Stories about hospital staff being beaten up by angry patients and their families have become all too common in China´s media. Corruption and underfunding are the base of that violence, says author Zhang Lijia, who pleads for health care reforms in the South China Morning Post.
Such attacks underscore the ills of the health care system as a whole. On the heels of economic reforms, hospitals were commercialised. With limited government funding, they have to generate income through treatment and drug sales to support themselves.
When I began work at a state-owned enterprise in the early 1980s, medical care was free, and thus wasted. I remember mock fights with a colleague where we would throw around the bountiful headache pills we had been given.
How things have changed. Three years ago, I went to Beijing Capital Dermatology Hospital, one of the largest of its kind, after finding a strange rash on my arm. Like all major state hospitals, queues snaked everywhere. When it was my turn, the doctor took one cursory look and sent me for an allergy test on an imported machine and then prescribed numerous creams and pills. The total bill was US$800 – more than the average monthly salary in Beijing. That is a typical patient experience in China, at least in one respect: I left feeling short-changed, even cheated. Over-prescription and excessive tests are commonplace…
It wouldn’t be fair to blame unethical doctors for everything. China’s medical care is severely underfunded. Although the total government health expenditure has increased over the years, the amount as a share of gross domestic product has been declining. In the past several years, the proportion has been around 5 per cent, much lower than the world average of about 10 per cent.
The Chinese government has made a major effort in providing health care for rural residents as well as the urban poor. For example, the Rural Co-operative Medical Scheme was introduced in 2003, funded by a combination of individual contributions and government subsidies. However, the coverage is minimal and too localised, meaning you can be reimbursed only for certain things, at limited amounts and for treatments at your local hospitals, which are not always equipped to cope with serious illnesses. Overall,
only 30 per cent of total outpatient expenses and 50 per cent of inpatient expenses are covered, on average. The out-of-pocket cost is a serious burden for many.
Rising medical costs and low quality of service have led to ever louder complaints about the health care system. And medical workers have borne the brunt of it.
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