La campagne chinoise contre la corruption médicale

In China, everyone is the bear's eye, everyone has their turn. On the Chinese Internet, people who have repeatedly exploited the object are called the bear's eye. The fact of being exploited is called the bear's eye scourge. And the part that benefits from the exploitation is known as scourge. Since the Chinese government is running out of money, now the hospitals go to the mill. You may not imagine how rich the Chinese public hospitals are. For many of them, the goal is not to save lives, but to earn more and more money. This lady described in a vivid way how a large number of Chinese hospitals have become rich over the past 20 years. When the ambulance rings, a year of effort goes to waste. After having been admitted to the hospital once, it is impossible to be able to do it again for three years. Because, if you get sick, your heritage will be reduced to the skin of sorrow. Ten years of effort to lead an easy life, and a serious illness is enough to lose everything. Countless people have seen the work of a whole life spent in the hospital in the space of a few days. For example, an old man who led a frugal life and saved 300,000 yuan, or more than 40,000 dollars, after a month of treatment at the hospital, has only 89 yuan, or 12 dollars. There is another old man who ran away from home after falling ill, because he did not have the means to get treated and he was afraid to compromise the future of his children. Recently, the Chinese government launched a large-scale anti-corruption campaign, unprecedented in the medical sector, which attracted attention. The meeting stated that it is necessary to intensify efforts to apply disciplinary laws, launch systematic governance deepening the entire domain, the chain and the coverage of the medical and pharmaceutical industry. The disciplinary authorities and local surveillance and the media have of course worked in close collaboration to echo the measures taken by the central authorities. Since the beginning of the year, at least 155 directors of hospitals and secretaries of the hospital party have been the subject of an investigation. What is the intensity of this anti-corruption campaign? Almost every day, new state-of-the-art funds of the health system have been scrapped. On August 1, Shanghai officially implemented the measures to implement the premium for donors, with a minimum amount of 5,000 RMB and a maximum of 1 million RMB. These measures encourage the public to report on food, medicine, including medical and cosmetic devices, special equipment, quality and safety of industrial products, etc. Chinese media have reported that there have been reports between doctors, even between spouses. For example, the title of this report is, a doctor from Shenzhen was denounced by his wife for having received wine skins. Authorities have intervened to investigate. This is very similar to what happened during the Great Cultural Revolution, when husbands and wives denounced each other, that fathers and sons turned against each other. The news published on the website of the Central Commission for the Inspection of the Discipline of the State mentions, increase the intensity of the application of the discipline and the application of the law, by focusing on the managers and the head of key posts, by insisting on the investigation, on the acceptance and receipt of wine skins, and by focusing on the investigation and the treatment of a certain number of corruption cases in the field of medicine, by creating a dynamic of dissuasion. The so-called managers and head of key posts are, more precisely, the directors and secretaries of the hospital parties. According to incomplete statistics, on July 26 of this year, at least 155 directors and hospital secretaries were investigated. Unlike previous anti-corruption campaigns, this one undoubtedly established a new record in terms of depth, scope and vigor. It should be noted that some of the officials who were subject to an investigation have already retired or have been transferred to positions within the Executive. Thus, over the course of this year, a number of reputed hospital managers were subject to an investigation and were sanctioned after their retirement. In their briefings, corruption has been mentioned, in all cases. For some, the crimes cited even include their disloyalty and dishonesty towards the party. The impact of the anti-corruption campaign is not limited to hospitals. Many pharmaceutical companies have also become the focus of rectification. Just in July, the real controllers of two pharmaceutical companies listed on the stock exchange were subjected to an investigation. What shocks the outside world the most is that this investigation into medical corruption dates back to 20 years. It turns out that since 2003, Chinese hospitals have gradually adopted computerized management systems, which means that all purchase and expenditure records can be traced with precision. The so-called 20-year-backward return tactic will allow the PCC to catch more people than it wants to liquidate. The Chinese Communist Party, PCC, tends to clean up or re-manage when it seems necessary to acquire power and wealth. This time, the anti-corruption campaign in the health sector intervenes at a time when financial constraints are increasing in various sectors, so that this campaign is supposed to be a new exploitation of the wealthy class. Even if the targets of these investigations are indeed corrupt, it is likely that the behavior itself is tacitly tolerated, or even encouraged by the Chinese Communist Party, PCC, and it is only when it is time to reap the fruits that these systems are made to contribute. At a time when governments at all levels of the country are very indebted and where local communities are in the throes of financial difficulties, a vast anti-corruption campaign in the health care sector could have three advantages. First, sanctions can be imposed on those who are corrupt in order to obtain funds. Secondly, a reinstatement of power can be put in place by replacing people in important positions. And thirdly, a good image can also be established with the public. You may be wondering why Chinese hospitals make incredible profits and who is responsible for this type of corruption. Twenty years ago, the end of the 1990s and the beginning of the 2000s marked the beginning of the Chinese market system. Most of the existing public hospitals before the 1990s were not converted into private hospitals, but