Tuesday, February 11, 2020

You Knew That China Has A Woefully Tiny Modern Healthcare System, Right?


nakedcapitalism |  ....so like mebbe they have no business phukking around with bioweapons laboratories until they get their basic modern healthcare steez up to snuff? jes sayyin...., DEFENSE IS #1, until that isht blows up in your face.
Delivery of high quality effective medical care and public health solutions in China suffers from a variety of problems. One of the most challenging is low levels of human capital in health care systems. According to one study, China has only 60,000 general practitioners or one per roughly 23,000 people. By comparison, in the United States there are 1,500 people per general practitioner. If all things were equal, this would mean Beijing one of the largest cities in the world would have fewer than 1,000 general practitioners. Nor are many medical professionals well trained. In community health centers, less than one fourth of doctors have a bachelor’s degree. Even as recently as a decade ago, only 67% of Chinese doctors had only been educated up to the junior college level, hardly enough under any reasonable standard to be a highly qualified medical professional.
The human capital deficiencies are compounded by government priorities. Buoyed by nationalistic support from Chairman Xi Jinping to traditional Chinese medicine, it occupies the second largest market share of the retail drug market behind chemical pharmaceuticals 29% to 43%. Leaving aside the weak evidence of traditional Chinese medicine efficacy in clinical trials, it diverts enormous resources from mainline medical service delivery and research at the altar of nationalistic sentiment. Addressing major public health challenges are better targets for public spending than boosting nationalist fervor.
Then oddly enough, health centers might be the only construction market in China to have missed out in the past decade. In 2009, China had 917,000 health institutions but by 2018 this number had only increased to 997,000 increasing roughly 1% a year. What has been happening however is a concentration of larger hospitals who are responsible for majority of growth in visits, bed space, and new institutions. This has led to wildly divergent health services. Primary level hospitals, the smallest hospitals in smaller towns, have bed occupancy rates of 57% while third level hospitals, which are the biggest and most advanced in bigger cities, register 98% in 2018 and 102% in 2014. In other words, in cities like Wuhan, hospitals the primary center of care for corona were already stretched beyond the breaking point.
These facts confirm our reaction when China rushed to construct a new hospital in Wuhan: so what? If you can’t staff it, what are you accomplishing? We had assumed it would be difficult to impossible to get qualified personnel (doctors with expertise in pulmonary ailments) to come to Wuhan even before we learned of the scarcity of medical personnel in general in China. Is the new hospital for show or merely to isolate people known to be sick? My understanding is that another constraint in any medical system, and it is bound to be much worse in China, is that the best hope of saving a severely ill coronavirus victim is to put them on a respirator…equipment not in great supply even in Western hospitals.