In this blog post, we examine from various perspectives whether healthcare welfare is an essential policy for guaranteeing citizens’ fundamental rights, or whether it has institutional limitations that could lead to moral hazard.
“Excessive welfare breeds laziness!” This is a phrase we always hear when attempts are made to expand or reform welfare policies. From free school meals and free healthcare to free childcare and halved tuition fees, all of these are subjects of controversy. Whenever welfare policies are proposed, one side argues for the protection of citizens’ fundamental rights and the rights of the socially vulnerable. The opposing side has fought back by citing concerns about welfare populism and moral hazard, and finally, by pointing to the example of Greece, which demonstrated the dire consequences of such policies. Setting political debates aside, these controversies have prompted much reflection on welfare. In particular, the ideal form of welfare—which seeks to guarantee everyone’s basic livelihood in an active and comprehensive manner—is often criticized. Ultimately, while concerns about the abuse of welfare, laziness, and the encouragement of moral hazard are entirely understandable, they are also something we wish to deny.
For humans to lead a basic life, they must, of course, be healthy first and foremost. Medical services are what protect that health from threats, and ensuring that all citizens are equally guaranteed this protection is the core of medical welfare. However, could the expansion of medical welfare also be criticized for encouraging moral hazard and laziness? This is precisely the concern many people have when discussing the expansion of medical welfare. The concern is that as low-cost medical services become more widely available, the number of people who abuse the system to overuse medical services will increase, potentially harming those who truly need them. Furthermore, there is a fear that healthcare professionals providing these low-cost services will not receive adequate compensation, leading to a decline in the quality of care.
Of course, if we view medical services simply as a business like any other service industry, this phenomenon would be natural. In a capitalist society, who would be willing to provide proper services for a small amount of compensation? However, healthcare is fundamentally different from other service industries. Healthcare is not merely a service; it plays a vital role in saving lives and helping people maintain healthy lives. Therefore, healthcare professionals must possess a high level of dedication and responsibility, and this is a key distinction that sets them apart from other professions.
One of the countries that has realized this ideal is Cuba. Despite being a poor country with a per capita GDP of just $9,500, Cuba has achieved results in its healthcare system that surpass those of developed nations. Cuba has one of the highest ratios of doctors per capita in the world and has significantly improved the level of basic healthcare coverage by introducing a family doctor system. This goes beyond simply providing benefits to the people; it is a prime example of how the state has prioritized healthcare in its policy-making. Furthermore, even amid economic hardship, Cuba prioritized the health of its citizens by cutting its defense budget in half and increasing spending on healthcare.
As a result, Cuba became the first country in the world to be certified by the World Health Organization (WHO) as polio-free, and it maintains life expectancy and infant mortality rates on par with those of developed nations. In particular, the sense of mission among healthcare professionals lies at the heart of all these achievements. Despite not receiving high compensation, Cuban doctors work devotedly, taking responsibility for the health of the people. This demonstrates that for healthcare welfare to succeed, a strong sense of moral duty among medical professionals and active investment by the state are essential.
Of course, there are many practical constraints to applying Cuba’s model directly to other countries. Under its communist system, Cuba was able to exercise strong government control, allowing for concentrated investment in healthcare and the imposition of high moral standards on doctors. In contrast, in countries with liberal democratic and capitalist systems, where individual freedom and rights are core values, it is difficult to demand the same level of sacrifice from healthcare professionals as in Cuba. Furthermore, excessive focus on a single sector risks marginalizing other social services.
So, what are the realistic solutions? The core goal of healthcare welfare is likely to ensure that no citizen dies simply because they lack the financial means. In particular, we must provide an environment where those without financial means can fully access medical services. All doctors should be able to provide the best possible care regardless of a patient’s financial situation or social status, and the system should offer greater benefits to patients with incurable diseases who truly need welfare support. Furthermore, medical infrastructure must be expanded to ensure that all citizens can receive appropriate medical care even in emergency situations.
Moreover, we must design balanced welfare policies that provide healthcare professionals with compensation commensurate with their dedication while ensuring that all citizens have access to appropriate medical care. This will also help improve the quality of medical services and strengthen the sense of mission among healthcare professionals. To achieve this, the state must recognize healthcare not merely as a service but as an essential element for safeguarding human dignity, and must not spare any investment in this regard.
Ultimately, the ideal goal of healthcare welfare is to ensure that all citizens can live a dignified life. Healthcare services should be regarded not as excessive welfare but as a social necessity, and through this, we must build a society that upholds human dignity. Healthcare professionals must not forget their sense of mission and must work devotedly for the people, while society must properly recognize and reward their hard work. We must all remember that there is no such thing as excessive healthcare welfare, and we must not abuse the system or become complacent.
