China's Health Care: Cash Up Front, Lots of Drugs
If you are Chinese, or visiting China, try very hard NOT to get sick. Here's why:
1. China has no system of general practitioners, so most people go to a hospital for health care.
2. Most hospitals demand cash up front. Chinese people cannot get treatment, even for life-threatening illnesses, until they hand over money.
3. Chinese hospitals have been turned into pharmacies on steroids, more than half their funding is from the sale of drugs. The system has in-built incentives for everyone to sell as many drugs as possible, including doctors, whose salaries are tied to prescription targets. It is no coincidence that one of the biggest corruption cases this year centred on the former head of the state food and drug administration, who was executed last month for taking bribes of $1m to approve new drugs.
4. The most common prescription is for antibiotics, with devastating effect. The health ministry says that 70-90% of child pneumonia patients are resistant to drugs used to treat the disease, because of overuse of antibiotics.
5. A Chinese journalist visited 10 hospitals this year and, pretending to be a patient, provided tea in the place of a requested urine sample. Six of the hospitals said they had discovered "blood cells" in the "urine" and immediately prescribed drugs.
Read more in the Financial Times here.
MP: China's health care system also has implications for China's trade surplus with the U.S.
The fear of being financially crippled by falling ill is an important driver of the country's high savings rates, which in turn feeds the economy's bias towards investment and, more recently, with a large current account surplus, in favor of exports.
Countries like Japan and China with high savings rates (and low consumption) typically have trade surpluses and countries like the U.S. with low savings rates (and low consumption) have trade deficits. Trade policies in the U.S. targeted at reducing the trade deficit with China will never work unless the underlying savings/consumption patterns are altered in both the U.S. and China. That is, unless the U.S. somehow becomes a high savings country, we'll continue to have a trade deficit, and unless China somehow beceomes a low savings country, it'll continue to have trade surpluses. Not likely during our lifetimes.
19 Comments:
If you are Chinese, or visiting China.....
ummm so...who excatly does this exclude ?
Is it OK if I were a Iraqi living in China ? or...
Matelot, I'd wager it would exclude people who are not Chinese or not visiting China.
Matelot, I'd wager it would exclude people who are not Chinese or not visiting China.
right...so i guess we Americans here in the great land of USA have nothing to worry about since our health care system is the envy of the world....yup
matelot, the American healthcare system is not the issue at hand here. This is a discussion on the Chinese healthcare system and its inefficiencies and levels of corruption. If you want to include the American healthcare system in this discussion, I propose you write a comparative analysis of the two.
I was in China last summer, injured a limb, and needed medical care. My Chinese colleagues took me to a hospital. The experience wasn't bad. They did an X-ray. The cost was 30 RMB, which is about $4. I don't recall if everything else was free or not, but if it wasn't, the total cost wasn't something I noticed -- significantly less than $20. The same visit in the US would have cost about $1000. The hospital wasn't as clean, the equipment wasn't as modern, and generally, things were not up to US standards, but it was pretty good. The facilities were similar to the wealthier parts of Eastern Europe, and the doctors seemed competent (on par with US).
As with anywhere, I think there's a spread in quality and cost. What I encountered was fine. My guess is that part of the issue was I had Chinese friends, who could make sure (a) I go to a reputable hospital (b) I don't get cheated. I'd guess the Chinese journalist was looking for disreputable hospitals, while the American one just got himself cheated.
Anonymous -
30 RMB was $4 to you, but the real question is how much is that to the average Chinese worker?
I just spent the last year in China with my wife and two children. My son was 2 1/2 and my daughter six weeks when we arrived in China. We lived in Tianjin which is a city of more than 10 million two and a half hours south east of Beijing. During the course of our stay both children came down with pneumonia and my son broke his arm. A friend was involved in a serious car accident and spent over a month in the hospital. I guess you could say I have now spent a fair amount of time working with the Chinese hospital system. The good news was that I found the doctors and nurses to be well educated and competent for the most part. The orthopedic surgeon we consulted for my sons broken arm is a Harvard graduate. If you have money and a white face you get special treatment and can avoid the long lines. The bad news is that the facilities are filthy and disgusting beyond belief. Somehow they have missed Sanitation 101. I have seen a sick patient defecate on the floor in a large ward full of beds and then watched hospital staff walk around it for an hour without any attempt to clean it up. You want to find soap to wash your hands forget about it. You want the staff to put new sheets on the bed you better bring them yourself. New gloves for a new patient, you better ask for them or it's not happening. By western standards the cost for care was incredibly cheap but for the average local Chinese the costs were quite high and you could see that extended family units were all pitching in to pay for care. I have seen first hand how hard they push drugs on you. To add insult to injury you get a double dosage because they prescribe traditional Chinese medicines on top of western meds. Again by western standards the price is a bargain but for the average Chinese citizen the costs are not cheap. For example an office visit in China for my kids to get their vaccinations is less than $10 U.S. dollars but that same visit using the same drugs costs over $200 here in the United States. So like everything else in life it's a give and take situation.
Sorry, this "Blog" is utterly wrong!
I lived in China for quite a time(enough to be able to apreciate its wonderful culture and be enraged at a post like this) and can tell you this whole posting is full of lies.
