E. Christiansen on health care in mainland China
Elinor Christiansen, M.D., President of the American Medical Women's Association, responds to Professor Uwe Reinhardt's comments on the health
care system in mainland China:
I believe Uwe Reinhardt is mistaken in his statement that "the Communist Peoples Republic of China on the mainland has a basically capitalist health system with millions of uninsured, among them all children."
The Communist Peoples Republic of China has provided free health care, including immunization and birth control, to everyone living in their country through government assigned clinics for forty years. Their public health achievements have been remarkable with eradication of epidemic diseases such as tuberculosis, malaria, yellow fever, liver fluke and other intestinal parasites, tetanus (which used to be the major cause of infant mortality prior to communism), and sexually transmitted diseases. Unfortunately sexually transmitted diseases and other infectious diseases had crept back into mainland China with opening its doors to the outside world.
Also unfortunately many of the government clinics, especially in rural regions, are staffed by "barefoot doctors" who are persons with minimal education and limited medical training, perhaps similar to a nurses aide, or in some cases an EMT. Some of the government clinics provide only traditional Chinese medicine, whereas others provide Western medicine (usually in urban areas), and some clinics provide both traditional and Western medicine (also usually in urban areas).
Hospitals are exceedingly well staffed with an abundance of well-trained physicians and registered nurses who are often housed in high rise residences on the hospital grounds. Quality burn care, reattachment of traumatic amputations, and organ transplants are done in hospitals in all the major cities with excellent outcomes. And the entire cost is paid by the government. Physicians, nurses and other health care workers are salaried by the government.
Recently, since the Tien An Men episode, retired physicians have been allowed to open private offices to see private patients on a fee for service basis (very modest cost). This recently permitted alternative allows patients (parents and their children who do not want to wait to be seen in the public clinics to which they are assigned a convenient alternative at their own expense.
I do not know Uwe's source of information or misinformation, but if Uwe or anyone else wants to know more about the universal health care which has been in place in mainland China for probably five decades they may contact me.
Elinor Christiansen, MD
R. Covell on health care in mainland China
Ruth M. Covell, M.D., Associate Dean, University of California at San Diego
School of Medicine, responds to Elinor Christiansen, M.D. on health care in
China:
Elinor and I must have been in a different country (5 years ago)....I
experienced good physicians but 1930s equipment, record keeping, technology
etc. in several medical school hospitals.
Elinor and I must have been in a different country (5 years ago)....I
experienced good physicians but 1930s equipment, record keeping, technology
etc. in several medical school hospitals.
Saturday, January 4, 2003
Uwe Reinhardt responds to Elinor Christiansen's comments on health care in mainland China:
We recently visited China and spoke with people both in major medical centers and in the Ministries of Social Affairs and of Health. None of them would agree with Dr. Christiansen. The rural health system has all but collapsed, we were told. The urban system is now run on a fee for service system, leaving out many uninsured altogether. Employed persons usually receive health insurance on the job, but it does not cover their children. That is what we were told.
The system Dr. Christiansen describes would not be recognized by the people we contacted and spoke to.