Chinese patients with Covid-19 have faced rising medical bills since state-funded health plans reduced or eliminated coverage of the disease from their plans, in response to an unprecedented wave of cases sweeping across the country.
According to information from local governments, since last month – when Beijing abruptly reversed its zero Covid policy – at least 14 Chinese cities and provinces have stopped offering free treatment for the coronavirus. For three years Chinese patients had subsidized treatment against the virus.
Hospitals in Shanghai and Guangzhou are charging patients with severe cases of Covid up to 20,000 yuan (R$15,000) per day of intensive care. The amount is equivalent to five months of income for an average urban resident.
The fear of accumulating healthcare debt adds to the risk of infection as the insurance industry seeks to avoid shouldering the cost of reimbursements. This market once sold tens of millions of low-cost medical plans, but now insurers are reluctant to approve claims for illness-related expenses.
Chinese health policy makes it difficult for patients to provide proof of infection with the virus. Health authorities have tightened the definition of deaths and cases of Covid, and last week they were criticized by the WHO (World Health Organization) for underreporting the severity of the pandemic.
An official at Taikang Insurance in Beijing, which has received dozens of complaints after denying coverage, said his company is “very strict” when it comes to approving claims. “It is necessary to present proof of the disease issued by hospitals, which rarely issue the document”, he said.
The scenario creates considerable difficulties for low-income patients and exposes inequalities in the Chinese health system, which does not have enough funds, according to analysts. Hospitals and clinics are flooded with elderly patients.
“China has never made its healthcare system accessible to everyone,” says Yanzhong Huang, a member of the Council on Foreign Relations think tank. “The most recent outbreak of Covid is compounding the problem.”
Until it suddenly changed course last month, Beijing had touted free Covid treatment as a symbol of its success in fighting the pandemic.
Last week, the country’s eastern Anhui province, which has a population of 64 million, began requiring people to pay 30% of their medical expenses linked to the pandemic. The city of Sanhe, close to Beijing, went further and announced last month that Covid patients would have to pay up to half of their hospital costs.
This has generated a high financial burden for many patients. 53-year-old farmer Gao Shengli from the central province of Henan suffered a stroke last week after being diagnosed with Covid. Two days after being admitted to a local hospital, he received a bill for 150,000 yuan ($115,000), more than double his annual family income.
Additional bills ranging from 5,000 to 10,000 yuan continue to arrive daily, driving her family to despair.
“My father has no health insurance,” says Gao’s son, who declined to give his name. “The hospital is hounding us daily to collect the debt and we have no way to pay it.”
The situation for China’s urban middle class is not much better: patients have difficulty claiming reimbursement from their medical insurance. Many hospitals refuse to provide evidence of infection to patients who have been diagnosed unless they also report having a lung infection and undergo a review by local health officials.
A doctor at No. 10 Hospital in Shanghai said, on condition of anonymity, that the city’s health commission had instructed the institution to restrict Covid diagnoses. According to the professional, the team was instructed to classify most cases as a respiratory infection.
An adviser to the National Health Commission in Beijing said the outbreak had happened so quickly that authorities had not had time to draw up a plan of action. The regime does not have the means to offer free treatment to everyone, according to the portfolio.
The National Health Security Administration said on Saturday it will fully cover hospitalizations of Covid patients but continued to exclude complications. And hospitals have been under pressure to cut medical costs since the national insurance fund has been overwhelmed by rising costs from the Covid-zero programme.
In the eastern city of Hangzhou, marketing manager Frank Wang, who purchased a Covid insurance plan early last year, developed infections of the lungs and kidneys after being infected with the virus and was unable to receive proof of having had Covid. .
“The hospital made it clear that it is not easy to obtain a receipt, as the diagnosis has been politicized,” says Wang, who paid more than 20,000 yuan (R$15,000) for the treatment. “Patients like me became victims.”
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