China in Focus #10: Per Capita Counts

April 16, 2013 | 5:39 pm
Gregory Kulacki
China Project Manager

China’s gross national income per capita ranks 114th among all nations and is below the global average.
(Source: World Bank, Last Update: Jan 17, 2013)

The most well known and the least well appreciated statistic defining contemporary China is the size of its population, officially estimated to be 1.344 billion. That’s equivalent to the combined populations of the United States, Japan, Germany, France, the United Kingdom, Italy, Poland, Russia, Brazil, Argentina, Mexico, Canada, South Africa, Australia and Jamaica. It is just about one out of every five of the estimated  6.973 billion people on earth. President Obama keeps calling on China to play a greater role in the world. China’s leaders argue taking care of their own is hard enough. They have a point.

President Obama also considers China a developed country no longer deserving of the international legal and trade accommodations accorded to developing nations. He’s dead wrong. China isn’t even close to being a developed country. It may be the world’s second largest economy but on a per capita basis China ranks approximately 90th on many comparative national economic indices, such gross domestic product. President Obama argues China needs to do something to curb its rising carbon emissions, and Chinese leaders agree, but U.S. insistence on equal treatment in a new climate treaty conveniently overlooks the size of China’s population and the relative historical contribution of the average Chinese family to the problem. China may now produce more CO2 as a nation, but the average Chinese person produces approximately one-third the CO2 produced by the average American. And their parents and grandparents produced a far smaller percentage of the CO2 produced by their American counterparts.

National level statistics are important, but per capita statistics count too. When talking about China, they count for a lot.

Ever since the Beijing Olympics the meme of China as a “great power,” ready to assume a leading role on the world stage, has overtaken U.S. perceptions of the country. U.S. commentary on high speed rail, the space program, fighter planes and Chinese cyber culture has created the impression China is catching up to the United States. But the focus of China’s new president on the “Chinese dream” of “national renaissance” is simply to build a “moderately comfortable society” by mid century. This isn’t the rhetoric of an ambitious “great power.” It is the cautious terminology of politicians who worry how difficult it will be to meet the expectations of their fifth of humanity for jobs, homes, education, health care and pensions without exhausting the national treasury or the Chinese environment.

Most Americans who visit China, including President Obama’s leading China advisors, see the country from an understandable distance. They notice all the new construction, crowded shopping malls stuffed with familiar brands, highways congested with new cars and countless other outward signs of China’s very real economic progress. But they don’t experience life here. They don’t depend on this economy for their individual health and well-being. If they did they might better understand just how much farther the average Chinese citizen has to go before he or she remotely approaches the quality of life the U.S. economy affords.

Even those Americans who live in China are relatively isolated from the harsher realities of Chinese daily life. Every now and then, however, those realities intrude.

A Trip to a Chinese Hospital

After experiencing chest pains I hopped on a bus and took myself to the emergency room of the closest hospital. Calling an ambulance or taking a taxi would have been slower. From the outside it looked great, a beautiful big new building constructed about the same time as the Olympic stadium. Inside, it was like walking back in time thirty years.

After standing in a variety of lines to register and get my papers in order, I stood in another line to see one of three doctors sitting in a dusty room packed with beat-up medical equipment. They were sitting behind the same wooden white-painted desks I remember from my time as a student in China in the 1980s. All manner of people milled about the room with various ailments, family and friends trailing close behind. I described my situation and got an abrupt EKG which didn’t look right at all. I am almost certain the fact that some of the contacts weren’t working had something to do with it. They stuck me in a bed, drew some blood, and put me on an IV of a substance that remains a mystery. They told me it made my blood vessels wider. The nurse said I needed to wait a few hours and left. Lucky for me a good friend came to sit with me, absolutely essential in a Chinese hospital since nurses are scarce relative to the volume of patients.

The blood tests showed nothing unusual and I was shown the door. My chest still hurt, so I went to another hospital that specialized in cardiovascular care. It was packed. The doctor, behind the same white-painted desk surrounded by beat-up medical equipment, looked at the EKG and the blood tests results. He strongly recommended I come back the next morning at 5am to stand in another line to register for a CT. The window to register would open at 7am. I could expect to have the test sometime after noon. He gave me prescriptions for nitroglycerin and Lipitor and moved on to the next patient.

My friend suggested I go to the foreign-run clinic on the other side of Beijing, near the embassies in the neighborhood where most expats live. I was attended by three nurses, given a private room, surrounded by pristine medical equipment and treated more or less like I would be at my local county hospital back in Los Angeles. It was back to the future, back to the insular safety of experiencing life in China as a guest.

This was in Beijing, the wealthiest city in the country. Had this happened in a rural village just 100km to the southwest there would have been no hospital to go to at all, no doctor, no pack of Lipitor. There might be a local health worker behind a small wooden white-painted desk with some antibiotics and aspirin. Getting that hospital built, educating the doctors to staff it and maintaining that capability in the face of intense population pressure are the immediate ambitions of China, the next “great power.” A decent school and local officials educated enough to know how to plan and operate industries without poisoning themselves and their communities are a priority as well.

The next time President Obama and his advisors travel to China, it might be useful for them to imagine how they would govern China’s 1.344 billion, what kind of resources they would need and how long it would take them to reach the standard of living they have come to expect as Americans. My guess is that China’s foreign reserves would not look so big, that they would demur from playing a greater role in the world, and they would have a bit more appreciation for the difficulties faced by the people sitting across the negotiating table.