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The lose-lose situation in China's healthcare system

By Luo Huaiyu
0 Comment(s)Print E-mail China.org.cn, October 2, 2011
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On Sept. 15, a doctor at Beijing Tongren Hospital was stabbed 17 times by a patient. The patient alleged that the throat operation the doctor had performed on him damaged his vocal abilities. He felt duped, and after a drawn-out litigation seemingly going nowhere, he attacked the doctor in rage. Less than a week later, another doctor in the same hospital was beaten in his office while a nurse was also bitten by the attacker.

When people fall ill, they entrust their wellbeing to the hands of doctors. Ideally, the patient and the doctor should enter into a cooperative relationship that is mutually beneficial. The patient may be cured or comforted physically or mentally, while the doctor is rewarded or his or her reputation is boosted. If this kind of relationship cannot be effectively established, however, the chance of a patient-doctor conflict will increase. The violent incident has marched this issue into the forefront.

The attacks of medical professionals are deplorable and we should always oppose violence. Yet, to some extent, the situations of the perpetrating patients are also lamentable. Their violent behaviors are the result of their feelings of helplessness, having nowhere to turn to in their misery. The fault therefore should not be placed rashly on either patients or doctors. Instead, China's current medical system, which has placed doctors, patients and almost the whole society in a no-win situation, is unmistakably to blame. It is satisfactory to no one except the privileged.

A market both overdeveloped and underdeveloped

In separated aspects, China's medical industry is both overdeveloped and underdeveloped. It is overdeveloped in the sense that hospitals provide healthcare to people of most income levels, matching tiers of medical services and products to their income levels.

The underdevelopment of China's healthcare industry is closely related to the overwhelming predominance of big state-run hospitals, which get the lion's share of quality resources including personnel, equipment and funding. As a result, patients are crowding into big hospitals in the cities believing those are where they can find the best doctors and the best treatment for the slightest of ailments.

As a result, smaller private hospitals, clinics and community medical facilities continue to dwindle, leading to the gradual eroding the foundation of the nation's medical security. The overdeveloped aspect of China's healthcare industry and its underdeveloped side are mutually detrimental, leaving the industry locked fast in a vicious circle of degradation.

Access and privilege

Because of the uneven distribution of medical resources and the scarcity of quality care, people are struggling for access to big brand hospitals. Because of the scarcity and high concentration of the quality care and supplies, more often than not, bribes and other under-the-table dealings take on a trend in big hospitals. Under such a circumstance, favor naturally falls to the privileged.

Moreover, the country's social environment of webbed bureaucracy gives people little confidence in the codes of conduct in big establishments. Instead, they believe anything is possible with money and power; without either, little can be achieved.

This increasing difficulty for the average person to receive quality healthcare has led to a distrust of healthcare professionals by the general public. People doubt that there are hospitals that still prioritize patients' wellbeing over money-making opportunities, or that doctors still seriously care about their health and budget.

A call for professional ethics

For the practitioners of medicine, promises to patients are taken dearly. And for a culture that traditionally honored doctors as "angels in white" who are saviors all beings, words should not be said cheaply to patients. Such ethics should neither be empty words on a piece of paper. They should be carried out to the letter in real world practices.

While doctors need to feel protected from various risks in their line of work, patients also need to feel confident that they are receiving proper care. The current healthcare system has placed too many restrictions as well as responsibilities on both the doctor and the patient. As a result, it not only reduced the utility of healthcare resources, but also negatively impacted people's confidence in healthcare professionals. The recent attacks have sounded an alarm for the need to reform China's healthcare system.

On the other hand, countless patients receive the care they need from healthcare professionals across the country. In those, we are reminded that, although there are many complex and intertwined problems, and although the management in hospitals may sometimes be cold and indifferent, the care from a devoted doctor can be particularly warming to those fragile souls in need.

The author is a China.org.cn columnist. For more information please visit:

http://www.ccgp-fushun.com/opinion/luohuaiyu.htm

Opinion articles reflect the views of their authors, not necessarily those of China.org.cn

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