Thursday, December 08, 2005

Healthcare in the Worker's Paradise....
Think the uninsured have it tough here? How about the People's Republic of China? From The Wall Street Journal:Chinese Doctors Tell Patients To Pay Upfront, or No Treatment
As soon as the money dries up, doctors warn, so will the drugs that could save the life of Cui Guangshun's 7-year-old son, Dejie, in the leukemia unit of Beijing Children's Hospital.

Such are the rules of China's pay-as-you-go health system: cash upfront, or no treatment.

Mr. Cui's wife, Yang Deyin, traveled more than 300 miles by bus to Beijing from their small farm on the grasslands of Inner Mongolia to be near her only child. For weeks, she camped out on a blue plastic chair in one of the hospital waiting rooms to save money on lodging, like dozens of other parents.

Back home, her husband pleaded with relatives and village neighbors for more loans to keep the boy's care going. Most nights, the mother queued up in a drab hospital lobby, littered with food wrappings and possessions, to use a touch-screen computer that told her how much of the family's cash was left. Sometimes the number flashed red, meaning the family was in arrears and prompting a frantic call to her husband.

In the past few weeks, Mr. Cui and Ms. Yang have been forced to accept a terrible reality: Even though their son's leukemia is considered highly treatable, they may never raise enough money to cure him. The hospital's estimated fees of $18,500 to complete an initial 6½-month course of treatment are impossibly high set against the family's annual income of less than $350. Like two-thirds of China's population, they don't have health insurance.

"There's nothing for it," Mr. Cui sighed, slumped in the doorway of his red brick home on a recent afternoon. He said he had dug up his potato crop and sold it all. He had threshed his corn and sold most of that, too, leaving barely enough to make the steamed bread that keeps his family going through the winter. "I'll just have to fetch Dejie home to die," he said.
No such thing as EMTALA in China:
A year ago, Sam Lin, a prosperous factory owner, took his pregnant wife to a hospital in the southern boomtown of Shantou to give birth. As he recalls it, the couple were startled in the waiting room of the maternity wing by a commotion. A woman who had just delivered her baby was bleeding profusely and needed an emergency blood transfusion. Mr. Lin heard nurses screaming at the bleeding woman's husband. "If you don't have any money, we don't operate," one yelled, according to Mr. Lin. He says he rushed up to the man, counted out a stack of banknotes and thrust them on him. He never found out whether his charity saved the woman's life.
These physicians seen to engage in "defensive medicine for fun and profit":
Today, China has plenty of large hospitals packed with state-of-the-art equipment to compete for paying patients. To maximize revenue, hospital doctors routinely overprescribe drugs and diagnostic procedures, according to studies by the Chinese government and international bodies like the World Bank. Hospitals sell many drugs directly to patients and add a profit margin.

A World Bank study estimates that drugs account for more than 50% of all Chinese health spending. In the U.S., prescription drugs account for less than 15% of total health spending, according to U.S. government figures. The World Bank study says 12% to 37% of Chinese national health expenditures are wasted because of unnecessary drug prescriptions.

"Hospitals have become huge corporate profit centers," says Chen Bowen, an official with the Society of Community Health Service, a nonprofit organization based in Beijing that advises authorities on health reform.

The physicians seem to be a bunch of heartless bastards:
At the Beijing Children's Hospital, doctors in the cancer ward quickly got to the bottom line. They explained to Dejie's mother that if the family's account dipped into arrears, that would be the end of the boy's treatment.

The hospital's Dr. Xie says doctors' income would be affected if they don't "push patients hard enough" to settle their bills. "Nowadays, doctors don't just treat patients. They've also got to chase for payment," she says.

According to hospital regulations, once patients owe more than $250, the doctor must issue a warning and take responsibility for getting the money. Usually patients pay in cash. Credit cards aren't widely used in China. "Hospitals are not charities," says Dr. Xie. "The biggest problem is the poor insurance system.".....
......The next day, Mr. Cui made the long road trip to Beijing and stood meekly by his wife as one of the doctors scolded them for getting behind on their payments. "We warned you about this at the very beginning," the doctor said, barely glancing up as her fingers tapped out a message on her mobile phone. "Now you've lost all your money and you'll lose the boy too." Mr. Cui stared down at his feet. His wife said nothing, but her eyes filled with tears.
There's more:
Medical horror stories have become a staple of Chinese state newspapers and investigative television shows. Last month, the China Youth Daily reported that the impoverished family of a 47-year-old migrant worker left her for dead at a crematorium in the eastern city of Taizhou after checking her out of a hospital where she was admitted with a brain hemorrhage. The woman was saved after undertakers noticed her hand moving and saw tears in her eyes. A hospital official confirmed the details of the story, and said the woman was now back in the hospital after donations poured in. The family apparently left her because they were too poor to pay for the treatment.
Government programs aside, demographics are working against the Chinese. With the "one child" policy in effect for so long the mean age of the population is rising, and there may not be enough workers to financially support the elderly in the coming years.
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