China's ailing health care

[Guest guest]

Hi all,

 

Taken from: http://news.bbc.co.uk/1/hi/world/asia-pacific/4062523.stm

 

The results of a survey recently released by China's Health Ministry

underline the problems facing the country's healthcare system and

what many see as a pressing need for reform.

 

The investigation found that 36% of patients in cities and 39% in

the countryside did not go to see the doctor because they were

unable to afford medical treatment. Nearly 28% of those admitted to

hospital left because of economic difficulties.

 

" There used to be an unwritten contract between the government and

the people, " said Wang Liang, vice president of the Shanghai Current

Economics Research Institute, which advises the city government on

health care reform.

 

" The government gave people low incomes but it looked after them

from the cradle to the grave. "

 

But more than a decade down the road of market reform, " the rich

aren't satisfied with the medical care offered by the government

because it's too inefficient, while the poor can't even afford it, "

he said.

 

Chinese state media said the study was conducted in late 2003 among

more than 190,000 urban and rural residents. It found that the cost

of medical treatment increased by 14% annually between 1993 and

2003, a rate far faster than the rise in people's incomes.

 

Health officials quoted in the media said a major factor was the

practice by doctors of unnecessarily prescribing expensive medicines

in order to increase hospital revenues.

 

" I think it's true that doctors take 'red envelopes' [bribes] or

they prescribe expensive medicines because their incomes are so

low, " admitted Yu Qiusheng, a doctor at a Shanghai hospital which

combines Chinese and Western medicine.

 

She said a doctor's average basic salary was about $360 a month.

 

But she said the pharmaceutical companies were also to blame

because " they corrupt the doctors, and the doctors on low incomes

can't resist the temptation " .

 

All this adds up to the fact that even among urban Chinese who

benefit from government-run medical insurance schemes, the cost of

medical care is a critical issue.

 

" I am having Chinese medicinal treatment because the Western

medicine is too expensive for me, " said Shanghai cancer patient Wang

Qi,

 

That is despite having 85% of her medical costs covered by the

insurance for 18 months as a cancer sufferer.

 

" From next year, I will have to pay 100% of the medical costs myself

up to a certain amount and then above that, the insurance will cover

half the cost, " said Ms Wang, 40.

 

" It's really too much for me. I might have to stop seeing the doctor

next year. "

 

Pilot reforms

 

These problems mean China is being forced to experiment with various

reform schemes.

 

One such is in Shanghai, where two hospitals are being established

with foreign ventures taking a majority shareholding, and 200 out of

the city's 600 hospitals are reported to have entered into co-

operation arrangements with foreign hospitals or foreign investment

capital.

 

Faced with what they call an increasingly " bipolar society, "

economists such as Wang Liang advocate a course of healthcare

reform, including concentrating government spending on fewer

hospitals, which should be run as public services, not for profit,

and contracting out the administration of hospitals, while retaining

the government's supervisory role.

 

But the biggest problem is that most rural Chinese have no access to

medical facilities and health insurance.

 

State media reports say that in the countryside, the cost of an

average in-patient treatment is about $270, compared with the

average rural income of $315.

 

In poorer inland areas of central and north-western China, that

ratio is even more extreme. Many families are plunged into poverty

by illness.

 

China is currently experimenting with pilot rural health insurance

schemes under which farmers pay in an annual $1.20, which is then

matched by local and central governments.

 

Out of it they get reimbursed on a sliding scale, increasing the

proportion according to the seriousness of the illness.

 

In one pilot area in eastern China's Anhui province, health

officials told the BBC more than 90% of local farmers had signed up

to the scheme.

 

The government says it plans to extend the scheme nationwide by

2010.

 

But among the problems raised by analysts are the problems with

revenue.

 

Economists say that in many inland districts, local governments are

having problems even meeting the cost of teachers' salaries, the

major expense on their budgets.

 

There is also rural people's lack of trust in the authorities, and

their unwillingness to spend even a limited amount of cash without

the certainty that they will get something back for it.

 

" Most farmers will have to cope with the costs of medical care

themselves for the foreseeable future, " said an academic who closely

studies the rural economy.

 

 

Attilio: I've seen first hand doctors prescribing unneseccary WM to

patients. As stated in this report, the wages are low and they need

to sell more medicine. Having said that, doctors in China usually

give out high doses of strong medication to cure the problem

quickly. As your career path comes from the ones you make better not

manage.

[Guest guest]

On 20/12/2004, at 1:24 AM, wrote:

> Attilio: I've seen first hand doctors prescribing unneseccary WM to

> patients. As stated in this report, the wages are low and they need

> to sell more medicine.......

 

I too saw a lot of this in my time in China.....it made me sick and

really shook my faith in TCM in China. A blind eye was turned to it by

the hospital authorities because it gave them reason to keep the wages

low:( " oh, they don't need more pay.......the drug companies subsidise

them well " .

