By Li Hong, People's Daily Online

It is incredibly a coincidence that both China and the United States are busy pushing a reform of their problematic medical care systems. The stakes are high as livelihood of 1.6 billion people is on the line, but the difficulties facing the two huge states to proceed and accelerate reform, and their eventual turn-outs could be very different.

The debate in either country is fierce, with the interests of the private pharmaceutical corporations, insurance companies and hospitals pitted against the public. Whose interest is to prevail is worth waiting and chewing.

Now, the quarrel and battle over new medical regulation look uglier and bloodier in the United States than in China, and increasingly, the former runs the danger of a depleted version of the reform plan put forward by Obama administration. Some American news columnists even worry about a complete abortion of the reform in the end. In contrast, no one in China suspects Beijing's ability to implement its plan, orchestrated and written by the government.

After a couple of years of failing measures, Beijing is embracing a government-dominated public medical insurance scenario. All Chinese nationals will be covered by the plan, which is to be financed overwhelmingly by government tax income and supplemented proportionately by employers and individuals.

This week, the cabinet, headed by Premier Wen Jiabao, decreed that 307 "basic" medicines will be provided to all hospitals and priced by the central government. The move, to the chagrin of pharmaceuticals, is welcomed by the public as it will lower their medical bills and cut the overall cost, lessening burden on the nation's budget. The loophole of pharmaceuticals earning outsized profits at the cost of the government-funded system is plugged.

And in China, the public are not obligated to buy policies from private insurance companies, which have been proved most of the time predatory and discriminative in picking up customers. Leaving out the private profit seekers from the system is the crux of reform.

America's medical system is seriously flawed and broken, as each passing day witnesses tens of hundreds of impoverished Americans losing medical coverage, while federal costs keep rising that leave its fiscal health and economic security in the harm's way.

President Obama has the ambition to force through an overhaul of the leaking system, but obstacles from Congressional Republicans and moderate Democrats opposing his mending the system seem insurmountable.

Obama is on a losing streak that he has seen the reform plan watered down in his compromise steps to garner a few Republican votes in the Senate, which Obama team believes is crucial in the vote to come. Lately, his administration agreed not to tax employer-provided health insurance and to impose less demands on drug companies.

Obama even seems to waver on the pivotal part of his plan: to yield on a federally-run public option, a fatal concession that will make private insurance companies celebrate in private with the way "reform" is unfolding. To protect their corporate profits, American drug companies, insurance industry and hospitals now have their tentacles all over Obama's reform effort, twisting and squeezing it for their own good.

Obama wants new legislation that will rein in costs, constrain insurance companies and extend coverage to most of the 46 million Americans without health insurance. However, Congressional conservatives, lobbied by private pharmaceuticals and insurances, are opposing Obamacare. They even staged a smearing war, alleging Obama plan will let the government decide when to stop care for the elderly, and will lead to rising euthanasia cases in America.

The conservative propaganda has led many Americans into confusion, and public suspicion of Obamacare is rising. Now with the hope of a government-run insurance option all but gone, it is sheer imagination that the United States could rein in medical costs, and extend medical coverage.

Why are all the smearing, misinformation and jostling in America? God knows that it is ruled by law, but, democracy has its limits.

In China, the president, the prime minister and whole society believe they are duty-bound, and morally required to extend care to the poor, the precarious with conditions, the disadvantaged rural farmers and more. So they get the resolve and just do it. However, in America, the elite haves have no stomach for the have-nots, who are making up your house, looking after your children or serving you at super-markets.

The article represents the author's view only. It does not represent opinions of People's Daily or People's Daily Online.