Thursday, October 21, 2010

Healthcare, Chinese Values, and What it Means to Be Middle Class

I absolutely do not have time today to be writing up a blog posting. Yet I felt compelled to share the conversation I just had with our Ayi. Ayi was off yesterday and went to the hospital with her husband (who has a bad heart!) and she was sharing a story about waiting for x-rays. We were talking about healthcare and how that process works in China. Now please keep in mind that the perspective she shared with me was not really from what think of as a "Shanghaiese" perspective. She thinks of herself as Pudongese and very different from the people in Puxi, who make up the more traditional definition of "Shanghaiese". Also, our Ayi was in Middle School and High School during the cultural revolution. So her last 4 years of school was a very different education than students before her or after her received. In fact, there are many Mandarin characters that she either doesn't know or had to teach herself as she missed much of that part of the education. But that's another story. Back to health...


She stated that every year, because she is in her 50's, she gets 500 RMB to cover her health care. She stated that as long as there is no major health issue, 500 RMB is enough to cover you. For minor issues (this is China, so don't know if minor includes losing a limb!), she would have to use her own money to pay. But she stated that within her community, this is rare. If she would have a major health issue, she can get up to another 1,500 RMB. She didn't state it explicitly, but I assume that after that, you have to cover all or some amount out of your own pocket. I explained that in U.S. we have insurance, we have high medical costs, yada, yada, yada. She wanted to know what, if anything, the government paid for. So of course I felt compelled to move us into a new subject:: socialism v. capitalism.


I used some paper to explain how in the U.S. we are mostly made up of a "Middle Class". And what you get from the government depends on how much/hard/type of work you do/did. I showed her the Chinese Character for socialism, 社会主义(Shèhuì zhǔyì). And told her that the US does not use the same type of government. [note that my blog entries are generally politically neutral, so please don't TeaBag me here] Which she knew. What then compelled me today to post this was that I was amazed at how well, a mostly self-educated Chinese could follow my simple explanations. We talked about what the U.S. was like before there was a large middle class and she could see the similarities between the two countries. We talked about how things are changing for China and about how more people are getting closer to the definition of "middle class" here. Ayi then made another observation: becoming middle-class changes your values! Aha! Absolutely.


Just as I am sure that American parents have worried over the past few generations that their children's values have changed, Ayi is now understands that her great-grandchildren may not possess the same values she has instilled into her son. She said this is not a good thing. So we talked about how as a middle-class American, Tom and I buy things that maybe our parents didn't or couldn't have. We buy our own houses, we buy our own cars, we have our own lives. I explained that for me, being a part of a middle class says that I have more choices when it comes to spending my money. We can choose to be thrifty or not. Many young Chinese will spend a month's salary to purchase and possess something that is totally impractical, but they appreciate tremendously that they now have the choice to do that. Ayi sees some changes in her son too, but was thrilled that he chose to marry a woman who will not buy Chinese Cabbage for 4RMB when she can get it at another store for 2RMB. 


So, what started as a simple discussion about the waiting in line for an x-ray, turned into an enlightening exchange about what it means to be a middle class American. Enlightening? Yes, because in explaining it I realized that while many non-Americans think we are just "lucky" to live in a country which gives us so many economic opportunities, I realized it is not about luck at all. It is about choice. I can choose to keep a particular family value, or I can adopt my own. I can choose to buy something, or not. It struck me that this is NOT uniquely American, and many Chinese are experiencing the exact same opportunity, albeit for the first time and on a more limited scale. Parents here worry the same as our parents did/do in the U.S about evolving family values. I cannot imagine what my great grandmother would think about my daughter owning and wearing jewelry! We had to be 10 years old before she would even let us try her jewelery on! But I have made sure that Natalie kept the important values: polite, empathetic, independent. We made choices as parents and hope that our choices result in happy daughter. Hopefully Granny knows that I have been known to search for the 2RMB Chinese Cabbage occasionally!

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