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Health and Capitalism in Communist China

As many of you may know, I recently moved from California to Beijing, China.  Today I had my tour of two of Beijing’s western medical facilities.  The first was the United Family Hospital and Clinic.  Their website is here, so take a look through it and see for yourself.  I was met by the Marketing Operations Manager (note the word “market") who gave me a guided tour of the entire facility.  A few brief points:

• This hospital was as professional-looking as just about any US hospital I have ever been in.
• All the rooms are private.  They have regular rooms, which are nicer than most US hospital rooms, and they have VIP rooms, which were nicer than the hotel room I stayed in for the two weeks before I found my apartment.
• All the rooms had en suite bathrooms, and the couches all converted to beds in case family members wished to stay in the room with the patient.
• They are a full-service hospital.  They have a neonatal intensive care unit, MRI scanners, anything you could ever need. 
• They have a full pharmacy.  I had brought along the medications that I take to treat my OCD.  I spoke to their head pharmacist, who looked at the bottles and stated that they had every one of these drugs.  Some of the dosages the pills came in were different than the US, but getting the correct dosage wasn’t a problem, I’d just have to take two or four pills instead of one. 
• I saw one of their maternity rooms.  Everything, from labor through to the birth and follow-up care, is done in this room.  Right down the hall is a surgical room in case a c-section is necessary.

Now, allow me to introduce a couple of the doctors.  First there’s Dr. Chickering.

Dr. Chickering is from the United States of America. He received his undergraduate degree from Yale University, his medical degree from the University of Cincinnati, and his Master of Public Health degree from Johns Hopkins School of Hygiene and Public Health.  He is dual board-certified in Emergency Medicine and Family Practice. Before coming to Beijing, Dr. Chickering worked in the Emergency Department at the Richmond VAMC where he was Clinical Assistant Professor of Medicine at the Medical College of Virginia. In addition to the United States, he has worked for prolonged periods in the Dominican Republic, Guatemala, French Cameroun, and Korea. Dr. Chickering speaks English, French, and Spanish.

Then there’s Dr. Springer, who I was briefly introduced to.

Dr. Springer is from the United States of America. He received his undergraduate degree from Amherst College in Massachusetts, United States and his medical degree from the University of Pittsburgh in Pennsylvania, United States in 1982. Dr. Springer completed his residency in Emergency Medicine at the University of Chicago where he was Chief Resident in Emergency Medicine in 1986. He also completed specialty training in Toxicology and Hyperbaric Medicine. Dr. Springer has taught Emergency Medicine in level one trauma centers in Chicago and California and was an Assistant Professor in Emergency Medicine.

Dr. Springer also has extensive international experience. He has worked in Nepal as a partner in an internationally renowned clinic supplying medical care to expatriates, and in Beijing as Chief Medical Officer at an international clinic. Dr. Springer has been involved in disaster preparedness and emergency readiness aid programs in Asia. He has also been a flight physician on two helicopter emergency services. He has a significant interest in wilderness medical care and has been an expedition physician in a number of remote sites. He ran a high altitude clinic near the base of Mt. Everest and another near Annapurna. He has published numerous papers on Emergency Medicine related topics. Dr. Springer speaks English and conversational French and German.

In other words, this isn’t some dump of a hospital.  I came away from there fully confident that they could handle any issue which may arise.  One interesting tidbit:  the maternity wards have been packed this year.  Apparently in Chinese folklore this is the Year of the Golden Pig, which is a lucky year to have babies.  Hospitals all over the country are swamped with expecting mothers, and the western hospitals are no exception.  Not only are foreigners having babies there, but the ever more affluent Chinese are choosing western medical hospitals as well.

Strange, that in a country with “free” medical care like China people would choose to pay, isn’t it?

The next facility I went to was the International SOS clinic.  You can read about their Beijing operation here.  I have a particular affinity for this company because they saved my father’s life twice.  In 1992, when he had a heart attack in Siberia in the middle of winter, they sent an air ambulance to pick him up and take him to Helsinki, Finland, the closest country with a major cardiac care unit.  (He ended up having a quadruple bypass there.) At any rate I was shown around their facility by the marketing director.  (There’s that pesky word “market” again.) They have a fully stocked pharmacy, featuring a wide range of western over-the-counter medicines, stuff like Immodium and Metamucil and Tylenol.  This facility is not on my company’s insurance plan, so I would have to buy one of their plans myself.  Before I tell you the price, allow me to quote some of their services.

With China’s growing and diversifying economy, our clinics and emergency services are also accessible to Chinese nationals. Our services will expand and continue to meet the growing demands of our members.

We help corporations analyze the cost of their medical care in China, and then work with them to develop solutions that lead to greater operational efficiencies.

At our clinics we offer standard family practice services, emergency medical services and a range of clinical services through a network of providers that is unparalleled in China today.

Each alarm center provides 24-hour hotline services to all our members when they are in China. Any problem, from lost luggage to a serious medical condition, can be reported to the alarm center, where multilingual coordinators and doctors are on duty to respond to all types of emergencies.

We have developed a network of hospitals, airlines and local authorities so that we can deliver a fast and efficient response. Through this network we support the medical staff, equipment and facilities that we provide to our clients at remote sites.

We have an exclusive agreement with the Ground and Air Force Divisions of the People’s Liberation Army (PLA), which gives us access to:

• military aircraft enabling medical teams to reach areas in China which are out of bounds to civilian aircraft
• military aircraft for medical transport: fixed-wing, helicopter and challenger jets under internationally supervised maintenance
• military hospitals, many located in remote regions and often better equipped and staffed than civilian facilities.

Our alarm centers can ship medications to remote locations, provide telephone advice, and guarantee medical expenses anywhere in the country where acceptable medical resources are available.

I walked through their call center.  Sitting at terminals were men and women of every conceivable age and race, speaking every language you can imagine.  They have these call centers all over the world, and they are all linked by satellite in realtime.  The marketing director told me an example of a Malaysian client who was arrested in the Philippines after getting into a bar brawl with some townies.  He had no idea how to speak the language, but he had the number to SOS’s London call center in his phone.  He called, and was put through to a Malay speaker.  He had just gotten the basic details of his legal predicament out when the call dropped.  The London office contacted their office in Manila, who contacted the police, and located the client.  Within two hours they had obtained legal counsel for him, and shortly thereafter he was released from jail.

When was the last time your insurance company did that?  Now, the cost.  Their program named the “Individual Resident Abroad Program” costs $430 a year.  A year. By way of comparison, I am currently paying $263 a month for health insurance in the US, and it’s, shall we say, “less than stellar.”

There are a number of these types of western hospital and clinics and Beijing, and the insurance provided by my company is accepted by most of them on a direct-pay basis—I show the card and get treated for free, much like in the US.  If I go to a Chinese hospital, or to one of the other clinics, I have to pay out of pocket but I get reimbursed.  Even so, I think that for $430 I’d be a fool not to hedge my bets by signing up for one of those International SOS plans.

This, ladies and gentlemen, is how the profit motive provides the highest level of healthcare imaginable, and illustrates with amazing clarity my opposition to government-run healthcare.

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