these hospitals were losing money like other public enterprises. At that time, Prime Minister Rong Jizhu wanted to find a way for hospitals to survive in society and not depend on the government's financial support. As a result, hospital revenues are divided into three parts. One is that the patient's medical expenses are reimbursed by the social security fund, instead of being reimbursed by the employer as before. But the Chinese social security funds are limited. The second is that a small part of the money is allocated to public hospitals by the government. The third and most important part is that the hospital invoices the patient, the rest is in charge. That is to say that, on the one hand, the government requires that public hospitals be dedicated to public well-being. On the other hand, it requires that hospitals are responsible for their own profits and losses. There is an essential contradiction between the two. And the absence of a regulatory system makes Chinese hospitals, which evolve towards a market economy, uncontrollable. Public hospitals are even less controlled than state-owned enterprises because health care is a highly specialized field and it is difficult for the poor to intervene on what is bought and what it is worth. As a result, the president and directors of large departments have at the same time the triple identity of experts, party members, and CEO of a large company. As they have both important power and difficult supervision, they naturally become the main target of corruption. Although large hospitals all have departments responsible for calls for offers and purchases, and also for formal procedures, there is no supervision outside the system. The director and the vice president in charge of the purchases can easily earn a lot of extra money thanks to their positions. Another problem with public hospitals is that the mandate of hospital directors is longer than that of the officials of the general administration. The head of the local health commission may have already changed several times, but the director of the hospital remains the same, which is the result of professionalism. The corruption that exists in the Chinese medical field is widely criticized by the public. The main reasons are as follows. It is difficult to consult a doctor, it costs too much, health insurance has been devalued in disguised ways, quality health care resources have been seized by the privileged class. Members of the family of patients, in order to care for their loved ones, do not hesitate to corrupt hospital directors and to give red envelopes to doctors. Recently, the Chinese internet has taken up a Weibo message, a Chinese Twitter, ten years old from the Security Times newspaper, in which a former vice minister of health, Daky Yien, revealed, in 2006, a study by the Chinese Academy of Sciences. It reported that 80% of the government's health spending went exclusively to party members, and that annual expenses rose to about 50 billion yuan, or 7 billion US dollars. The public criticized the fact that it is these millions of party members who make it difficult and expensive for the Chinese to access care. Corruption in the health care sector in China is an old and growing problem that concerns not only doctors, but also a wide range of interests involving pharmaceutical representatives, drug resellers and many other parties. In hospitals, if doctors do not use certain drugs, it is difficult for pharmaceutical representatives to meet their performance indicators. As a result, the sale of drugs and consumables in the form of wine skins has become a secret of polychinel in the industry. Of course, it is the hospital directors who take up most of the money from corruption. It is therefore not a problem of moral deficiency on the part of some doctors, but rather an evidence-raising of the gaps and risks of the entire Chinese medical system. In recent years, hospitals have been pointed out on many occasions as having not paid the money hard-earned by employees. I denounce with my real name the popular hospital of the city of Suyue, for perpetually holding salaries and verbal violence against employees. I have been an ordinary hospital employee for 13 years. In 13 years, the hospital has changed a total of three pay cards. The accounts of these three cards can prove that over the years, salaries have never been paid in full. Every year, a few months of salary are missing. We are in July 2023 and the money has still not been paid. Every time I get evidence to ask for justice and help, the hospital director summons the Department of Nursing and the concerned officials to question me individually. The director asked them to exert mental pressure on me. When I could no longer stand mental pressure and financial difficulties, I approached the director and begged him to pay me my salary on time and I complained about my financial difficulties. But he got me out of his office to drive me down the corridor and insulted and mistreated me, he told me that he had the money, but that he was doing what he wanted and that I was not allowed to know. I was very scared after these insults and I did not understand why I was not allowed to know when I was being paid for what I had worked so hard for. Why am I not allowed to know? Why don't they give me my salary? Why do I have to beg for the money I have earned myself and be insulted in every way? Where is the hard-earned money going by the low-level workers? Why do hospitals have money? Why does the treasurer who knows his secret receive four salaries a month? Why do those of us who really work not even receive basic respect and wages? Do you not have a bad conscience when you brag about our salaries when we have nothing to eat, dress us and our children do not have the means to pay their school fees? Here, doctors are waving banners to demand their salaries. This centennial hospital is in great difficulty. It has been three months since they have not been paid for their bonuses, but only for their basic wages. Doctors spend their free time defending their rights. The roles of bears and foxes also transform from one to the other. In China, hospitals are foxes as far as patients are concerned. Now, in the eyes of the PCC, hospitals have become a bear field. In addition to hospitals, it is likely that drug resellers and medical equipment distributors will be hit hard. The pharmaceutical industry is an important sector of the economy, and any change that is linked to it can have an impact on the entire market.