[File under ... Department of Just When You Think You've Heard Everything]
During the course of my still young years, I’ve spent enough time embroiled in the US and Chinese medical systems to know that nobody’s perfect, and some systems are even less so. Still, not all things are equal, and once in a while something happens to remind me of why – if given the choice – I’d still rather receive medical care in the US than in China (despite the lower costs here).
And that brings me to this little story.
This past week a friend in Shanghai learned that he had a serious medical condition requiring as-soon-as-possible surgery. The timing couldn’t have been much worse: the Chinese New Year starts next Sunday night, and most of China – and its health care industry – will shut down for two weeks. Anything beyond emergency medical treatment (ie, something involving an ambulance) will be nearly impossible to obtain. The practical result is that Chinese hospitals – and surgical wards, in particular – are booked solid with patients in need of care before the holiday sends the doctors jetting to warmer climes.
My friend is luckier than most. Despite receiving a diagnosis on the verge of Chinese New Year, he was able to secure a surgical appointment for Monday (today, this morning, barely a week after the diagnosis). There was just one problem: he was told that he’d need to check into the hospital as soon as a bed became available … and that happened to be Wednesday, fully five days before the scheduled surgery. The hospital (an awfully good one by local standards) told him that if he declined the Wednesday bed and the Monday appointment, the “opportunity” would be passed onto the next cust – er, patient – in line and he’d have to wait until after the Chinese New Year. At the earliest.
Now, keep in mind that my friend’s condition – though serious – will only require hospitalization after the surgery. For now, he’s fully capable of living his day-to-day life without any assistance whatsoever. But he does need that surgery, and so – with more than a little reluctance – he’s been spending his days at the hospital, reading books in between having his temperature taken.
In fairness, I have no idea if the hospital’s offer is more the result of a hobbled bureaucracy incapable of efficiently allocating its beds and services, than it is a matter of gross profiteering. But the end result is the same: my friend has spent five days paying for a hospital bed that he didn’t need, and from which he’s been exposed to a zoo’s worth of pathogens.
At some later date, I’ll have much more to say about the extreme market-oriented nature of Chinese health care (it is, in many ways, much more so than what exists in the US). But, for now, I refer readers to this excellent 2007 article from the Guardian which offers a range of disturbing statistics that haven’t changed much since it was written.
Just for calibration, how much is your friend paying for his hospital stay for each day for these 5 unneeded days? Perhaps this might be expressed as a percent of his daily salary since absolute numbers are probably not all that useful.
How was he assigned to this hospital and the surgeon?
Rich -
I’m afraid that I don’t know the answer to the first question, and – for reasons of privacy – I can’t really answer the second one. I will say, however, that employer-provided insurance is covering most of the cost.
I remember getting a terrible sore throat and bad cough when I first arrived in China. I visited a doctor in Shanghai and he prescribed two bottles of cough syrup, four boxes of Chinese herbal tea (both for hot and cold illness for those familiar with Chinese medicine), and a two week supply of antibiotics. When I picked it up from the pharmacy the other patients laughed when the saw the bag of medicine that I received. The total was about 2/3 more medicine than what he advised I take.
In another instance, a Chinese friend of mine took a day off work for a bad cough and went to the hospital to get a doctor’s note in order to get the day off counted as a sick day. The doctor refused to write the note until my friend filled the prescription.
There are lots of stories like these. I don’t know about other cities, but at least in Shanghai you can get a lot of medicine from antibiotics to antidepressants from pharmacies WITHOUT a prescription so you can avoid the doctor if it’s something minor. Of course surgery is another matter.
Having said all of that, even with the over-prescribing one doesn’t pay nearly as much as one would in the US for a visit to the doctor.