Summary of Key Points
This article recounts the story of Feng Jian, a former director of a public hospital, who embarked on the private healthcare sector with the ideal of enabling ordinary people to receive medical treatment without having to rely on others. However, his two attempts at entrepreneurship over a ten-year period both ended in failure. His experience reflects the process of private healthcare development in China from fervor to decline, as well as the inherent pitfalls of the public healthcare system, the "pseudo-marketization" of private hospitals, and the profound conflict between capital-driven profit-seeking and the long-term vision necessary for healthcare. Idealists who wish to establish "good hospitals" repeatedly face barriers due to real-world power struggles over interests.
1. The Original Aspiration: Why Even Senior Leaders Can't Achieve It?
Feng Jian's ideal was not unfounded. While working at a public hospital, he observed that even those who had held leadership positions in the health sector still had to rely on connections to get medical care after retirement; ordinary citizens faced long waiting times, complicated procedures, and inconsistent quality of treatment. He wanted to create a hospital like Mayo Clinic or Chang Gung Hospital in Taiwan—one with excellent technology, warm service, and no need for favors. Behind this public-minded goal was a personal desire: he didn't want to rely on connections for his own medical needs in the future.
However, the distribution of healthcare resources has long been tied to administrative power and networks of influence. For example, at public hospitals, those with connections could bypass capable doctors for promotions; in private hospitals, capital and power often interfere with procurement and personnel decisions, rendering the concept of "patient priority" an empty promise. Can an idealist alone change such a system, even with great enthusiasm?
2. Public Hospital Reform: Why Was Feng Jian Removed from His Position?
Feng Jian managed to turn around a public hospital that was in debt and in disarray. He resisted pressure to use favoritism, promoted capable doctors despite their lack of political connections, and replaced politically influential "pseudo-experts." Within two to three years, he had cleared the hospital's debts and doubled its outpatient volume. His innovative approach offended many, including officials who hinted at the need for him to learn to balance relationships, leading to his transfer.
This reveals a deeper issue in public hospitals: the performance of a director is often judged not by the quality of care but by their ability to satisfy higher-ups and balance various interests. Those who try to make changes often face resistance and are ultimately marginalized. Feng Jian thought private hospitals would be a haven for freedom, only to find himself in another similar situation.
3. The "Pseudo-Marketization" of Private Hospitals: Power Interference and Interest Transfer
Feng Jian's first attempt at private healthcare involved a tertiary hospital funded by a state-owned technology group. He invested heavily in creating a patient-friendly environment and brought in experienced staff and experts. However, just before the opening, the procurement department sought to profit by cutting out intermediaries (reducing the cost of equipment from 13 million to 9 million). The management turned a blind eye to this corruption because they were still driven by bureaucratic interests rather than patient welfare.
Despite its market-like facade, this private hospital was no different from public hospitals in terms of power interference and profit-seeking. Feng Jian's efforts to improve transparency were met with slander, and the management did not believe in his integrity. He realized, "This isn't my ship; I can only build the hull, not steer it."
4. The Short-Sightedness of Private Hospitals: Capital Focused on Immediate Profit
His next venture was a county-level private hospital, where he hoped genuine market competition would lead to improvement. He developed a long-term performance plan that adjusted salaries to encourage surgical departments and increase profits without additional costs. However, before the paychecks were due, the investors implemented a secret 20%-30% salary cut—because capital prefers quick returns over long-term investment.
This is a common problem in private hospitals: healthcare is a slow-burning business that requires investment in talent, technology, and time, but capital seeks immediate profits. Feng Jian's vision of sustainable growth was thwarted by short-sightedness, forcing him to leave again.
5. The Dilemma of Idealists: Can Good Hospitals Really Be Established in China?
Feng Jian is now confused. Despite his integrity and dedication to creating quality hospitals, he has failed twice. He wonders if he is too naive, but then he remembers how Academician Lu Daopei successfully established a blood disease hospital through technology and commitment. The problem lies in the overall system: public healthcare is constrained by institutional barriers, while private healthcare is either controlled by capital or influenced by power. Establishing "good hospitals" requires more than just individual ambition; it also needs a healthy market environment where capital is willing to invest patiently, power does not interfere with operations, and doctors can focus on patient care. Feng Jian has not given up, but the path ahead seems incredibly difficult.
This article serves as a mirror, highlighting the challenges in China's healthcare sector. Simply having a few idealists is not enough; systemic changes are needed to enable ordinary people to receive medical treatment without relying on connections. Feng Jian's story is both a personal tragedy and a reflection on the entire industry.