Healthcare

China’s hospital utopia

Why Shenmu is the only place in the nation where it pays to be sick

"Don't worry, it's free..."

There are few government policies in China likely to get the public’s blood pressure up as high as healthcare.

Despite the country’s rapid economic progress over the past two decades, all but the most basic healthcare provision continues to be largely unaffordable for millions of Chinese citizens.

The government recognises the problem and has committed to remedying it. Earlier this year, the State Council unveiled plans to spend Rmb850 million ($124 billion) over the next three years to reform the healthcare system. More recently still the Chinese government promised universal healthcare by 2020.

Thankfully, some people do not have to wait so long. In an effort to put a positive spin on healthcare reform, Shenmu county is getting publicity as the first to experiment with (almost) free healthcare provision.

The county in Shaanxi has been offering universal healthcare to its residents since March and the results have been “very positive and significant,” says Zhao Jie, a medical reform expert with the Party School of the Central Committee of China’s Communist Party.

“We are so lucky to be born in Shenmu,” is the opinion of He Fengying, an unemployed intestinal cancer patient. “It is the only place in the country that has such a good policy,” He told China Daily.

Under the programme Shenmu’s citizens can have their medical expenses reimbursed if they spend more than Rmb200 in township clinics, Rmb400 in county-level hospitals or Rmb3,000 in hospitals outside the county.

But the scheme is a victim of its own success. Since the launch of the pilot project in Shenmu, all seven hospitals in the county have been flooded with patients. In fact, more than 2,000 people were hospitalised in March alone.

Now those in need of emergency treatment complain of a lack of available beds. And some of the patients who have been treated have been refusing to leave, despite their doctors assuring them of their healthy recovery.

Apparently, some people consider it foolish not to take full advantage of the new policy, says Xinhua. A hospital manager told the newspaper: “Because of the free medical care some patients demand hospitalisation despite unserious diseases.”

Meanwhile, critics argue that the county finances will not be able to afford the new programme for long if patient numbers continue to swamp the scarce medical resources.

The Shenmu experiment takes place against a backdrop of general disatissfaction with the healthcare business in China. Patients routinely complain about the expense of going to the doctor, and the reputation of the medical profession amongst the general public has declined with high-profile cases of unethical behaviour (such as the prescribing of unnecessary or inappropriate medication for profit).

The findings of a 2006 survey from the Chinese Hospital Administration Association lamented a surge in antagonism towards doctors, citing numerous instances of patients refusing to pay bills or even assaulting medical staff.

The latest case to capture public attention belongs to embittered patient Dai Shaorong, who went as far as to take a nurse hostage.

The nurse in question had persuaded Dai to invest in cosmetic surgery (a nose job). But after paying Rmb2,000 for the work at a hospital in Foshan in February, Dai found her nose disfigured and swollen for months.

So she visited the hospital to demand compensation, but without success. As a last resort, she abducted the nurse and threatened to kill her. Police rushed to the scene, arresting Dai and freeing the nurse.


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