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Nation
Nation
UPDATED: March 1, 2007 NO. 10 MARCH 8, 2007
Healthcare Under Fire
Tension between patients and hospital staff, insufficient health insurance coverage, and a limited supply of quality medical services have caused pressure for a reform of China's healthcare system
By LI LI
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Doctors and nurses, normally seen as protecting their patients, are increasingly coming into confrontation with them due to the dysfunctions of China's healthcare system, and in some cases tension has even led to physical violence.

On December 24 hospital staff at Shanxia Hospital, a private 460-bed hospital in the southern city of Shenzhen, were issued with helmets to protect themselves against potential attacks from friends and relatives of the victim of a traffic accident, who had died unexpectedly in the hospital after initially responding well to treatment.

The accident victim's family demanded compensation but refused to allow an autopsy to be performed on the body as suggested by the hospital. Meanwhile, the hospital's president objected to being made to pay compensation to the victim's family without an autopsy to confirm the cause of death.

Commenting on the protective gear, a hospital official told the official Xinhua News Agency: "It's kind of weird but we have no other choice. For our safety, our hospital decided to give everyone a helmet, including doctors, nurses, accountants and even utility men."

While the Shenzhen situation is extreme, it reflects growing tension between staff and patients across China, according to Mao Qun'an, a spokesman for the Ministry of Health. "The hostility between hospitals and patients has never been more outstanding in Chinese history," he said.

This tension is one of a multitude of problems facing China's healthcare system, which has been failed by reforms over the past two decades.

While the Shenzhen drama was unfolding, the Chinese Academy of Social Sciences released its 2006 report on China's development trends. The report concluded that "difficult and costly access to medical treatment" has for the first time surpassed "unemployment" and " excessive income disparity" to become the primary concern of Chinese citizens. The study also found that medical care expenses on average accounted for 11.8 percent of non-food household expenditure over the year. That figure approaches the highest historical record for medical care spending in China, according to the main author of the survey Li Peilin.

Failing reform

According to a joint study conducted by the Chinese Government and the World Health Organization in mid-2005 that reforms of China's healthcare system have been "basically unsuccessful." In fact, reforms have resulted in declining levels of both fairness and the efficiency in the sector.

The "business- and market-orientation" route that China's healthcare system has taken is "absolutely wrong" and conflicts with the proper goal of public health, it concluded. "There are obvious flaws with the urban medical insurance system and its prospects are not good."

Speaking at a national medical work conference in January, Minister of Health Gao Qiang, said the four pillars of a new round of medical reforms would be: a basic health care system; medical insurance coverage at all levels; a basic medication system; and a better management system for public hospitals. The outline for this fresh reform is expected to come out later this year.

China's phenomenal economic growth in recent years has failed to translate into improvements in the public provision of social welfare services. Economic reforms designed to reduce government spending on social services and to shift more of the burden for social welfare onto individuals and decentralized economic units, have widened the healthcare gap between urban and rural populations and poor access to healthcare has been a major failure of medical system reforms.

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