The crazy health system in China: What’s wrong with it?
Coronavirus is the hot topic these days. Yet there is something nobody has talked about…
How does the Chinese healthcare system work? Here on VisualPolitik we’ve already talked
about how China reacted to the pandemic… but now we want to focus on how their healthcare
system may or may not play a role in this. After watching this video, you will understand
a fundamental piece in this whole puzzle. Let’s get started.
INTRO VISUALPOLITIK
Here is the question we will all be asking in 30 years… Where were you during the Coronavirus
crisis? And I’m sure we will all remember pictures like this one...
https://www.youtube.com/watch?v=GNjQdZ2yvQg https://www.theguardian.com/world/2020/mar/19/china-positions-itself-as-a-leader-in-tackling-the-coronavirus
China sends doctors and masks overseas as domestic coronavirus infections drop
Yes, we have all seen those news stories about China sending aid to European countries. Some
media outlets are already praising China for how they did what needed to be done in order
to contain the infections. Nevertheless… there is something we still need to know:
How does China’s healthcare system work? Could the Coronavirus become the Chinese Chernobyl?
China has been characterized by very low-level, if not non-existent, health regulations.
If you have travelled to China, you might have seen the wet markets where food is handled
without gloves and there are hardly any higiene controls. This is why we started researching
more about their hospitals and their healthcare… is it private? Is it state sponsored? How
does it work? And… of boy! Today’s video is going to blow your mind.
So now the question is… Does China deserve such a bad reputation for their healthcare
system? Why is it that so many Chinese don’t want to visit the doctor? And the most important
of all… does the Chinese Communist Party have some responsibility for the spread of
the disease? Today we are going to answer all of these questions but, since we are going
to talk a bit about health, we are going to be joined by a doctor. Dr. AMYAD RADUAN, who
has a wonderful channel about health in Spanish called GLOBULO AZUL.
AMYAD: Hello Simon and hello to all the VisualPolitik subscribers!
(((HERE IT WOULD BE NICE TO ADD SOME MENTION OF VISUALPOLITIK DE BUT ONLY IF YOU WANT TO)))
Now, before we continue, let me introduce you to a brand new channel: VisualPolitik
DEUTSCHE. Yes, that’s right, now German speakers can learn about international politics
and economics in their own language. So if you have German, Austrian or Swiss friends,
please, let them know about this channel.
… and now, as always, let’s have a look back at the history.
(TITLE: AN ARM AND A LEG)
In 1949, Mao Zedong rose to power in China. He found a vast country that seemed frozen
in time. In most of the Chinese villages, talking about modern medicine was like talking
about the Internet. So having no budget to train the required doctors, he came up with
a creative solution, the so-called ‘barefoot doctors’.
The success of barefoot doctors was its expansiveness. The programme reached 90% of China. The medical
knowledge was not profound but provided three basic services: attending in childbirth, which
reduced infant mortality; carrying out wide-scale vaccinations, which was vital for preventing
infectious diseases; and improving information on the basic hygiene habits of the population,
which went a long way in preventing potential epidemics.
And yes, I know you’re all dying to know. But Simon, did they really go around without
any shoes?
Well, no, they did have shoes. But remember that they were in the country. And if they
had to go into the rice paddies to attend to someone, they had no choice but to go barefoot
if they wanted their shoes to last until the next Five-Year Plan.
But during the 80s and 90s, these barefoot doctors became outdated. The country was growing
fast and the people prospered. Everything was good except two things: the environment
and healthcare. (AUDIO: China Healthcare Costs Forcing Patients
Into Crippling Debt. Fortune)
Think about it: the modern, market-friendly, China, wanted modern hospitals. Those barefoot
doctors sounded like a thing from the past. And the quickest way to get those modern hospitals
built was a fully private system.
The existing health system was eventually privatized. China's new economic policy required
that the Chinese make money. Lots of money. Enough to pay their medical bills. In other
words, they wanted to move from a system of "Equally poor", to, hey, "Wouldn't it be better
to all be rich?"
China's economic growth in these decades is evident. The problem is the usual one: inequality.
By 2000, only 30% of China's population had health insurance. The rest had to show up
with money in hand. A medical consultation was roughly equivalent to a month's salary.
What’s more, in rural areas, medical attention left a lot to be desired. So the Chinese preferred
to go to hospitals in the city. The average week-long stay in hospital could set you back
the equivalent of three months' salary. In addition, China is the only country in Eastern
Asia that charges for childhood vaccines.
Faced with this scenario, diseases that China once had under control have returned. This
is the case with tuberculosis, measles and snail fever. The worst thing for the Chinese
is that health care costs them an arm and a leg and on top of that they have to tip
the doctor if they want to be treated well.
