Free Education, Free Health and Sri Lanka

This post is part of a series in addressing the several questions posed by the people who support SAITM, private medical college in Sri Lanka.

Foremost point they argue on is that all the other countries are having private medical colleges why Sri Lanka should not have them. First let's take the countries who are in the top 10 positions in the Human Development Index of United Nations and also the regional countries (SAARC) and compare their GDP, percentage of GDP on health, education, health level, structure of their medical education.

Human Development Index is a summary measure of average achievement in key dimensions of human development: a long and healthy life, being knowledgeable and have a decent standard of living.(1) 

HDI Rank	Country	Life Expectancy at Birth	Infant Mortality Rate per 1000 live births	Maternal Mortality Ratio per 100000 live births	Total Health Expenditure as % of GDP	Government expenditure on education as % of GDP	Expenditure on education as % of total government expenditure	Gross tertiary education enrolment ratio as %	Military Expenditure as % of GDP	Medical Education
1	Norway	81.6	2	5	9.6	6.6	15.0	78	1.4	Provided in 4 public universities. No private universities for medical education. Tertiary education is free and grade point requirement is extremely high for medicine.
2	Australia	82.4	3	6	9.4	4.9	13.2	89	1.8	19 universities provide medical education. 17 are public and 2 are private not-for profit universities. Students are provided government loans and scholarships. Entrance is by UMAT test which also requires high score.
3	Switzerland	83	3	5	11.5	5.0	16.1	56	0.7	6 medical schools and all are public. Financed by the government.
4	Denmark	80.2	3	6	10.6	8.5	15.0	82	1.3	Provided in 4 public universities. No private universities. University education is free and students also provided financial aids.
5	Netherlands	81.6	3	7	12.9	5.5	11.6	77	1.1	30-50% of applicants are turned down. Yearly enrolment is 2850 and Dutch population is 16.3 million. All 8 medical schools are publicly funded.
6	Germany	80.9	3	6	11.3	4.8	11.0	60	1.2	Admission is highly competitive. 36 medical schools in Germany. Only one private medical school. No tuition fees at public universities.
6	Ireland	80.9	3	8	8.9	5.9	12.7	71	0.5	6 medical schools, 5 are public and 1 is not-for profit private. Tuition is free.
8	United States	79.1	6	14	17.1	5.2	12.9	89	3.5	141 medical schools including both private and public. Funded by scholarships, federal and private loans and grants. Entry by completion of pre-med courses and is highly competitive.
9	Canada	82	4	7	10.9	5.3	12.2		1.0	19 medical schools and all are public.
9	New Zealand	81.8	5	11	9.7	7.4	18.7	79	1.3	4 medical schools and all are public. Fees by government subsidies, government loans and scholarships.
14	United Kingdom	80.7	4	9	9.1	5.8	12.7	60	2.0	32 medical schools and 31 are public and 1 is private not-for profit. Percentage of applications accepted in 2014 was 8.0%.
73	Sri Lanka	74.9	8	30	3.2	1.7	8.8	19	2.3	9 public medical schools and 1 private medical school which is not accredited by SLMC
104	Maldives	76.8	7	68	10.8	6.2	15.3			No medical schools
130	India	68	38	174	4.0	3.9	14.2	25	2.4	381 medical schools of which 160 are public and 188 are private.
132	Bhutan	69.5	27		3.6	5.6	15.6			No medical school
142	Bangladesh	71.6	31	176	3.7			13	1.2	83 medical schools of which 29 are public and 54 are private.
145	Nepal	69.6	29	258	6.0	4.1	21.4	17	1.5	18 medical schools of which 4 are public and 14 are private.
147	Pakistan	66.2	66	178	2.8	2.5	11.6	10	3.4	94 medical schools of which 39 are public and 55 are private.

Of the regional countries Maldives and Sri Lanka stand highest in health indices and are comparable with the developed countries. When comparing the expenditure on health of GDP, Sri Lanka with a very low value of 3.2% has achieved the results while Maldives has spent 10.8%. When considering the education sector Sri Lanka spends 1.7% of GDP and it is the lowest in the region but still manages to provide tertiary education to 19% of students who complete secondary education. Countries providing free education even in universities, are Denmark, Finland, Iceland, Norway, Sweden, Germany, Brazil and Slovenia. Neo-liberal principles that the present government bases its development policy views education as a private investment and a commodity. But the well-developed Nordic countries view it as a civil right, public service and equality issue. Meanwhile the countries which privatized the education in the last two decades like India, Pakistan and Nepal are still lagging behind in the health indices and this disproves the popular conception that privatization of medical education will result in the improvement of the health status of the country.

This proves that the education and health sector of Sri Lanka caters well enough when comparing with the funding allocation. The data used in the table are from World Bank and of the available most recent data.