After reading an article about the myriad problems facing China’s health system, I asked the doctors in my medical English class to briefly reflect on the system based on their own ideas and opinions. Of the 17, 15 doctors wrote that China’s system faced serious challenges. The following are excerpts from their papers that I think accurately reflect the challenges currently facing China’s health. I have not fact checked them, and in some cases I’m fairly certain they aren’t accurate, but that the doctors believe these statistics is revealing.
This one echoed many of the main points of the other doctors.
“For patients, medical services are too expensive. It is said that the average cost is about 500 yuan for a common cold in a mid-level hospital (the average income per day is about 80RMB in Beijing). About 70% of people living in the city get social insurance, which could cover 60% of the cost. For chronic diseases, the cost is even more. So people with diabetes or cerebral vascular disease, do not go to see the doctor and do not take the medicine regularly because they cannot afford the cost. What is worse, some people living in rural areas do not go to the village hospital when they are ill because they have to sell their house and go into debt to treat the disease. In order to raise China’s health level, the cost of medicine should be lowered.
For doctors, this job is no longer a good choice. 90% of doctors said that they are extremely tired. Most doctors have to work 60 hours per week (the average work week is 48). Additionally, being a doctor is a high pressure job which means that they have to focus almost every minute. 30% of doctors admit that they are depressed. In these years even the doctor’s personal safety is threatened. Several doctors were killed by their patients or their family members because of the unexpected therapeutic effects. However, the income for the doctor is low, which is not enough to raise a family. In this situation, some doctors choose to quit for an easier life and fewer students want to go to medical school.”
Red Envelopes and unnecessary prescriptions appeared in more than half of the papers -
“Although most doctors do their best to help patients, there are a few doctors who did some ugly behaviors such as accepting red envelopes, lacking responsibility, and so on.”
“The government does not pay enough money for the health-care system, so the hospital and doctors want patients to buy more drugs to get more money. Even some drugs are unnecessary. 75% of hospital’s income is from drug sales. World bank’s report on China’s health system found that less than 1% of drug prescriptions were reasonable in 2005.”
Concerns for safety came up in nearly half of the papers, this was partially because of the murder of a doctor in Harbin around the time of the assignment.
“…Under these circumstances doctors are worried about troublesome patients and their families. They only dare to make secure diagnosis and operations that insure success. If the risk of the operation reaches a certain degree, some doctors may avoid it. Therefore many patients who have difficult or rare diseases can’t get treatment.”
Government waste was also a major concern, and it surprised me that they were so forward with their discontent.
“The rich and officials waste medical resources. VIPs are very common in many large hospitals. They always do many unnecessary tests and waste the expert’s time.”
“Currently, China is an extremely unfair society. The possession of medical resources is extremely unfair too. It seems the Chinese government only serve themselves. It is reported that about 80% of the health care costs were consumed by 8.5 million governmental officers of the Chinese Communist Party. Despite a loud voice demanding an increase in spending on public health care, the government never wants to spend too much on medical care. It is not difficult to understand. The Chinese Government has a huge budget for spending on cars, banquets, travel, and economic development, but it cannot afford the health care of the large population.
Chinese health is a big problem, and I do not believe that the Chinese gov’t will change its policy on public health care in the near future.”
“Huge gaps in medical resources make many people prefer to seek treatment at prestigious hospitals, instead of at local health centers, for even minor complaints such as headaches and colds. In many large- and medium-scale cities of China, doctors see at least 50 patients a day. Emergency services are so overcrowded that the staff has set up beds in the corridor. People start lining up early in the morning to obtain appointments the following day.”
“Production and circulation of drugs in China is in full accordance with the operation of the market – to pursue profit maximization. This is a serious departure from the public welfare and health services. As of the end of 2005, China has more than 4,000 certified pharmaceutical manufacturing enterprises, as well as 120,000 of the pharmaceutical retail enterprises. In 2005, China’s State Food and Drug Administration approved 1,113 new drugs, while the U.S. FDA approved less than 100.” (This author later wondered whether the oversight was really sufficient).