在中國，想見自己剛出生的孩子需要付多少錢？
中國廣州——朱莉安娜·布蘭迪·洛戈博(Juliana Brandy Logbo)本月在中國一家醫(yī)院進(jìn)行了緊急剖腹產(chǎn)手術(shù)，生下了一對(duì)雙胞胎。她本以為最糟糕的部分已經(jīng)結(jié)束了。但次日，院方開始催她交錢。
First, Logbo said, the hospital told her that she had to pay $630 in hospitalization fees if she wanted to see her girls. Three days later, she said, the amount rose to nearly $800.
洛戈博稱，醫(yī)院一開始跟她說，要想見到自己的女兒，她必須支付630美元的住院費(fèi)。三天后，她表示該費(fèi)用漲到了將近800美元。
She didn’t have the money. The demands left her weeping outside the newborn department in the hospital.
她沒有那么多錢。這些要求令她只能在醫(yī)院的新生兒室外哭泣。
“I want to get my kids discharged because I need to breast-feed them,” said Logbo, a 28-year-old Liberian living in Guangzhou. “I gave birth to my babies, and I can’t even see my babies. Which type of country am I in?”
“我想讓我的孩子們出院，因?yàn)槲倚枰o她們母乳喂養(yǎng)，”洛戈博說，28歲的她是一名住在廣州的利比里亞人。“我生了孩子，卻不能哪怕是見見自己的孩子。我是在一個(gè)什么國家?”
In most developed countries, patients who need urgent care are given it first, regardless of whether they can pay. That isn’t always the case in China.
在大多數(shù)發(fā)達(dá)國家，需要緊急救護(hù)的患者會(huì)首先得到援助，不論他們是否能夠支付。在中國卻并非總是如此。
Logbo is living in China on an expired visa and can’t speak Chinese. But her experience mirrors that of millions of Chinese people who have to put up with an inflexible health care system that sometimes requires patients to pay upfront for treatment.
在中國生活的洛戈博簽證已經(jīng)過期，也不會(huì)說中文。但她的經(jīng)歷與數(shù)百萬中國人類似，他們不得不忍受僵化的醫(yī)療保健制度，患者有時(shí)必須先付費(fèi)才能得到治療。
China has rolled out an ambitious $130 billion package designed to make medical care more affordable. It now has almost universal health insurance for its nearly 1.4 billion people.
中國已經(jīng)在實(shí)施一項(xiàng)1300億美元的宏大計(jì)劃，旨在減少醫(yī)療保健負(fù)擔(dān)。該國近14億人已經(jīng)接近實(shí)現(xiàn)全民醫(yī)保。
But the system is still plagued with gaps in coverage. Depending on the disease, whether the person lives in a city or the country and other factors, many Chinese can face huge out-of-pocket costs.
但這個(gè)體制仍然在覆蓋面上存在漏洞。根據(jù)疾病不同、一個(gè)人住在城市還是農(nóng)村或者其他因素，許多中國人可能會(huì)面臨高昂的自付費(fèi)用。
Then there are the remnants of the country’s “pay as you go” system. People who can’t cough up the money are often denied care — even in life-or-death situations. Some hospitals require patients with particular diseases to pay a hefty deposit first.
此外，中國還有殘存的“現(xiàn)收現(xiàn)付”制度。不能支付這筆費(fèi)用的人往往無法得到護(hù)理——哪怕是生死攸關(guān)的情況。一些醫(yī)院還要求患有特定疾病的病人首先支付一筆可觀的押金。
While medical reform was supposed to make health care more accessible, industry analysts say the problem persists. In 2015, for example, national health officials recommended that for critically ill patients, hospitals had to “first save them and then demand payment later.”
盡管醫(yī)改本應(yīng)讓醫(yī)療保健更加方便，但該行業(yè)的分析人士表示問題依然存在。比如在2015年，國家衛(wèi)生官員建議，對(duì)于危重患者，醫(yī)院必須“先救人，后收錢”。
New parents are vulnerable, according to Chinese state media reports.
根據(jù)中國官方媒體的報(bào)道，新生兒父母格外容易受此影響。
In 2012, a couple in Shenzhen were denied access to their newborn twins for two months because they could not pay nearly $19,000 in fees. In 2011, a 57-year-old grandmother in Nanjing, whose son owed a hospital $2,800 in medical fees for his newborn, knelt and begged doctors and nurses to allow him to see his child. That same year, a hospital in Dongguan told the parents who owed it more than $1,600 that it had sent their newborn child to an orphanage in order to “frighten” them into paying. While the families inevitably get their babies back, hospital officials can use their demands for faster or fuller payment.
