Is there a doctor in the house?

Consumer researcher Darryl Andrew

By Published on .

My son Jack seems to be well and truly jinxed when it comes to his health. At age seven, he is already onto his second broken arm, and I have insufficient fingers and toes to count the total number of times he has spent the night in the hospital.

Our experiences in Shanghai in getting healthcare for Jack in a timely fashion could read like a Stephen King novel. But they also provide valuable insights about the daily life of Chinese consumers and the challenges they still face in accessing certain services.

Accompanying family or friends for medical aid is a harrowing experience anywhere in the world at the best of times. In Shanghai, it takes on whole new proportions. I have been to three different hospitals now that specialize in pediatrics, and each one left me in awe.

On the lighter side, after working in China for 12 years, encounters that still set the adrenaline flowing are rare but welcome. At the same time, my experiences pale compared to hardened, experienced locals for whom easy access to healthcare is not necessarily a given.

Imagine rush hour in New York’s Grand Central Station, or the Leicester Square station on London’s Underground, and you will have a pretty good feel for what it is like visiting a public ward in a Shanghai hospital: complicated, congested, chaotic, and cash-hungry. Unlike commuting, which is pretty much a solo affair, when visiting hospitals here, the best strategy is to go in groups of four. Each member of the group has a predetermined role:

--the patient
--the caregiver, who remains at the side of the patient, to offer constant attention and reassurance
--the banker, usually a man, who specializes in dipping into a wallet on multiple occasions to pay for the initial consultation, the blood test, the follow-up diagnosis and on and on, each requiring a separate visit to the cashier’s window
--the negotiator, who is there to harangue the health professionals and organize the positioning of the patient in the queue, in order to keep the patient flowing through the stages of diagnosis and treatment in a smooth fashion.

If ever there were a worthy role for management consultants, surely it’s streamlining the system for patient admissions in China's public hospitals. It should be said that once you actually get to a doctor, the standard of care is excellent. (Quick tip for Shanghai residents--the People’s Liberation Army hospital on Huashan Lu once gave us preferential attention without premium payments, simply for the novelty of treating a Eurasian.)

But when I saw Synovate's latest Hotspots study, a syndicated research program which covers 14 developed and developing markets, there was a surprise in store for me. While my sense of order was compromised by my experiences and I was convinced Chinese consumers faced world-class healthcare hassles, the study revealed that the degree of dissatisfaction with the healthcare system in China is no worse than in South Korea, the United States or Germany.

One in every five Chinese is dissatisfied with healthcare provision here, smaller numbers than I would have expected. But spare a thought for the poor Russians and Romanians, where half give their healthcare industry a negative rating. It would be interesting to correlate this with life expectancy.

Further into our own hospital expeditions, we discovered there is a two-tiered system in each of the three institutions we visited. To avoid the commuter-like conditions for healthcare, substantial sums need to be paid out, roughly 1,500 RMB ($200) to get a private room for a night. This equals approximately one-quarter of an average family’s monthly salary in Shanghai.

We had an embarrassing experience in one place where we tried to gain VIP treatment. The nurse looked me over skeptically and asked whether we were sure I could afford their rates, even though I had just come from a client meeting and was dressed in suit and tie.

I now recognize the Louis Vuitton bag I bought my wife has a functional role to play after all. Luxury brands crop up in the most unusual places in China. In this case, her luxury handbag was the badge that ultimately proved we could afford the best medical treatment.

From here, I was also able to piece together a revelation from a study on talent attraction and retention in China. In that survey, healthcare benefits rate among the top five attributes influencing Chinese when they consider new job offers.

Even though employers already pay an additional 40% of an employee’s salary into a government welfare fund, and a fair proportion of that money goes into a dedicated medical fund, employees clearly feel they need more peace of mind for their health protection, and are clamoring for top-up health insurance.

The hard-earned lessons I have taken from my family’s healthcare experiences in Shanghai are useful reminders for anyone with an interest in China: To succeed, you need to know the system, and the ways around the system. You should solicit local counsel to educate and calm you. You need to understand that academic excellence is prevalent, but a country of well over a billion people struggles a little with process.

And never, ever underestimate the power of Louis Vuitton.

Darryl Andrew is Shanghai-based CEO, China of Synovate, an Aegis-owned market research company based in Hong Kong.
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