A case of bad oranges in healthcare
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This revelation was not completely new information. My graduation thesis had been about medical care during China's Cultural Revolution, and through my research, I had learned a great deal about China's medical past and present. After Deng Xiaoping's "Open Door" policy, China's previous medical cooperative system collapsed and most of its population (those living in rural areas) were left to fend for themselves. Recent reforms, like the New Cooperative Medical System initiated in 2005 are meant to remedy this lack of affordable healthcare. However, according to the World Health Organization, China, with a population of 1.3 billion and a rapidly developing economy, spends less than 5 percent of annual GDP on healthcare. Healthcare in China is not mandated, but government programs cover about 90 percent of the population. Public insurance does not cover basic care and is used mainly for emergencies. Moreover, while most people end up paying out-of-pocket, the supply of medical services still does not meet demand.
Contrast this situation to the States where 15 percent of Americans have no health insurance and where the medical system predominantly exists in the private realm. Obama's recent healthcare bill was meant to provide a solution to the large number of uninsured. However, a judge from Virginia recently declared the obligatory provision unconstitutional. I don't personally believe the issue is really whether the bill is constitutional or not. The main problem is the bill's inability to tackle key problems – like the growing pressure placed on medical personnel. Like in China, most physicians working in public hospitals are overworked and many run to private practice to pay off medical school loans. Does providing healthcare to 100 percent of Americans really resolve the fundamental problem of American healthcare?
As an American, I believe we as a country are addicted to medical services. What happened to self-prevention, eating right, exercise, and natural healing? Do we need to ask for five tests for a simple cold? Admittedly, there are many problems with the American healthcare system that cannot be easily remedied by a national public health campaign. However, I do not believe physicians should pay the price for individuals who do little to prevent their own ill health. This is not to say that doctors should ignore the Good Samaritan rule or disregard the Hippocratic Oath. Rather, physicians should be part of the conversation, advocating for prevention and limiting the amount of gifts they accept from pharmaceutical companies. I can only hope that in America's reform efforts, we do not go further down the "medical nemesis" path articulated by Ivan Illich in 1975.
While waiting for the results of my blood test (which came out normal), I couldn't help but think, did I really need to take this test for an obvious case of food poisoning? Probably not. However, my case simply demonstrated that what patients demand of the medical system in both China and the States will not necessarily produce the best health results. Just like the orange that made me sick, current efforts at reform seem beneficial, but can cause more problems when you breach the surface.
The author is a Chinese American who currently works and lives in Beijing.
Opinion articles reflect the views of their authors, not necessarily those of China.org.cn
