Cross-cultural communication （100）　

102) A Look at the State of Healthcare in Modern China
There was an interesting article in the September 1st 2020 morning edition of the Nikkei newspaper, a translation from the British magazine The Economist, on the topic of “China's doctor shortage caused by low income”. I knew from various public sources that the quality of medical care in China a few decades ago was quite poor, with a significant gap in the skills of doctors and the equipment of medical institutions compared to the developed countries of the time. However, despite being the country that was the initial source of infection with the new coronavirus, according to the news reports, the measures taken were quick and the quality of medical care seemed to have improved considerably. However, according to this article, it seems that this is not the case.

There is a modern Chinese saying that goes “The doctor's child does not become a doctor”. Also, there have been many recent incidents of doctors being bribed and incidents of the production of counterfeit medicine. The icing on the cake is that, according to a 2017 survey by the Chinese Medical Association, more than two out of every three doctors have been assaulted or threatened by angry patients or their families. According to the article, the root of this problem is the poor treatments of doctors. Even experienced doctors in China earn an average annual income of 100,000 yuan (about 1.5 million yen=10,000 US dollars), which is not a very high income in a big city, or rather, it is too low for doctors in the world's second largest economy.

From here, I would like to share my thoughts on this information. In China, where there are said to be tens of millions of super-rich people who earn far more than the highest-paid people in Japan, the annual income of 1.5 million yen (10,000 US dollars) for doctors who are part of the country's 'elite' is nothing short of shocking. This is hardly a motivating factor for doctors to try to increase their medical knowledge or improve their medical skills. It's not hard to understand why Chinese doctors are sometimes assaulted or threatened by patients' families due to a lack of knowledge or skill. Extremely low incomes for doctors were not just a problem in China, but also in Russia during the Soviet era, and it seems that this is still the case today. Under communist and socialist systems, regardless of occupation, incomes are low across the board. Since 1990, China has suddenly changed to capitalism in terms of the economy, but has retained communism in terms of politics, while Russia has changed to capitalism in both respects. I think that in both countries, the income of doctors was left as it was. As far as I know, the hospitals used by Chinese Communist Party officials are well-equipped and have good doctors, so they can receive medical treatment on a par with that in developed countries. Considering this, I think that Japanese medical care is far more truly communist than China, which is currently the only “rich communist country”. Whether they know it or not, I feel that the Japanese media only think about denigrating Japanese doctors and medical care.

So, here is my own conclusion. In order to protect the lives of its citizens, China should at least increase the average income of its doctors to ten times the current level. Even then, it would still only be about the same as a small fortune in China today. On a related note, I would also like to say a few words about Japan's healthcare policy. The rigidly fixed “universal health insurance” system is causing doctors to become increasingly exhausted. This has become even clearer with the current COVID-19 pandemic. We should have a system that allows confident doctors to legally provide transparent, free medical treatment at a fixed rate, as has been done for a long time in ordinary European countries with universal health insurance. Politicians, members of the media, and executives of the Japan Medical Association, please read “Akahige Shinsh?tan” (Tales of Akahige, Red beard) by Shugoro Yamamoto again. Akahige did not charge the poor, but he charged the rich as much as he wanted.

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