In many people's minds, unlicensed clinics are where illegal doctors make money at the expense of patients' lives. They are undoubtedly illegal and should be banned. But if those who go to these clinics have nowhere to get their ailments treated after the dubious facilities are removed, we need legal alternatives before shutting them down.

Eighty-five percent of 100 migrant construction workers surveyed by the Beijing News say they see doctors in unlicensed clinics when they have minor health problems because it is cheap. They know these clinics are unlicensed, but they do not mind because they are sure that doctors there will at least give them medicine. In fact, many low-income residents go to such clinics because they cannot afford to see doctors in licensed hospitals, where medical bills can be several times higher.

Of course, meeting the healthcare needs of low-income residents should never justify the illegal existence of such unlicensed clinics.

Yet, if no legal alternatives are provided, banning them in the name of protecting the interest of patients will become an act of hypocrisy.

The healthcare supervision department of Beijing's Haidian district is reportedly planning a proposal for higher authorities to have small and simple clinics established by township or district government at places where low-income migrant workers are concentrated, so that they may access affordable, safe healthcare.

This could be one solution. But do township or district governments have the money to invest in such clinics? And how can they reduce the cost of healthcare for it to be accessible to low-income residents?

In the latest healthcare reform, flexibility will be given to competent doctors for them to treat patients in different hospitals. Why not allow them to have clinics of their own, with financial aid and subsidies from the government?

Similarly, it may be a better solution for those unlicensed clinics to give their doctors proper training and financial aid, to improve their facilities to help them become licensed ones.

Providing affordable healthcare and access to doctors are some of the greatest challenges for low-income residents. The new healthcare reform promises to establish universal medical insurance for all residents, including low-income residents such as migrant workers. But it could be some time before they have medical insurance that will be able to cover their bills from treatment in big hospitals.

The existing unlicensed clinics have met the needs of those who want cheap healthcare. So the best and easiest way to help these patients is to turn these unlicensed clinics into licensed ones.

Preferential policies such as lower tax or subsidies should be given to guarantee they provide affordable healthcare to their low-income patients.

(China Daily April 17, 2009)