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 A Co-operative Medical Service Greatly Welcomed By Poor and Lower-Middle Peasants

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Source: Peking Review, No. 3, January 17, 1969
Transcribed by www.wengewang.org

   
   China's great proletarian cultural revolution is now in the midst of a high tide in the mass movement for struggle-criticism-transformation. Struggle-criticism-transformation means taking Mao Tse-tung's thought as the guide to thoroughly transform all parts of the superstructure which do not conform to the socialist economic base, so as to bring about the dictatorship of the proletariat in the superstructure. The transformation of the medical and health system is an important part of the transformation of the superstructure.
   Under the leadership of our great leader Chairman Mao and the Chinese Communist Party, a series of measures to ensure medical care and hygiene to the people were taken in the countryside after the founding of New China. The health of the working people was greatly improved. But the big renegade, traitor and scab Liu Shao-chi pushed a revisionist line in medical and health work and put the stress on the cities in this work. Manpower and material were not concentrated on the most essential problems for the working masses, and the lack of medical facilities in the rural areas, a historical heritage, was not fundamentally overcome for a long time.
   The co-operative medical service is a new medical system created by China's poor and lower-middle peasants in accordance with the socialist orientation pointed out by Chairman Mao. This system embodies the communist spirit of mutual concern and mutual aid. It conforms to the socialist orientation, and to the level of economic development in China's countryside. The establishment of this system will swiftly and fundamentally change the state of inadequate medical facilities in the countryside. Since being reported in the press early last December, this system has been welcomed by poor and lower-middle peasants everywhere and enthusiastic discussions on it are being held across the land.
   The following article describes the co-operative medical service of the Chunhsing Production Brigade in Chuchiang County, Kwangtung Province, which has been in operation for 11 years. In a comparatively systematic and comprehensive way, it tells of the contents of this system, its superiority and the process of its birth and development.   It will help our leaders get some idea of what this system is.

—'"Peking Review" Editor

THE co-operative medical service of the Changshih People's Commune's Chunhsing Production Brigade in Chuchiang County, Kwangtung Province, was started in 1957, when the peasants in that locality had formed an advanced agricultural producers' co-operative. In the 11 years since then, guided by the proletarian revolutionary line of Chairman Mao, this medical system has steadily developed and become increasingly consolidated in the struggle between the two lines.

