new video loaded: Inside China’s Predatory Health Care System
transcript
Inside China’s Predatory Health Care System
Homemade cancer drugs, violence in hospitals, doctor shortages: We take you inside China’s broken health care system to reveal how dire the situation is for over a billion people.
[music] This is Zhang Zhejun. Today, he’s making drugs. He isn’t a chemist or a dealer. He’s making medicine for his mother. She has stage 3 lung cancer. Zhejun earns $300 a month, but the medicine needed to treat his sick mother costs $2,000. Looking for options, he turned online. Today, he’s making WZ4002. It hasn’t been approved by Chinese or American regulators, and it doesn’t have a commercial name yet. But he can still order the raw ingredients for drugs like this online at a fraction of their official prices. The Communist Party of China says it provides close to universal health care coverage. Nearly 95 percent of people are insured here, including Zhejun’s mother. So why is he making drugs on the floor of his apartment when his mother has insurance? It’s a symptom of a health care system in crisis. To understand this crisis, we need to rewind a bit. Under Mao Zedong, the Communist state provided free health care for all. Decades later, China adopted a unique brand of capitalism that transformed the country from a poor farming nation into an economic superpower. Life expectancy soared. But the introduction of capitalism and the retreat of the state meant that health care was no longer free. Hospitals became profit-driven. And with limited accountability, they were widely accused of predatory behavior. A culture of mistrust and inequality now plagued the system. Here’s what that looks like today for ordinary Chinese. It’s 5 a.m., and about 100 people have gathered in a line in downtown Shanghai. This isn’t the line to the movies or a holiday sale. It’s the entrance to the Shanghai Cancer Center at Fudan University. Those who were willing to lose a night’s sleep trying to get a spot in line now have one question in their mind: “Will I be able to see a doctor today?” The scalpers are out, and they’re selling spots in line. China’s line scalpers symbolize a greater dysfunction. The chance of seeing a doctor here is directly related to how big your wallet is. Corruption is inherently part of the system. And in rural areas, it’s worse. But leaving your home in the countryside could have a profound impact on what type of care you can get in the city. Despite its rapid modernization, China still uses what is known as the Hukou system. Your Hukou is defined by your birthplace, and you’re only entitled to social services within that region. Everything from the schools your kids can go to, to what your health insurance will cover is determined the moment you are born. So if you get cancer and live in an area without an oncologist, you could be in trouble. Some here compare it to a caste system. By 7 a.m., it’s one hour before opening time. The line has tripled in size, and then the news hits. Those are not good odds. But even worse, they aren’t unusual. There are nearly 7,000 people per general practitioner in China. To put this number in perspective, the World Health Organization’s international standard is one doctor for every 1,500 to 2,000 people. General practitioners we talked to in China typically see 70 to 80 patients per day. Specialists said they see up to 200, each just for minutes at a time. The doctors we talked to in the U.S. said they see fewer than 30 patients a day. While rich Chinese will pay for individual care or leave the country altogether for it, the rest of the population, those dependent on health insurance, end up paying roughly 30 percent of their health care costs. Americans pay about 10. Numbers like these have added up to a culture of conflict. With more and more patients and underpaid doctors, violence has become commonplace in hospitals across China. And with the state insurance system not meeting the rising costs of treatments and drugs, medical disputes often play out in public on the hospital floor. Violence in hospitals has become so common in China, there’s a word for it — yi nao. Roughly translated, it’s medical disturbance. Back at the Shanghai hospital, it’s opening time. Scalpers are making a last effort to sell off doctors appointments they secured in advance. Some that wouldn’t wait, or couldn’t afford the scalpers’ tickets, try to cut in line and are thrown out by security guards. Once in the hospital, patients will stand in another line. It’s the second, and there are more to come. They scan the board of available specialists, selecting one based on their best self-diagnosis. If they’re lucky, the one they choose will have time to see them. For those who choose wrong, the cycle will begin again tomorrow. Others prefer to solve their problems at home.
Inside China’s Predatory Health Care System
Homemade cancer drugs, violence in hospitals, doctor shortages: We take you inside China’s broken health care system to reveal how dire the situation is for over a billion people.
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