New York Times: Less Communism = Bad News

Apparently, not even the communists are socialistic enough for the New York Times. Cleaning up my office this morning, I noticed the front-page of Saturday’s Times featured a large photo of an ill Chinese man with the headline “Wealth Grows, but Health Care Withers in China.” The subheadline explained, “Rural Areas Lag With Fall of Socialized Medicine.”

Reporter Howard W. French rued the fact that Chinese communist leaders are discarding elements of Mao’s system: “Until the beginning of the reform period in the early 1980's, China's socialized medical system, with ‘barefoot doctors’ at its core, worked public health wonders. From 1952 to 1982 infant mortality fell from 200 per 1,000 live births to 34, and life expectancy increased from about 35 years to 68, according to a recent study published by The New England Journal of Medicine.”

As for the purported health benefits of Mao’s version of communism, estimates of the number of deaths vary widely, but most are in the tens of millions.

But while admitting that more economic freedom has brought prosperity to many in China, French highlighted the victims of China's flirtation with capitalism. At one point, he even suggested that health of the world was being put in jeopardy: “The near total absence of adequate health care in much of the countryside has sown deep resentment among the peasantry while helping to spread infectious diseases like hepatitis and tuberculosis and making the country — and the world — more vulnerable to epidemics like severe acute respiratory syndrome, or SARS, and possibly bird flu.”

Now, excerpts from French’s January 14 article:

China's economic reforms have turned an almost uniformly poor nation into an increasingly prosperous one in the space of a mere generation. But the collapse of socialized medicine and staggering cost increases have opened a yawning gap between health care in the cities and the rural areas, where the former system of free clinics has disintegrated....

That China finds itself in this situation today is as remarkable as the country's economic takeoff and, paradoxically, is inseparably related to it. Until the beginning of the reform period in the early 1980's, China's socialized medical system, with ''barefoot doctors'' at its core, worked public health wonders.

From 1952 to 1982 infant mortality fell from 200 per 1,000 live births to 34, and life expectancy increased from about 35 years to 68, according to a recent study published by The New England Journal of Medicine.

Since then, in one of the great policy reversals of modern times, China has dissolved its rural communes, privatized vast swaths of the economy and shifted public health resources away from rural areas and toward the cities. Public hospitals were urged to charge commercial rates for new drugs and most procedures, and today the salaries of health care workers are typically linked to the amount of income they generate for their hospitals.

More than half of urban residents, by comparison, enjoy some kind of coverage, which is supplied by their employers.

The recent emphasis on profit, meanwhile, has led doctors and other well-trained health care workers to abandon the countryside, with a result that peasants are left at the mercy of unqualified caregivers and outright charlatans who peddle expensive, improperly prescribed drugs and counterfeit medicines.

''From the liberation to the Cultural Revolution, conditions in the rural areas were fairly good,'' Dr. Wang Weizhong, a physician and member of the National People's Congress from Jilin Province in the northeast, said of the period from 1949 to the 1970's. ''There were township clinics in every area, and there was no problem getting at least small illnesses treated everywhere.''

Dr. Wang insisted that the government was working hard with its recent health care reforms to address the problems, but agreed that the old public health system that once protected peasants ''had dissolved.''