Traditional Chineses medicine is known worldwide and chinese are very proud of it.
In China there are 2 kinds of treatments: (traditional)Chinese and "foreign"(our "drugs").
I can tell you for a fact, that it isnt true that Hospitals will "cash first". And you can also choose if you prefer the far cheaper chinese or foreign medicine(not expensive either).
In fact most chinese prefer to be treated with traditional medicine. They trust it more... and doctors will actually advice you to take it.
The times i went to the hospital i always got a good treatment and the doctor also gave me the choice and encouraged me to try the chinese cure. The first times i choosed the drugs... but then used the chinese ones and i actually think they were better.
I know that China has not always the best opinions... but postings like this just serve to tighten prejudices and show the informative quality of Blogs.
I am quite worried that things like this make it to top ranks in social networking sites.
Having spent most summers in China since 1996 and having had to use/visit the hospital for everything from a broken ankle, a visit to hospice and food poisoning I can say that while things are not usually as clean as they are in the U.S. they are NOT as bad as this article states. For the busted ankle, there was a choice of a regular doctor (20 yuan) or a specialist (40 yuan). X-rays were taken, traditional chinese medicine was prescribed, and a cast was applied. No problems. No paying up front either (where did you get that from... jeez). No complaints from me and frankly the treatment wasn't much different from how it is here in the States.
What a horrible post. Cut and pasting comments from a negative-China propaganda piece, without any personal investigation of the situation. I have experienced two hospital visits in China, and both were comparable in cost and level of service to visits to a Canadian hospital.
anonymous:
So you're saying that Richard McGregor, the author of the Financial Times article, is lying? He completely fabricated the story he writes about happening to him?
>30 RMB was $4 to you, but the real question is how much is that to the average Chinese worker?
Lunch in China costs about $5. Not a bottom of the barrel dirty-chopsticks street stall lunch, and not a fancy lunch, just a good basic lunch in an average restaurant. The same lunch here would cost around $12. So there is a price difference, but maybe not as high as you think. Salaries for yuppie types are around 1/4 to 1/2 the salaries in the US, which makes that $5 lunch a bit pricey for most, but the x-ray, not being a daily thing, is still quite reasonable compared to the rapacious prices here in the US.
I think the comments here are too reactionary. The fact is that China is a very large country with a huge range of standards of living. I've only spent 6 months in China, but in that time I visited Nanjing, Shanghai, Xi'an, Suzhou, Beijing, Harbin, and hiked all over Yunan. Most of my time was spent in Beijing, and I never had to make a hospital visit, but from my experience it was very clear that the lifestyle of citizens varied widely from city to city and even more greatly between city and countryside. Some hospitals are probably more corrupt than others.
Personal anecdotes are circumstantial evidence. Foreigners are also likely to receive different treatment (both positive and negative, depending on area). To really assess the state of the country's healthcare system you'd need a comprehensive independent study, something I suspect the party would not allow. I'd personally be willing to bet the story about the Chinese journalist and the tea is probably true.
china, shmina. lets just bomb 'em and be done with it.....
Paying up front might be a hassle, but I'm thinking it's all relative when a visit to a doctor in a reasonable hospital costs 3 RMB, or 30 eurocent.
This article is ridiculous. Have the author ever been sick in China? I have- twice in the past 5 years. Both times in the Hubei province. And twice I wound up in one of their cities' emergency rooms. Both times, I was sick with a fever and a wicked cough- probably caught the flu from my travels both times. And yes, I paid upfront. But the total each visit was on the order of a few hundred yuan- which is about $30-$40 USD. And I recovered while in the emergency room stay of about a few hours each. Each time, the docs stuck an IV tube into my veins and hooked me up to some drugs I know nothing about (I'm not a doctor)- and both times, I felt fine within a few hours.
The doctors and nurses working in China's hospitals deserve a lot more respect than this article's author grants (or not).
It's not just China, healthcare costs have skyrocketed world-wide in the past few decades.
It's a huge rip off, not by the doctors and nurses but by the owners of the hospital chains and the drug companies.
Perscriptions are supposed to be about anti-biotics not the mood altering drugs they force on people in the US.
Well golly gee! If China is such a medical paradise and American health care is such a cold, heartless rip-off then get the hell out and don't let the door hit you in the ass on the way out...
The most asinine comment by A @ 1:10 A.M.: "Perscriptions are supposed to be about anti-biotics not the mood altering drugs they force on people in the US"...
Hmmm, when was the last time anyone had a gun held to their heads in this country and told to take a mood altering drug? Anyone? Anyone at all?
I remember going to a top hospital in Beijing with a friend who had injured her ankle. The doctor applied a cast which cost a couple hundred yuan, didn't bother to x-ray.
When I asked for a crutch (she couldn't walk) 'not his problem', when I asked reception about a crutch 'she can use the wall' to help her walk. I asked the drug-store where can I buy a crutch, 'don't know'.
So she could use the wall to hop out of their hospital and 'good riddance!' That's the service Chinese people get in China. Lucky there were 3 of us. I found a walking stick at a tourist site and bought it for 25 yuan.
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