenditure of Chinese residents dropped from 34.34% in 2012 to 27.7% in 2021.
Again, from 2007 to 2021, the proportion of individual out of pocket expenditure in China’s total national health expenditure dropped from 55.3% to 27.7%.
27.7%, what level is this? I say it in three cases:
The first situation is comparable to the following countries, because the proportions of the countries I want to read below are between 20% and 30%: Canada, Belgium, Germany, Spain, Belarus, Lithuania and Estonia.
The second situation is better than the following countries, because the proportion of the countries I want to read below is more than 30%. They are: the United States, Argentina, Kazakhstan, Russia, Georgia, South Africa, Mexico, India, Indonesia, Latvia.
In the third case, compared with the following countries, we are worse than them, because the proportions of the countries I want to read next are between 10-20%. These countries are: Japan, Sweden, Britain.
This is the general situation.
Finally, highlight the key points and say that Cuba is a star country. This is because Cuba’s private health expenditure accounts for only 4.5% of the total health expenditure.
In my opinion, it can be said that it is really free when this ratio is reached, so the original words in the people’s daily article in 2012 are as follows:
“Our correspondents abroad have investigated the medical systems of more than 70 countries in the world and found that only Cuba implements free medical care for all in the true sense, that is, patients do not need to pay any fees to see doctors.”
In fact, this statement is a statement of conscience, but it is also a rough statement, because after all, individuals still pay 4.5% of the money.
I think the proportion of China’s personal medical expenditure in total expenditure has dropped from 55.3% in 2007 to 27.7% in 2021. Next, our goal should be Cuba. This should be our pursuit.
However, I would like to remind my friends that we must not aim at countries such as Russia, Britain, Canada and Germany. Some of them have lagged behind us and some are almost the same as us. Although some are better than us, we are close to their level. For example, Japan, Sweden and the United Kingdom have private health expenditure accounting for 10% ~ 20% of the total expenditure. Therefore, our pursuit should be Cuba, with a target of 4.5%.
As for the United States, I would like to say this: shall we not talk about the United States? Shall we compare ourselves with countries with higher standards? Comparing everything with the United States, it will appear that we are inferior, and even make us feel proud and complacent. Because the private health expenditure in the United States accounts for more than 50% of the total expenditure, China was at the same level with him more than a decade ago, but now, sorry, we don’t play with him anymore. We have reduced from 55.3% a decade ago to 27.7% in 2021.
Therefore, on this issue, we can worship many countries, first of all, Cuba. But you must never worship America! You can worship Japan, Sweden and Britain, but you can’t worship the United States.
This is like a child who wants to improve his academic performance and wants to find a model to learn from. Then you need to find a classmate whose performance is the best in the class to set an example. You can’t find a classmate who is the lowest in the class to set an example, can you?
Having said that, today’s topic is basically clear. But there is a big loophole, because so far, I have not mentioned a well-known country on this issue, that is, North Korea. North Korea has indeed implemented free medical care since 1950, and it is relatively complete. However, it’s a pity that we can’t find out the proportion of personal health expenditure in total expenditure in North Korea. We can assume that this ratio may be 0, but the people’s daily article in 2012 said: according to the data in the 2010 China Health Statistical Yearbook, among the 193 countries in the world, there are no countries with zero personal health expenditure.
I infer from this that the proportion of the DPRK’s personal health expenditure in total expenditure is not zero, and it is likely to be relatively low. Because I was in a hurry to do the program today, I didn’t turn to the 2010 China Health Statistics Yearbook, because it takes too much time to find this figure in this statistical yearbook with more than 1000 pages. Friends who are not afraid of trouble can go and have a look at the figures of North Korea. I believe that the people’s daily is reliable, and I also believe that the statistical yearbook issued by the Chinese health department is reliable, so I infer that the proportion of the DPRK’s personal health expenditure to the total expenditure is not zero, so I believe the statement of the people’s Daily: the number of countries in the world that really provide free medical care is zero.
There is still a loophole in my statement today, that is, I mainly quoted an article in the people’s daily 10 years ago, and the article in the people’s Daily quoted the figures published by the World Health Organization 10 years ago. When I finally compared China with the world and other countries, I quoted the latest Chinese data. It seems that there is no comparability, but I think there is comparability. Reason: in the past decade or two, there has been only one country in the world that has undergone earth shaking changes, that is, China. Therefore, the proportion of private health expenditure in total expenditure in all countries in the world will not change much in general. In case of individual exceptions, it will not affect the overall judgment.
At the same time, there is another problem that can not be solved, that is, the rumor monger said more than a decade ago that only 20 countries did not implement free medical care, and 10 years later said that only 7 countries did not implement free medical care. He spreads rumors every day and we refute them every day. However, it is too difficult to find out the percentage of private health expenditure in total expenditure in more than 100 countries. So I’m afraid we can only use some elements of reasoning. The key is to think about whether these reasoning is reasonable.
Speaking of this, I turned to look out of the window to see the city of tens of millions of people where I live. If one day there is a rumor that only seven people in this big city have not stolen bicycles, and others have stolen bicycles, I want to refute this rumor. I want to investigate whether more than 10 million people have stolen bicycles in the past decades, and I want the latest data. This is an impossible task. Therefore, to refute this rumor, there must be some elements of reasoning, which is impossible.
Therefore, we need to consider whether the reasoning is reasonable. If you insist on reasoning, you will not accept it. I think you are not against this argument. You are mentally ostracized. You are a person who pretends to sleep.
I can’t wake someone who pretends to sleep. I admit, I don’t have the ability.
Finally, I would like to say that I support criticizing the malpractices of China’s medical system. I am an active participant and an actor who takes action to resist China’s malpractices. However, I said that the work should be reliable, not nonsense. In a word, you can’t talk nonsense when you’re doing business. Just because you’re doing something serious, you don’t have the right to talk nonsense.