In March, as surgeons prepared to operate on the father of Mr. Liu in a county hospital in central China, hospital staff suddenly called him and other patients’ family members over for a secretive meeting.
Under the pretense of needing “special fees” for experts coming from a larger city, the staff members of the Xihua County People’s Hospital in Henan Province told Liu that they would require 1,500 yuan (about $225) to operate on his father, who had suffered a heart attack. He and the other patients’ family members paid the fees.
“These fees were not part of the medical bill,” Liu told Henan Television.
Rather, they were part of what has essentially become institutionalized bribery.
In China, the service industry and bribes go hand in hand. This is especially apparent in hospitals, where patients lavish exorbitant sums of “red envelope” money on doctors to ensure high quality—or just adequate—treatment.
The phenomenon, which gets its name from the small, red, money-filled packets given to friends and family during the Lunar New Year, may not always involve the iconic holiday envelope. But bribery is firmly entrenched in the Chinese medical culture and has its roots in the structure of the Communist Party’s health care system.
Statistics for the medical scene in China are difficult to come by, but surveys done by various Chinese news sites suggest that bribery is the norm. In a survey of 60,000 netizen respondents, online medical community Disease.39.net found that 64 percent had given red envelopes to doctors. Another survey done by the same site showed that nearly 90 percent of patients had paid their doctors extra fees, whether in hard cash or by treating them to meals.
In May 2011, an academic thesis published in a Chinese medical journal did a study based on 4,000 survey subjects and determined that about 55 percent of patients paid bribes. They were more likely to do so if they had higher education or lived in economically developed parts of China.
A patient who does not pay bribes runs the risk of receiving sloppy medical treatment or no treatment at all, and in some cases, vindictive reactions from medical staff.
In a 2014 case reported by Chinese news outlet Sohu in Jiangsu Province, a patient was abandoned in the operating room when he refused to pay an additional fee of 2,000 yuan ($300). Another incident, reported this February, saw an Inner Mongolian doctor get halfway through an operation before abruptly demanding 7,000 yuan from the patient to continue. In 2010, a nurse in Shenzhen was reported by Southern Metropolis Daily to have sewn shut the anus of a new mother, after the latter provided a paltry sum in an envelope (a mere 100 yuan, or $15).
