Does the "National Free Health Care" have financial sustainability in China? A case of Shenmu County, Shaanxi Province, China

The most populous country in the world, China needs more health care. Shenmu's practices show that National Free Health Care (NFHC) system has played an active role in fulfilling the citizen's needs of health care, and alleviating the difficulties in affording the medical costs and seeing doctors. But NFHC system needs substantial financial supporting. It is worth in-depth discussing and reflecting on whether the NFHC system suits China's national conditions. The paper establishes the population age structure forecasting model and NFHC financial burden model by decomposition methodology and actuarial modelling. And it finds than the financial burden of NFHC system in Shenmu will be increased from 256.64 million Yuan to 656.04 million Yuan in 2013-2020, with the growth rate 12.45%. Meanwhile, the percentage of the financial burden in government's annual revenue is less than 2% in 2013-2020, NFHC system has financial sustainability in Shenmu. According to the successful experience abroad and the calculated results in Shenmu, to extend the NFHC system to the whole of China has financial sustainability and realistic possibility.