May 19, 2024

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China’s medical corruption is quite shocking!

China’s medical corruption is quite shocking!


China’s medical corruption is quite shocking!

In February 2023, a collaborative research paper titled “Understanding Medical Corruption in China: A Mixed-Methods Study” was published in the academic journal “Health Policy and Planning,” co-authored by researchers from China and the United States. The paper employed various methods to collect and analyze data on the current state of medical corruption in China.


China's medical corruption is quite shocking!


The study employed an interesting research approach, primarily utilizing verdict information from the Chinese Judicature Document Network to analyze medical corruption-related cases from 2013 to 2019. This data was used to categorize the situation of medical corruption in China.

The chosen time frame provided up-to-date information, including the post-implementation scenario after medical insurance bulk procurement, which holds relevance in the present context.


Furthermore, the research involved a national survey to examine a representative phenomenon of past medical corruption in China: “red envelopes” (financial kickbacks). These were prevalent in previous years.


In addition to these large-scale data analyses, the researchers also conducted in-depth interviews with 17 key individuals in the medical field, including pharmaceutical representatives, medical administrators, doctors, and patients. These interviews aimed to capture the latest changes in medical corruption and the perspectives of various stakeholders.


The study’s findings indicated a notable decline in the occurrence of “red envelopes.” The analysis of a nationwide survey from 2011 to 2018 showed that only 0.4% of outpatient and 1.4% of inpatient cases involved red envelope exchanges.

This trend aligns with other research on medical corruption in China, highlighting that compared to other developing countries, direct bribery of doctors by patients is less prevalent.


However, the previous prevalence of red envelopes continues to impact the public perception of the medical sector in China.

The strained doctor-patient relationships resulting from past red envelope practices have not improved despite the decline in their occurrence. The disappearance of red envelopes has not garnered significant public attention.


This phenomenon can be attributed to the inherent power imbalance between service providers and recipients within the healthcare system. Hospitals, doctors, nurses, and patients do not possess equal access to medical information, creating a context where red envelopes represent a stark exploitation of the weaker party by the stronger. This results not only in short-term economic losses for the vulnerable party but also in long-term psychological harm on a broader scale.


While the prevalence of red envelopes has diminished, the study delved into the various forms of medical corruption existing in China today.

Medical corruption typically falls into three categories: theft, bribery (including kickbacks), and dissemination of false information (such as insurance fraud).


The researchers analyzed nearly four thousand cases of medical corruption from verdict documents, with bribery being the dominant form, accounting for 68.1% of cases, followed by embezzlement at 22.8%, and fraud at 9.1%.


China's medical corruption is quite shocking!



Of note, the primary form of medical corruption is now commercial bribery. Suppliers within the medical system, including pharmaceutical and medical equipment companies, bribe personnel within medical institutions to gain a competitive edge in the market. This contrasts with the historical prevalence of patient-based bribery.


Commercial bribery’s pervasiveness is reflected in the current anti-corruption campaign within the medical sector, with pharmaceutical representatives being prominently involved.


Several factors contribute to the rise of commercial bribery as the main form of medical corruption. Interviews with key individuals provided significant insights. For instance, the financial pressure faced by healthcare system personnel plays a role in succumbing to bribery.

This is understandable considering the power dynamics and income disparity within the medical field, where many frontline doctors have relatively low incomes compared to their high-ranking peers.

Flawed pricing mechanisms further exacerbate the issue, as lower compensation for medical professionals compared to the profits from drugs and tests creates a need for additional income sources.


Additionally, the hierarchical power structure within medical institutions can create peer pressure, where those who do not accept bribes may face isolation.


In addition to pressure on medical personnel, systemic weaknesses in China’s regulatory framework also contribute to the opportunities for corruption.

Internal monitoring capabilities within medical institutions are often weak, and external oversight systems can be limited by factors such as resource constraints. Government authorities and local governments may also be reluctant to intervene due to political and economic interests.


On the other side of commercial bribery, the homogeneity of China’s pharmaceutical industry and high-profit margins create an environment conducive to bribery, which has become a key competitive strategy.


While commercial bribery dominates, the study also highlighted the significance of analyzing another form of corruption: embezzlement. Embezzlement cases mainly involve high-ranking personnel within medical institutions, with 77.4% of cases stemming from this group.

Unlike bribery, which may involve external pressures, embezzlement is considered voluntary, as those in leadership positions often enjoy high income and power status.


The study underscores the need for a comprehensive approach to combating medical corruption.

While temporary crackdowns can deter criminals, long-term systemic changes are necessary to address the root causes of corruption.

Establishing transparent reporting mechanisms for economic interactions between pharmaceutical companies and medical institutions, similar to the Physician Payments Sunshine Act in the United States, could be an effective step.

Furthermore, enhancing internal and external regulatory mechanisms and addressing income disparities within the medical profession can contribute to a more trustworthy and ethical healthcare system in China.




China’s medical corruption is quite shocking!

(source:internet, reference only)

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Important Note: The information provided is for informational purposes only and should not be considered as medical advice.