Wednesday, 11 June 2014

Communist health minister quotes Adam Smith to support privatisation of China's hospitals

by Michael Woodhead
In its inimitable way, the Chinese government is dressing up a very capitalist idea in socialist clothing and presenting it as "a Chinese solution to a Chinese problem". The problem in question being the mismatch between supply and demand in medicine - too many patients and not enough doctors. Or put more simply, overcrowded hospitals. In the Peoples Daily, the former health minister Chen Zhu and leading Communist Party member Chen Zhu is quoting Adam Smith and talking about market solutions to the Chinese healthcare system. He speaks a lot of jargon but the take home message is that doctors deserve to be paid a lot more - they work hard to qualify as doctors, they do a demanding job and work long hours, but get paid a pittance and get no respect. And thus his conclusion is that medical reform must "move into the deep water zone" and tackle doctors' income. Doctors need a high income to be motivated, he says, and the income must not come from sales of drugs - as it does at the moment. Therefore to rebuild trust in the medical system and to put it on a more sustainable path, doctors must earn more - and therefore must charge more. An accompanying article notes that itcosts only 5 yuan to register for treatment at a public hospital, whereas it costs a few hundred yuan for a woman to get her hair done. Why does a hairdresser charge a higher fee than a doctor? [Misleading question - the 5 yuan fee is only to register for treatment - actual out of pocket costs can be astronomical, running to thousands per day for inpateint treatment].
Chen Zhu says "we entrust our health and our lives to doctors but expect them to accept only 5 yuan."
The article says that like many other aspects of Chinese life, healthcare has become a market - and people want the best. The big improvements in roads - and expectations means that people i regional areas are no longer satisfied to go to their local community clinic or county hospital for treatment. When they get sick they get i the car and drive to the big city hospital. Chen Zhu says people have rights to access healthcare, but they also have responsibilities to use the system properly and not to abuse it. He says legislation alone cannot force people to go to community clinics, but there needs to be a more orderly gatekeeper system to stop the overloading of major hospitals - and also the drain of talent from local hospitals and clinics to big city medical markets. His article is short on specifics when it comes to answers - but hints at the usual privatisation slogans of using 'social capital' (ie private investment) and greater flexibility in medical models (ie deregulation) as the way forward. As with so many other areas of Chinese reforms, it's state-directed capitalism decorated with a  few socialist-sounding phrases.

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