Tom Spender

I was asked to take a few photos at Peking University this month of visiting faculty staff from Duke University in North Carolina, who were teaching a health science course in Beijing. It was quite a tough gig because the lecture hall was dark and I didn’t want to use a flash, so I was shooting at 1600 ISO/f2.8, which meant a lot of background noise, washed out colours and hassles with getting the focus right. I mainly learned that I really need to invest in a new camera.

I also learned about the US health system because one of the visiting teachers gave a lecture about it. It always seemed confusing to me – in theory you only get treatment if you have insurance, yet hospitals basically do treat emergency cases regardless of insurance. It turns out the hospitals simply don’t recover these costs because it’s not worth pursuing someone who can’t pay. The whole Medicare/Medicaid system seems to mean free treatment for almost half of hospital cases and appears to face a funding shortfall as the population ages, with a decreasing active population paying tax to cover more elderly people. Doctors practice ‘defensive medicine,’ which means they carry out a lot of procedures and treatments that may well not be necessary simply to cover themselves if they end up being sued by patients over mishaps.

The PKU students said patient-doctor disputes are on the up in China too. News coverage has focused on a spate of violent attacks on hospital doctors. Patients say doctors are arrogant, doctors say they are underpaid. In Shanxi, a powerful local family forced scores of medical staff to kowtow at the funeral of a man who died in hospital and also forced the hospital to close temporarily as punishment.