中国伤医事件为什么频频发生？如何解决医闹问题？

2021年4月24日的《经济学人》China 版块中有篇文章，分析了中国为什么频频出现伤医事件，以及如何解决这一问题，今天我带大家一起来读一下这篇文章。

学习内容：

如何描述伤医事件？（What）
为什么发生伤医事件？（Why）
如何应对伤医事件？（How）

学习目标：

了解伤医事件的原因和解决办法；
学会用英语分析医闹事件；
掌握与医疗话题有关的词汇与表达。

学习步骤：

听力+原文预读
文章精读

一、听力+原文预读

大家先听音频、预读原文：

向上滑动阅览

Health care: Dangerous work

Violence against doctors is frighteningly common

PATIENTS IN CHINA keep attacking their doctors. On January 27th Hu Shuyun, a physician in the southern province of Jiangxi, died after being assaulted on a ward. A few days earlier three medical workers at a hospital in Hangzhou, an eastern city, were injured when a patient set off a homemade bomb. Every month brings more shocking stories. Chinese even has a word for it: yinao, meaning “medical disturbance”. Between 2004 and 2016, the number of such disputes that ended up in court rose from 8,854 to 21,480. But only a fraction of cases get that far. In 2016 the National Health and Family Planning Commission acknowledged that it had mediated more than 60,000 disputes.

The problem of yinao has become so acute that, on March 1st, Shanghai became the first city to start a blacklist of people deemed to have engaged in banned behaviour in medical facilities. As well as facing criminal penalties, they can be barred from holding public-sector jobs and denied access to outpatient services under the social-credit system, in which bad behaviour can mean loss of rights and privileges.

These measures build on a national law that came into effect last June. It is the first to specify that citizens have a right to “basic health-care services” provided by the state. It also bans them from attacking medical staff. In July Beijing’s city government adopted its own guidelines for hospital security, recommending checks at entrances and surveillance cameras inside. On April 15th Beijing’s health commission said that 86 hospitals had installed facial-recognition systems.

China’s doctors have long worried about violence. In 2015 600,000 physicians signed a petition calling for an end to such assaults. A survey in 2019 found that 85% of doctors had encountered violence at work. Officials have hailed medical staff as heroes during the covid-19 pandemic, but at the height of the outbreak last year there were several reports of patients with the disease assaulting doctors.

Much of the anger originates in the 1980s, when reform began on the free, state-funded health-care system. Hospitals, starved of government funds, began charging patients for treatment, and often resorted to overprescribing. Many ordinary people were unable to pay. This has created a “generalised sense of distrust” towards the medical profession, says Cheris Chan of the University of Hong Kong.

Even though the government initiated further reforms in 2009, under which nearly everyone is now covered by some form of basic health insurance, the quality of care in rural areas is still poor. So people go straight to large city hospitals, many of which sell tickets for consultations that touts buy up and resell for profit.

Fully 36% of spending on health care in China comes from patients, compared with 14% in the OECD, a club mostly of rich countries. The insurance system gives hospitals an incentive to treat out-of-province patients, since they must pay upfront. And China still has only two doctors per 1,000 people, compared with 3.5 on average across the OECD. Most are poorly paid.

Medical scandals further undermine confidence. A well-known case in 2018 involved hundreds of thousands of children receiving faulty vaccines after the manufacturer fabricated inspection records. In February this year 70 people were arrested for making fake covid-19 vaccines.

Tougher regulations to protect doctors from angry patients do not seem to be working. Since the new laws were introduced in Beijing more than 180,000 prohibited items such as knives have been seized at hospital entrances. With covid-19 under control, people are going back to hospitals. This could cause violence to rise again. Until the government deals with underpaid doctors and overstretched hospitals, it is likely to continue.

