What the Chinese healthcare system could learn from ours

It seems China is beating us on every front. They've got some 7,000 miles of high-speed rail tracks, while we have managed to manufacture at least that many arguments against building a high-speed train system. When the U.S. began debating the use of more renewable energy sources, it quickly outpaced us in manufacturing solar panels to sell back to us at a lower price than we could build them. That scenario has been repeated over and over again during the past decade.

But our healthcare system, for all its problems, is light years ahead of China's.

There are a couple of illustrations of this. One occurred a little more than a decade ago, when my new daughter tripped and bumped her head in our Guangzhou hotel room. We were told the hotel had an in-house doctor, whom we visited. His advice: put an egg on her head. No recommendation as to whether it should be scrambled, hard-boiled or over easy.

It turns out that this gentleman was likely a so-called "barefoot doctor," people with little education but receive rudimentary medical training, according to a recent article in the New Yorker magazine regarding medical care. These are the primary care providers for the most populous nation on earth. Actual physicians are rare and their meager salaries are often supplemented with bribes.

And while China is on a mission to ensure everyone has access to healthcare by the end of the decade, that seems highly unlikely. The urban hospitals with trained medical professionals are flooded with patients, and the amount of care one can receive under their government-issued insurance policies vary widely depending on geography. When the author of the article developed a rash while traveling in Yunnan Province last year, the doctor told him the best cure was to leave the area.

As a result of this fragmented, hit-and-miss healthcare system, violence against medical professionals has increased an average of 23 percent a year between 2002 and 2012, according to the China Hospital Management Association. In a two-week period earlier this year, three medical professionals were either murdered or paralyzed by one of their patients. Another patient the article followed, a 17-year-old with an agonizing neurological disorder called nkylosing spondylitis, killed a doctor after the hospital in Harbin refused to treat him because he had tuberculosis--the result of the prior Remicade injections his family had used every cent to pay for. He had traveled 10 hours by train from Mongolia and had been given a days-long runaround before they refused to help him.

Imagine the infection and surgical error rates in this provider environment.

Our healthcare may be overpriced, but it is functional, often highly so. Incidents of violence do occur in hospitals, but for the most part they're isolated and don't lead to murder. We have a tendency to sue instead--which for all the grumbling about tort-happy patients from the medical establishment is a reflection of an evolved society.

The Chinese obviously have a lot to learn in this area. Could we help?

That is not to say that the U.S. healthcare sector should be focused on medical tourism--if the Chinese want to build themselves into a world-conquering power, they have a moral obligation to provide high-quality and well-coordinated healthcare to its citizens.

However, we seem to be the world capital of healthcare consultants, software and hardware vendors, and architecture firms that schedule patients, keep track of their medical records, design efficient hospitals and more or less keep very complicated systems from descending into chaos.

Will the Chinese government make the hard decision and import some of our know-how? Probably not just yet. But if the isolated incidents of violence toward providers get much worse or hardens into an organized movement, it may have little choice. – Ron (@FierceHealthcare)

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