China series, Part 14: Health Care

[Prometheus]

Contrary to what many might think, China does NOT have UHC. Upon entering a hospital, one of the first things you'll see are the rows of ATMs. If you prefer to go cashless, there will be a QR code at the cashier's desk. And, yes, you must pay to be seen. You will need to pay before anything happens (I'll discuss emergency cases later).

Once you see the doctor, s/he will talk to you for a minute or two the prescribe tests. They might not even touch you at this point even to check your heart. Why do that when they can just order up an EKG?

Once you have the list of tests, you must go back to the cashier's desk to pay for the tests. You can't even get your blood pressure taken until you pay. Once you have your receipt in hand, you must go to each and every separate location and wait in line for your tests. If you need a wheel chair or gurney you must pay to rent one first. Some hospitals even have devices for renting wheelchairs that are like the "rent a baggage trolley" things you see at airports.

Once all of your tests have been completed, YOU will transport all of the reports back to the doctor. Yup. YOU are responsible for getting the X-rays, CAT scan images, and everything else back to you attending physician yourself.* Then you will wait some more until the physician looks at the documents and images and decides your next course of treatment and/or testing.

"Treatment" will also (most likely) include the doctor saying that you should stay in the hospital for at least one night for monitoring... even if you just came in with a rash. In case it hasn't struck you yet, one of a doctor's main jobs is to sell the services of the hospital to you. I'm not certain, but I'm pretty sure that doctors get paid bonuses based on how much they get you to spend. They certainly get paid kickbacks for the medicines they sell... err... prescribe.

The other day, I had some excruciating pain in my right side. The doctor walked into the room, saw my white face and diagnosed me with gall bladder disease and prescribed an immediate operation to remove my gall bladder. This was before any tests had been run. He never touched me or asked anything more about my pain except its location. His diagnosis was made in less than 20 seconds, not by evaluating me, but by evaluating what he saw as my ability to pay.

I opted for the tests. I had an EKG, CAT scan, blood drawn, urine tests, blood pressure checked, and temperature taken. Guess what. Not my gall bladder, but the doctor still advised that I stay in the hospital for a day or two for monitoring. I opted for going home and lying in my own bed rather than being put in a ward with really sick people and having to lay on a rock-hard hospital bed. Of course, I could have opted for a private room at 3 times the cost....

He also prescribed medicine that he told my friends (who went with me to the hospital) was for pain but was actually gall bladder medicine that I didn't need.

Everything is for sale. You come in with a cut that requires stitches, you can let your doctor know how awesome s/he is with a little extra money in their pocket and get a scar commensurate with your level of appreciation... while signing a piece of paper that says that you absolutely did NOT just pay off the doctor to do so. You can practically tell a person's socio-economic status from visible scars.

Emergency situations

If you come into the ER under your own power and unattended by a family member or friend, you WILL go stand in line to pay first.

If you come in with a friend, THEY will pay first and act as your advocate.

If you come in by ambulance and are unconscious, you will receive whatever care is necessary to "save your life"... while other people scramble to find out who you are and who can come to the hospital and pay your bills. The phrase "save your life" is in quotes because we're talking basics here. Your life is only as valuable as your ability to pay. When someone shows up with the ability to pay, you had better hope they like you more than they like their money and that they trust that you will survive so that you can pay them back.

Basic Medical Knowledge

The average Chinese person has none nor do they seem inclined to learn any. That's what doctors are for.** If a Chinese person gets itchy red eyes and a runny nose every spring, they will go to the hospital and see a doctor every spring just for the doctor to tell them to go buy the same allergy medicine that they buy every spring.

I know you must be asking how stuff like this can be going on in the modern world with internet access etc. and I seriously don't know because I can't read or write Chinese, but I seriously doubt that there is any sort of WebMD site in China. China isn't actually well known for wanting the masses to be well-educated about certain things and hospitals are big money.

TCM (Traditional Chinese Medicine)

There are actually entire hospitals dedicated to TCM as well as numerous acupuncture clinics, reflexology parlors (massaging certain parts of your feet will heal internal organs), and an absolute plethora of shops selling all sorts of powders, plants, and dried animal organs to calm your upset stomach, put some lead back in your pencil, and everything in between.

A lot of it is absolute bullshit but some has some actual science behind it (After all, many of our man-made medicines are just souped-up versions of naturally occurring chemicals). And some things seem to work (in certain instances)... just not for the reasons espoused. Acupuncture isn't really re-aligning your "qi" as much as it is blocking certain nerve impulses allowing strained muscles a chance to heal.

I was having some trouble with Cubital Tunnel Syndrome (same as Carpal Tunnel but in the elbow) and anti-inflammatories weren't working, so I finally took the advice of a friend and saw an acupuncturist. 10, 20-minute sessions later and the pain was completely gone and hasn't come back. If this pain in my side doesn't fully go away pretty soon, I'll be seeing the acupuncturist again.

So, there's a quick overview of healthcare in China. I hope you enjoyed it.

*You also get to keep them. Since no one has a personal physician, physicians don't need to keep records. You do.

**It should also be noted that Chinese people generally don't do DIY in the home or with their vehicles etc. If they need to replace the hose from the back of the washing machine, they will call someone. If they need their oil checked, they will pay someone who knows how to do it. And so on.