Medical corruption in China: the views of the general public
Munro, Neil. Medical corruption in China : the views of the general public. China Policy Institute Blog, August 12, 2015. URL : http://blogs.nottingham.ac.uk/chinapolicyinstitute/2015/08/12/medical-corruption-in-china-the-views-of-the-general-public/ (consulté le 12 août 2015)
China’s public hospitals are notorious for such unethical practices as offering treatment and diagnostic tests which are not medically indicated and taking extra payments (such as the ‘hongbao’ or ‘red envelope’). Such practices present patients and their families with a dilemma: how to ensure that doctors offer, at a reasonable price, the same quality of care as they would for their own family? Citizens have available a variety of strategies to deal with this kind of “agency risk”, varying from passive to active, from the universal to the particular, and, in Hirschman’s terms, between exit, or changing providers, voice, or seeking to change the terms of the relationship with an existing provider, and loyalty, or just doing as the provider says. Data from a nationwide survey carried out in China in the winter of 2012-13 provides us with the opportunity to examine two questions. Firstly, how likely do Chinese citizens perceive unethical practices to be in their local hospitals; and secondly, what strategies do they prefer to deal with the agency dilemma. Citizens’ preferences reveal a great deal about the health care system—to what extent patients are disempowered, how modern the system is in the Weberian sense, how flexible provider behaviour is and to what extent market mechanisms provide an exit from the agency dilemma.