Co-operative Medical Service: Created by The Poor and Lower-Middle Peasants

   In Chuchiang County, the area of the Chunhsing Brigade was a place which had a greater incidence of schistosomiasis and epidemics such as typhoid fever, malaria and dysentery. Before liberation, when schistosomiasis was rampant here, it took a toll of many poor and lower-middle peasants' lives. Once stricken, many poor and lower-middle peasants, unable to afford treatment, lost their power to work and could only await death. Others who tried to get some money for treatment had to beg, or sell their children with the result that their homes were broken up. The whole population died off in some villages. After liberation, with the solicitude and under the leadership of the Party and Chairman Mao, a number of measures to prevent and cure disease were taken before the co-operative medical service was instituted in 1957, and the health of the masses greatly improved. However, because the renegade, traitor and' scab Liu Shao-chi and his agents pushed a counter-revolutionary revisionist line, the backward state of the masses lacking medical care saw no radical change. The area of the present brigade then had a total population of 2,916, which included a labour force of 1,139. About 2 per cent of the population were hospitalized annually because of serious illnesses, while some 10 per cent had various common diseases. Since there were no medical facilities in the locality, once the poor and lower-middle peasants got sick, even with a cold or the flu. they had to walk all the way to the township clinic. There and back often took all day. They not only could not get timely treatment, but they felt the added financial burden. If they were ill and were hospitalized, the burden was felt even more keenly.
   In his illustrious work On the Question of Agricultural Co-operation, our great leader Chairman Mao issued a great call to the peasants throughout the country: "The only way for the majority of the peasants to shake off poverty, improve their livelihood and fight natural calamities is to unite and go forward along the high road of socialism." This call has pointed out the road of advance for the hundreds of millions of peasants in China. In the high tide of agricultural cooperation in 1957, the poor and lower-middle peasants of the Chunhsing Advanced Agricultural Producers' Co-operative (the present Chunhsing brigade) set up the co-operative medical service in order to completely overcome the lack in medical facilities.
   The Chunhsing co-operative medical service roughly went through two stages. From 1957 (during the period of the advanced agricultural producers' cooperative) to 1964 (when the brigade was the basic accounting unit), the brigade paid for all its members' fees for treatment and medicine. The patient only paid the registration fee. In this way, the brigade spent around 8,000 yuan annually for medical expenses. From 1965 (when the production team became the basic accounting unit) up to now, medical expenses are shared at three different levels — by the brigade, the team and the commune members themselves. The medical fund is jointly contributed to by all three at the time of distribution of income every year. The amount to go into the fund and the proportion of contribution between the three are decided after discussion by the poor and lower-middle peasants' representative conference. This proportion is rationally readjusted each year according to the medical needs of the brigade and its financial condition. The practice in recent years is that each commune member pays one yuan a year, the production team pays one yuan per capita annually from its welfare fund, and the production brigade pays around 2,000 yuan from its side-line occupation income. These add up to some 8,000 yuan. Experience shows that this method of medical expenses being shared at three different levels embodies the communist spirit as taught by Chairman Mao — that all people in the revolutionary ranks "must care for each other, must love and help each other." It conforms to the general orientation of socialism and to the present rural economic base — the three-level ownership of the means of production [i.e., ownership by the commune, the production brigade and the production team], and the level of economic development in China's countryside.
   Under this service, the commune members get timely treatment for minor ailments from the production team's health worker and are treated for more serious maladies at the brigade's medical station. As for difficult cases which this station is unable to cope with, it sends patients to the people's hospital in the county or special administrative region, with which the brigade has a contract. Medical expenses incurred by these patients are paid annually to the hospital by the brigade. This co-operative medical service is greatly welcomed by the poor and lower-middle peasants. They say with feeling: "Chairman Mao is our saviour. He has also solved the problem of getting medical treatment for us. A big load has been taken off our minds and we are rid of a centuries-old worry."

