The Chinese government spent over 245 billion yuan (about 38 billion U.S. dollars) on health care in the first half of this year, according to a report submitted to China’s top legislature on Thursday.
The government’s expenditures on health care during the period represented a sharp increase of 61.4 percent year-on-year.
Now this is tremendous news, so I will forego the pleasure of opening this piece with a particularly tasteless piece of Mandarin/English hospital signage which would have rankled Western feminist sensibilities.
If you are prepared to do your google homework, you would be aware of the many and various structural problems confronting the contemporary health care system in the Celestial Kingdom.
Now, dear reader, I am sure you have had real-life hospital experiences worth submitting. Respectfully, please don’t bother as I have already heard and sniggered at the majority.
Having done a couple of gigs teaching medical English, I have to say that most of the doctors and nurses I met were very pleasant individuals. The doctors were overworked and tired, while the nurses all wanted to improve their English and emigrate to the US. I was also a joy to lounge in the Senior Cadres Boardroom during breaks, sipping tea and talking to some of the cuter class members.
That aside, it was a challenge teaching some of the basics such as taking down a confidential medical history, sharing information with your patient, the billing procedure, etc, and no, I don’t want a f…… drip because I have giardia. Maybe, these challenges was induced by the architecture, which was a combination of Belsen functional and railway restroom.
Lets throw a few statistics around. In 2000, the WHO ranked the world’s health- care systems drawing on 1997 data and using a number of performance indicators, and produced this TABLE. Of the 191 member states assessed, the PRC clocked in at no. 144, being trumped by such shining examples of modern governance as Albania/55, Sri Lanka/76 and Bangladesh/88. Now, China spends about 18% of its total budget on the military and about 9% on health care. When talking about health care expenditure however, one has to factor in elements such as equity, efficiency and wellness outcomes and the big one, corruption in the purchasing department
Personally, I think the above stats are hogwash. China in reality spends about 4.3% of GDP on health care, which is below the 6% of GDP generated by its sex industry. The latter figure is footnote 30 taken from this dense ARTICLE.
The Lancet, (that esteemed medical journal which has banned all submissions by Chinese would-be-contributors because of plagarisation and/or cooked research data) points out that:
“China has about 20% of the world’s population, yet its national health expenditure is only 2% of the total world expenditure on health.2 Although China’s gross domestic product (GDP) has become one of the world’s largest, the total expenditure on health is only 4·3% of GDP, only 44·7% of which is government expenditure.3”
Following Healthcare in China, the non-government contribution comes from:
“Selling drugs whether they are needed or not is also in issue in non-profit hospitals, since they still need a revenue stream in order to maintain the infrastructure. It is estimated that approximately 70 % of the finances of these hospitals are generated from sales income from medicine”.
Okay, my stats appear a bit dodgy, but it is clear that the sex industry captures a greater share of GDP than GDP spent on healthcare, and so it should be, since the latter value adds to social harmony and wellness outcomes, whereas the health care industry has been experiencing considerable
The NYT article Chinese Hospitals are Battle Grounds of Discontent HERE provides an excellent account of the new doctor-patient relationship.
“In 2006, the last year the Health Ministry published statistics on hospital violence, attacks by patients or their relatives injured more than 5,500 medical workers….
In June alone, a doctor was stabbed to death in Shandong Province by the son of a patient who had died of liver cancer. Three doctors were severely burned in Shanxi Province when a patient set fire to a hospital office. A pediatrician in Fujian Province was also injured after leaping out a fifth-floor window to escape angry relatives of a newborn who had died under his care”.
In Shenyang, administrators from the 27 local hospitals requested police protection “to keep disgruntled patients and their relatives from attacking the doctors. The decision was quickly reversed after Chinese health experts assailed it, arguing that the police were public servants, not doctors’ personal bodyguards”.
More reading on some of the structural problemsHERE. Now, it could be argued that this new muscular doctor-patient relationship could be attributed to the fact that 100 million folk suffer from mental health problems as reported by the China Times HERE with a pretty good demographic breakdown.
However the above suggestion is misguided, as will become evident if you read this excellent piece by Barbara Demick in the LA Times HERE.
We are talking about a new form of PATIENT POWER, but first a bit more local colour.
“Friends and relatives of a patient who died on the operating table marched on Nanchang Hospital No. 1 brandishing pitchforks and clubs. About 100 staff members, among them young doctors, prepared for the onslaught by arming themselves with long sticks and cans of mace, while the security guards donned police vests and helmets.
Medical personnel advocates complain that the more violent incidents are staged by hired thugs, paid by families of the deceased in hopes of winning compensation from the hospitals. Sometimes the protesters are from the same village or are semi-professionals in causing trouble. The Chinese have even coined a word for the paid protesters: yinao, meaning “medical disturbance.
It has become a very sophisticated system for chasing profits. Whenever somebody dies in a hospital, the yinao will get in touch with the family and offer their services in exchange for 30% to 40%,” said Liu Di, who is setting up a social network for medical professionals.
Liu said the practice arose in the last few years as hospitals became more commercialized. “You see this mostly in second- or third-tier cities where the legal system is less developed.
I always tell my clients, if you start a big disturbance, you’ll get a bigger compensation package. If you start a smaller disturbance, you’ll get a smaller package. And if you don’t do anything, you’ll get nothing,” the man, identified as 42-year-old Xiao Ming, was quoted as saying.”
Why bother with the Medical Complaints Tribunal, when this approach to non-wellness outcomes will pay for your holiday in the Caribbean.
Many thanks to all the link providers.
Apologies. Two links didn’t take, but trust me as I’ve worked with numerous doctors.