二、文章精读
01
如何描述医闹(What)

文章开头描述了伤医事件的普遍：

①Patients in China keepattacking their doctors. ②On January 27th Hu Shuyun, a physician in the southern province of Jiangxi, died after being assaultedon a ward. ③A few days earlier three medical workers at a hospital in Hangzhou, an eastern city, were injured when a patient set off a homemade bomb. ④Every month brings more shocking stories. ⑤Chinese even has a word for it: yinao, meaning “medical disturbance”.

在中国，病人殴打医生的事件时有发生。在1月27日，中国南部省份江西省的一名内科医生胡淑云在病房遭到袭击后死亡。此前几天，在东部城市杭州市的一家医院里，一名病号引爆自制炸弹，导致三名医护人员受伤。每个月都会有更多令人震惊的伤医事件。汉语里甚至有一个词来描述这一现象：医闹，即“医疗纠纷”。

①句先通过 keep 体现出伤医事件的频繁，接着②③两句举了两个具体的例子（江西省、杭州市的伤医事件）进行说明，然后④句总结：Every month brings more shocking stories，呼应了①句的keep，最后⑤句介绍了这一现象的专门叫法，突出了此类事件的「常态化」。

这一段是「总①→分②③→总④→强化主旨⑤」的结构，核心观点就是「医闹频繁」，keep, every month, has a word for it 都能体现出来。如果我们在写作中要描述某社会现象/事件/问题的频繁，就可以套用到这几个词，比如关于共享单车频繁被盗，我们就可以说：

Shared bicycles keep being stolen. Some riders hide the bikes in or near their homes to prevent others from using them. Others take pictures of a bike's QR code and then scratch it off to stop others from scanning it. Every day brings similar stories.

共享单车总是被盗。一些人把自行车藏到家里或附近，不让别人用。还有一些人把自行车上的二维码拍下来，然后把车上的二维码刮掉，不让别人扫。每天都有类似的事件发生。

再看一下文中这段话的语言点：

1）「袭击医生」可以说 assault, attack；

2）这段话出现了几个「医务人员」的说法，medical workers 泛指「医护人员」，也可以说 healthcare workers；physician 指「内科医生」，与之相对的是 surgeon「外科医生」。

3）ward 在这里作名词，指「病房」，on/in the ward 是「在病房」的意思，再比如 a maternity ward 产科病房；a children's ward 儿科病房。

ward 还经常用作动词，用法为 ward off，表示 to protect or defend yourself against danger, illness, attack, etc.「防止、避免」，比如《哈利波特与魔法石》的第 8 章就出现过这个表达：

His classroom smelled strongly of garlic, which everyone said was to ward off a vampire he’d met in Romania and was afraid would be coming back to get him one of these days.
他上课的教室里充满了一股大蒜味，人人都说这是为了驱走他在罗马尼亚遇到的一个吸血鬼，怕那个吸血鬼会回过头来抓他。

4）XX has a word/term for it 可以当成一个语块积累下来，表示「XX 语中有一个词来描述某种现象」。

文章中间也有一段关于医闹的描述：

①A survey in 2019 found that 85% of doctors had encountered violence at work. ②Officials have hailed medical staff as heroes during the covid-19 pandemic, but at the height of the outbreak last year there were several reports of patients with the disease assaulting doctors.

2019年的一项调查发现，85%的医生在工作中遭遇过暴力。在新冠疫情期间，政府官员把医护人员誉为英雄，但就在去年疫情最严重的时候，也出现过几起新冠患者袭击医生的报告。

这段话主要交代了伤医事件的普遍，以及疫情期间的伤医事件。

我们看几个语言点：

1）「遭遇暴力」动词可以用 encounter，举一反三，「被家暴」就可以说 encounter domestic violence. 此外，也可以用 suffer, experience 表示。

2）the pandemic, the outbreak 都是指「新冠疫情」。

3）hail...as...表示「把...誉为...」，hail 在这里是「赞扬、称颂」的意思，此外也可以表示 call「叫、喊」，比如我们出门时会先在网上 hail a ride/taxi「叫车」。

文中 hailed medical staff as heroes 和 at the height of the outbreak there were several reports of...这两部分形成强烈对比，体现出伤医事件的恶劣性质。

4）「XX 疾病患者」可以说 patients with XX 或 XX patients.

