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The new Heritage Freedom Index ranks Hong Kong #1 in the world for economic freedom.
So I thought I’d use my hours of jetlag-induced sleeplessness to swot up on how the libertarian paradise provides health coverage.
The Hong Kong system is built upon a foundation inherited from Britain: a National Health style single-payer system. Funded by tax dollars, and lots of them, the basic Hong Kong health system extends coverage to all through a system of publicly owned and operated hospitals.
This reliance on hospitals is outdated. A Hong Kong citizen hit by a bus is rushed to a government-run hospital, given advanced care, and released without charge. Nice deal. Primary and preventive care is not handled so well – mental illness very poorly – and so Hong Kong citizens who can supplement their government basic care with private insurance.
The sort of person whom a visiting foreigner meets will of course all have private insurance of some kind or another. Yet despite the growth of the private medical sector, government still spends 60% of all the territory’s health dollars, a lower ratio than in Canada or most European countries, but well higher than the U.S. at 51%.
One-sixth of all government spending is spent on health care, and that figure is sure to rise in the years ahead as
1) Citizen pressure forces governments to recognize that health care means more than just hospital care;
and
2) as native-born Hong Kong medical workers press to raise their wages up to the levels received by the expatriate doctors who staff the private insurance system.
I won’t make any bold predictions of the future – I have only grasped the roughest idea of the Hong Kong present – but if there’s a bottom line, it’s this:
The world’s freest economy has universal, mandatory, single-payer health insurance, cushioned by flexible and widely available private insurance. It’s not a perfect system, but it does deliver the 5th longest life-expectancy on earth (almost 3 more years of life expectancy than the U.S. system), and significantly superior infant mortality. And I think we can safely acquit the people of Hong Kong of any interest in socialism whatsoever.
canadaman // Apr 12, 2010 at 9:32 pm
Good analysis. My understanding, though, is that once you factor in government employees’ insurance benefits and subsidies for employer-based insurance, the percent of healthcare spending in the US that is “public” actually pops up to something like 60% (circa 1999). I would imagine that this will be considerably higher once you factor a decade of medicare/medicaid (etc) growth, and the fact that HCR will soon be putting several million more people on to medicaid.
I wouldn’t be surprised to hear that as much of US healthcare system is government funded as Canadian system, which has hovered pretty consistently at or a tad above 70% since our medicare was passed a generation ago. In another decade or two, that percentage might well put the UK’s truly ’socialized’ system to shame in terms of healthcare spending originating from the government.
Oldskool // Apr 12, 2010 at 9:49 pm
I can’t wait till Fox jumps on this story, meaning they probably won’t and I only have so many decades left to live.
Although, one of their bloggers committed truth against Teabaggers this morning and caused quite a stir. So maybe there’s hope for them yet. At some point their demographic will succumb to mortality so they better do something, and soon.
rbottoms // Apr 12, 2010 at 9:59 pm
The new Heritage Freedom Index ranks Hong Kong #1 in the world for economic freedom.
Did I miss something or did Hong Kong stop being a province of one of the most oppressive regimes on Earth, the People’s Republic of China?
I know that WalMart would cease to exist without the labor of all those people imprisoned inside the massive system of censorship and show trials. I also know hat anything ObamaHitlerMao does freaks conservatives out, but Hong Kong more free than the United States?
Yeah, right.
windsorboy // Apr 12, 2010 at 10:34 pm
rbottons:
Your view of China seems a little bit myopic. Perhaps it is time to take off the blinkers, put on some travelling shoes and go see what the rest of the world has to offer?
LauraNo // Apr 12, 2010 at 10:42 pm
This is where the republican party goes so wrong. (well, one of the places) Instead of recognizing we have a problem and setting out to solve it, they stick their fingers in the ears and cry ’socialism’ if anyone else wants to try to solve it. US is backwards as can be and the people suffer for it but what does the republican party care, if they can get a certain demographic to vote for them? Public services are naturally going to cost less than privately run ones and with better results, if they are managed well. This would preclude former frat brothers being appointed to important positions such as head of Homeland Security though.
sinz54 // Apr 13, 2010 at 9:38 am
rbottoms: Did I miss something or did Hong Kong stop being a province of one of the most oppressive regimes on Earth, the People’s Republic of China?