Superiority of Co-operative Medical Service

   The Chunhsing brigade's co-operative medical service has great vitality, and has shown much superiority in the past 11 years.
   1. It has greatly deepened the proletarian feelings of the poor and lower-middle peasants for our great leader Chairman Mao. One woman commune member, a poor peasant, had serious injuries after giving birth. Because of her critical condition, she had to be treated in Die big cities. The service paid all her medical expenses. Whenever she talks about this, she is moved to tears. She says: "Chairman Mao and the Communist Party gave me a new life. As long as I live, I will live up to the expectations of Chairman Mao and work hard for socialism!*'
   Poor peasant Lai Shih-ying once had a serious case of schistosomiasis, but could not afford treatment. After joining the co-operative medical service, his disease was cured. With great emotion, he said: "Chairman Mao, Chairman Mao! If your revolutionary line in health work hadn't saved me, I would be unable to work for the socialist revolution and socialist construction any more. I'll never forget what I owe to you. I'll never depart from your proletarian revolutionary line.'' These words express the sincere feelings the poor and lower-middle peasants have for our great leader Chairman Mao.
   2. It has developed the class love among the poor and lower-middle peasants. Guided by the teachings of our great leader Chairman Mao, the poor and lower-middle peasants have profound class love for each other, which finds better expression in the cooperative medical service. Last September, poor-peasant commune member Tseng Tsao-chiao of the Hungwei Production Team was bitten by a poisonous snake one day while cutting grass in the hills. The poison spread swiftly through her body and her whole body turned black. The poor and lower-middle peasants of her team immediately sent her to the city. The effects of the poison caused her to lose a great deal of blood, and she urgently needed a transfusion. When her team's poor and lower-middle peasants heard this, more than a dozen of them immediately volunteered to donate their blood. They said: "In the vicious old society, when a class brother got sick, we couldn't even help if we wanted to. Now that our country is liberated, and we have a co-operative medical service, everybody pitches in to help when anyone is sick; class feelings between us have become even deeper."
   3. The co-operative medical service has promoted production and consolidated and developed the collective economy. Most of the production teams of the Chunhsing brigade are about 10 li away from the commune clinic. The furthest is 18 li. Without this service, the commune members would have to leave their brigade to get treatment. Nearly 6,000 workdays would be taken up by these trips every year in the brigade as a whole. After the service was established, the commune members could see the health worker for such minor ailments as colds and flu right in the production team and be treated at the brigade medical station for common diseases. Thus, about 95 per cent of the 6,000 workdays can be saved annually for production work to develop the collective economy. (Only some 5 per cent o[ the 6:000 workdays are taken up by patients who need to go out of the brigade for treatment.) On the other hand, with the establishment of the service, those poor and lower-middle peasants who lost their power to do manual work due to schistosomiasis or other diseases have been given thorough treatment and many of them have regained their health and their ability to work. This helps to further consolidate and develop the collective economy. The total labour power of the brigade's Hsinghsing Production Team increased by more than 14 per cent over the last 11 years because those people who used to be sick, have become well through the co-operative medical service. This shows that the establishment of this system has not only greatly relieved the suffering of the poor and lower-middle peasants, but has also enabled the socialist collective economy to be steadily consolidated and developed.
   4. It helps implement the policy of putting prevention first. After the co-operative medical service was put into effect, propaganda and education in the prevention of disease have been frequently carried out and the masses are mobilized to look after health and hygiene. Timely inoculations against epidemics and early treatment have greatly reduced the incidence of disease and its chances of spreading. The Chunhsing brigade had a "Thousand-Household Village" which embraced six adjoining villages having some 800 families. There used to be a greater incidence of schistosomiasis here. Before liberation, this was like the place where, as Chairman Mao described in a poem, "Thousands of households dwindled, phantoms sang with glee." Under the care and leadership of the Party and Chairman Mao, the introduction of the co-operative medical service and timely prevention work on a mass scale have basically wiped out schistosomiasis. The working people here are fit and strong. The poor and lower-middle peasants have nothing but gratitude for the happiness brought to them by the Communist Party and Chairman Mao and praise for the co-operative medical service. They say: "Now, those who are well can guard against disease. Those with minor ailments tan get early treatment. Those who are seriously ill are cured by collective efforts. Our health is well guaranteed."

Co-operative Medical Service Consolidated and Developed in the Struggle Between the Two Lines

