Wednesday, August 03, 2005

Just like everything else right now in China.

Please put away any notions of any other motive operating at this time.

link to original article.

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August 04, 2005

Barefaced greed has replaced barefoot doctors, says bold report on Chinese healthcare

From Jane Macartney in Beijing

OLD Mrs Wang hardly dares to go to hospital these days. She is deterred not by fear of the doctor’s diagnosis but by the size of hs bill.

A report from a think-tank that advises the Chinese Cabinet brands modern healthcare a failure. It says that medical services have been turned into the preserve of the rich in a country that, a generation ago, prided itself on the provision of free medical treatment for all.

The health review, by the Development Research Centre, is unusual not only for its forthright assessment of healthcare inadequacies but also for having been published at all under an authoritarian system that usually keeps its weaknesses out of the public eye.

A senior official at the Ministry of Health said privately that many people who lived in rural areas died at home, having been deterred from going to hospital by the expense.

The numbers are irrefutable. In 1993 about 10 per cent of patients in small towns chose not to seek medical treatment because of the cost. In 1998 that number had more than quadrupled to 42 per cent. In rural areas, where incomes are lower and where more than 700 million of China’s 1.3 billion people live, the figures are even more alarming.

The report points out that in such poverty-stricken areas 80 per cent of people in need of hospital treatment did not seek such care because they could not afford it.

Mrs Wang had joined dozens of people in a waiting room at the Capital Paediatrics Institute, in central Beijing, to pay 40p to register her granddaughter to see a doctor. To register to see a specialist would cost £5 — and this is in a country where the average annual income is £1,130.

“Since medical reforms, we almost don’t dare to go to hospital,” Mrs Wang said. “No matter what disease it is, no matter if it’s necessary, doctors are bound to ask you to undergo a complete check. How can normal people afford that?” Two decades ago, healthcare was universal and free. Chairman Mao’s “barefoot doctors” gained fame throughout the world for fanning out across China’s poorest areas to treat the sick.

Questions may remain over whether they were effective, but they did provide care. Today, China’s public health system has become one of the least efficient and least equitable in the world, the think-tank report says.

Hospitals routinely overprescribe medicines to boost revenue. One writer in an internet chatroom worked in a clinic where, he said, doctors delivered 95 per cent of babies by Caesarean section to make more money.

Medical institutions deprived of government funding for nearly a quarter of a century of market-driven economic reforms have been transformed into cash-hungry businesses. The World Health Organisation, which sponsored the report, ranked China the fourth- worst country in the world for the fairness of its allocation of medical resources.

The report says: “Most of the medical needs of society cannot be met because of economic reasons. Poor people cannot even enjoy the most basic healthcare.”

Cao Hui would agree. His six-year-old daughter was being treated for an ear infection picked up while swimming. He had paid £160 at the Beijing hospital for a check-up and medicines. “I don’t know if the treatment is correct, but the cost is really too much and this is a small illness,” he said. “But I can’t begrudge the money to treat my child.”

It is not uncommon for hospitals to demand a deposit before treating emergency cases. State media expressed shock at the story of a three-year-old boy who was scalded by boiling water in an accident at his home in western Xinjiang and who died of his injuries after his parents were turned away from one hospital because they could not afford a £1,500 deposit demanded by doctors.

The answer is for the Government to step back into the picture and reform the health system, the report says. The consequences of not doing so could be far-reaching, leading to an erosion of public support for reform and exacerbating social instability. “Owing to the overall decline of medical service, the Government will become a target of fierce public criticism,” the report concludes.

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