Yes, you missed a few things.
China is trying hard to become an economic powerhouse, and they are moving more and more toward market-oriented reforms. They wouldn’t interfere with Hong Kong on that score; they’re trying to become more like Hong Kong on that score.
Ironically, this combination of a one-party dictatorship with a vibrant private sector has a name.
Red China is becoming Fascist China.
The system they’re moving toward is reminiscent of Mussolini’s Italy.
sinz54 // Apr 13, 2010 at 9:48 am
Singapore also has a vibrant private sector–and it provides universal health care to its citizens quite efficiently.
That efficiency comes from geography (it’s just a small island), and from the “benevolent dictatorship” that they have. The national government directs where hospitals should be built to get the most bang for the buck.
rbottoms // Apr 13, 2010 at 10:23 am
Your view of China seems a little bit myopic. Perhaps it is time to take off the blinkers, put on some travelling shoes and go see what the rest of the world has to offer?
I spent 13 years in the Army. Uncle Sam sent my shoes quite a few places.
China is a repressive country and I do my best to buy as few products made there as possible. It’s one reason I have resisted shopping at WalMart even though my budget could use the lift. I know it comes on the backs of someone else.
iveyguy // Apr 13, 2010 at 11:28 am
rbottoms, it was economic, not political freedom. Although they are generally closely linked, this is a glaring exception.
Alex2000 // Apr 13, 2010 at 11:37 am
rbottoms – But Hong Kong is not China. I lived in Hong Kong for a year, and still have friends there. Ask a Hong Konger where he is from and he will say Hong Kong, not China. There is a big difference.
Don’t forget that Hong Kong was a Crown colony until 1997. And since then it has operated under the one country – two systems rule. The people of Hong Kong have more political freedoms than “mainland” China.
windsorboy // Apr 13, 2010 at 12:52 pm
rbottoms — I don’t disagree that China seems respressive to those of us who live our lives elsewhere, but I don’t think that we are always in the best position to make this judgement. The people I know who were born and raised in mainland China as well as two of my employees who were born there don’t hold this view.
Regardless, as Alex2000 stated, Hong Kong is not China. I have a number of clients in Hong Kong,as well as employees from there, and I can tell you that they are all as hard working and capitalistic as they come. More so, I sometimes think, then myself and many others in the western world.
sdspringy // Apr 13, 2010 at 1:13 pm
Some new lessons from the sham of HCR:
http://www.latimes.com/news/nationworld/nation/la-na-health-premiums13-2010apr13,0,6096091.story
HCR will not stop premium increases, imagine that, we really did have to pass the bill to find out whats in it.
And OH the irony of this story:
http://www.nytimes.com/2010/04/13/us/politics/13health.html?ref=politics
Congress has been removed from the Federal Employee Health Benefits, ROFL. Can the Dems be any more stupid, its possible, there is still about 1000 pages left to read. LOL.
sinz54 // Apr 14, 2010 at 10:05 am
sdspringy:
Thank you for those references, in which they said:
Sen. Dianne Feinstein (D-Calif.) said. Feinstein and Rep. Jan Schakowsky (D-Ill.) are pushing legislation to expand federal and state authority to prevent insurance companies from boosting rates excessively.
Gee, what a surprise. Just like MA after RomneyCare.
After all this talk about “bending the cost curve” and all those touted features of the bills which were supposed to lower health care costs, liberals fall back on their favorite (and worse than useless) mechanism: price controls.
Don’t like skyrocketing premiums? Pass a law to stop it. Ignore the fact that even nonprofit insurers are raising premiums, and that upwards of 90% of the revenue earned by those insurers goes to pay providers. Just put government controls on premiums, and watch even the nonprofit insurer market collapse–after which we’ll go to single-payer!
That’s exactly what we conservatives said would happen.
And that’s exactly what’s happening–first with RomneyCare, next with ObamaCare.
Rabiner // Apr 14, 2010 at 12:46 pm
Sinz54:
Nothing wrong with price controls when the market being regulated is a monopoly.
Ruder Finn Asia - Asia Health and Wellness News Summary // Jun 25, 2010 at 5:17 am
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