Mainland poor are left to count high cost of medical treatment

PUBLISHED : Tuesday, 07 April, 2009, 12:00am
UPDATED : Tuesday, 07 April, 2009, 12:00am

You can afford to be without anything except money and acquire anything except a disease, goes a well-known Chinese saying.

But these two worst-case scenarios are often impossible to avoid for the less privileged on the mainland, who can fall through gaping holes in the social security net.

Gong Bencai, a farmer from Weihai in Shandong province, has amassed a debt equivalent to 10 years' income to save his sick daughter. On a Wednesday afternoon near the registration building of the Peking Union Medical College Hospital, Mr Gong sat patiently next to his luggage waiting to secure a ticket to see a neurologist the next day. There was already a line behind him that would grow hopelessly long during the night. By the time the registration window opened the next morning, those just arriving would be unable to get an appointment to see a doctor.

But the problem of getting access to good medical care is trivial compared with the financial burden of treatment, which can fast-track the families of chronically sick people into poverty. Like many of those queuing with their luggage, the 52-year-old farmer had spent a small fortune on medical costs and had to travel to a 'trustworthy hospital' in Beijing as a last resort to save his loved one because the medical care in his hometown failed his family.

Mr Gong had been in Beijing for eight days in his quest to have a neurologist examine his daughter, 21, to find the cause of her frequent seizures. 'My family has gone 70,000 yuan [HK$79,500] into debt' to treat her, he said. 'I just hope the doctor will tell me she can be cured.'

His savings from his 7,000 yuan yearly income were quickly used up on visits to local doctors and his trip to see doctors in Beijing is proving so costly the family has had to work to keep expenses to a minimum. 'For the past few days we have slept in the corridor of a public toilet to save money on accommodation,' he said.

The family joined the much publicised New Rural Co-operative Medical System, which offers rudimentary insurance to farmers with serious medical conditions or who need hospital treatment. Premier Wen Jiabao has pledged to raise government funding for the scheme, but it remains of little real help to rural families who on average must foot about 70 per cent of their hospital bills.

'The hospital bill was around 7,000 yuan when my daughter stayed at the local county hospital, but we were reimbursed only around 300 yuan. That's peanuts,' Mr Gong said.

The insurance system allows patients to seek care at higher-level hospitals, but refunds are lower and a transfer requires referral from a lower-level medical facility, which is reluctant to grant that because it would mean losing income.

Mr Gong said the local hospital agreed to a referral only after he dragged his daughter to the office and showed them scars on her head from falls during her seizures.

State statistics showed urban health care expenditure was 4.5 billion yuan more than that for rural residents in 1990, but the gap increased to 331.9 billion yuan in 2006.

But even for urban residents who do enjoy basic medical insurance, there are difficult choices to make. Retiree Wang Lanlan, 60, from Ordos in Inner Mongolia, needs an operation to remove a growth on her neck. She is covered for medical costs but has to decide between poor-quality surgery in her hometown, with 80 per cent of the hospital bill covered, or an operation in Beijing for five times the cost, paid for out of her own pocket.

'The operation in the Ordos hospital costs around 10,000 yuan, but I have seen people relapse and even become paralysed after the surgery,' she said. 'The famous 301 Military Hospital [in Beijing] said surgery would cost 50,000 yuan, but I can't afford it. I guess I will just have to endure the pain day in, day out. I don't have money and I don't want to take the risk of being paralysed.'