Hospital is Badly Needed

Yifan got fever from Saturday. Not a very big deal – just the typical fever because of getting cold. However, I took the chance to get to a world that I haven’t touched too much before.

Yifan started to be hot at round 5:00 AM in the morning. Wendy and I got up and sent him to Huashan Hospital. When we approached the hospital, we saw about 100-200 people lining up already. It is obvious that they have been there for a while. They waited just to get a “number” to see an expert doctor. The big gap of healthcare resources and people’s demand for such services is obvious. Among the hundred people, there are 10-20 agents greeted us and asked if we need to “buy” a “number”. They make a profit by getting tickets from either inside the hospital or wake up earlier to line up.

Huashan Hospital does not accept children, so we drove to another hospital – Ruijin Hospital. It is the same there – 100 people lined up at 5:00 AM. I am sure many of them need to go there to line up the second day because of the scarcity of the “numbers”.

18 thoughts on “Hospital is Badly Needed

  1. People want cheap medical service and the government give people cheap medical service, by mandating ridiculously low prices for basic services, without subsides to the hospital. Nobody seems to understand that low price creates shortage.

  2. @ xge:

    You’ve created the most astonishing post I’ve ever read in this blog. You really think the hospitals are charging low prices, and that’s the reason why China is lacking of hospitals?

    Try posting your opinion on a Chinese BBS. You would get drowned in objectors’ slobber.

  3. @Adam

    Have you ever tried to find out the reasoning of my comment besides the astonishment?

    “a typical cough can cost more than one month’s salary”

    This is true. But most of the cost of a typical visit will not be related to the treatment of cough. Do you really think the solution is to lower the cost of treating cough further?

    It is like that the government, in order to appease the public, mandates that ginger root should only be sold at 1 cent per pound, since it is a necessity to people and some people can only afford it at such a price. But when you go to buy ginger root in a store, in order to make money, they always sell you a pound of garlic with every pound of ginger you buy which costs you 10 rmb /pound. Do you really think the solution is to lower the price of ginger to 0.5/pound?

    If people can not afford healthcare services. The government should give people money if it can afford to. The only effect of mandating a low healthcare service price is to shift the blame to hospitals and doctors, while the real problem is low government subsides and absurdly high portion of health care resources consumed by privileged classes.

    Try to imagine what happens when Wen Jia Bo broke his leg instead of you. Will he be standing in line for a number to see the doctor? He probably will even pay for the one pound of ginger he got and be satisfied at the fact that it only cost him 1 cent and be thankful to the wonderful achievement of the government.

    It is only sadening that poor people are also thankful to the government.

  4. Hi, Jianshuo,

    Firstly, I hope Yifan could get well soon.

    Secondly, you are right. There always are so many people in each hospital. I don’t know why so many hospitals say that they have no profits. There are soooooo many patients and the medicines are so expensive, at the same time the doctors offen send you buy the medicine in the drugstores near to their hospital, I don’t know why but I think there is some specail relationship between them.

    It’s terrible!!!

  5. @ xge:

    I see your point: Government is mandating low prices on some medicine/service. But I don’t think that’s the reason why a typical cough can cost more than one month salary.

    Actually we can hardly find medicines with “ginger root” prices nowadays. All medicines we can find in the pharmacy are so expensive. Even if there are still some cheap medicines hiding in the cabinet corners, doctors are tending to “forget” them, since these cheap medicines won’t bring any “incentive”.

    It’s not difficult to find reports, disclosing that the retailing price of most medicines are double/triple/…10 times, even 20 times of the ex-factory price. There is a long profit line to go through before the medicines finally reach patients.

    Maybe you will tell me that hospitals/doctors are not holding the biggest scoop. Well, I won’t argue on that, as I don’t have any proof. But will you be kind enough to share some more inside news with us? I’ve been curious on this for long. Let’s take CT scan for example.

    How much does a CT machine cost?

    How much is a patient charged for each CT scan?

    How many CT scans does a hospital carry out everyday?

    How many years does a CT machine serve?

    It’ll be even better if you could provide info on some other diagnosis/treatment items, such as blood test, X-ray, MR…I’m sure you can easily name a dozen.

    Everyday, we have restaurants, shops, factories closing down. But I never heard a hospital bankrupt.

    One of my colleague once commented: “We must work hard when we are young, so we can have the money to pay to the hospital when we get old.”

  6. I hope Yifan gets well soon… now there are two of you… poor Wendy.

    Unfortunatly this is all too familar to me. I had to spend a lot of time in the hospitals in the past 3 years whenever I was back in China for my father was not well. The hospitals/healthcare in general are not good… in my experiences. Too few hospitals, not enough doctors and nurses, too many people, and pretty low professional care/service standards. It was even “recommended” to us that we give gifts (红包, sometimes) to the doctors who were in charge of the operations etc. etc.

