News / Asia

China's 'Black Clinics' Thrive as Government Debates Health Reform

An elderly man talks to a girl who was injured after a stampede accident at a primary school, at a hospital in Xiangyang, Hubei province, China, Feb. 27, 2013.An elderly man talks to a girl who was injured after a stampede accident at a primary school, at a hospital in Xiangyang, Hubei province, China, Feb. 27, 2013.
x
An elderly man talks to a girl who was injured after a stampede accident at a primary school, at a hospital in Xiangyang, Hubei province, China, Feb. 27, 2013.
An elderly man talks to a girl who was injured after a stampede accident at a primary school, at a hospital in Xiangyang, Hubei province, China, Feb. 27, 2013.
Reuters
— A one-room shack with a single, bare light bulb on a nondescript Beijing side street is 29-year-old Chinese migrant worker Zhang Xuefang's best recourse to medical care.

Not recognized as a Beijing resident, she does not qualify for cheaper health care at government hospitals, and her hometown is too far away to take advantage of medical subsidies there.

Like millions of other migrant workers, Zhang, on whose labor China's economic boom depends, is forced into a seedy and unregulated world of back alley "black clinics" if she falls ill.

The issue highlights the two-tier nature of China's overburdened healthcare system and goes to the heart of a heated debate about how to reform the contentious "hukou" system of household registration, a cornerstone of government policy for decades which essentially legalizes discrimination between urban and rural residents.

The hukou system, which dates to 1958, has split China's 1.3 billion people along urban-rural lines, preventing many of the roughly 800 million Chinese who are registered as rural residents from settling in cities, and enjoying basic urban welfare and services.

China's new government has vowed to change this divisive system with reforms aimed at sharing more equally the bounty of China's economic growth and consumption-led growth.

Newly-appointed Premier Li Keqiang vowed at his debut news conference earlier this month to press ahead with reforms to narrow China's urban-rural gap, including giving migrant labor equal access to medical insurance.

No details have yet been announced, so black clinics will remain the affordable last resort for migrant workers.

"Health care insurance and other social insurances are closely linked to hukou. Providing better social insurance is, I believe, an incentive to reform hukou system," said Zhang Shuo, a senior health specialist with the World Bank's Beijing office.

"China's urbanization will be unprecedented in speed and scale," Zhang explained. "Portable social insurances is key to encourage labor migration, but it will take some time for a country as big as China."

Dark corner of health system

"Black clinics are the dark corner of China's medical system," said Jiao Zhiyong, a professor at Beijing's Capital University of Economics and Business. "Migrant workers are their main patrons largely due to flaws in the health insurance system."

World Bank's Zhang also pointed out that China's health care insurance system is a fragmented one, mostly coordinated within counties. But migrant workers usually have to seek medical treatment outside their home counties.

The Beijing government has shut down about 1,000 black clinics a year since 2010, according to government figures.

Many, however, reopen nearby or at the same place only days after being closed.

While China has never published numbers for how many black clinics exist, every so often state media reports deaths at these unlicensed health centers.

In January, Chinese newspapers reported that a migrant worker from Fujian province died from a cardiac arrest hours after receiving an intravenous drip to relieve her cold symptoms in a black clinic in one of Beijing's gritty outer suburbs.

Migrant worker Zhang has seen the dangers of black clinics close up. On one occasion, out of fear that authorities might be nearing the illegal clinic, Zhang's doctor locked her inside the clinic, still hooked up to an intravenous drip, as he fled.

"We don't want to go to those places, knowing that the substandard hygienic conditions affect us, but we really can't afford big hospitals," said Zhang, who once paid 800 yuan - a quarter of her monthly salary - for treatment of a common cold at a government hospital in Beijing.

China has beefed up spending on health care reform with last year's overall expenditure at 719.9 billion yuan, a 12 percent increase from the previous year. Yet last year's figures from the Ministry of Human Resources and Social Security showed that only about 20 percent of migrant workers have health insurance.

"To build a countrywide health care reimbursement system is our goal, but there is still quite a long way to go," Hu Xiaoyi, vice minister of Ministry of Human Resources and Social Security told reporters this month.

For those who are insured, reimbursement only comes after payment, and often is complicated by bureaucratic red tape, putting families at risk of bankruptcy when major health problems strike.