伤医事件的原因(Why)

文章原因从医生、医院、医疗行业三个维度分析了发生医闹事件的原因，我们先看第一个维度——医生。医生多开药、开贵药，使人们失去了对医生的信任。
Much of the anger originates in the 1980s, when reform began on the free, state-funded health-care system. Hospitals, starved of government funds, began charging patients for treatment, and often resorted to overprescribing. Many ordinary people were unable to pay. This has created a “generalised sense of distrust” towards the medical profession.
对医生的愤怒主要源于上世纪80年代，当时政府开始对免费的、由国家出资支持的医疗系统进行改革。由于缺乏政府资金，医院开始向病人收取治疗费用，并且通常会过度开药。很多老百姓看不起病。这造成了人们对医疗行业的“普遍不信任”。

这段话主要从历史角度，分析了人们对医疗行业缺乏信任。

在 1985 年前，中国的医疗制度还处于计划体制下，看病免费，但效率低下、设备落后、治疗效果差。1985 年进行医疗行业改革，扩大医院自主权，提高了医院的效率和效益，但也带来了一些问题，比如改革的基本做法是“只给政策不给钱”，所以很多医院缺乏资金（starved of government funds），就多开药、开贵药（overprescribing）以维持运营。当然这次改革要全面、客观看待，不能像文中一样一刀切（Much of the anger originates in the 1980s）。西方看待中国的问题，总喜欢上升到体制、制度层面，做也是错、不做也是错。

我们看一些语言点：

1）the anger 指的是患者对医生的愤怒；

2）when reform began on the free, state-funded health-care system 中，on...这部分是跟在 reform 后面的，reform on 指「针对...的改革」。此处之所以把 on...放在最后，是为了避免头重脚轻，试对比：

when reform began on the free, state-funded health-care system

when reform on the free, state-funded health-care system began

是不是前者的结构更加平衡一些？

3）be starved of 是固定搭配，starve 是「饥饿」的意思，所以 be starved of 就是「缺乏...」，比如：

The schools are starved of funding.
这些学校缺乏资金。

文中 (be) starved of government funds 就是「缺乏政府资金」的意思，也可以说 fund-starved, cash-starved.

我们在上篇推文《如何通过回译学英文（10）》讲过「缺钱」的表达，比如：

cash-strapped

be short of cash

financially stretched

live paycheck-to-paycheck

前三个都可以和文中 (be) starved of government funds 替换。

4）charge sb for sth 表示「因sth向sb收费、向sb收取sth的费用」，看两个例句：

What did they charge for the repairs? 他们收了多少修理费？
We won't charge you for delivery. 我们送货不收费。

5）resort to 是固定搭配，to 是介词，后面加 doing 或 n.，表示 make use of sth, especially sth bad, as a means of achieving sth, often because there is no other possible solution「诉诸于某种方法/手段、采取某种方法/手段」，比如 resort to violence 诉诸于暴力。

6）overprescribe = over + prescribe，意思是「过度开药」。

第二个原因在于医院——挂号难：

①Even though the government initiated further reforms in 2009, under which nearly everyone is now covered by some form of basic health insurance, the quality of care in rural areas is still poor. ②So people go straight to large city hospitals, many of which sell tickets for consultations that toutsbuy up and resell for profit.

尽管政府在2009年深化医疗体制改革，使基本医疗保险几乎覆盖了所有人，但农村地区的医疗质量仍然很差。因此人们会直接去大城市医院看病。很多大城市医院需要挂号会诊，而票贩子会把号挂满，再高价转卖以获取利润。

这段话主要讲了大城市医院「医疗资源紧张、挂号难」的问题，①句是因：尽管深化改革，但农村医疗水平仍然落后；②句是果：农村人跑到城市看病，造成医疗资源紧张（用文中的词表示就是 overstretched hospitals），而且城市医院的票贩子会把挂号费炒高。

