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Scalping seems to be an integral part of the life of the society in China just like in some other developing countries of the world, but it is hardly as topical and problematic in any other spheres as in the Chinese health system. In fact, the Chinese health system suffers from a wide range of various issues and problems that the government has been trying to solve through launching a comprehensive reform in the industry and plans to resolve by 2020. Regardless of the state efforts to address and eliminate such a phenomenon as ticket scalping in the health system, scalpers are still present across all healthcare settings all over the country in huge numbers. They assist patients in getting an appointment with a doctor they need to see without having to wait in long lines in hospital lobbies. Patients have to pay a certain fee that is much higher than the one traditionally charged by hospitals. Although many Chinese people are indignant and furious about scalping in the health system and publicly decry the practice as an exorbitantly priced illegal scheming, there is still a high demand for scalpers’ services, especially among urban middle- and upper-classes, as well as rural Chinese citizens coming to city hospitals without proper documents. Moreover, the practice is a consequence of an inadequately structured health system that does not allow all patients willing to see a physician doing that in a timely and efficient manner because of the shortage of medical professionals and other systemic issues. Overall, the issue of scalpers is extremely complicated by nature as it has both shortcomings and benefits for all stakeholders involved and calls for systemic changes in the entire health system as a solution.
As the issue of ticket scalping is so widespread nowadays in China, there are many real-life stories published about scalpers and people who either decide in favor of using their services or are strongly against the practice. Hence, the article entitled “Scalped: At China’s Creaking Hospitals, Illegal Ticket Touts Defy Crackdown” by Adam Jourdan tells the story of a scalper named Yu Wei. The man is 32 years old and he has been a ticket scalper operating in hospitals in Beijing for several years. Thus, the main service offered by the scalper like by hundreds of his colleagues across China consists in selling a ticket for consultation in one of the city hospitals, which he has bought from hospital representatives in advance so that a patient would not have to stand in extremely long lines. The man charges $131 or 850 yuan for an appointment ticket that would have cost three times less if patients were willing to stand in lines for days or even weeks to do that on their own. However, the scalper does not keep all the money for himself as he receives about 200 yuan and gives the rest to hospital insiders who supply him with tickets for sale. Yu claims, “The city’s upper middle class are willing to pay this amount or even higher – as long as they can get an appointment”. Hence, there is an evidently high demand for scalpers’ services among the Chinese as evident from the Yu’s story and observations of any hospital lobby where dozens of scalpers can be spotted working the line and looking for prospective customers.
A similar story is told by another scalper in the article entitled “China Cracks Down on Scalpers Reselling Hospital Tickets to Desperate Patients” by Victoria Ho. One scalper who wished to remain anonymous claims that the scalping business continues thriving in hospitals all over the country, despite the danger of being detained by the police and a recent massive public outcry. He has been in the business for two years, primarily operating in Beijing and earning about 7,000 yuan or $1,068 per month, which exceeds his former salary that he had earned as a welder in the rural district in the North of the country before joining scalpers. He also emphasizes that scalping is not only a profitable but also a risky and complex business. Thus, he has to bribe hospital guards, pay to hospital insiders, and do the utmost possible to spot and avoid undercover police officers. Nonetheless, he also believes that his services benefit people as it allows them not to stand in long lines and receive the medical attention they need in a timely manner. Besides, scalpers’ tickets are the quickest way to register for citizens coming from rural parts to urban hospitals, who do not have required IDs and documentation, but want or need to see a doctor as soon as possible.
At the same time, not all patients value services rendered by scalpers and many of them consider these individuals to be illegal schemers who prevent ordinary citizens from seeing a doctor and who raise the prices for hospital services. One patient named Cao Dongxian refused to pay scalpers and had to spend months in hospital lines to get an appointment for tests and then to wait for a hospital bed. The man traveled to Beijing after rural doctors refused to operate his intestinal cancer in May, yet he underwent the required surgery in the city only in October, thus having to wait for more than four months. He says, “On top of that your body’s in pain – it really hurts”. Looking back at his decision not to buy an appointment from scalpers, he thinks that he should have done that since by the time he could receive the medical attention on his own, doctors found metastases in other organs. If he had bought the appointment, he would have had to wait for two days rather than for four months. Like Cao, many patients blame scalpers for the lack of free appointments and long waiting lines, which is why they call for tougher actions. Hence, recently the court in Beijing has sentenced 15 scalpers for their practices to jail while police raids have been taking place all over the country to detain and punish scalpers.
However, as evident from the above stories of both patients and scalpers, as well as from the analysis of secondary sources pertaining to the issue under consideration, the problem runs much deeper and scalpers can hardly be blamed for the lack of an effective and efficient health care system in China. It seems that scalpers merely satisfy the existing demand and speed up the process of seeing the doctor for patients who can afford to pay the market price for hospital services. The real problem that has resulted in the emergence of scalpers consists in shortcomings evident in the health system. There is a saying in China that can be roughly translated as follows: “It’s difficult and expensive to see a doctor”. The matter is that the number of physicians is extremely small as compared to the total population and the existing demand for their services, which is why each doctor sees more than 100 patients a day, being able to spend about 3 minutes on each consultation. At the same time, they receive low salaries, sometimes earning less than hairdressers do; therefore, they prescribe some unnecessary procedures to fulfill hospital quotas and receive a bonus so that they would be able to earn a living. The problem is that hospitals are state-owned and their budgets allocated by the government cannot satisfy all their needs. Thus, to survive, hospitals have to resort to capitalist means and inflate medical bills whenever possible.
The government realizes that the health system faces numerous challenges and that scalpers are merely a symptom of a more pervasive problem, which is why it has launched several reforms aimed at making the health care accessible to all citizens and of high quality by 2020. One of the elements of these reforms is the achievement of a “comprehensive universal health coverage by 2020,” which has so far cost $125 billion and resulted in the start of the systemic reform aimed at improving primary care, prevention, and redistribution of funds and specialists to poor rural regions. In fact, the reform has improved the Chinese health system, which is impressive given the rapidness of changes occurring within it. The reform is also aimed at creating a sufficient and effective healthcare workforce by introducing and maintaining norms and ethical codes governing their professional activities. This way, the government attempts to address public accusations that doctors and other healthcare specialists work together with scalpers with the only purpose of soliciting money from patients rather than rendering quality services. According to the state sources, the health system reform has already significantly improved the industry and ensured that all citizens have access to healthcare professionals. Despite this statement, they acknowledge that “problems still exist regarding China’s health resources, especially the shortage of high-quality resources and the unbalanced distribution of those resources,” but these problems are to be addressed by further reforms. However, regardless of police raids and increasing state condemnation of the scalping practice, official sources do not mention this issue as a problem.
Withal, scalpers have become an integral element of the Chinese health system and their activity points at deeper underlying problems existing in it. Nonetheless, they cannot be considered a purely negative phenomenon since they help many patients to receive urgent medical attention at a price that complies with the market conditions. Scalpers exist because there is a demand for their services in the country and sometimes they offer the only way of seeing a doctor. The true problem is the lack of a sufficient number of professional physicians and the lack of financing for hospitals that need to devise some ways of earning money to survive. The government seems to realize the need to introduce changes, which is why the healthcare reform has been launched. However, it is yet to be seen whether it will be effective, which would be evident if scalpers disappeared in the future and patients could see doctors in a timely manner without being forced to buy an appointment ticket from a scalper.