D.I.Y. Dialysis? For Some Chinese, Good Medical Care is Elusive

Wang Lanqin, left, helps her son Fu Xuepeng breathe using a PVC resuscitator pump at their home in Taizhou, China on January 28, 2013. AFP/Getty

Seven years ago, a 25-year-old Chinese man name Fu Xuepeng was severely injured in a motorbike accident: paralyzed from the neck down, he was unable to breathe unaided. His family rushed him to Taizhou First People’s Hospital, where he was kept on a ventilator for four months. But the money soon ran out. Unable to pay their son’s $1,600-a-week medical bill, the family had no choice but to bring him home. The solution to this desperate situation? They bought an emergency, hand-powered ventilator and, together with other family members, took turns pumping in two-hour intervals. Their task eased when one son-in-law rigged an electric motor to power the pump after dark. “If our son cannot care for us, we will care for him. As long as he’s still here, all is well,” Fu’s father, a farmer, said in an interview with Zhejiang News earlier this month.

Fu and his parents are not alone. Facing a growing wealth gap and rising health-care costs, China’s poorest often cannot afford the medical devices that could keep them alive. So more and more are turning instead to their own ingenuity. In 2009 a group of patients facing late-stage kidney disease pooled funds to buy several secondhand dialysis machines. And in 2012 Hu Songwen, who had exhausted his family savings on dialysis treatment, posted a video online detailing how he had survived for 13 years on a homemade blood-filtering device.

“Their actions might be atypical,” says Chinese health expert Yanzhong Huang, “but they epitomize the helplessness and hopelessness of a significant group of people in China who still cannot afford quality health care.” Huang, a senior fellow for global health at the Council on Foreign Relations, says the high cost of health care is the biggest problem facing people like Fu and Hu. For years, health-care costs in China have far outstripped Chinese citizens’ ability to pay. Until several years ago, few Chinese—less than 30 percent in 2003—had access to health insurance.

The Chinese government is doing what it can to ease this burden. In 2009 China’s Ministry of Health launched an ambitious $124 billion plan to increase coverage for the uninsured. By 2011 more than 95 percent of China’s 1.3 billion were covered. At the same time, out-of-pocket health-care costs for the average Chinese citizen have decreased dramatically, dropping from approximately 60 percent of all health-care costs in 1999 to just over 35 percent in 2011.

Even with these changes, effective health care is still unaffordable for many Chinese, according to Karen Eggleston, director of the Asia Health Policy Program at Stanford University’s Shorenstein Center. Coverage is “wide but shallow,” she wrote in a 2012 paper. Despite additional subsidies for the poorest of China’s poor, advanced health care is often beyond the reach of this segment of the population.

As for Fu Xuepeng, a more sustainable solution to the ventilator problem came from the generosity of strangers: in January the story inspired Chinese Internet users to donate almost $18,000 to buy him an electronic one. In addition, local government officials have pledged to provide the Fu household with an uninterrupted supply of electricity to power their son’s new ventilator. The outpouring of help has been overwhelming for Fu’s parents. His mother, Wang Lanqing, told a reporter from Taizhou Commercial News: “There are too many good people on this earth.”

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