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Health Medicine

Disastrous Chinese Health Care After 1980s…

Chinese deprived from state-financed health care

Like many other developed countries, Republic of China (ROC) was offering universal health service i.e. state-run health care system, till 1980. But afterwards it began to implement market reforms which converted its healthcare system into financed care to provide more privately financed delivered health care. This sudden and disastrous change took turmoil and state financed health service was no more available to general public. It resulted into skyrocketed medical fees, and due to this lower medical insurance coverage. Patients were left to bear their own health care expenses. In case of dangerous disease having costly treatment, people fell into poverty. It now has become most volatile social issue named by the public as one of the new ‘three big mountains’ fell on public’s shoulder.

Chinese are not happy with available health care facilities

In March 2012, in the city of Harbin (Northern China), a young man stabbed four officials of hospital staff, resultant of which one junior doctor, died on the spot. Stabber complained that doctors refused his treatment, while the hospital officials explained that he had a particular illness which firstly required treatment in another hospital. This incident took hype in China’s social media. After this incident, an internet survey was and the participants were asked about their feeling by choosing between four responses: ‘sympathetic’, ‘sad’, ‘angry’ and ‘happy’. Of 6161 people who responded to survey, Only 258 felt ‘sympathetic’, while 410 were ‘sad’, 879 felt ‘angry’, and shockingly 4018 indicated that they were ‘happy’.


Reason behind this attitude was the ambiguous nature of Chinese health sector, low salary of health professionals, difficult and risky medical work, chaotic medical market, tense doctor-patient relationship, predicament about firstly treatment of patient or demanding medical fee, and above all responsibility of government and administrative agencies. And situation is further deteriorating since past three decades.

In a survey conducted in 2013, it reveals that conflict and dissension between doctor and patients is rising day by day, and patients are dissatisfied with health professionals. On the other hand health professionals are not satisfied with their jobs and income and healthcare system fell very low in post-reform era. Not having enough earnings, to satisfy their needs, public doctors generate their income through kickbacks, over-prescription, part time jobs and bribery. In this way they are also losing their moral position among general public. These negative consequences destabilized the public opinion about Chinese government.

Chinese healthcare system after 2009

But since 2009, China is trying to reverse this healthcare system, which has only one goal i.e. state-sponsored health system to provide universal health care coverage. To achieve this goal government introduced eight functional instruments to support health care reforms i.e. financing, pricing, medical institution operation, health care administration, governance and surveillance, medical technology innovation, health information system, and legislation mechanism. This reform also encouraged private sector to play wide role to provide healthcare services to meet with growing demands of population.

For availing emergency medical services (EMS), you have to pay in China. Supposedly, emergency service is a non-profit job funded by the government, but due to lack of funds from government, practically private payments are important source of funding for daily operations of EMS. Ms. Jiong Tu, who is an assistant professor at School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, China, quoted an incident in her book mentioning an incident, when a couple died on arrival of emergency services, but despite of the fact of their demise, emergency officials were yelling to pay them 98 yuan. She mentioned that ambulances services, after getting know that that patient is unable to pay them, left patients unattended. Even patients are left to die in hospitals who have no finance. Emergency doctors usually attacked by angry patients due to medical charges, because patients or their families often in shock due to sudden illness or sudden death. And at this stage after hearing demand of fee makes them angry.

Money first or Rescue first?

In market, public hospitals are continuously being asked to become self-sufficient with less state investment. This approach inevitably makes hospital services as target for profit based business. The first-aid service includes use of ambulances, petrol, and equipment, together with the charges of health professionals and drivers, and if ambulance is called in the evening, they would charge overtime payments. Chinese doctors are in a dilemma of ‘money first or rescue first’ consequently there are many incidents of patients death. Although China is successful in maintaining her monopoly in international trade business, but healthcare system in China is overall chaos. People are letting die due to poor financial situation or doctors’ least interest as they are not getting sufficient stipend for their services.   

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Noah Liam

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