China’s health service is in total disarray. Government officials freely admit it and Xinhua has carried numerous stories highlighting the problems of bribery, extortionate medical costs and fake medicines. The latest post on Time’s China Blog has a few stats. But just recently there has been a drive by propaganda chiefs to extol the virtues of the new rural co-operative health system.
Under the scheme, each person pays a mere ten yuan a year, while the state supplies another 40 yuan for each participant to the cooperative fund. Members of the scheme are then entitled to discounts on their medical fees using the fund pool. The idea is a very good one. The difficulty of providing medical care to 1.3 billion people can not be underestimated and China is a developing country. So let’s be honest about it. Yes, the situation is better than it was five years ago but it is still virtually unworkable in practice. Report the problems the Chinese government faces and how it proposes to overcome them.
Last week, Xinhua released this feature with the headline “Chinese government under pressure to make rural healthcare system work”. Ok, it’s long and not sparkling journalism but worth a read I reckon. Some of the quotes are very telling:
”With an average reimbursement rate for hospital fees only standing at a meagre 27.5 percent, the current subsidies are still utterly inadequate in dealing with grave and terminal diseases,” said Wu Ming, professor with the Medical School of Peking University.
and:
Zhao Jiqing, director of the Public Health Bureau of Beipiao, believes that the funding is not enough.
”Without the consistent support from central government coffers, the new scheme can hardly sustain itself. It is imperative the government increases the fund pool to make hospital fees more affordable for farmers,” he said.
and:
According to Wu Ming, professor with the Medical School of Peking University, the problem of rural healthcare should not be underestimated.
”The fact that 900 million farmers have limited access to medical care is so grave that it could diminish the government’s efforts to close the yawning wealth gap by throwing disease-plagued farmers back into poverty,” he said.
Given these opinions, it was immensely frustrating that the story had to go through four revisions before all of them were included in the story. Of course, there is always going to be a problem if a story is written with the specific aim of “showing the world that China’s rural healthcare system is better than it was” as one editor put it. This led to a glowing appraisal of the whole scheme with the reality buried in the second half of the story. A polishing colleague saw this story before I got my grubby hands on it and became embroiled in arguments with the writer about how we should be reporting the whole picture. The writer believed that the co-op scheme deserved high praise. But gradually she managed to pull out more information to the contrary.
She even managed to change one farmer’s quote which finished up looking like this:
Farmer Ma Yongshan, in Beipiao County of northeast China’s Liaoning Province, was stricken by colon cancer and a brain infarction. He received a reimbursement of 6,590 yuan for his hospital fees after joining the scheme.
But he still has 10,000 yuan left to pay by himself, which is not easy for a farmer whose annual disposable income is around 3,000 yuan.
“The program eased my burden - at least I could pay the bill on my own without borrowing. But if 60 percent of the expenses could have been refunded, that would have been a great blessing,” Ma said.
The first version of the story had no acknowledgement of the difficulty Ma faced in forking out 10,000 yuan. The original quote went something along the lines of “The program is fantastic”. Who knows if Ma exists, who knows what he really said, but the writer was willing to change his quote into something more believable.
It is not the first time, a story on rural healthcare in China has had to be turned on its head and it won’t be the last. But there are now three features on the Xinhua database and, more importantly on the Internet, depicting something approaching the reality. (The third is here). So surely, there can’t be many more occasions when a piece of blinkered rural healthcare propaganda lands on the polishing desk …
mike | 27-Apr-07 at 3:03 pm | Permalink
sorry chris, I know I wind up on here a bit too much, but this one really annoyed me. Since when are polishers paid to become “embroiled in arguments with the writer about how we should be reporting the whole picture.”?
As far as I can see, one party is a polisher, the other a journalist. Neither is an editor.
I guess it is this constant wittering about who is best positioned to decide on what news should or should not be considered acceptable in the Chinese media that most annoys me about this blog (and related comments). But keeps me addicted all the same.
I would advise your colleague to get on with what s/he is paid to do. If s/he wants to write the news, resign and try to become a journalist in his /her own right, instead of sniping and condescending from the wings. Actually, that last comment goes for this blog in its entirety.
[another] Michael | 27-Apr-07 at 7:57 pm | Permalink
Interesting stuff. There is very little [English language] reporting of the mess that is China’s public health system, so every bit helps - epsecially when we can see here how much is potentially being kept back.
Chris O'Brien | 28-Apr-07 at 2:01 am | Permalink
Oh dear Mike, I can handle your predictable cynicism but I can’t be doing with ignorant preaching. At Xinhua, foreign editors (no apologies for that self-important job title) are actively encouraged to rewrite, advise and ask journalists to find more information in order to present a more competent piece of news journalism. We have been asked to make comments on particular news stories for future training of journalists and are now involved in editorial meetings. Sitting like a zombie and changing grammar is frowned upon and certainly does not win any friends.
