This morning, while sipping my coffee and looking at my Twitter feed, I saw a much re-tweeted blog post that contained misinformation about health care in China. The writer was arguing that medical innovation does not arise out of a single-payer hospital system. Medicine and medical breakthroughs only come about in the robust environment of capitalism.
I could quibble, but I'm not going to argue about that. What I took exception to was the blog writer's portrayal of a Chinese hospital and Chinese medical care as squalid and dirty. Overall, that's a misleading picture.
First, China has prosperous provinces (the ones on the coast, the ones filled with factories and trade) and it has poorer provinces. Better health care is available in the more prosperous areas and in the bigger cities. That applies to us as well -- if you live in a dinky little small town, there is no giant gleaming hospital down the road, is there?
But they are building giant gleaming hospitals in China and perhaps you'd like a description of what happens when you go to one, as I did a number of times when I lived there.
Also, China abandoned communism a long time ago. Health care is not socialized. it's not free for everybody. When you go to the hospital, you register and pay some money and you get a smart card with your ID and your credits. Suppose you want to talk to a doctor. You then go to the relevant department and wait in the hallways until you get called into the consultation room.
The Chinese are, in my experience, more casual about the concept of medical privacy than we are in the West. Some other patient might come in to talk to the doctor while you're trying to talk to him. He slides your card through a little gadget attached to his computer and assigns the tests. Then you go line up in public to have your blood drawn; you are not whisked away to a little cubicle. You present your card again.
To get your blood results, you return in a few hours, insert your hospital card into a machine, and it prints out your results. Then it's back to talk to the doctor, if necessary. It's all very brisk and efficient.
I had the very great pleasure of teaching medical English to some doctors in China and I learned something of their lives. They do not enjoy the prestige and of course, nothing like the salaries, of their counterparts in the West. It was pretty routine, however, for a family to "tip" the surgeon with a substantial bribe before an operation in the hope that he or she would give their best efforts, or give them some lavish gift.
So far as I could understand, the Chinese do not have a family doctor. In Canada, the GP is the gateway to specialists. If you want to see an arthritis specialist or a hearing specialist, you must be referred through your family doctor. Then you might wait for weeks or months. That is a single-user system.
In terms of the facilities themselves, most of the hospitals and clinics I went to in China could stand comparison with the oldest parts of my local hospital in Canada (endless corridors, linoleum everywhere, that sort of thing) and the new hospitals could stand comparison with ours as well.
But China is, on a per-capita basis, a much poorer country than the West, so yes, there are going to be clinics in rickety old buildings, and ancient-looking equipment. But China had advanced rapidly in economic terms, if not in terms of personal liberty.
Some doctors study Western medicine, some study Chinese Traditional Medicine and some hospitals offer both kinds of treatments. Another feature of Chinese hospitals that we don't have in the west is that instead of drinking fountains with cold water, they have spigots in the hallway that dispense scalding hot water so people can make tea or prepare instant noodles.
If you want a view of the "real" China, I highly recommend the movie, "The Farewell." The opening scene and several other scenes, are set in a hospital. Wonderful performances and a touching story.
The finale to my Mansfield Trilogy is on the way!
Here is an excerpt from A Different Kind of Woman about John Price, Fanny Price's brother, bumping into his older brother Richard on a cold winter's day in London. Richard is a third mate with the East India Company. He's back from Cathay, and the two brothers decide to walk onto the Thames, which is frozen over. A Frost Fair is being held on the river.
The two brothers awkwardly slid down the causeway to the frozen river. The Thames was black with people and tents; they could hear a fiddler playing an Irish air, and young girls shrieked with laughter on the swings. They could smell wood-smoke and roasting meat.
Richard hailed the sight of a temporary tavern made of two canopies stitched together, called the “North-West Passage.” John ignored his invitation to go in for a drink and instead wandered slowly along the row of stalls that stretched almost across to the opposite bank.
The usual foul stench of the river was subdued by the cold, and the thick layer of ice beneath his feet. As to the thickness of the ice, he had no qualms about walking where so many others went, but he wished to know its precise thickness, merely as a knowable fact, because not knowing that fact was like an itch he could not scratch. He supposed someone in authority had drilled a hole and had measured the ice, to ensure the safety of the populace, and he hoped the information might be supplied somewhere, or had been printed in the papers.
Out of habit, he also watched the people, training himself to spot pick-pockets. Everyone appeared to be in excellent spirits. Rationally, though, John could see no advantage to walking out on a frozen river to go shopping. The same articles were for sale on the ice that one might buy anywhere, on any day—honey in the comb, candles, gloves. And yet everyone treated the occasion like a festival day. Just the novelty of being able to walk on the Thames, and suddenly everyone was willing to pay a higher price for gingerbread. There was no understanding people sometimes.
He came across a small bundle of rags which someone had left upon a low wooden stool. The bundle moved and he saw it was a tiny, hunchbacked old woman. Two crutches lay on the ice in front of her. She extended a bony hand with long dirty fingernails. “Your fortune, young sir?”
“Pardon?” said John.
“I can trace your fortune, sir. Give me your palm.”
John’s hands were firmly tucked in his pockets, out of her grasp.
He looked at her. “You can see into the future?”
“Yes, sir. I have the sight.”
“Then why are you dressed in rags if you know which horse will win at Newmarket?”
The woman gave John a piercing look. “Sir, I do not see horses, I see destinies.”
