Truth and Consequences….

Sorting out the truth and realities of healthcare on the ground in China from the implausible and often outrageous claims made by government agencies and ministries could be a full-time occupation.  It has always amazed me how the large international consulting firms, China ‘experts’ of various ilk, journalists, and general pundits will solemnly repeat the claims of the government with an air of professorial dignity and acceptance.  It’s as though if enough experts repeat something the government has claimed, it must be true.  It ends up in white papers, year-end summaries and endless speeches without a shred of skepticism.

My favorite example of this is the government’s frequent claims that in the last few years, China has progressed to a state of achieving 98% (or 99% or even 100%) universal healthcare coverage; far greater than almost any country or region in the world including Scandinavia.  Now even a modest amount of inquiry would certainly lead one to question such a statement yet you will see this claim repeated over and over again by foreign experts and speakers at conferences.  Does anyone stop and say, “Now wait a minute.  China has a population of 1.3 billion people.  If 98% (let’s be conservative) have healthcare coverage, that means something like 1.27 billion Chinese are receiving healthcare benefits.  Is this believable?”  Of course, it’s not believable.  OECD data reflects that China’s healthcare spending is among the lowest in the industrialized world.  So where is this coming from and how does it have any credibility?

At a conference recently, I pinned a government colleague of mine who had just given a speech quoting this data against the wall, challenging him on this statement.  His answer was classic:  “David, we’re not saying 98% of the population is actually receiving any benefits through their universal coverage.  We’re saying they’re eligible to receive benefits at some point.”  Well now, this is an interesting shading of a blatantly false statement, isn’t it?  On this basis, any country in the world could claim 100% universal healthcare coverage and not spend a penny on healthcare.  A quick review of the government’s own data reveals that only approximately 14% of the Chinese population actually receives any government healthcare benefits.  A far cry from the 98% implied in the government’s claims.


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