Leadership

What China Can Learn From San Francisco's Police Department

There's a reason to pay civil servants highly

More from Shaun Rein

One of my biggest nightmares is that I wake up in a Chinese hospital. I'm scared not because the doctors lack knowledge or their equipment is old--the opposite is often true--but because of the endemic corruption there. In China stories abound of patients' families slipping packets of money into doctors' hands before surgery to ensure good care. Sometimes they feel compelled to give money because they worry that otherwise the doctor will retaliate by giving them too little anesthesia or stitching them up sloppily.
A Chinese hospital can be a scary place if you don't have money or connections. It seems that every week the Chinese media tell of a hospital denying treatment that costs only $50, leading to the death of a poor person who had no cash on him. That is why the billionaire Mr. Chen, who I wrote about in "What I Learned from A Chinese Billionaire," walks the halls of hospitals giving out money to poor people as they wait in line for hours to see doctors. Mr. Chen feels he is literally saving lives when he does that.

Why is there so much corruption in China's health care system? Part of the problem is that doctors make so little. A brain surgeon named Dr. Xie at a famous hospital complained to me that he officially made only $400 a month, which is less than many factory workers now get. Doctors can't make money legally, he lamented. Some 95% of hospitals are state-owned, and the government caps consultations at $2 to $3 even for the country's most famous doctors, so that even peasants can afford to see the best ones.

Although capping prices has an honorable motive, the low pay inevitably leads to corruption. In order to be able to live the lives they think they deserve, many doctors take home hundreds of thousands of dollars a year in bribes from patients. They also overprescribe medicines and get kickbacks from pharmaceutical and medical equipment companies. It's not uncommon for a patient to go to a doctor with a common cold and be sent home with five boxes of pills and an IV drip.

The Chinese government recognizes corruption as a serious problem and has been cracking down not just in the hospital system but also in the political ranks. Every week the government publicly arrests or executes some doctor or official who has hurt the public trust. A few years ago it even arrested the powerful party secretary of Shanghai, Chen Liangyu.

Yet even with the threat of execution and arrest, corruption still remains endemic and the government seems to make little headway. What can the government do? It should look to the San Francisco Police Department for an answer.