Healthcare in China and USA




From Nanning, China, Istvan Simon writes: Though China's health care system has it's problems, it has been clear to me, ever since I have personally experienced the Chinese Health Care system as practiced in Nanning, Guangxi, China, that the United States must learn from China how to deliver high quality, universally available medical care, at low cost, delivered to a very large and ethnically diverse population, in an enormous country. The way that the Chinese health care system is financed is particularly interesting, because the government in fact spends very little money on health care. Most of the money comes from the sale of medications by the hospitals and clinics where the health care is delivered.

Yesterday I took my wife to a Nanning Hospital for medical care. We paid 3 yuen to see the doctor, 6 yuen for a medical lab test, and 65 yuen for three medications that were prescribed for her. Total cost, including the drugs, was therefore 74 yuen, which is about $9. There are no insurance cards involved, no billing, no expensive administrative costs, and no documents involved in medical care at all. If you are a human being and need medical care, you will be seen and given excellent medical care for the same costs as I just described.

If the same system were adapted to the United States, where salaries are much higher, but removing the expensive and  misguided medical liability laws, litigation costs, the expensive and wasteful administrative costs, and remodeling the obscene pharmaceutical companies' profits, that badly need re-regulation, maybe the cost would have been 20 times that of China, or $180. That would be a small fraction of what it costs now.

Doctors ought to be always well paid, Allowing immigration of large number of foreign doctors would decrease the excessive salaries now paid to doctors, and maybe they would then be content to be paid only say twice as much as I am paid. That would further reduce medical care costs.  Further reduction of costs could be achieved by not covering useless medical care given to terminally ill patients, where medical care is meaningless, and only prolongs the agony of dying. People desiring such medical care could obtain it by buying private medical insurance that covers it. Many sensible people would not, as the medically assisted suicide laws enacted in Oregon attest to.

Daryl DeBell writes: I heartily agree with Istvan Simon and his comments on health care. As a doctor I have always felt that I was adequately compensated, even though my fees were lower than many with less training and experience. My three sons have all gone to graduate schools, and I have a comfortable financial position. I am old and have a number of health problems and regularly incur very large medical bills, which are mostly disallowed by Medicare, with Medicare paying the majority of the remaining amount, while I pay the rest. From the evidence supplied by the MDs whom I treat, it appears to me that MDs' charges account for a relatively small fraction of the costs of medical care, the rest being allotted to bookkeeping, record keeping, preparing and sending reports, (all required by the system) and the totally non-productive. parasitic, HMO operation which includes the profit it makes on each transaction. The Chinese system of relying on drug profits to pay for care does not appeal to me. Eliminating the parasitic HMOs and the useless paperwork might very well make universal health care affordable. RH: Daryl does not mention a major element: malpractice insurance.

Regarding the comparison between medical charges in Ghina and the U,S., Miles Seeley writes: Dr. DeBell is right about only a small part of medical expenses in the U.S. being physician fees. The surgeon who did my two cataracts said that he'd gladly do them for almost nothing, but the main charges were going to come from the hospital facility he uses. As I saw the bills come in, he was right. His charges were $138.00 per eye, and the hospital charges exceeded $6,000. Luckily, Medicare discounted that heavily, and I actually paid a reasonable amount. Now the same thing has happened with my radiation treatments.

Siegfried Ramler writes:Traditional Chinese medicine, such as acupuncture, suction cups, herbal treatments, etc. has a growing following in Western nations, partially explained by the substantial numbers of emigrating Asian practitioners.   During recent trips to China I befriended the director of the traditional wing of the Peking University hospital, a leading medical facility in China. Her comments regarding the current role of traditional medicine in China were interesting. There are two categories of patients in China who seek traditional treatments in preference to Western medicine: the very poor, particularly in rural areas, for whom traditional medicine is much more affordable, and then there are those who elect traditional treatment as a last resort when all else has failed. Generally Western medicine is the preferred option in China.

RH: Istvan Simon did not mention traditional medicine in Nanning.

Your comments are invited. Read te home page of the World Association of International Studies (WAIS) by simply double-clicking on:   http://wais.stanford.edu/ E-mail to hilton@stanford.edu. Mail to Ronald Hilton, Hoover Institution, Stanford, CA 94305-6010. Please inform us of any change of e-mail address.

Ronald Hilton 2004

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last updated: October 8, 2004