Friday, September 16, 2011

A Carnival of Healthcare

The way things are done in China can be very alien to Westerners. Healthcare is a good example of this and in some ways this is not a bad thing.

When you do a great deal of things in China, it is often a bureaucratic nightmare. This is even truer for foreigners living and working in China. Whenever you open a bank account, open a cellphone account, visit the hospital, and do any number of essential activities that require official approval, you must bring your passport. It's also a good idea to have an interpreter because if you are outside of Beijing, Shanghai, or any number of cosmopolitan internationally diverse cities, English will be hard to come by. Even if the official or person you are dealing with speaks some English, they will sometimes pretend they don't understand you because they don't want to lose face or on the rare occasion be bothered by anyone, let alone a laowai. It's a lot like the DMV except for this level of bureaucratic obfuscation clouds every aspect of governmental interaction. You also have to fill everything out correctly, such as using a check when required, because sometimes they will not accept the wrong symbol that acknowledges that yes, you are a man and no you have not suffered from leprosy. My personal theory is that this is a combination of the Chinese tradition of having a complex bureaucratic infrastructure and the Chinese government's subsidization of the paper and big stamp industries.

When we first arrive at the hospital, our guide for this adventure into the believed "heart of darkness" that is Chinese healthcare talks to the clerk. There is a long line for appointments and at the pay counter we notice this too. In China, you generally pay for healthcare before you receive it. If you have insurance, you will have to contact your provider on your own and get them to pay you back some of the cost afterwards. We are then led away from this area though and into a nice waiting room where we fill out our residency health forms. We laugh for a good 5 minutes about checking the box to confirm a past history of "yellow fever" and then finish up. The form by the way lists a number of diseases not seen in the Western world since the Second World War but I think this is mainly because there are many immigrants from less industrialized countries in China. From there we wait in the check in line. After about 10-15 minutes we get our pictures taken and a series of medical vial stickers are given to us.

Our journey begins by ascending the stairs to the second floor and going into the blood sample room. The room is clean and the needles are all new. Our biggest fear is put to rest because needle safety is always a concern. We also get scolded at by an older nurse for laughing at some unintentionally funny posters about AIDs and HIV, one of which shows a topless cartoon woman breast feeding her baby. After our blood is taken, we are given a tiny plastic cup about half to three-quarters the size of a dixie cup. This is the urine sample cup. After supplying this sample, we place it on a tray full of about a hundred urine sample cups, all without lids but numbered so you don't have to worry about samples getting mixed up. After that trial, we are directed to the area where our other tests are done.

This is where the title of this post comes from. The area where the many tests are done is a long hallway with different signs describing what's inside. The first room I enter is to look at two pages in a book that tests color blindness. I pass with flying colors. The next room is the x-ray. I am not given a lead shield to wear or anything.  The Chinese apparently don't need such decadent things as radiation shielding. A man works the x-ray machine and then begins to move my body into strange poses in front of the machine, most the time smashing my face into the machine. It was like a cross between being arrested and a massage. Following that is a blood pressure test, like the ones at supermarkets, and my height and weight are measured simultaneously on a machine.  I don't recall what it was but I'm sure it's about the same. The oddest test is the ultrasound. Yes, I was given an ultrasound but luckily I am not with child. The last room is the ECG. This one has a longer wait because the ladies get theirs done first and the door has to be closed because it requires them to take off their shirts. When the men do it, it's pretty fast and uses an older clamp machine. After that, we are done. In the span of an hour and a half, we complete what took several trips and a combined time of 5 hours to do in the United States. There was also a lot less complaining than in the States where every technician acted like you were being a nuisance because you expected them to do their job, the job that they are paid a good deal of money to do. The Doctors also did not act like you were asking them to perform some arduous task.

So in China, where a monolithic bureaucracy is the force that moves this giant country, healthcare is better in some respects and better than the expectations of outsiders. Pretty much everyone passes these health tests too and no one makes them out to be the monumental task they can seem to be. The medical checkup was quick, friendly, and did not involve degrading procedures like a genital check or threats of testing for STD's by cotton swab. The actual medicine of the Chinese speaking world might be suspect, I'll talk about Chinese medicine another time, and safety is always a concern in less affluent areas but the healthcare system adequately made a simple checkup a simple checkup.

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