Market credo tarnishes healing arts as profit comes before people
- By Wan Lixin
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Shanghai Daily, December 9, 2011
Healing as business
Some top hospitals are reaping 1 to 3 billion yuan (US$159 to 476 million) in annual revenues, and are very smug about their profits, just like successful businesses.
To increase their profit margins, these hospitals all place particular emphasis on exclusive "special service treatment" that caters for the wealthy.
Another lucrative business is to put to clinical use techniques that are still being tested, such as numerous stem cell treatments.
The push for profit further worsens the already unfair distribution of limited health resources, often at the expense of rural and remote areas.
Before market reform was kicked off 30 years ago, China boasted one of the world's most extensive state-subsidized rural health care system that benefited 90 percent of the rural population, and was the envy of the world.
In 2003, the percentage of medical coverage in cities dropped to 43 percent, and to 3.1 percent in rural areas.
In cities medical services steadily gravitate towards the affluent and the privileged.
In 2000 and 2005, the United Nations' World Health Report evaluated 191 national public health systems for equitable funding of medical services, and China ranked 188th, behind Ethiopia and Honduras.
It is common knowledge today that some patients need to favor some doctors with "red envelopes" (cash) to be hospitalized or undergo surgery.
These developments reflects the domination of capital in medicine.
According to professor Du Zhizheng, an expert on bioethics, the domination of capital means the pursuit of capital in medical services to expand capital and maximize profits.
Commitment to these purposes leads to such problems as over-medication, ostentatious medicine (showing off technology), or treatment of fictitious diseases. These tendencies obstruct the more sensible policies of putting prevention first, or paying equal attention to prevention and treatment.
Another tendency is the domination of technology, in which the practice of medicine, the management and operation of hospitals and the professional aspirations of the medical staff are subjugated to science and technology, rather than human beings.
Cult of technology
This unrelenting pursuit of technology can lead to inhuman, criminal consequences.
Last year the US government apologized for a 1946-48 experiment in which US government researchers used prostitutes to deliberately infect prison inmates in Guatemala with syphilis.
The experiment was conducted to test the effectiveness of penicillin, which was relatively new then, in treating sexually transmitted diseases.
The superstition about technology, while enormously profitable for hospitals, also encourages many patients to entertain such unrealistic illusions about medical treatment that they simply cannot accept failures.
American bioethics scholar Pelligrino observed that "most clinical choices are made without the certainty of having all of the facts, without knowing what the future is going to hold ..."
Even for those with the most resources for the prolongation of life, it must be acknowledged that his or her earthly tenure will end in the form of a medical failure.
As a Chinese proverb goes, herbal roots and stalks (common elements of traditional Chinese medicine) can cure illness, but cannot save life.
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