HowToLiveWorse

CHAPTER 24 · 12 SOURCE ENTRIES

Navigating Healthcare

看病：怎么少花钱少走弯路

[← 回总目录](../README.md) 口径：金钱与时间。这一节讲看病本身怎么走：先去哪家医院，怎么往上转，钱能少花在哪。另外讲急诊怎么排队，重伤治完之后要做哪些鉴定、办哪些证。能领什么待遇见第 7 节。慢性病长期怎么管见第 16 节。急症现场先做什么见第 13 节。 本节主要依据国务院办公厅 2026 年 4 月印发的《关于加快建设分级诊疗体系的若干措施》。分级诊疗就是按病情轻重决定先去哪一级医院。这份文件把「去基层」和「省钱」直接挂上了钩。但各地落地进度不同，正文写的是国家层面的规则。具体到你所在的统筹地区，要以当地医保和卫健部门的说法为准。统筹地区就是你的医保参保地，通常是一个市。

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24-001
Evidence AmoneySource-sensitive

For common illnesses, patients should first visit community clinics; referrals then proceed stepwise to larger hospitals, after which the hospital deductible is calculated only once.

常见病先在社区看，经基层逐级转诊上去，住院起付线接着算

Start by going to a community clinic, which will then refer you to a larger hospital for inpatient care. The amount you pay out-of-pocket at the start is counted only once. If you go directly to a tertiary hospital for admission and later return to a community clinic for recovery, you might have to pay that amount twice. However, if a larger hospital refers you back to a community clinic for continued treatment, the deductible is not recalculated for the same condition during that period.

Open the low-ROI detour

Move “For common illnesses, patients should first visit community clinics; referrals then proceed stepwise to larger hospitals, after which the hospital deductible is calculated only once.” to Future Me's calendar

Future Me has a clearer calendar, more patience, and apparently the same responsibilities.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
24-002
Evidence AmoneySource-sensitive

Within the same medical insurance region, the lower the hospital level, the higher the reimbursement rate — the difference is roughly 10 percentage points.

同一个统筹地区（医保参保地）里，级别越低报销比例越高，差距约 10 个百分点

For the same hospitalization bill, the lower the hospital level, the more you get reimbursed. Regions are required to set reimbursement rates that differ by about 10 percentage points between each successive level. Choosing a larger hospital when a community clinic can handle the case means you’ll have to pay roughly 10% more out of pocket. Newly allocated medical insurance funds also favor primary‑care facilities.

Open the low-ROI detour

Move “Within the same medical insurance region, the lower the hospital level, the higher the reimbursement rate — the difference is roughly 10 percentage points.” to Future Me's calendar

If I do not open the notes, no new task has technically appeared.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
24-003
Evidence Atime-energySource-sensitive

Go to a major hospital via a referral from a local clinic or the hospital’s referral center — don’t turn to scalpers.

要去大医院，走基层转诊或者医院的转诊中心，别找号贩子

Major hospitals must set aside a portion of appointments and beds specifically for patients referred from local clinics. They must also establish a referral center or designate a dedicated department to handle referrals — this requirement will be fully implemented by 2027. Not being able to book a slot online does not mean there is no way in. Scalpers charge exorbitant fees and may even route you to the wrong department.

Open the low-ROI detour

Move “Go to a major hospital via a referral from a local clinic or the hospital’s referral center — don’t turn to scalpers.” to Future Me's calendar

One more exception feels free because the bill arrives outside the current scene.

Today I keep a few minutes and avoid interrupting my default routine.

Read the source and trade-off
24-004
Evidence AmoneySource-sensitive

Before seeking medical care outside your home province, ask locally first — the need for such care should ideally be assessed by an associate chief physician or higher.

跨省异地就医之前先在本地问一句，必要性原则上要副主任医师以上评估

Whether a patient needs to travel elsewhere for treatment should, in principle, be evaluated by doctors holding the rank of associate chief physician or above at secondary or tertiary hospitals. Reimbursement rates for temporary out-of-area treatment differ from those offered at local hospitals of comparable level; exact terms depend on local regulations. Asking locally beforehand is far better than discovering later that no reimbursement is possible.

Open the low-ROI detour

Move “Before seeking medical care outside your home province, ask locally first — the need for such care should ideally be assessed by an associate chief physician or higher.” to Future Me's calendar

I can spend longer deciding whether to start than the small action would take.

Today I keep a few minutes and avoid interrupting my default routine.

Read the source and trade-off
24-005
Evidence AmoneySource-sensitive

Stop treating tertiary hospitals as mere prescription hubs — stable chronic disease patients should turn to primary care

每次看完病，把病历、检查报告和影像自己存一份

Moving forward, tertiary hospitals will primarily handle emergency cases, critically ill patients, and complex medical conditions. Routine follow-ups for common illnesses and regular outpatient visits for patients with stable chronic diseases will gradually be phased out. The same expert physicians who previously saw patients in tertiary hospitals will now provide care at community clinics. Continuing to use large hospitals solely for medication refills will become increasingly difficult as appointment slots dwindle.

Open the low-ROI detour

Move “Stop treating tertiary hospitals as mere prescription hubs — stable chronic disease patients should turn to primary care” to Future Me's calendar

The routine already works until the day the source says it may not.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
24-006
Evidence AmoneySource-sensitive

If you have doubts about treatment, request to seal the medical records on the spot; both parties must be present, a list must be drawn up, and each side gets a copy.

