Sham penile surgeries are just one part of a much larger system of poorly regulated and corrupt private healthcare in China. In other instances of medical malfeasance, physicians at private clinics have bargained with patients during surgery, female patients have been tricked into aborting healthy fetuses, and there have been many documented deaths as a result of physician negligence. Pseudoscientific medical devices are in wide use, as is the practice of proffering false diagnoses, as more than 60 private hospitals have done to Chinese undercover journalists in the past six years. Meanwhile, the number of private hospitals in China is blossoming—between 2005 and 2015, 9,326 new facilities opened their doors. Today they make up about half of all hospitals in China. That proportion will likely grow as ongoing Chinese healthcare reforms aim to increase private investment in the sector and government-run insurance schemes expand to cover private healthcare facilities. American companies including Morgan Stanley Private Equity Asia, a division of Morgan Stanley, are pouring in millions of dollars as well.On May 2, China's internet regulator announced it would investigate Baidu, China's equivalent of Google, which is the dominant source of traffic for private hospitals. Before Wei Zexi, a 21-year-old college student with a rare form of cancer, passed away on April 12, he publicly accused Baidu of promoting false medical information that led to his spending 200,000 yuan [about $31,000] for cancer treatments supposedly developed by Stanford University. A Chinese journalist showed the treatments held questionable medical value and that Stanford did not partner with the public hospital, which had been contracted out to private entrepreneurs.Physicians at private clinics have bargained with patients during surgery, female patients have been tricked into aborting healthy fetuses, and there have been many documented deaths as a result of physician negligence.
"It was serious. He scared me. He told me I needed to be circumcised. When I said I didn't want to, Dr. Tang Congxiang just repeated it again and again."
–Junjun
In total, he spent $2,400, equivalent to about four month's salary. He still owes his classmate money. After refusing more treatment, Junjun returned home to his parents' small apartment and searched Baidu for information on the surgery that Dr. Tang had added. He read about the potential side effects. He read patient accounts of being duped. He read of their erectile dysfunction. "I fell down, down, into a type of hell," he says.The next day, Junjun called Dr. Tang and asked how he could do this to him. "He said it was nothing. He said I'd be fine." Nurses at Shenzhen City Hospital told Junjun the same thing. "The nurse kept telling me how good this surgery is. She has a son, so I told her I'd pay for her son to get this surgery done. Her husband, too. They could all do it for free, on me."When Junjun went to a public hospital to understand his options, the doctor told him he'd been tricked. "Doctors at public hospitals all know these private hospitals harm people," Junjun sighs. "But no one stands up and says anything."In coming weeks, his parents got involved, and after eight visits, the hospital agreed to return his treatment costs. "Return my treatment costs?" Junjun posted on an online Baidu forum. "They've turned me into a eunuch. I want them to cure me." Reached by phone, Shenzhen City Hospital's legal representative, Hu Jianfan, declined to comment for this story."Doctors at public hospitals all know these private hospitals harm people," Junjun sighs. "But no one stands up and says anything."
It was hard to tell, I thought, who was scamming whom. Both the hospital owners buying the machines and the salesmen knew patients like Junjun and Little Huang would trust the advanced, "imported" machines if physicians recommended them. Information asymmetry between doctor and patient is extreme in healthcare. The traditional moral compass for physicians—the Hippocratic Oath—has fallen victim to unbridled capitalism and corruption in China, especially in private hospitals, which saw 11 percent of all visits, totaling 325.6 million, in 2014. Once primarily a trap targeting the young or naïve or uninsured, private hospital chains like Baijia are now moving upmarket and beginning to accept government-run insurance, drawing in new swaths of society as patients. But when false marketing campaigns and supposedly low prices lure people of the middle class, will they too trust the doctor in the white coat and the big machines with English lettering? "The clinic is just a hole waiting for someone to fall into," Junjun says. "And the health department stamps it with a chop—Legal!"The traditional moral compass for physicians—the Hippocratic Oath—has fallen victim to unbridled capitalism and corruption in China, especially in private hospitals.