Wu Guangqiang

    jw368@163.com

    CHINA’s health care system is ailing and calling for an immediate cure. One of the obvious symptoms of the illness is that both patients and doctors are unhappy. It’s all in a day’s work that dissatisfied patients physically attack medical personnel, sometimes with deadly consequences.

    A survey conducted by the Chinese Hospital Association showed that 47.7 percent of Chinese hospitals experienced violence induced by medical disputes — including verbal insults, physical attacks and homicides — in 2008, but the figure rose to 63.7 percent in 2012, with each hospital witnessing an average of 27 cases in 2012 against 21 in 2008. No more recent statistics are available, but it’s believed that violent incidents have been on the rise in recent years.

    Both patients and doctors have grievances.

    It is a chronic problem that patients find seeking medical services too difficult and expensive while doctors and nurses, most of whom are caring and hardworking, find themselves unfairly treated.

    Patients have to rush to the hospital in the early morning to secure a place in a long line so that they have a chance of seeing a doctor. Normally, there are enormous lines in most State-run hospitals every day.

    But after so much effort, the services patients receive at hospitals are often barely satisfactory. Driven by pressure to make their hospitals profitable, some doctors try every means to woo or threaten patients to accept unnecessary tests or surgeries. A patient with a minor cold could be asked to take a dozen tests. In some hospitals, cesarean births account for 90 percent of the total deliveries. The World Health Organization recommends a national C-section birth rate of only 5-10 percent. Some patients who only need a cast for a minor fracture are often pressured to have artificial joints implanted.

    Medical personnel have their own complaints. Most city hospitals are understaffed while the doctors and nurses are overworked. Most medical workers are conscientious and professional, but they frequently become the victims of violent medical disputes. Dissatisfied with treatment outcomes, patients or/and their family members vent their anger at doctors and nurses.

    Behind the doctor-patient tensions lies the fundamental conflict between the soaring demands for quality medical service and the acute lack of medical resources. Reforms in recent years have extended health care insurance to 95 percent of the population — most of whom have never had insurance before — a development that has caused serious strains on the delivery system. Now that consumers have access, everyone wants to go to major academic health centers, but medical facilities and workers have not been increased to meet the new demands.

    In Shekou, where I live, the residents had two hospitals 20 years ago. The population has surged 10-fold since then, but the two hospitals have merged into one. Despite the slightly increased capacity, it is far from sufficient to provide satisfactory service to the enormously expanded population.

    China has enacted two major reforms in the health care system in the past decades. The first one, a market-oriented act in the 1980s, proved a failure. The day hospitals became profit-chasing enterprises, chaos began. The second reform that started in 2009 redefined the government’s role as the financial provider for the health care system and other public products.

    The second reform is on the right track but has been far from successful. On March 30, the government unveiled a five-year roadmap for the overhaul and revamp of the medical system.

    Medical reform is a global challenge, as, fundamentally, it is about balance between the three sides of an “Iron Triangle,” a phrase that describes the three main cornerstones of health care: access, cost and quality.

    Huge spending is necessary to build more hospitals and train more medical personnel, but without an effective mechanism of oversight and examination, service quality will not improve automatically and medical resources may suffer enormous waste.

    Medical resources should be more evenly distributed to divert more patients to grass-roots clinics to relieve stress on major hospitals. Advanced technology can play a more active role in this regard.

    Shifting emphasis from cure to prevention is a better policy.

    (The author is an English tutor and freelance writer.)