I can only assume that you once had a bad experience as a “polisher”. Maybe you were chained to a post in the corner of the People’s Daily newsroom and whipped until you had made 100 spelling corrections. Or maybe you are just going on second-hand information from a former polisher who sat at a desk for a year changing grammar and not uttering a word to their colleagues, happy to take home a fat pay cheque at the end of the month - the kind of person that when their name is mentioned in Xinhua’s corridors evokes a eye-roll, a shake of a head or a snigger.
You can bang on about the worthlessness of Xinhua’s news coverage all you want. The fact is, Xinhua stories - good and bad - are relied upon by the world’s media. I virtually rewrote that rural healthcare system myself. I would not for one minute say it is good journalism - piles of stories ensure time is limited - and probably looks like a series of quotes cut and pasted together. But the facts are all there. Who else is going out and reporting these facts? As (another) Michael said, there is very little reporting in English about the subject. Foreign media simply don’t have the access, the time or the resources to send reporters roaming around the countryside. Those facts can be reported in future articles on China’s health system by international media, NGOs etc. Hardly anyone reprints Xinhua features in full but they will extract statistics for their own stories.
And by the way, I’m delighted you enjoy reading this blog. Similarly, I was always an avid reader of Jeremy Clarkson’s (http://en.wikipedia.org/wiki/Jeremy_Clarkson) columns in the Sun newspaper. Can’t stand the man but love to be irritated by him.
cat | 28-Apr-07 at 3:47 am | Permalink
And Mike, that’s where I just don’t understand where you’re coming from. I’ve seen you complaining elsewhere about how crap the news is in China and Singapore. And then you make snide comments about anyone who wants to improve the little bit of the news they have some responsibility for. So what exactly is your point?
Your view appears to be fueled by complaints from former foreign employees who you say didn’t know anything about what goes on in their own place of work. And based on this testimony from people you say don’t know anything, a foreigner should only ever be correcting grammar.
In that case, stop complaining if the news is shite, because when no one knows and no one cares, that’s all you’ll ever get. Since you have never worked at these places, you don’t know that there actually are people - writers, editors, directors - who want to produce something worth reading and watching. If a foreign employee understands the political reality of China and helps produce something better within that reality, many people appreciate that. When a foreign employee screws their reports up, they get pissed off.
No one’s kidding themselves that Xinhua is just about to become the world’s leading news agency. But if people can read a report that is actually useful and readable, rather than instant bin fodder, what is your problem with this? Do you just like having something to complain about?
Charlie | 28-Apr-07 at 11:25 am | Permalink
I made a minor quip about Manchester the other day and someone pertaining to be from the city called me a wanker.
Sticks, stones etc…
This is an interesting blog - for every person who thinks you are a hypocritical, talentless apologist, there are 100 others who know better.
Keep doing it.
mike | 28-Apr-07 at 12:54 pm | Permalink
the dog barks and the two cats meeow. now that’s predictable.
cat. improving the news is worthy, and I hope you can manage it one day.
“If a foreign employee understands the political reality of China and helps produce something better within that reality, many people appreciate that.”
Good stuff. and not over earnest in the slightest (aw, shit, I’m being cynical again. And I try so hard to be unpredictable)
charlie. the manchester thing. was it me? I too ‘pertain’ to be from there and I write so much shite on these websites that I forget? If so, I was probably right. Don’t ever take the city’s name in vein again (Oh Manchester, so much to answer for).
and charlie, of course it is interesting. to you. I find it more fascinating than interesting. fascinating that someone would spend so much time trying to deconstruct xinhua’s output line by line, while not forgetting to add (whine) how he would do things so much better if only they would let him. and now he is on the editorial board or something, so everything is alright. keep it coming chris. And don’t forget to look in the mirror each morning and keep tellin yourself “I am important. I am important”
Mark Binnersley | 28-Apr-07 at 1:10 pm | Permalink
What’s wrong with Jeremy Clarkson? The man is common sense personified.
nanheyangrouchuan | 28-Apr-07 at 1:35 pm | Permalink
Why wasn’t health care as big a problem during the “barefoot doctor” days? Profit mandates on every institution, unbridled greed and little regard for human life come off as some reasons.
Du Yisa | 28-Apr-07 at 3:21 pm | Permalink
Make that three cats.
Personal disclosure: I spent some time working inside a PRC news organization (I was sacked a couple days after a disagreement with the editors regarding news coverage - some details are in this long comment on imagethief).
