China attempts to fix its failing health care system

By Gillian Wong
The Associated Press

JIZHUANGCUN, China (AP) — Unable to rely on China’s broken health care system, the Ji family was desperate.

Doctors took 15-year-old Ji Xiaoyan off a ventilator and she was discharged because her family could no longer pay her hospital bills. Her uncle cobbled together a makeshift ventilator from bicycle and washing machine parts, driven by a noisy electric motor. The contraption pumped air into the teenager’s lungs for more than a month, until the family got donations for treatment.

“I knew my child didn’t want to leave this world. We had to save her no matter what,” said Yang Yunhua, the girl’s mother.

Such horror stories prompted the government to launch a three-year, $124 billion effort earlier this year to rebuild the crumbling health care system.

China once provided rudimentary but universal care. But as the country shifted from socialism to a market economy over the past 30 years, the health care system has frayed. Nearly a third of the poor say that health is the most important cause of their poverty, according to the World Health Organization.

“People are paying too much out of pocket for their services for their health care. Many are becoming impoverished in the process,” said John Langenbrunner, a World Bank health economist in Beijing.

Affordable medical services could help to reduce China’s dependence on exports by encouraging people to stop saving so much for potential medical costs — and spend their earnings on consumer goods instead.

In Ningxia, farmers now pay 30 yuan ($4.40) a year to join a rural cooperative insurance program that allows them to see a village doctor for 30 common illnesses including colds, bronchitis, and diarrhea for one yuan.

“It’s so convenient. I don’t have to travel far to see the doctor, and it’s affordable,” retired farmer Shi Xiulan, 56, said one afternoon at a clinic in the village of Xihu. She spends 1 yuan for diabetes and high blood pressure medications, instead of the 300 yuan she used to fork out at the county hospital.

It’s too early to declare the Ningxia program a success. A lack of coordination means rural clinics are competing with township and county hospitals for patients, while village doctors are quitting because they cannot earn enough under the new policy.

“I don’t feel like doing this anymore,” said Ji Caixia, a 56-year-old doctor in Lijiajuan, a village in northern Ningxia. “Even the farmers can earn about 80 yuan a day when they do work in the city. I can’t earn any money.”

In Beijing, Wei Qiang said he and nearly a dozen other migrant workers pooled their money for secondhand kidney dialysis machines and treated themselves in a dirty suburban apartment when they started running out of money for hospital treatment.

The parents of Ji Xiaoyan, the teenager who survived on a makeshift ventilator, ended up spending 160,000 yuan ($23,400) to treat her for a rare neurological disorder that paralyzed her from the neck down.

Ji has since recovered partial use of her limbs and no longer needs a ventilator to breathe. Her mother massaged her thin arms and legs as part of a daily physiotherapy routine. Scribbled in white chalk all over the living room’s concrete walls were the names and phone numbers of people who had helped. ♦

Associated Press researcher Xi Yue contributed to this report in Beijing.

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