   A sharp struggle between the two lines took place throughout the course of adopting the co-operative medical service in the Chunhsing brigade. This struggle was focused on whom the medical and health work should serve. Always holding high the great red banner of Mao Tse-tungs thought, the brigade's poor and lower-middle peasants have firmly carried out Chairman Mao's proletarian revolutionary line. They have waged resolute and consistent struggles against the counter-revolutionary revisionist line in medical and health work pushed by Liu Shao-chi and his agents, opposed the sabotage and harassment of the co-operative medical service by the handful of capitalist roaders in the Party and the class enemies in the countryside, and ceaselessly consolidated and developed this service in the course of struggle. In the past 11 years they engaged in several rounds of big struggle.
   The first round took place in 1957. Less than a year after this medical system was put into effect, Liu Shao-chi and his agents in the public health departments, pushing the revisionist line in medical and health work, ordered a drastic reduction in rural health workers, virtually paralysing medical and health work at the grass-root level in the countryside. At that time, some people in the Chunhsing brigade also sprang up, saying: "By spending several thousand yuan a year, the co-operative medical service weakens the collective economy." Advocating that "those who get sick should pay their own medical fees," they wanted to chop down the service. The poor and lower-middle peasants held that this service reflected their interests and demands and ensured their health, and that upholding or opposing it involved a question of the struggle between the two lines. Firmly sticking to Chairman Mao's revolutionary line, the Party branch of the brigade thwarted this revisionist adverse current and resolutely kept on with the co-operative medical service.
   The second round happened in 1961, when China's economy met with temporary difficulties. The handful of capitalist roaders headed by Liu Shao-chi vigorously fanned up the evil wind of "san zi yi bao" (the extension of plots for private use and of free markets, the increase of small enterprises with sole responsibility for their own profits or losses, and the fixing of output quotas   based   on   the   household),   "four freedoms" (freedom of usury, of hiring labour, land sale and private enterprise), and "individuals paying medical expenses." They did this in an attempt to break up the collective economy and thereby remove the basic guarantee for co-operative medical expenses. In order to resist this evil wind, the Party branch led the poor and lower-middle peasants in recalling the past and comparing it with the present. The latter used their personal experience to accuse the vicious old society. This stimulated their class feelings and raised their level of consciousness in class struggle and the struggle between the two lines.    When Chu Ju-hua recalled his past sufferings and contrasted them with the present happiness, this poor-peasant member said indignantly: "I grew up in a family of 12 children, including myself. Because we had neither sufficient food nor adequate clothing and could not afford to pay for medical fees in the old society, nine of my brothers and sisters died one by one.  After liberation, Chairman Mao guided us to take the road of co-operation and there is no worry about food and clothing. Since the adoption of the co-operative medical service, we have stopped worrying about medical care. I had typhoid fever in 1958 and stayed in the hospital more than a month. The next year my wife and child were seriously ill. Altogether, my family used over 970 yuan of (he co-operative medical fund in being cured. If we had been in the old society, my whole family would have died." With tears in his eyes, Chu Ju-hua said with great emotion: "Chairman Mao gave my whole family a second life. I must firmly follow Chairman Mao to take the socialist road and will never retreat." His words express the poor and lower-middle peasants' bitterest hatred for the evil old society, their boundless love for their saviour Chairman Mao, and their determination to take the socialist road.  The poor and lower-middle peasants not only resisted the sinister wind of "san zi yi bao" and "four freedoms." but also rejected the revisionist trash of "individuals paying medical expenses," thereby upholding the co-operative medical service.
   The third round came in 1964. Liu Shao-chi and his agents in the locality pushed a bourgeois reactionary line which was "Left" in form but Right in essence, and compelled the brigade to transfer half its enterprises to its production teams. They threatened: "If these enterprises are not transferred down to the teams, the brigade cadres evidently want to engage in corruption.” This is the way they pushed their vain efforts to destroy the co-operative medical service. Should this medical system be upheld or not under these circumstances? The brigade's Party branch called a meeting of representatives of poor and lower-middle peasants to discuss the matter. The poor and lower-middle peasants listed a host of facts to explain the advantages and necessity of the service. They said: "Chairman Mao teaches us to take the road of mutual aid and co-operation and we should take the same road on the medical and health question. We cannot fold our arms when our class brothers are in difficulty because they are sick." It was decided after discussions by the poor and lower-middle peasants that, instead of the brigade paying all the medical expenses, these expenses would be shared by the brigade, the production teams and the members. Once again they defeated the sabotage attempts by the revisionist line.
   The fourth round took place in the great proletarian cultural revolution. Frantically, a handful of class enemies leapt out to sabotage the brigade's collective economy and force the brigade to hand over bamboo groves and wooded areas to production teams. They ranted: "Give us the bamboo grove, and then the brigade need not pay the co-operative medical expenses." Armed with Mao Tse-tung's thought, the poor and lower-middle peasants saw that this was the class enemies' attempt to rebel against socialism, and they firmly opposed them. Guided by Chairman Mao's revolutionary line, the poor and lower-middle peasants smashed the sabotage scheme of the class enemies. They dragged out the handful of bad elements, refuted and overthrew them, and thereby consolidated the collective economy and upheld the co-operative medical service. Recently, in the movement to study the history of the struggle between the two lines, the poor and lower-middle peasants of the Chunhsing brigade made further efforts to thoroughly repudiate Liu Shao-chi's revisionist line in medical and health work. Many of them said: "Now we have raised our level of consciousness about the struggle between the two lines. Our brigade's cooperative medical service must be upheld under all conditions and we will not permit the class enemies to destroy it."
   In the course of carrying out this service, there has always been the struggle between the ideas of self-interest and public interest. Some cadres regarded the adoption of this service as "seeking trouble for one's self." Following Chairman Mao's teaching that "political work is the life-blood of all economic work" and dealing with such living ideas in the minds of these cadres, the brigade's Party branch educated them in the struggle between the two lines through deep-going and careful ideological and educational work. Taking the "three constantly read articles" as the criterion, they examined themselves: Whether or not they had the idea of wholehearted service to the people, whether or not they took the stand of the poor and lower-middle peasants and showed concern for the well-being of the masses, whether or not they had the class feelings of being concerned about what the poor and lower-middle peasants were concerned about and hated what the poor and lower-middle peasants hated. By deepening revolutionary mass criticism and repudiation, fighting self-interest and repudiating revisionism, and other methods, the Party branch has constantly raised the masses' awareness of the struggle between the two lines, so that the masses love the co-operative medical service still more and give it still stronger support. Physically strong and relatively well-off in his family income, a member of the May 1 Production Team had misgivings about the co-operative medical service, thinking that it "brings benefits to others and some losses to myself." In 1967 he was seriously sick twice and was cured by the hospital of the special administrative region. This cost 200 yuan for medicine alone. After leaving the hospital, he said: "I used to think it was unfair for those who were not sick all year and those who suffered from all-year round diseases to pay the same dues to the co-operative medical fund. Though I wasn't sick, I had to pay the medical fee. Thus, I felt I suffered a loss while the others made a gain. However, from my experience in being cured, I realized that the co-operative medical service is fine. It not only cured me physically but ideologically, overcoming my lack of collective spirit."