(AUDIO: Chinese doctor took more than $18m worth of bribes, say reports. The Guardian)
However, things have changed in the last 10 years. How? Let’s take a look.
(TITLE: HIMALAYAN VIAGRA)
When the SARS crisis occurred in 2003, the Government decreed that those affected would
receive free treatment. But this created a quandary for the population.
How many Chinese with SARS didn’t go to the doctor for fear that theirs was a normal
flu and then they’d get an unwelcome bill? If your population is afraid to go to the
doctor, this is a problem for any country.
Reforms of the health system that began in China in 2009 have gradually brought about
changes. The main one is that now 95% of the population has health insurance.
But wait a moment because this hasn't solved all the problems either. Insurance only covers
between 50% and 75% of the cost. So when the disease is severe and treatment is expensive,
the Chinese have to dig deep. And not everyone can do that.
In fact, China’s health system combines the worst of both worlds: the worst from a
fully private system and the worst from a universal one.
So, on one hand, the Government wants to help citizens cover the cost of healthcare. But,
on the other hand, they need to control public spending. So what do they do? There are limits
to the amount of subsidized treatment that hospitals can claim from the government: approximately
$1,700 per patient in the best hospitals; considerably less in rural areas. As a result,
very few patients will spend more than two weeks in hospital, regardless of whether they're
healthy or not.
So it seems whichever way you look at it, the system is inefficient. On one hand, hospitals
are being encouraged to treat their mildly-ill patients to collect the maximum subsidies
from the State; but, on the other hand, there is little interest in caring for seriously
ill patients with little means to pay the difference.
And on top of that the cost of healthcare has multiplied for the state. To what extent?
Well about 300 billion dollars a year. To put that into perspective, that amount is
the same as Chile's total GDP or equivalent to the entire Mexican annual budget.
As you can imagine, this is a huge mess. Bad healthcare combined with huge government spending.
So they Communist Party officials met one day… and they came up with something. And
what do you think their great solution was? Get ready for this… traditional Chinese
medicine!
And no, this isn't just something for tourists. Many Chinese continue to believe in the ancient
traditions that have been passed down generation to generation. In a country that didn’t
have modern medicine until some decades ago, most of the people still rely on herbs, acupuncture
and gymnastics.
In 2016, the Chinese government regulated the traditional medicine practice... and because
they needed doctors, they relaxed all the requirements to be a doctor.
You used to need to have a degree in conventional medicine and then specialize in other fields.
Now you just needed to know about traditional medicine and have two colleagues willing to
endorse you.
That’s right! But hold on a moment because, at the time of making this video, there were
already more than 4000 traditional medicine hospitals in China. Do you think I am exaggerating?
Do you think this is a conspiracy theory? The truth is that, as far as the Chinese officials
are concerned, this is far from a secret to be hidden. In fact, the Traditional Chinese
Medicine, also referred as TCM, is something to be proud of. Just check this out.
AUDIO: China now has 4,238 Traditional Chinese Medicine (TCM) hospitals, with 877,000 beds
This news is not from any anti-China, Western imperialist outlet. This is XINHUA NET, the
official news from the Chinese Communist Party. In other words, they brag about how much they
use their Traditional Chinese Medicine! And this is especially popular in rural areas.
So, for example, some treatments include dried geckos. According to some, those would cure
some types of tumors. If you have erectile dysfunction, you can try the so-called Himalayan
viagra. This is a mushroom that grows…You guessed it!, in the Himalayan mountains! And
the demand for these mushrooms has increased so much lately that one kilo of this miraculous
and natural medicine can cost more than 110,000 dollars!
And, I know, I know what some of you might say… there is currently a debate even in
Western countries about Traditional Chinese Medicine. But so far, there is no clear evidence
that it works. Both the British NHS and the American Secretary of Health do not advise
those treatments. Then again, the WHO has included some of Traditional Practices for
diagnostic purposes only. We should also consider that China is a member of the WHO and they
have been lobbying for decades in order to promote TCM.
Maybe some of you think because these are natural remedies they cannot be bad, right?
Well… you’d better think again.
(AUDIO: Report: One fifth of China's soil contaminated. BBC)
So, to give you an example, in 2013, they discovered that some rice harvested in China
contained Cadmium. Cadmium is an element that can cause cancer. This is just one of the
many scandals. So, if there is contaminated rice, there could also be contaminated herbal
treatments. Think about it this way… when you release a brand new pill to the market,
you have to go through lots of clinical tests. Meanwhile, the himalayan viagra comes straight
from the field. It is much harder to detect dangerous trace elements.