“So can I. I can tell you what yours is, for I am about to report you to the river police. You will be brought up at the Old Bailey, and you will be placed in the stocks. I’m surprised you did not know that.”
The woman swore a colourful string of oaths at him, snatched up her stool and crutches, and scurried away with surprising rapidity.
John continued his exploration of the fair and came across a stall of books. Out of habit, he started glancing over the titles laid out on the wooden counter.
“Well, hello yourself, John Price,” said a female voice. He looked up and saw a small figure swaddled in blankets and scarves standing behind the counter, and recognised Prudence Imlay, whose father owned his favourite book shop.
“Oh, hello Miss Imlay,” John answered. “How do you like being on the river?”
“I am slowly freezing to death,” answered Miss Imlay calmly. “And I might as well not have bothered to drag all these books down here. These, on the other hand, are extremely popular.” And she held out a poster with an engraving of London Bridge and a bit of doggerel:
The season cold
You now behold
A sight that’s very rare
All in a trice
Upon the ice
Just like a Russian fair.
“What a terrible verse,” said John.
“I know. I wrote it,” answered she. “The first time I have sold my writing to the public and it has to be this.”
John wanted to say something encouraging. “Maybe if you write something better, the public will like it as well.”
“Are you going to buy a book, John Price?”
“Not today. I spent all my money at the King’s Arms.”
“Oh!” she said, surprised. “That’s not like you, surely.”
“For my brother,” he amended.
“Ah, well, you seldom buy our books anyway. Father says you treat our shop like a lending library.”
“That is why I take care to visit when he is not there,” said John. “And anyway, I prefer it when you are there.”
Miss Imlay looked away, then looked back.
“I think you are getting too cold,” said John, “your cheeks are turning red. If they turn white, then it is frostbite. You should be careful.”
Richard appeared out of the throng, and saluted John with another hearty slap on the back.
“Ho, John, you artful bugger! Not so backward with the ladies after all!” And he turned to bestow a devastating smile on Miss Imlay. He looked at her, and his smile dissolved.
“Oh,” he said, taking in the red smallpox scars which disfigured her entire face.
The girl flushed again, and turned away. “I think I shall start packing up. The sun is going down.” She bent down and disappeared behind the counter.
“Do you want any help, Miss Imlay?” asked John.
“No, thank you,” came her voice. “I can do it myself. My father is meeting me at the quay.”
“Very well, good afternoon,” said John, and he and Richard walked away.
“Poor girl—what a shame,” said Richard, his loud voice carrying across the ice. “Nice eyes. Pretty hair, too. Too bad about her face.”
“What about her face?” asked John.
“The pock-marks, what d’you think I meant!” Richard laughed. “There isn’t enough ale in London to make her into a beauty.”
“That is just her skin,” answered John. “That is not... that is not... what she looks like.” He tried to explain but Richard was not listening anyway.
Something was making John feel uncomfortable. He was not sure what it was. He thought he should go back to talk to Miss Imlay. “You go on, Richard,” he said. “Meet me back here tomorrow at the North-West Passage. Around midday.”
He ran, slipping and sliding, back along the rows of stalls, dodging children and stray dogs.
Prudence Imlay was still clearing the books off the counter.
“Even if you do not need help, Miss Imlay,” said John, “I can help you. That is, do you want help?”
Prudence tossed her head, but made no reply.
“Is something wrong? Are you angry?” asked John.
“Leave it to you, John Price, to not know when somebody is angry,” said Prudence. “A fine thief catcher you would make, if you do not know if someone is angry, or happy, or sad.”
“Are... you feeling sad?”
Prudence sighed. “I caught the smallpox when I was a child, and I did not die, but I know what I look like, and—and—that is just the way things are and I cannot change it. And I do not want to talk about it.”
“All right,” said John. He was rather relieved, because he was not good at that sort of talking. “Are you sure you do not want any help?” He was going to add, “books are heavy,” but decided that she, a book-seller’s daughter, already knew books were heavy.
“Not today, John,” said Prudence. “Go away.”
The King's Arms was a real tavern and lodging-house for sailors. The London Mudlark found an ale jug from the King's Arms while scavenging along the banks of the Thames. More about the 1814 Frost Fair at Madame Gilflurt's blog.
The East India Company sent trading ships to India and China to bring back silk, shawls, spices and more.
My novel, A Different Kind of Woman, is available for pre-order on Amazon now!
In the exciting conclusion of the Mansfield Trilogy, the lives and destinies of Jane Austen’s well-known characters are deftly blended with dramatic historical events. Fanny Price is torn between her love for William Gibson and her duty to her family. In London, Fanny’s brother John meets his match in a feisty bookseller’s daughter. And Edmund Bertram’s wife Mary meets the charismatic poet Percy Bysshe Shelley and risks everything to gain the power and influence she craves.
Regency England comes alive in this tale of love, loss and second chances set against the real-life backdrop of political turmoil in England.
About the author:
I'm a writer and a teacher of English as a Second Language. "Laowai" means foreigner. Check further down for tags for specific subjects. My earlier posts (prior to June 2017) are about my time in China, more recent posts focus on my writing. Welcome!
JAFF: Jane Austen Fan Fiction
TINYFCC: This is not your father's Communist China
YDCTHTCAETTBELH: You don't come all the way to China and expect things to be exactly like home.