The Orientation of Medical and Health Work As Seen From the Chunhsing Brigade's Co-operative Medical Service

   Chairman Mao teaches: "In medical and health work, put the stress on the rural areas." Practical experience in adopting the co-operative medical service in the Chunhsing brigade over the past 11 years proves that it is necessary to tackle well the following questions in order to uphold the fundamental orientation in medical and health work as taught by Chairman Mao.
   1. Only by putting the leadership of the brigade's medical and health work firmly in the hands of the proletariat and putting the work under the supervision of the poor and lower-middle peasants can Chairman Mao's proletarian line in medical and health work be carried out in the rural areas and better service be given to the poor and lower-middle peasants. Practice by the Chunhsing brigade in the past 11 years proves: Only by establishing the "three-in-one" leading group of poor and lower-middle peasants, cadres and medical personnel under the leadership of the Party, calling regular meetings of the representatives of the poor and lower-middle peasants and receiving the supervision of the poor and lower-middle peasants can it be guaranteed that the leadership in medical and health work is firmly held by the proletariat. The poor and lower-middle peasants, the most reliable ally of the working class, must manage rural medical and health work, Only then can the so-called top to bottom "perpendicular leadership" in the old public health system be discarded and the domination of rural medical and health work by bourgeois intellectuals be ended.
   2. It is necessary to train a group of medical and health workers who are boundlessly loyal to Chairman Mao and wholeheartedly serve the poor and lower-middle peasants. In the past 11 years, the brigade has trained five "barefoot doctors," and 32 health workers who are not divorced from production. Together with the original six country doctors of traditional Chinese medicine, they form a medical and health network. Fearing neither hard work and fatigue nor dirt, these medical personnel serve the people wholeheartedly and are warmly welcomed by the masses. To help consolidate and develop the co-operative medical service and expand the medical ranks, they are now preparing to further organize the "country doctors." Medical and health workers in the county and the people's commune will also go to the countryside and the basic units by groups at different stages, take the road of the "barefoot doctors," receive re-education from the poor and lower-middle peasants and better serve the latter.
   3. It is necessary to vigorously carry out the policy of putting prevention first. Only by implementing this policy can the enthusiasm of the masses of commune members be brought into full play and disease be prevented, discovered and cured at an early stage. Thus, the incidence of disease can be reduced and medical expenses cut. This will consolidate the co-operative medical service, and consolidate and develop the collective economy.
   4. It is necessary to take the road of self-reliance. The Chunhsing brigade is making use of the rich resources of local medicinal herbs and mobilizing the masses to collect them; popularizing folk and empirical prescriptions that have proved effective; popularizing economical and effective methods of treatment, such as acupuncture, cautery, cupping; mobilizing the masses to treat minor diseases and injuries by simple methods so as to save on co-operative medical expenses and support the class brothers who get serious diseases and injuries. This helps solve the problem of drugs, promote the integration of Western and traditional Chinese medicine, and lighten the commune members’ financial burden.
(“'Hongqi," No 1, 1969)
  
  
  

 
 
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