At this point you might be wondering… what does this have to do with coronavirus? Get
ready.
(TITLE: THE BATS ARE BACK IN TOWN)
I know what many of you are thinking. What's the problem with traditional medicine? If
you don't believe in it, don't use it.
The problem is when someone turns away from modern medicine and throws themselves into
the arms of a charlatan. Then you get things like this happening.
(AUDIO: A Chinese alternative medicine empire is under fire after doctors say it gave jujube
tea to a 4-year old cancer patient: Washington Post)
The other danger of traditional medicine is ecological. Yes, that’s what I said: ecological.
For some reason, many traditional "treatments" ((COMMA GESTURE WITH FINGERS))) require rare
and endangered animals. Animals of which there are few specimens left. And then, suddenly,
they become extremely desirable. That's the case with the RHINOS, PANGOLINS and… BATS!
And here is where coronavirus comes into the picture!
AUDIO: rapid classification of betacoronaviruses and identification of Traditional Chinese
Medicine as potential origin of zoonotic coronaviruses
Of course, this is just a study with a theory! You see, this is not the first time there
has been a coronavirus epidemic. The SARS was also another type of coronavirus. And
the original host that passed this virus to humans was a bat. The second coronavirus outbreak
was the MERS, that one originated in Saudi Arabia in 2012. In this case, the animal that
transmitted the virus to humans was a camel. But the camel had been infected by a bat.
In other words, it seems that some types of bat might be natural hosts for some coronaviruses.
And it turns out that those type of bats are used in Traditional Chinese Medicine.
It is not yet known what caused the current coronavirus crisis. Some theories pointed
to bats, others pointed at pangolin. Obviously, we at VisualPolitik don’t have the answer.
What we do know is there is someone influential who encourages the Chinese to eat weird things
thinking they cure all ailments. And he is... this gentleman.
(AUDIO: Xi urges enhanced efforts to promote Traditional Chinese Medicine. Chinadaily)
And why the big push from the top? Well, it all comes down to money. Because traditional
Chinese medicine is cheaper, it is much more popular. According to official Chinese figures,
traditional medicine has reduced hospital expenses by 24% and outpatient costs by 12%.
According to Xi Jinping’s narrative, what we call science-based medicine is just Western
medicine. Traditional medicine is just another type, just as good and as bad as science.
Or maybe it really is better? At the end of the day, it is Chinese! And it is 4,000 years
old! This could be the proof that this ‘socialism with chinese characters’ is better than
Western democracies… couldn’t it?
All of this explains China’s efforts with promoting TCM all over the place: at the WHO
and also legacy media. Oh! Do you think I am talking about fake news now? Of course
not! I’m talking about media outlets like this one.
AUDIO: Coronavirus: Can Traditional Chinese Medicine help fight the disease?
This headline is from DEUTSCHE WELLE, which is the German equivalent to the BBC. I mean…
we are talking about an authoritative source, with an undisputed reputation. And, of course,
Chinese official media can go even further.
AUDIO: Traditional Chinese Medicine treatment effective against novel coronavirus, says
official
So the question is… are bat-based treatments the origin for coronavirus? We definitely
don’t know the answer to that one. Maybe we never will. There is only one thing we
can tell you: if that were true, China would hardly admit it. Why do we know they would
act that way? Here is a clue.
(AUDIO: Chinese Doctor, Silenced After Warning of Outbreak, Dies From Coronavirus. NYTimes)
Once again, it’s up to you to form your own opinion. But it is hard to imagine China
being transparent about this. In fact, they have every incentive to cover this whole crisis
with a huge dose of propaganda. Think about it this way… these last two years have been
a nightmare for the regime. First, the Hong Kong protests, then, the trade wars and now
coronavirus. This pandemic could easily become the Chinese Chernobyl. Just like Chernobyl,
this is not a conspiracy. Nobody wanted the plant to explode. It was the lack of security
measures and the lack of transparency that led to the reactor blowing up. Something similar
could happen here. There is no conspiracy, no master plan but… Can we really say China
has acted responsibly in this matter? Do you think the Chinese Healthcare system did play
a role here? Will this coronavirus have a political impact in China? Please, leave your
answer in the comment section below.
And if you speak Spanish and want to learn more about healthcare, check out my channel,
GLOBULO AZUL!
Before we finish, I would like to thank AMYAD, from GLOBULO AZUL for helping us on this video.
If you want to know more about health and you speak Spanish, please do check out his
channel. Also remember to visit our friends from reconsider
media, the podcast that provided the vocals on this episode that are not mine. If you
liked this video, subscribe and hit that bell button so you won’t miss any post. And,
as always, I’ll see you next time.