2012年，深圳一對(duì)夫妻因?yàn)闊o法支付將近19000美元的費(fèi)用，連續(xù)兩個(gè)月無法接觸他們新出生的雙胞胎。2011年，南京一位57歲的奶奶由于兒子欠醫(yī)院2800美元醫(yī)藥費(fèi)，跪地乞求醫(yī)生和護(hù)士允許自己見見孩子。同年，東莞一家醫(yī)院告知一對(duì)欠了醫(yī)院1600多美元的父母，他們已經(jīng)把新生兒送到了孤兒院，以此“恐嚇”他們付款。家人最終都能要回孩子，但院方會(huì)利用這一點(diǎn)要求更快或更完整地收到費(fèi)用。
Rebecca Taylor, an Australian breast-feeding counselor in Beijing, called Logbo’s case “a ginormous violation of human rights.” She added that separating Logbo from her babies could be “almost catastrophic” in terms of breast-milk production.
駐北京的澳大利亞母乳喂養(yǎng)咨詢師麗貝卡·泰勒(Rebecca Taylor)稱洛戈博事件是對(duì)“人權(quán)的極大侵犯”。她還說，使洛戈博和自己的孩子分離，對(duì)母乳的產(chǎn)生來說可能是“災(zāi)難性的”。
“I’m saddened, disappointed and horrified, but I’m not surprised,” Taylor said. “If anybody goes to a local hospital for anything, everybody knows you have to go to the ATM first to carry a fistful of cash. You will literally not get things without paying.”
“我感到傷心、失望和害怕，但我并不意外，”泰勒說。“在當(dāng)?shù)匾メt(yī)院做點(diǎn)什么，誰都知道你得先去ATM機(jī)取一大把現(xiàn)金。不付錢你真的什么都得不到。”
Logbo acknowledged that her situation complicated matters. Her boyfriend, also a Liberian and the father of her twins, has been detained in China since September, she said, accused of lending his Chinese bank account to a friend for a money transfer.
洛戈博承認(rèn)，她的處境使事態(tài)更為復(fù)雜。她說，同為利比里亞人的男友，也就是雙胞胎的父親，因?yàn)榘阉闹袊y行賬戶借給了一個(gè)朋友用于轉(zhuǎn)賬，從9月起就被拘留在中國。
At the Huadu District People’s Hospital in Guangzhou, the demands for money came early. On May 5, as Logbo was going into labor, she had to pay $130 for an “ambulance fee.” After her C-section the next day, she had to pay a $790 deposit.
在廣州市花都區(qū)人民醫(yī)院，催繳通知格外早一些。在5月5日洛戈博準(zhǔn)備生產(chǎn)時(shí)，她須支付130美元的“救護(hù)車費(fèi)用”。第二天在進(jìn)行了剖腹產(chǎn)后，她要支付一筆790美元的押金。
Logbo gave birth at 3 a.m., and the nurses whisked the twins away without letting her hold them. When she asked to see her girls the next day, administrators demanded a $630 discharge fee, she said. 洛戈博于凌晨3點(diǎn)生產(chǎn)，然后護(hù)士很快便帶走了雙胞胎，沒有讓她抱。她說，當(dāng)她第二天要求見自己的女兒時(shí)，管理人員要求她支付630美元的出院費(fèi)用。
Her friend Salome Sweetgaye helped her raise the money, but they were too late. On May 10, they were told that they had to pay $800, according to Logbo. Logbo told the hospital that she had no money. It reduced the price to $707. Copies of these bills were viewed by The New York Times.
她的朋友薩洛姆·斯威特蓋耶(Salome Sweetgaye)幫她籌到了這筆錢，但為時(shí)已晚。據(jù)洛戈博稱，5月10日，她們被告知需支付800美元。洛戈博告訴醫(yī)院自己沒錢。醫(yī)院將費(fèi)用減至707美元。《紐約時(shí)報(bào)》查驗(yàn)了這些賬單的副本。
That afternoon, Logbo held her babies for the first time.
那天下午，洛戈博第一次抱到了自己的孩子。
A woman surnamed Tang, who works in the hospital’s medical disputes department, challenged Logbo’s account. “There definitely isn’t this situation of demanding that she first pay up before letting her see her children,” said Tang, who declined to give her full name. She said hospital workers had merely been “reminding” Logbo to pay up.
