I wouldn't use the word primitive, but inconsistent, non-patient-focused and underfunded in many places.

Larger cities can have excellent treatment, smaller cities less so. After a car accident I had pin-hole surgery on a badly broken collar bone (three pieces and several fragments) and only afterwards discovered the lead surgeon was internationally published in leading journals for his work, and the second surgeon would soon be departing for Northern Europe for a 2 year secondment to complete his PhD. Physiotherapy with minimal but sufficient. After-patient care consisted of being invited to dinners with other ex-patients for sharing over dinner, which is very unlike the West.

Certainly I was fortunate and the vast majority of care is not like this, which is why I don't use the word 'primitive' but prefer 'inconsistent'. The doctors described hospitals more like factories: There's a lot of throughput. He chuckled "You get lots of practice, but the focus is on how to do things better."

Edit: When I say 'not patient focused' here's a typical process flow:

1. Go to ER. Have a friend, family member or colleague pay a fee for consultation for a General Practitioner, and specify Chinese Medicine or Western Medicine GP.

2. Wait to see the GP, usually in a queue or ticketing system. There's a nurse on front desk and if it's obvious and urgent you'll be fast-tracked.

3. See the GP. They'll have some idea and request further work, like an X-Ray, Blood Test, CT Scan, etc. That's all in ER. Have the friend, family member or colleague pay a fee for that and wait in a queue/ticketing system or get fast-tracked again.

4. Get the results and return to GP for further prognosis. They'll recommend medicine (go to the front desk, pay a fee, etc, then go to a separate part, typically a separate floor, for that), operation, or other work. At this point you're referred to a specialist department and need to make your own way there, or if urgent have a wheelchair or stretcher and nurse take you there.

5. Turn up at the specialist department. Now this varies. For urgent treatment you'll likely be seen immediately, better, larger hospitals work 24/7. For non-urgent there might be a ticketing system. For something like a bone operation as I had there'll be a junior doctor on front-desk who will make a further assessment. If non-urgent and they're busy, schedule a few days later.

6. A ward consists of several rooms, typical Marie-Curie design with a central lift block and wards coming off from that. Rooms are rarely individual, if fortunate you'll have 2 to a room, sometime 8 or more. Some pre-op, some post-op. Nurses don't do a lot other than administer drips, observe, and escalate to the doctor on-call. For stuff like getting in or out of bed when you can't walk, friends, family or colleagues are there for that. Often you'll see family members on rotation with a small chair or camper bed next to the patient. You can also hire private unskilled unqualified helpers.

How to choose a hospital: Always go with a Medical University. It's a rule-of-thumb the world over and especially true in China. They have the most experienced, best qualified, best paid (outside of a handful of private international hospitals in Shanghai/Beijing/etc) doctors. If there's a #1, #2, #3 etc affiliated hospital, go to the #1, if that's too far, go down the numbering system until distance/urgency tradeoff works best. If you're out in the countryside, the quality of the care isn't likely to be the best.

Sorry, wrote quite a lot there. Thought it would be interesting to share with Hacker News as most readers here probably won't have had experiences with hospitals in China.

In the crisis like Wuhan at the moment I imagine they'd be incredibly overworked.

Well it might be partially due to culture. Large parts of population is skeptical to the modern western medicine, and rather use traditional Chinese medicine practices.

Yea those damn antivaxxers. Oh wait

I have to wonder at what point "culture" becomes an excuse for being ignorant and/or under-educated about what science is.

Especially away from the large cities.

> China’s medical system is primitive by comparison.

Comparison to what? Isn't US hostpitals notorious in that regard? Getting flu and either dying or being bankrupt.

At least you have options. Some countries only have the first.

Countries such as?

...because they are not for profit so people can actually afford to get help even if they are poor

Well, yes... but that's not really the point. There's plenty of better hospital systems, socialized or not.

Large parts of the world have government-funded healthcare, including many countries where it's anything but "overcrowded and underfunded."

I think you're a bit off the mark. Healthcare is cheap in China, but people are even poorer. Only rich people can afford the important stuff. It's common for young people from poor families to work or forgo their education to pay their sick parent's medical costs. Usually old people just die because they can't afford medical care where in the west, they would be treated. Also doctors are poorly paid and commonly supplement their income with under the table drug sales. Oh, and most of them prescribe fake herbal medicines as if it was real and patients are fooled by it because their culture tells them it works. Imagine getting a vial of homeopathic diluted water and a sugar pill when you complain about a cough. I once knew someone who had TB and was recommended to treat it with an OTC sachet of herb from the pharmacy! It's common to find beggars outside hospitals with signs asking for money to continue their treatment. Insurance? Yes, that exists but the excess is often something like 1/3 the total cost so if you couldn't afford it yourself, you still can't afford it with insurance. That's if you have a high enough income to afford insurance in the first place.

> Imagine getting a vial of homeopathic diluted water and a sugar pill when you complain about a cough.

This happens regularly in western europe, especially by pediatricians. The charitable interpretation is that the doctor knows the child will get better in a few days anyway, but has to give _something_ to soothe the parents. Giving the substance-free stuff is better than unnecessarily medicating the child, and placebo-effect can also play a positive role.

In your subsequent comment you add the important point - this is Germany. Having lived both in Germany and (now) in China, i can confirm that both of these countries have a problem with quack medicine. I've never been anywhere else in the world where you need to argue with pharmacists to persuade them to sell you evidence-based medicine.

In China there is some historical reason for it - Mao needed something to placate the peasants while trying to figure out how to provide healthcare to rural areas[0]. Unfortunately the government is still trying to figure that out.

I don't know what the history is in Germany that caused it to be the way it is.

[0] https://respectfulinsolence.com/2019/05/29/mao-triumphant/

Note that homeopathy was invented by a German doctor, Samuel Hahnemann. It grew big at the turn of last century, with hundreds of homeopathic societies with their own apothecaries.

Today, lobbying powers of a profitable industry also play into it.

Curious about the downvotes -- this is common practice e.g. in Germany, and one that I consider largely beneficial to society.

This probably only works with parents who're too dumb to comprehend what's being prescribed, or ones that are ok with homeopathics?

Here in Belgium all the doctors that have seen my kids have no problem saying paracetamol and they'll be fine in a few days.

W-Europe is particularly hostile to medical quackery IMHO.

The parents that know they're gonna get a placebo because the kid will get better regardless probably aren't bringing their kids to the doctor for the kinds of ailments that result in a placebo.

Anecdotally, 90% of the times I've taken my toddlers to the doctor I've gone home with advice to take paracetamol and wait it out.

Kids can get high fevers really fast and you just want to make sure their lungs & heart are ok, they don't have a throat / ear infection etc. A doc can verify that for you in 5 min so I rather be safe than sorry, an "OK" is all I need.

> Insurance? Yes, that exists but the excess is often something like 1/3 the total cost so if you couldn't afford it yourself, you still can't afford it with insurance.

In the USA or China?

China

yes, but still they are not as developed in human indices