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On Health Care in China

12/31/2019

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PictureNew hospital in a third-tier City in Shandong, China
   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? ​

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  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. 

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Take a number and give a blood sample at one of the stations
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Consulting room
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Station for taking blood samples
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Getting blood test results
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.
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My husband getting acupuncture treatment
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Original hospital building founded by Western missionaries
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. 
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A display of medicinal plants in a Traditional Chinese Medicine hospital
At right: Traditional Chinese Medicines on display at a TCM hospital
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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.
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    More about me here. My earlier posts (prior to June 2017) are about my time as a teacher of ESL in China,(just click on "China" in the menu below.) more recent posts focus on my writing, as well as Jane Austen and the long 18th century. Welcome!


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