As COVID ripped across China and filled emergency wards, privileged patients cut hospital queues because they knew someone, offered a bribe or paid people with connections, said three people who accessed care through such means and seven doctors in six cities.
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The practice has long been commonplace in navigating an under-resourced Chinese health system that was severely stretched after Beijing abruptly ended its zero-COVID restrictions in early December, with widespread reports of packed hospitals and mortuaries, Asahi Shimbun reports.
China had only 4.37 ICU beds per 100,000 people in 2021, compared with 34.2 in the United States as of 2015, according to a paper by Shanghai’s Fudan School of Public Health.
Connections can take the form of the patient being a government official, connected to one, or being related to a medical worker, the doctors said.
“The higher and more senior your connection, the better the treatment, or the easier the queue-jump. If you know the head of the hospital, then there won’t be trouble getting a bed,†a Shanghai doctor said.
The practice has long been commonplace in navigating an under-resourced Chinese health system that was severely stretched after Beijing abruptly ended its zero-COVID restrictions in early December, with widespread reports of packed hospitals and mortuaries.
China had only 4.37 ICU beds per 100,000 people in 2021, compared with 34.2 in the United States as of 2015, according to a paper by Shanghai’s Fudan School of Public Health.
Connections can take the form of the patient being a government official, connected to one, or being related to a medical worker, the doctors said.
“The higher and more senior your connection, the better the treatment, or the easier the queue-jump. If you know the head of the hospital, then there won’t be trouble getting a bed,†a Shanghai doctor said.
“Many of those rural patients, COVID patients, that had severe symptoms would choose not to proactively seek care; instead they just die at home,†Huang said.
In 2020, 546,657 new medical workers joined the system, according to the National Bureau of Statistics, the fewest since 2017.
“You get 10,000 yuan ($1,463.70) to 15,000 yuan a month; what kind of money is that for the long hours and the expertise?†said a trainee doctor in wealthy Shanghai, adding that physicians are often in their mid-30s by the time they qualify for such a salary. “It’s humiliating.â€
In smaller cities, new doctors can earn as little as 3,000 yuan to 5,000 yuan a month, said two doctors in a city in Sichuan province.
“If you can live and have enough to eat off your salary, then you’re already doing very well,†one of them said.
Access-granting gifts such as expensive tea and red packets with money are often given to the lead doctor, but also sometimes to the head nurse and the person who made the connection. That can lead to a total care bill that is double the official medical cost, said two people who recently made under-the-table offerings.
“For many of the doctors in hospitals, their main income is not from their basic salary, it’s from grey income, the red envelopes they receive from the patients, despite the crackdown on corruption in the healthcare sector,†Huang said. ■