    I don’t know enough about why there are so few hospitals. It seems to me that there are very few hospitals built in my hometown in the past 20 years. The rate doesn’t match the increase of population nor the wealth. Maybe instead of spending so much money on developing aircraft carriers or going to the moon, the goverment could build more hospitals and handicap facilities. Or, let people have the right to open private clinics. It is too crazy that getting an apointment number at the hospital is a business.

    Also, what does it mean… that some hospital don’t take children? I know there are special hospitals that are only for children. But general hospitals should have pediatric departments, no?

    By the way, US is having the hotest debats over healthcare reform right now… I never saw anything like this before. Like it or not, whichever side one takes, people are really speaking out, and loud.

  7. Incidentally, I am in the CT manufacturing business. Below are just some random statistics and comments.

    It is difficult to see companies in high demand bankrupt. If hospitals are in shortage, no matter what the government do, they can always find ways to make profit.

    Low price only discourages new comers and prevent hospitals from making money legally.

    CT machines cost relatively the same across the world.

    When the economic crisis hit the world, China was the only place where we can sell high end CT machines.

    A typical high end CT machine costs more than 10 million RMB.

    The buyers of the high end machines in the crisis are those privileged hospitals which serve the government officials, or the army(For example, Huadong hospital in Shanghai, 301 hospital in Beijing)

    The money mostly comes from Government stimulus found which is intended to build up the social safety net in china.

    A typical Chinese hospital can scan more than 100 patients per day.

    Each scan costs from 300-1000 depending the type of the scan.

    A lot of the scans proscribed in Chinese hospitals are not necessary. I’ve seen doctor order a abdominal scan for patients complaining dizziness.

  8. Thank you very much, xge, for sharing above statistics.

    Now I start to dream of openning a CT clinic beside a normal hospital. I can retrieve the machine investment in one year, and earn 10 million RMB in the 2nd year.

    That’s just the profit for CT department alone. CT is definitely not the only money printer in the hospital.

    “Low price only discourages new comers and prevent hospitals from making money legally. ” If this is still called a low profit business, what is an ideal business? To rob a bank?

    Human greed is so hard to satisfy.

    P.S.

    I do see new hospitals are setting up gradually. Many of them are private. I wish proper competition could somewhat bring down those terribly inflated prices.

  9. Interesting differences in medical culture. We have two young boys and they usually get a few colds and maybe flu every winter. I’m glad we don’t have to take them to a hospital every time, we manage to avoid ‘fever phobia’. If they have a fever, we don’t take them to see the doctor unless they are obviously very ill. Fever is nature’s way of protectig the body from infection. Most fevers are caused by viruses and there’s not much a doctor can do – antibiotics are certainly a waste of time, and may even cause side effects. We usually just give them some cough and cold medicine from the pahramcy and make sure they are comfortable and have enough fluids. If we do go to the doctor, we go to see a family doctor, not the hospital. The few times we have taken children to the hospital for serious illness (asthma, a broken arm) it has always involved long waits and uncertainty.

    As China develops, perhaps it will also build a primary care system for minor illnesses rather than rely on expensive hospitals for family medicine.

  10. More random notes on this topic.

    The best medicine for cold is plenty of water and rest. But has anybody ever seen a Chinese doctor prescribe water and sleep to a patient.

    In shanghai, the doctor’s labor worth 14 rmb /visit. Assuming a hourly rate of 100 rmb for the doctor and he make 50% of the 14 rmb you pay. Then 14 rmb only buys you 4.2 minutes. That’s in accordance with how much time a Chinese doctor usually spent with a patient.

    A CT clinic is not practical right now in China. No Chinese hospital will accept outside CT images if the CT scans are their primary profit source.

    The same CT scan cost 2-3 times less in china then in developed countries.

    A Chinese hospital usually can scan 2-3 times more patients than a hospital in developed countries does.

    A low service price is not good for the private hospitals. It will be very difficult for them to make money if most of the common care is priced too low. Even if some how, they manage to make money, there will be too much legal risk. The same deeds by the government owned hospitals are ok, but it will not be the same for private hospitals.

    If hospitals are in short supply, the government should either invest money to build more hospitals or make policies to encourage others to do so. Making the price too low without subsides is neither.

  11. Last winter, I received mild form of Bronchiectasis when I was in Shanghai, so I rushed to this Huashan hospital for treatment.

    The registration was swift and easy, about 10 mins later a doctor came to see me and typed in my symptoms into a computer, and simultaneously told me the remedy are ready for pick up at the pharmacist desk down stair. The process only taken 2 mins.

    I told the doctor I need Codeine for remedy but to my surprise the hospital does not have a English version of drug list and the doctor does know either.

    After paying 300RMB I received my remedy and it is four different kinds of vitamin pills and are totally irrelevant to my symptoms.

    Finally I received the Codeine pill I need despatched from a doctor in Hong Kong and the symptom disappeared in two days.

    @xge, you are right! Did anyone dispute the quality of the Chinese medical services? and also the reason I asked @JS if there is private clinic in Shanghai.

  12. I visited a good quality private clinic in Shanghai. The physical cost $1000… Almost on-par with the fees in the US.

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