前几年确实存在这一问题：

不过现在挂号都改为了实名制，炒号行为大大减少。

我们来看语言点：

第一句话：①Even though the government initiated further reforms in 2009,(让步状语从句) under which nearly everyone is now covered by some form of basic health insurance,(让步状语从句中嵌套定语从句) / the quality of care in rural areas is still poor.(主句)

1）initiate 是 make sth begin 的意思，比如 initiate a programme of economic reform「实施经济改革方案」，文中 initiated further reforms 就是「启动进一步改革」，用政府的口吻说就是「深化改革」。

表达「开启改革、启动改革」，如果 reform 作主语，可以说 reforms begin on...；如果政府作主语，可以说 the government initiates reforms on...，此外也可以说 carry out/through, implement, put into practice, undertake reforms on...

2）under which 中，which 指 further reforms，所以从句部分可以看成：under the reforms / nearly everyone is now covered by some form of basic health insurance 根据这项改革，几乎每个人都能被基本医疗保险覆盖。

3）cover 在这里表示「给...上保险」，比如：

Does this policy cover my husband to drive?
这份保险单是否保我丈夫的驾车险？

再比如去医院或药店拿药，我们一般要问一下这药在不在医保范围内，可以说：

Are the drugs covered by the medical insurance?

第二句话：②So people go straight to large city hospitals (主句), many of which sell tickets for consultations (定语从句) that touts buy up and resell for profit. (定语从句中嵌套定语从句)

4）go straight to：径直去、直接去，《哈利波特与魔法石》第17章中也出现过这个表达：

Unfortunately, while everyone else was running around looking for it, Snape, who already suspected me, went straight to the third floor to head me off.
倒霉的是，当大家都匆匆忙忙到处寻找巨怪时，早已对我起了疑心的斯内普直接赶到四楼，试图阻拦我。

5）which 指 large city hospitals，所以从句部分可以看成：many of the large city hospitals sell tickets for consultations that touts buy up and resell for profit

6）tickets for consultations：会诊票，也就是我们到医院挂的「号」。

7）that touts buy up and resell for profit 是定语从句，修饰 tickets for consultations.

tout 指「黄牛、票贩子」；

buy up 是「买光、全部买下」；

resell for profit 是「转卖以获取利润」。

第三个原因在于医疗行业：医疗丑闻进一步降低了人们的信任。

①Medical scandals further undermine confidence. ②A well-known case in 2018 involved hundreds of thousands of children receiving faulty vaccines after the manufacturer fabricated inspection records. ③In February this year 70 people were arrested for making fake covid-19 vaccines.

医疗丑闻进一步削弱了信心。2018年，数十万儿童因制造商伪造检查记录而接种假疫苗，这一事件弄得人尽皆知。今年二月，70人因生产假冒新冠疫苗而被逮捕。

这段话是总分的结构，①句为总，交代了第三个原因：Medical scandals 医疗丑闻，②③两句为分，分别举了2018年「假疫苗」和今年「假新冠疫苗」的例子进行说明。

相关阅读：《我们可以从疫苗事件中学到哪些表达？》

我们看一下语言点：

1）further undermine confidence 承接了上文 created a “generalised sense of distrust”；

2）②句的主干是：A well-known case in 2018 involved hundreds of thousands of children；

receiving faulty vaccines 是分词形式的后置定语，修饰 children，意思是：接种假疫苗的孩子。

表示「接种疫苗」，可以说 receive vaccines/jabs，或 be given a jab，「打新冠疫苗」知道该怎么说了吧？

记得穿上疫苗装去打疫苗~

3）fabricate 是「伪造、篡改」的意思，比如伪造GDP数据，英文就是 fabricate GDP data.