"Health insurance works locally, but when we go work in other places, only some provide health insurance, which still requires a lot of procedures. And each could take months and still wouldn't come through," Cao Yong, a migrant worker delegate to parliament, told state radio.

You May Like

Is Air Travel Safe?

Aviation expert says despite tragic losses of Malaysian Airlines flights 370 and 17, industry experienced lowest fatality rate in recorded history last year More

Multimedia 100 Days Later, Nigerian Girls Still Held

Activists holding rallies in Nigeria and several other countries to mark 100th day of captivity for more than 200 schoolgirls being held by Boko Haram More

Chocolate Too Bitter? Swap Sugar for Mushrooms

US food technology company develops fermentation process using mushrooms to reduce bitterness in cocoa beans, believes it will cut sugar content in candy More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
US Carriers Suspend Travel to Israeli
X
Carolyn Presutti
July 23, 2014 1:21 AM
The United States is prohibiting American carriers from flying to Israel's airport in Tel Aviv for 24 hours, because of rising violence between Israel and Hamas militants. The action was announced on Tuesday, after a rocket fired by Hamas militants in the Gaza Strip landed near the airport. As VOA's Carolyn Presutti tells us, international officials soon may have to determine which combat zones are too dangerous for commercial flights.
Video

Video US Carriers Suspend Travel to Israel

The United States is prohibiting American carriers from flying to Israel's airport in Tel Aviv for 24 hours, because of rising violence between Israel and Hamas militants. The action was announced on Tuesday, after a rocket fired by Hamas militants in the Gaza Strip landed near the airport. As VOA's Carolyn Presutti tells us, international officials soon may have to determine which combat zones are too dangerous for commercial flights.
Video

Video NASA Focuses on Earth-Like Planets

For decades, looking for life elsewhere in the universe meant listening for signals that could be from distant civilizations. But recent breakthroughs in space technology refocused some of that effort toward finding planets that may harbor life, even in its primitive form. VOA’s George Putic reports on a recent panel discussion at NASA’s headquarters, in Washington.
Video

Video IAEA: Iran Turns its Enriched Uranium Into Less Harmful Form

Iran has converted its stockpiles of enriched uranium into a less dangerous form that is more difficult to use for nuclear weapons, according to the United Nations’ Atomic Energy Agency. The move complies with an interim deal reached with Western powers on Iran's nuclear program last year, in exchange for easing of sanctions. Henry Ridgwell reports for VOA from London.
Video

Video Relic of Saint Draws Catholics Worried About Immigration Issue

A Roman Catholic saint who is a figure of devotion for those crossing the border into the United States is attracting believers concerned about the plight of undocumented immigrants. Mike O'Sullivan reports from Los Angeles, where a relic of Saint Toribio has drawn thousands to local churches.
Video

Video US Awards Medal of Honor for Heroics in Bloodiest of Afghan Battles

U.S. combat troops are withdrawing from Afghanistan, on pace to leave the country by the end of this year. But on Monday, U.S. President Barack Obama took time to honor a soldier whose actions while under fire in Afghanistan earned him the Medal of Honor. VOA's Jeff Seldin has more from the Pentagon.
Video

Video Ukraine Rebels Surrender MH17 Black Boxes

After days of negotiations, a senior separatist leader handed over two black boxes from an airliner downed over eastern Ukraine to Malaysian experts early Tuesday. While on Monday, the U.N. Security Council unanimously demanded that armed groups controlling the crash site allow safe and unrestricted access to the wreckage.
Video

Video In Cambodia, HIV Diagnosis Brings Deadly Shame

Although HIV/AIDS is now a treatable condition, a positive diagnosis is still a life altering experience. In Cambodia, people living with HIV are often disowned by friends, family and the community. This humiliation can be unbearable. We bring you one Cambodian woman’s struggle to overcome a life tragedy and her own HIV positive diagnosis.
Video

Video Nature of Space Exploration Enters New Age

Forty-five years ago this month, the first humans walked on the moon. It was during an era of the space race between the United States and the Soviet Union. World politics have changed since then and -- as Elizabeth Lee reports -- so has the nature of space exploration.

AppleAndroid