Some basic observations:
1. PRC English-language media are not intended primarily for domestic consumption. They are China’s face (as in 面子) to the world. This means the leaders of PRC English-language media institutions have two main objectives: a. to disseminate ideologically correct information, b. to look respectable. Note that ‘truth and accuracy’ are not on this list.
2. The leaders of these media institutions care very much about foreign opinion, as their mission is precisely to influence it. However they don’t care about foreign opinion regarding their mission as media, or how it influences content. Put in simple terms, they will accept foreign critiques of form, if it serves their purposes - but not of content as they understand it.
3. As these leaders get very little reader/viewer feedback, their main channel for foreign opinion regarding their products is in-house foreign staff: viz. polishers and presenters.
4. This means that foreign staff at PRC media institutions have power to influence content which domestic staff lack, precisely because they are foreign. This is not because PRC editors care about facts - it’s because they don’t want to look like fools. They are happy to adhere to current ideological restrictions as convincingly as possible. If this means including more facts they consider innocuous, they will. Please note that their criteria for this judgement are often rather different from that of polishers or foreign media professionals and audiences. This means that something a PRC editor views as negligible can be something a reader might see as revealing or incriminating.
So what? So, the game played by PRC media workers - including editors - is to pass information through this ideological gauntlet. Again, polishers enjoy a particular authority regarding content that domestic reporters (+ page editors, etc.) don’t have, because the polishers represent foreign opinion - the perceptions of the target audience.
Due to their foreigness, polishers & presenters are unquestionably kept outside the loop regarding many internal institutional concerns (e.g. they are not required to attend regular propaganda sessions), but it is precisely this status which allows them to wield greater influence over content - within limits.
In fact, polishers provide reporters and editors a justification to introduce content that would otherwise simply never be considered, due to its perceived ideological irrelevance.
The true art of the polisher is not to correct grammar, but to defy boundaries, just as any other author working under a regime of censorship must do. The results can be disappointing and trivial, but they can also be brilliant and humane.
To give you an idea of what I mean, here is one of my favorite old Soviet jokes (translated into English):
This is Armenian Radio; our listeners asked us: “We are told that the communism is already seen at the horizon. Then, what is a horizon?”
We’re answering: “Horizon is an imaginary line which moves away each time you approach it.”
If this were an article, the definition of horizon would have to be placed more tactfully, requiring greater finesse on the part of both polisher and reader. Here, it is presented in a form which should be easily accessible to readers such as Mike.
Of course there are limits to this practice - this is its nature. However, a great deal can be done working within limits….
This is China Radio International; our listeners asked us: “Are there questions you can’t answer?”
We’re answering: “No. We perform our job according to Party guidelines. To any question we can give any answer.”
cat | 29-Apr-07 at 4:57 am | Permalink
Hi again Mike. That sentence you quoted - something tells me your interpretation of it was not what I meant. Never mind.
mike | 29-Apr-07 at 1:06 pm | Permalink
okay cat. apologies. I like to read what you write (mostly). Having someone with a brain at CCTV is certainly a good thing and better than it was in the old days. Whether ot will actually achieve anything, however, is a whole different issue. My criticism goes nowhere, I realise that, so no more from me.
chris. as above. but don’t always presume that anybody who doesn’t agree with what you write is in someway jealous or bitter. I have never worked at cctv, china daily or xinhua (although during my time in Beijing I was offered jobs at the first two).
Maybe the real reason is that some people (me) just get a little pissed off with the inflated levels of self-importance - the jeremy clarkson analogy is perfect - that leak through the posts on these pages (and confirmed by your ‘must be bitter’ defence mechanism).
But, being fair, you are not the first chinese media english-language polisher who felt this way. most change in time, one way or another.
Anyway, have it to yourself from here on in.
Global Voices Online » China: Please, no more rural healthcare propaganda! | 30-Apr-07 at 1:57 pm | Permalink
[...] blogged about the editorial process of a Xinhua article about China rural healthcare system: it was immensely frustrating that the story had to go through four revisions before all of them (opi…. Share [...]
mike | 30-Apr-07 at 2:14 pm | Permalink
du yisa. and I thought the egos on here were already big enough. This is Jeremy Clarkson on cocaine.
I can’t pretend to have completely understood everything you wrote (just not accessible enough for me you see) but as is par for the course on here, it is loaded with self-importance, not to mention misplaced arrogance. But if you want to believe influence equals the ability to change, go ahead. I have less important things to get on with now.
Du Yisa | 30-Apr-07 at 5:21 pm | Permalink
A pithy rejoinder, indeed.
“I can’t pretend to have completely understood everything you wrote”
I see.
Nevertheless, you managed both to pass judgement on my character (rather than any facutal content in my comment) and define what I want to believe.
“I have less important things to get on with now.”
Thanks for clearing that up.