问题的矛盾之根，就在于「信任」问题，对医生的不信任、对医院的不信任、对医疗行业的不信任。当然医闹频发也有患者方面的原因，但本文没有提到。

如何解决医闹问题(How)

文章分别介绍了上海和北京的相关措施，我们先看上海的做法：

①The problem of yinao has become so acute that, on March 1st, Shanghai became the first city to start a blacklist of people deemed to have engaged in banned behaviour in medical facilities. ②As well as facing criminal penalties, they can be barred from holding public-sector jobs and denied access to outpatient services under the social-credit system, in which bad behaviour can mean loss of rights and privileges.

医闹问题已十分严重，在3月1日，上海成为首座发布医闹黑名单的城市。一旦被列为黑名单，除了要面临刑事处罚外，还会被限制担任公共部门的工作，而且根据社会信用体系，将无法享受到门诊服务。这意味着医闹行为会使人丧失权利和特权。

①句交代了上海市的措施，②句具体介绍了对医闹者的惩罚。这段话难度比较高，我们先看①句：The problem of yinao has become so acute that, on March 1st, Shanghai became the first city to start a blacklist of people / deemed to have engaged in banned behaviour in medical facilities.

became the first city to start a blacklist of people：成为第一个启用 XX 人员黑名单的城市。

deemed to have engaged in banned behaviour 是分词形式的后置定语，修饰 people，意思是：被认为从事禁止行为的人。

in medical facilities：在医疗场所

合起来：上海成为第一个启用「被认为在医疗场所从事禁止行为的人」的黑名单的城市。

简单说就是：上海成为首座发布医闹黑名单的城市。

我们再来看②句：As well as facing criminal penalties, they can be barred from holding public-sector jobs and denied access to outpatient services under the social-credit system, in which bad behaviour can mean loss of rights and privileges.

1）As well as 在这里表示「除了...(也...)」，类似 besides, apart from, in addition to，我们再看几个相关例句，《经济学人》中曾有篇文章讲到了小米公司的发展，文中有这么一句话：

As well as smartphones, Xiaomi has hundreds of other products, from vacuum cleaners to electric bicycles, and even owns 30% of a small bank.
除了智能手机，小米还有数百种其他产品，如吸尘器和电动自行车等，甚至还持有一家小型银行30%的股份。

2）face criminal penalties 指「面临刑事处罚」，补充相关表达： face civil penalties「面临民事处罚」。

3）bar sb from doing 禁止某人做某事，同 be banned/prevented from doing.

4）holding public-sector jobs 的意思是「担任公共部门的工作」，注意动词搭配。public-sector jobs 指公务员和事业单位（比如学校）的工作。

5）deny sb's access to...：阻止某人接触/使用/进入...

access 这个词我们在很多文章中都讲过，复习一下：

经济学人精读丨代际冲突

看完何同学采访苹果 CEO 的视频，我总结出 21 个高频实用表达丨内含讲解视频

deny access to 也在《生活大爆炸》中出现过：

6）outpatient 指「门诊」，比如 an outpatient clinic 门诊部。

7）under the social-credit system 指「按照社会信用体系、根据社会信用体系的规定」。

under 后面加 system/law，表示 according to 的意思「按照、根据」，前面 under the reforms 也是这个用法。

8）in which bad behaviour can mean loss of rights and privileges

which 代指前面提到的几项惩罚措施，in which 可以理解成：在这种情况下。

bad behaviour 在文中指「医闹行为」。

我们再来看北京的做法：

In July Beijing’s city government adopted its own guidelines for hospital security, recommending checks at entrances and surveillance cameras inside. On April 15th Beijing’s health commission said that 86 hospitals had installed facial-recognition systems.

7月，北京市政府实施了医院安检制度，建议在入口进行安检，在医院内部安装监控摄像头。4月15日，北京健康委员会表示，86家医院已经安装了面部识别系统。

这段话讲了北京的医院安全措施，语言比较简单。

1）表示「实施(措施/政策)」，可以用 adopt, implement, put... in place, put... into practice 等词。

2）check 此处指「安检」，每次乘地铁前都要「过安检」，英文是 go through security check.

今天的讲解就到这里，我把今天的内容整理成了思维导图，大家可以根据思维导图梳理一遍：