The problems of China's Health care system

Bachelorarbeit von Abdula Hamed

Abstract:

A couple of dramatic scenes were seen in China and also after getting more information about the problems of the healthcare system of China the decision were created to learn more about the healthcare system of China for being able to present solutions for the general problems. Trough the change in 1978 from communism to the implementation of the economic reforms by Deng Xiaoping the media all around the world is talking about the incredible increasing of China. The changes to liberalized trade principle waged to decreased poverty levels and determine China on the path to economic sharpness. There is no doubt that China ushered in an era of unprecedented receptivity to foreign leverage. But beside the positive effects of the reform it also showed massive change within the once centralized medical system. Even though many efforts of the government some sections of the population are at a disadvantage. The implementation of the economic reforms have been a blessing for the Chinese as well as the improved reforms concerning to the healthcare system. On the other hand through the higher quality of the healthcare system the access is very difficult due rising costs.

In that research it will be schematize the misbehaviour of many farmers concerning to health and disease and it will be shown that the present health care system that is working in the shadow of the centralized state which is managed by the government, is not the efficient way concerning to the rising costs. Furthermore solution and suggestions for improvement which could lead to an improvement in the health care system in China are introduced.

Inhaltsverzeichnis:

Text Sample:

Chapter 4, Problems in the supply of drugs:

Medicines are directly related with people’s health while recent years of fake medicine production and sale has been rampant. Medical organizations as the main channel of medicine use are principal for the rampant situation of fake medicines. In China, medical organizations are not liable for legal responsibilities applying fake medicines, thus the majority of fake medicines are sold through medical organizations, the grey area that legal or judicial organizations seek to include in legal regulation. Therefore, it becomes more and more important that the Penal Code states criminal liabilities of medical organizations using fake medicines, cracking down fake medicine crimes and regulating medicine markets. According to Article 2 of Administration Rules for Medical Institutions, medical institutions include hospitals, health centers, nursing houses, impatient departments, clinics, health stations (posts) and emergency stations practicing diagnosis and medical treatment. There are 3 channels for medical institutions using fake medicines:

Firstly, fake medicines used in the name of medical institutions. Some medical institutions with small capital and little profits rent some departments to quack doctors who make advertisements about their exclusive medicines in the name of medical institutions where they are. The exclusive medicines are mostly fake medicines.

Secondly, illegal purchase of fake medicines by medical institutions themselves; In the recent years, medical institutions have become the main channel of fake medicines sale with the prevailing fake medicines production. Those medical institutions, coveting the low price and huge profits fake medicines bring along, flagrantly violate Drug Control Law and buy in lots of fake medicines.

Thirdly, good quality medicines become fake ones, mainly the result of deterioration and contamination. Some medical institutions, especially institutions at county level or village level, are usually badly equipped with staff of little medical knowledge, which often results in chaotic management of medicine preservation, no shelf life reports, bad preservation conditions, non-standard preservation temperature and humidity and measures of deinsectization and mice-killing. Thus good quality medicines deteriorate into fake medicines.

Prevention of the circumvention of law:

According to Article 2 of Drug Control Law, ‘Any person or unit makes researches about medicines, produce, sell, use and supervise medicines, inside the People’s Republic of China, should obey the law.’ Some scholars said that medicine use in medical institutions is equal to medicine sale; therefore fake medicine use should be investigated as fake medicine sale for criminal liabilities. But the statement is not legally defined. Medicine use in medical institutions belongs to medical treatment behaviours rather than medicine sale. Scholars in Criminal Law give no definition of medical treatment behaviours, but simply list a few examples of medical treatment behaviours and non-medical treatment behaviours. ‘Health Department, Executive Yuan’ in Taiwan interprets medical treatment behaviours as follows: ‘Medical treatment behaviour is any behaviour with purposes of treating, curing, preventing people’s diseases, injuries, mutilation and purpose of health care, and its relevant diagnosis and medicine prescription.’ Therefore, medicine use in medical institutions is medical treatment behaviour with the purpose of completing the medical treatment, which is also the case of the medical instrument use. The use of gauze, absorbent cotton, supporting steel pins used in an operation, anaesthetic and antibiotic medicines before and after an operation are all for the purpose of completing a medical behaviour, instead of selling those things to patients.

The users of medicines in medical institutions are only comprised of patients, while medicine enterprises can sell medicines they purchased to medicine manufacturers, medical institutions and patients. Thus fake medicine sale and fake medicine use in medical institutions are two different behaviours; the latter cannot be applied to fake medicine sale crime, but is liable to punishment according judicial interpretation or definitions by other means. While ‘Principle of a legally prescribed punishment for a specified crime’ of Criminal Law, which means that a crime is not a crime unless legally specified, and no punishment ensues, excludes the illegal medicine use in medical institutions that escape legal sanctions easily. In a word, statement of fake medicine use in Criminal Law should be made in order to prevent to the circumvention of criminals, and in a way improve the criminal provisions and make sure those crimes will be punished according to law.

Coordination between drug control law and criminal law should be established.

Drug Control Law and its complementary Rules for Implementation have clearly defined legal responsibilities of fake medicine production, sale, and using fake medicines in medical institutions, thus fake medicine problems have been greatly cracked down and law enforcement authorities become more proactive with the help of the law. However, Drug Control Law is simply an administrative law with only administrative jurisdiction, but without power of enforcing penalties. So there is a disjoint here: Drug Control Law specifies that using fake medicines in medical institutions constitutes a crime, therefore criminal liabilities should be investigated. But there is no relevant statement about fake medicine crime in Criminal Law. So it is highly necessary that legal statement about fake medicine crime should be made to connect these two laws and enforce more powerful sanctions.

The provision for fake medicine crime can be made referring to ‘Crime of Inferior Medical Instrument Production and Sale’, in which criminal liabilities have been made as to any medical institution or person responsible for it. In 1997, Article 145 in Criminal Law specifies penalties for actual damage offence of inferior medical instrument production and sale. In 2001, Interpretation by Supreme People’s Court and Supreme People’s Procuratorate supplements Criminal Law in this aspect. In 2002, the 4th Amendment of Criminal Law defines criminal responsibilities for potential damage offence of inferior medical instrument production and sale. Therefore judicial interpretation or amendments of Criminal Law should be made to sanction fake medicine use in medical institutions, inform medical institutions of the harmfulness and criminal liabilities of fake medicine purchase and use. Fake medicine problem exists not only in China, but also all around the world. According to statistics of WHO, fake medicine production makes up to 80 billion francs a year globally. And by estimation of the International Chamber of Commerce, fake medicine accounts for 6-7 % of the global medicine market, which results in a loss of 36 billion francs of global medicine enterprises, equal to 3 times the annual sales of the world largest medicine manufacturer Merck & Co Inc. While medical institutions is the biggest channel for fake medicine, so criminal liabilities defined in Criminal Law will be as effective as to block the main channel, and as significant as for orderly medicine market and interests of medicine manufacturers.