White Coat Underground

China—a (medical) capitalist paradise

China’s a communist country, totally different from the capitalist U.S., right? They probably have some sort of socialized health system that makes Canada look downright libertarian. Right?


I was talking to a friend (who I’ll call “Pu”) this week. She was surprised that I had to bend over backward to get someone insulin.

Pu: “In China, this would never happen.”

Pal: “Really? You mean because the State would take care of it?”

Pu: “No. In China, you pay a deposit for your care, and have to pay as you go, or that’s it. Can’t afford insulin? Tough. Go home and die.”

Hmmm…socialist paradise.

She told me about her father’s open heart surgery in a major Chinese city.

Pu: “They gave my mother a slip of paper to pay a deposit. During the surgery, the Chinese valve was a bad fit—they needed an American one. So they stopped the surgery and told my mom to go to the cashier and pay like $6000.00. Then she came back, rang a bell and gave them the receipt, and they finished the surgery.”

Pal:“Um, what would happen if she didn’t have the money?”

Pu: “They close him up and send him home and no one complains.”

She also told me how doctors are paid on the grey market. Grey market brokers introduce patients and doctors, and money is passed under the table to both the broker and to the doctor. If you want surgery early in the day, when the surgeon is “fresh”, it may cost you $3000.00 extra dollars. If you don’t mind care later in the day, maybe only $1000.00.

It’s a nearly ideal free market. You pay more for more, less for less. A libertarian paradise.

So, do you think the U.S. needs more free market in health care?


  1. #1 Jared
    August 30, 2009



    Really, why do we have to explain this to people? Are they that ignorant of the world around them?

  2. #2 red rabbit
    August 30, 2009

    Wow. I thought “rationing” and “death squads” were scary. Holy crow.

  3. #3 mxh
    August 30, 2009

    If anyone in the US had some guts (and weren’t deathly scared of the Chinese), this is how the misinformation of the republicans should be countered.

  4. #4 JThompson
    August 31, 2009

    @Jared: No, it’s even worse than ignorance. Most know exactly what they’re pushing for, they just don’t care.

  5. #5 Dianne
    August 31, 2009

    When people complain about the cost of “socialized medicine” I sometimes point out that the US spends more money on medicine than any other country and that it is also among the top spenders of public money on medicine. So what we have now is clearly an inefficient, not cost effective system.

    There are two ways to go with this. There’s the “socialist” route of making sure that everyone has health insurance. This can be done by the German/Swiss method of multiple payors but with public backup or by the Canadian model of single payor everyone covered. Either would likely be cheaper (after the initial set up costs) and either would probably be better for public health.

    The alternative is the “capitalist” model that the Chinese appear to have adopted: The patient pays or he/she doesn’t get care. Many people are all for this until you point out the consequences: Suppose you walk to the corner store (or go for a jog or run out to get the paper, etc) one morning without your ID and insurance card. Unfortunately, you’re hit by a car and knocked unconscious. The ambulance arrives to take you to the hosptial but leaves you there because you have little money on you and no evidence of insurance. Or your house catches fire. You are badly burned and your ID goes up in smoke. You’re left to die painfully for lack of proof of insurance. And so on. Few people are willing to take that risk. (And I usually don’t even get to what happens if your job or insurance disappear…)

  6. #6 Theodore
    August 31, 2009

    Let’s not be alarmist the heart surgery is an exception ofcourse, you know because of this patients hedonistic lifestyle. I am sure these things are never factored into decisions like whether or not to do surgeries like Caesarian sections.

    Sarcasm off.

  7. #7 Paul Heikkila
    September 1, 2009

    I wouldn’t care to characterize health care in the largest country in the world based on a single anecdote. Open heart surgery is hardly the typical procedure performed by Chinese physicians. Western medicine, like capitalism, is new to China. Until China institutes the necessary laws and regulations there will be abuses in medicine, as there are in many other areas of a fledgling capitalist economy.

  8. #8 PalMD
    September 1, 2009

    “Western medicine” is not at all new to china. And this is not a single anecdote, but a representative one. This is how the system, at least in one major chinese city, works.

  9. #9 The Blind Watchmaker
    September 1, 2009

    Hey, we beat China is the World Health Organization’s ranking of health care systems. They are not even close to us! 37 to 144!

    Check the list. In the words of Colbert, “Eat it, Slovenia!”


  10. #10 The Blind Watchmaker
    September 1, 2009

    “When people complain about the cost of “socialized medicine” I sometimes point out that the US spends more money on medicine than any other country and that it is also among the top spenders of public money on medicine. So what we have now is clearly an inefficient, not cost effective system.”

    Not so. The Marshall Islands is way more inefficient than us. Check it out….


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