 

So much for the ethics of medicine once again..........

 

Best Wishes,

 

Steve

[Guest guest]

Well at least its not isolated to just China. The UK has it worse, drug

companies pay the doctors in the form of dinners, gifts and holidays.

 

It's totally unethical. How the hell do they get away with it?

 

Kind regards

 

Attilio D'Alberto

Doctor of (Beijing, China)

BSc (Hons) TCM MATCM

07786198900

attiliodalberto

<http://www.attiliodalberto.com/> www.attiliodalberto.com

 

 

Steven Slater [laozhongyi]

19 December 2004 14:59

Chinese Medicine

Re: China's ailing health care

 

 

 

On 20/12/2004, at 1:24 AM, wrote:

> Attilio: I've seen first hand doctors prescribing unneseccary WM to

> patients. As stated in this report, the wages are low and they need

> to sell more medicine.......

 

I too saw a lot of this in my time in China.....it made me sick and

really shook my faith in TCM in China. A blind eye was turned to it by

the hospital authorities because it gave them reason to keep the wages

low:( " oh, they don't need more pay.......the drug companies subsidise

them well " .

 

So much for the ethics of medicine once again..........

 

Best Wishes,

 

Steve

 

 

 

 

[Guest guest]

wrote:

 

>

> Hi all,

>

> Taken from: http://news.bbc.co.uk/1/hi/world/asia-pacific/4062523.stm

>

> Chinese state media said the study was conducted in late 2003 among

> more than 190,000 urban and rural residents. It found that the cost

> of medical treatment increased by 14% annually between 1993 and

> 2003, a rate far faster than the rise in people's incomes.

>

> Health officials quoted in the media said a major factor was the

> practice by doctors of unnecessarily prescribing expensive medicines

> in order to increase hospital revenues.

 

 

Anne: I couldn't resist thinking, welcome to Western Medicine. There

are some that think our (U.S.) society is hypnotized by the AMA (in

connection with pharmaceutical companies) and that we are poisoning our

masses and especially our children.. I have to admit WM has saved my

life a few times so I wouldn't throw it out entirely. I am dismayed

that it is the " authority " when so much of it can be driven by economic

gains. I have nothing against making money. It's just for what

reason. This " standard of care " is starting to give me heartburn.

Tightening the chloesterol levels, blood pressure levels, diabetes

levels only puts more people on medication that can have very damaging

side effects. Now the doctors buy into this 1) because AMA sets

standard and 2) they don't want to be sued. So the public has some

responsiblity for this.

 

Anyway - I go off on a tanget. Educated consumers I believe are the

best defense against all this. And it is our responsbility to do that

education and theirs to be open to it.

 

>

>

>

> But she said the pharmaceutical companies were also to blame

> because " they corrupt the doctors, and the doctors on low incomes

> can't resist the temptation " .

>

>

>

> " I am having Chinese medicinal treatment because the Western

> medicine is too expensive for me, " said Shanghai cancer patient Wang

> Qi,

 

Anne: This might not be a bad thing.

 

> That is despite having 85% of her medical costs covered by the

> insurance for 18 months as a cancer sufferer.

>

> " From next year, I will have to pay 100% of the medical costs myself

> up to a certain amount and then above that, the insurance will cover

> half the cost, " said Ms Wang, 40.

>

> " It's really too much for me. I might have to stop seeing the doctor

> next year. "

 

 

Anne: This happens in the U.S. a lot of people, 44million uninsured. I

needed an External Demons treatment after our last election.

 

>

>

>

> There is also rural people's lack of trust in the authorities, and

> their unwillingness to spend even a limited amount of cash without

> the certainty that they will get something back for it.

 

 

Anne: Sounds like the U.S. red states.

 

I know the U.S. is not China, but the parallels are amazing.

 

>

>

>

>

>

> Attilio: I've seen first hand doctors prescribing unneseccary WM to

> patients. As stated in this report, the wages are low and they need

> to sell more medicine. Having said that, doctors in China usually

> give out high doses of strong medication to cure the problem

> quickly. As your career path comes from the ones you make better not

> manage.

[Guest guest]

I wonder how many Western MD's would continue practicing medicine

having to face the discrimination that we do, as well as the

considerably lower incomes. Add in the fact that I can't remember the

last time my herb suppliers bought me dinner or a vacation, and I expect

we'd see far fewer Western MD's plying their trade.

[Guest guest]

Anne Crowley wrote:

<snip>

 

> in the U.S. a lot of people, 44million uninsured. I needed an

> External Demons treatment after our last election.

 

Hi Anne!

 

You must have a pass. I get my hands slapped if I post anything that

political. Doubt if this will get through.

 

Regards,

 

Pete