A reminder that we have a first-class health care system in Hong Kong affordable to all puts its occasional shortcomings into perspective. Who could imagine having to find second-hand medical equipment and materials to self-administer life-saving treatment? A group of mainland kidney patients formed a co-operative to do just that. Our report today beggars belief and compels compassion. It is also a graphic illustration of why the provision of adequate health care remains one of the central government's most urgent social tasks. Despite its economic achievements, the mainland's medical services remain inefficient, rife with corruption and unaffordable to the poor, while rates of chronic diseases are growing fast. Few are covered by adequate medical insurance. The story of the kidney patients from different parts of the mainland and their survival co-operative in Beijing is a cameo of the big picture. Unable to afford dialysis treatment in a hospital, four patients bought two used dialysis machines, hired one untrained nurse and opened a 'clinic' in a rundown suburban courtyard room. Other migrant kidney patients joined in and the cost of treatment was slashed. Now health authorities have closed the illegal operation, promising free treatment until other arrangements are made in their hometowns. To the patients, that means an uncertain future. They are pinning their hopes on Premier Wen Jiabao's promise that 850 billion yuan (HK$965 billion) will be spent on health care reforms in the next three years. They include urban and rural medical insurance, subsidised basic medicines and a pilot improvement project for public hospitals. That could be a good start in reversing the decline of the system since it was exposed to market forces two decades ago. But mainland health authorities need to fill in the detail, including how more than half the cost is to be met by local governments. Given the size and mobility of the population, the reforms should be a first step towards a national health insurance scheme that is portable and ends the discrimination between urban and rural residents.