Shades and variations Pure, or solid red, the color of most ripe raspberries. Scarlet is one quarter of the way between the colors red and orange.
The Chinese have a saying: This is evident at 8am in the foyer of a hospital in Kunming, the largest city in Yunnan Province, south-west China. This is the frontline of healthcare in China because there is no primary care gatekeeper system to filter and triage.
Since the early hours, scores of people with minor ailments have arrived, hoping to claim a place in one of the outpatient clinics. Many of them are poor families from rural areas, who have come to the city because they have little faith in their primitive township clinics and under-trained barefoot doctors.
To see a doctor at a Chinese hospital, you first have to register and pay a cash deposit.
Because of the value of the registration tickets, scalpers exploit the economic possibilities and are brazenly working the queue, reselling tickets for many times their face value. And faced with long and often unsuccessful waits to get a clinic appointment, there is no shortage of willing buyers.
Hospitals are state-owned enterprises that receive meagre funding from government following the market reforms of the s. To cover their operating costs, hospitals resort to a wide range of surcharges that inflate medical bills.
They have also come to rely on the commissions they charge on medicines, tests and procedures. While most Chinese citizens are, in theory, covered by a national health insurance system, in practice, the caps, exclusions and lack of portability of these policies means that most people still face high out-of-pocket fees.
Healthcare in China is strictly user-pays: This is the routine first-line treatment for any patient with a fever, cough, cold or gastro complaint in China. Chinese doctors know antibiotic infusions are not best practice for minor illnesses, but infusions have become embedded in routine care because doctors depend on commissions for about a quarter of their monthly income.
Senior doctors, especially those working in procedural specialities such as orthopaedics, can make considerably larger sums of money from commissions.
The government is trying to tackle this well-recognised cause of overservicing by banning drug commissions and allowing hospitals to charge higher consultation fees.
However, the early signs from pilot programs carried out in regional and rural healthcare facilities suggest that hospitals simply shift from drug mark-ups to additional fees for services.
Violence against doctors Unsurprisingly, this mix of overservicing and overcharging is a source of widespread public distrust of doctors and hospitals.
The feelings of being short-changed extend to the short consultation times. But not so in China, where doctors working in clinics routinely see patients during a four-hour shift.
I eat at my desk," one doctor told me during my visit to the hospital in Kunming last year. A patient can expect to be with the doctor for about three minutes — six minutes if they are lucky.
The perfunctory nature of such medical consultations means some patients resort to verbal and physical aggression to vent their frustration over perceived mistakes or miscommunication. Violent attacks against medical staff are commonplace.As a follow-up to Tuesday’s post about the majority-minority public schools in Oslo, the following brief account reports the latest statistics on the cultural enrichment of schools in Austria.
Vienna is the most fully enriched location, and seems to be in roughly the same situation as Oslo. Many thanks to Hermes for the translation from skybox2008.com China News on medicine, healthcare and pharmaceuticals in China, independent and updated daily by Michael Woodhead.
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