該醫(yī)院一位在醫(yī)療糾紛部門工作的唐姓女子對(duì)洛戈博的說法提出了異議。“絕對(duì)不會(huì)是要她先交了錢才能去看小孩的這種情況，”拒絕提供全名的唐女士說。她表示，醫(yī)院工作人員僅僅是在“提醒”洛戈博付錢。
Tang said Logbo’s babies were premature and could not be taken out of the newborn department. Many Chinese hospitals have a policy of denying parents access to premature babies because of a lack of nurses to monitor the visit and a fear of infections.
唐女士稱，洛戈博的孩子是早產(chǎn)兒，不能被帶出早產(chǎn)兒科室。中國許多醫(yī)院都有這種拒絕父母接觸早產(chǎn)兒的政策，因?yàn)闆]有足夠護(hù)士對(duì)來訪進(jìn)行監(jiān)管，并且會(huì)有感染的可能。
Logbo rejected Tang’s assertions, saying her babies were born healthy at 37 weeks. 洛戈博不接受唐女士的說法，稱自己的孩子是在第37周健康生產(chǎn)的。
Sweetgaye, 28, verified her friend’s account and said the hospital was “lying.”
28歲的斯維特蓋婭證實(shí)了朋友的說法，她還表示，醫(yī)院在“說謊”。
“They refused to give the babies to Juliana,” Sweetgaye said. “She had to cry a lot.”
“他們拒絕把孩子交給朱莉安娜，”斯維特蓋婭說。“她哭了很多次。”
Hospital officials didn’t respond to additional requests for comment.
醫(yī)院管理者沒有回復(fù)更多置評(píng)請求。
Hospital employees didn’t speak English, so it isn’t clear how much was lost in translation. Employees used smartphone translation apps, Logbo said.
醫(yī)院員工不會(huì)說英語，所以不清楚翻譯過程中遺失了多少信息。洛格博稱，醫(yī)院員工使用的是智能手機(jī)翻譯軟件。
But the hospital’s demands were clear, she said. One employee, she said, typed on his phone that she needed to pay 5,000 renminbi — nearly $800 — to get her babies discharged.
但她表示，醫(yī)院的要求很明確。她說，一名員工在他的手機(jī)上打字，寫明她需要支付5000元人民幣(近800美元)，醫(yī)院才會(huì)讓她的孩子們出院。
Logbo and her twins were discharged on May 13 after she paid nearly $3,500 in total, money raised through donations. She named her girls Grace Annabelle and Gracious Anna. (“Because I’m grateful to God for everything.”)
5月13日，洛格博支付了近3500美元，她和雙胞胎女兒才被允許出院。那些錢主要是募捐來的。她給女兒們?nèi)∶麨楦窭俳z·安娜貝爾(Grace Annabelle)和格拉西婭絲·安娜(Gracious Anna)(“因?yàn)槲覟檫@一切而感謝上帝”)。
The pay-as-you-go system persists in part because, some doctors say, they get stuck with unpaid bills themselves. Hospitals stress that they are not charities.
一些醫(yī)生表示，“付賬出院”制度持續(xù)的原因之一是醫(yī)院受拖欠的賬單困擾。醫(yī)院強(qiáng)調(diào)自己不是慈善機(jī)構(gòu)。
Felicity Miller, a British woman who was working at a factory in China, said a Shanghai hospital refused to give her premature daughter, born in 2011, an injection to prevent her lungs from collapsing because it had not received a deposit of about $1,600. Then, it threatened to withdraw treatment because her insurance company had not given the hospital a deposit of nearly $7,900.
曾在中國一家工廠工作的英國女性費(fèi)莉西蒂·米勒(Felicity Miller)稱，2011年，因?yàn)闆]有收到約1600美元的押金，上海一家醫(yī)院拒絕給她早產(chǎn)的女兒注射防止肺部衰竭的藥物。后來，由于她的保險(xiǎn)公司沒有向該醫(yī)院交付近7900美元的押金，該醫(yī)院威脅要停止治療。
“They said, ‘If we don’t get the money, we would stop the treatment,'” Miller said in a telephone interview. “And if she stopped the treatment, she would die.”
“他們說，‘如果收不到錢，我們就會(huì)停止治療，’”米勒在接受電話采訪時(shí)說，“如果停止治療，她就會(huì)死。”
Miller said she left China that year because of her experience.
米勒表示，因?yàn)檫@段經(jīng)歷，她在那一年離開了中國。
“I love China so much,” she said, “but it feels that if things go wrong, it’s not the right place to be.”
“我非常喜歡中國，”她說，“但我感覺，如果出現(xiàn)意外，那里就不適合待了。”
