Patients impatient with too many corrupt doctors
28/12/2005 15:29
Shanghai Daily news
"In no way should China's medical
services be degraded into becoming nothing but a money-making machine," Minister
of Health Gao Qiang pledged last July. His remark resonated and sent a warm
message to the people who are feeling the chill of the whopping cost of going to
a doctor nowadays. Indeed, expensive medical services have gone beyond what
many ordinary people can afford. A Ministry of Health survey in 2003 found
that 48.9 percent of the people covered would not go to a doctor even if they
were ill and 29.6 percent of the total surveyed would not be hospitalized even
if they should be. Most of the poor patients came from the countryside, the
survey said. The challenge for Gao is to put a brake on the wheels of the
current medical care system that might otherwise head towards yet another abyss
of unbearable costs for rank-and-file citizens. To be honest, you can't
comfortably label China's market-oriented medical reforms since the 1980s as a
"total failure," as certain Chinese scholars have proclaimed. Poor
ethics But the scholars' claim of failure does point to a glaring
problem: Single-minded pursuit of profit on the part of many hospitals and the
ever-decaying morality of quite a few doctors. This article does not seek a
quick cure for the country's thorny medical problems. Rather it calls for a
swift end to the moral decadence of physicians that is adding to the pressure
already on patients. There is a strong philosophical point to be made here:
Man doesn't have to be avaricious just because he can be in a given environment.
To put it plainly in a medical context: A doctor doesn't have to take or ask
for bribes even if such a practice has been tacitly accepted in the medical
circle. If poor medical insurance coverage is a major problem to be
addressed on Gao's watch, ending the deadweight losses caused by the avarice of
many doctors is urgent. Doctors' rampant charges to line their own pockets
not only causes real financial loss to patients but stirs up their resentment to
society. It's double jeopardy. If every doctor and hospital believed that
saving a life is better than making a million dollars by cheating, there would
not be so much cursing of the medical profession by patients. Some doctors
also take bribes from drug dealers as well as from patients and there are drug
retailers who rush to hide cheap but effective medications under the counter
when you rush in at midnight with a running nose. Got a cold? Sorry, we have
only the most expensive drug. Here are two classic examples of how physicians
wring money from patients in a bad mad way. In the case of the second
affiliated hospital of Harbin Medical University in Heilongjiang Province, an
old man named Weng Wenhui died after 67 days' treatment in this hospital and the
total medical fees - according to the hospital - hit a whopping 5.5 million yuan
(US$680,000). The bill consisted of many fabricated and non-existent items.
For example, the amount of blood transfusions in one day for Weng was more than
double that of a normal person. And then Weng had a test done on his chest
after he was dead. The despicable state of the minds of those doctors has
profaned their holy vocation and they should be expelled from the
profession. A similar case occurred in Shenzhen in Guangdong Province. At the
beginning of the year, Zhu Shaoxia, an ICU (Intensive Care Unit) patient in
Shenzhen People's Hospital, was billed 1.2 million yuan for four months'
treatment. Later it was discovered that more than 10 thousand yuan of the
bill occurred after Zhu's death. Both Shenzhen and Harbin are big cities,
and both hospitals are standard, large ones. A former drug dispenser who quit
her job out of disgust over the rotten behavior of some doctors gives us another
glimpse into the state of the profession. Liang Xin, a former drug sales
person in Changchun, the capital of Jilin Province, was quoted in a report in
the People's Daily last Wednesday as saying that her heart ached "whenever I
recall the days I worked as a drug sales person." The 30-ish Liang earned
10,000 yuan a month in those days but said she could no longer do a job that "is
always in the dark." "Everyone on the earth knows that doctors take our
kickbacks," she said. "I knew 90 percent of the doctors in a hospital and not
one of them was clean." A doctor with the title of professor could get a
monthly kickback of 100,000 yuan from her drug company, a sum more than 10 times
a doctor's normal monthly income. Who in the world do those doctors serve -
drug salesmen or patients? Patients might complain less if they were well
insured. Unfortunately, according to Guan Zhiqiang, a researcher at the Ministry
of Labor and Social Security, China's total medical expenses so far this year
have hit 700 billion yuan, more than 60 percent of which is borne by the
patients themselves. In small cities and towns, 44 percent of the population
do not enjoy any kind of medical insurance. When it comes to the
countryside, the insurance coverage is even lower, as Gao Qiang has
admitted. Given such a stark reality, how can doctors look after their own
pockets in such vile ways? To Gao Qiang, it's not enough for the government
to find more funding for hospitals. He should make sure that bad apples stay
out of the medical profession. There's no rule that says a free market has to
lead to corruption.
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