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Additional resources for China: Bioethics, Trust, and the Challenge of the Market (Philosophy and Medicine Asian Studies in Bioethics and the Philosophy of Medicine)

Sample text

The trend of the commercialization of health care has affected medical professionals. A profit-seeking ethos emerging from the new market economy has eclipsed medical ethics and undermined standards of professional conduct. Unfortunately, we have no effective regulations and professionalism to counteract the negative effects of the commercialization of health care. , which have seriously damaged the patient’s interests, increased the conflicts and dissensions between doctors and patients, and have resulted in the crisis of the doctor–patient trust.

Patients are classified by both their income and their willingness to pay for healthcare. There are six classes of health care services: A1, A2, B1 (air-conditioned), B1 (non-airconditioned), B2, and C. The first three classes are available in private hospitals where patients pay 100% of their costs. In government hospitals, patients may pay as little as 19% of their total costs, depending on how they are classified. Central to all of this is a mandatory savings plan, Medisave, whereby all employees contribute 20% of their income, and their employers contribute 13% of the employee’s salary into an individualized medical savings account.

In a word, the original health care system became increasingly unfit for the new economic system. Labor-protection health care “diverted enterprises’ financial and human resources and affected production and business operation. In enterprises with poor economic returns, the employees could not be cared by the basic health care service” (Liang, 2003). After the implementation of the household-contract responsibility system in rural areas, the cooperative health care system collapsed immediately.

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