对诊疗有疑问就当场要求封存病历，双方在场、开清单、各执一份

If you’re unsure about any aspect of your treatment, you have the right to request that your medical records be sealed. Both you and the medical staff must be present for this process, which involves creating a detailed list, signing and stamping it, and each side receiving a copy. If the records aren’t fully completed yet, only the finished portions should be sealed first; the rest can be sealed later. Should you suspect that an intravenous infusion, blood transfusion, injection, or medication caused a problem, the actual fluid bag, medicine vial, and infusion set must also be sealed together with the records.

Open the low-ROI detour

Move “If you have doubts about treatment, request to seal the medical records on the spot; both parties must be present, a list must be drawn up, and each side gets a copy.” to Future Me's calendar

There is no immediate alarm, so the sensible choice can wait for a less busy week.

Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
24-007
Evidence Atime-energySource-sensitive

After every medical visit, keep a personal copy of your medical records, test reports, and imaging scans

急重的伤病直奔急诊预检分诊台，别去挂号窗口排队

You have a legal right to access and copy your own medical records. This includes outpatient records, inpatient charts, lab results, imaging scans, surgical and anesthesia notes, pathology reports, and itemized billing statements. Hospitals provide dedicated counters for this purpose, where only basic copying fees apply. These documents prove invaluable when switching doctors, seeking a second opinion, filing commercial insurance claims, or in case of any legal disputes.

Open the low-ROI detour

Move “After every medical visit, keep a personal copy of your medical records, test reports, and imaging scans” to Future Me's calendar

Future Me has a clearer calendar, more patience, and apparently the same responsibilities.

Today I keep a few minutes and avoid interrupting my default routine.

Read the source and trade-off
24-008
Evidence AmoneySource-sensitive

Even without money or ID, and unable to identify yourself, emergency care must be provided first

没带钱、没带证件、说不清自己是谁，急诊也必须先救

The state maintains an emergency medical assistance fund designed to cover emergency treatment costs for two groups of patients: those whose identities cannot be verified, and those whose identities are known but who cannot afford the bills. Healthcare facilities are prohibited from refusing, delaying, or shirking emergency care for any reason. Likewise, emergency dispatch centers cannot decline or delay responses due to payment concerns. Therefore, never hesitate to call for help just because you lack funds — this fund covers only the initial emergency phase; subsequent inpatient treatment still relies on yibao (basic medical insurance) and other medical assistance programs.

Open the low-ROI detour

Move “Even without money or ID, and unable to identify yourself, emergency care must be provided first” to Future Me's calendar

If I do not open the notes, no new task has technically appeared.

Today I keep a few minutes and avoid interrupting my default routine.

Read the source and trade-off
24-009
Evidence AmoneySource-sensitive

Disability assessments must be conducted only after treatment is complete; doing it too early results in a lower rating.

伤残鉴定要等治疗终结之后再做，做早了等级会评低

The amount of compensation one receives depends largely on the disability rating assigned, which in turn reflects how much functional ability remains after full recovery. Official guidelines stipulate that assessments must be performed only after treatment concludes or when clinical results are stable. If an assessment is done while bones are still healing or metal implants remain in place, it reflects the individual’s condition at that moment, effectively lowering their rating. For ordinary fractures that do not impair function even after healing, no disability rating is assigned at all.

Open the low-ROI detour

Move “Disability assessments must be conducted only after treatment is complete; doing it too early results in a lower rating.” to Future Me's calendar

One more exception feels free because the bill arrives outside the current scene.

Today I keep a little money, a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
24-010
Evidence AmoneySource-sensitive

After treatment, functional impairments may indeed remain; apply for a disability certificate at the county-level disability association in your hukou area.

治完之后确实留下功能障碍，去户籍地县级残联申请残疾人证

A disability certificate serves as a prerequisite for receiving disability-related benefits; it is not a medical proof of injury. It categorizes disabilities into seven types — visual, hearing, speech, physical, intellectual, mental, and multiple — each with four severity levels. The application process involves submission, acceptance, assessment at a designated facility, public posting, review, and issuance; the certificate remains valid for ten years and can be renewed free of charge. If you do not meet the criteria, no amount of personal connections can secure one.

Open the low-ROI detour

Move “After treatment, functional impairments may indeed remain; apply for a disability certificate at the county-level disability association in your hukou area.” to Future Me's calendar

I can spend longer deciding whether to start than the small action would take.

Today I keep a little money, a few minutes, a bit of persistence and avoid interrupting my default routine.

Read the source and trade-off
24-011
Evidence AmoneySource-sensitive

Thank the doctors who saved you — send thank-you letters, banners, or satisfaction ratings instead of cash gifts. The rules prohibit money, not gratitude.

谢救过你的医生，走感谢信、锦旗和满意度评价，别走红包：准则禁的是财物，不是谢意

Offering money beforehand to “jump the queue” won’t work — allocating appointment slots, beds, scarce medicines, tests, or surgeries is strictly forbidden. After treatment, it’s perfectly fine to show gratitude toward doctors who saved your life, but the method matters. Accepting cash or alcohol gifts puts them in violation of professional ethics. Three proper ways to thank them are: completing a satisfaction survey, writing a personalized thank-you letter, or presenting a commemorative banner, plus following medical advice for follow-up care.

Open the low-ROI detour

Move “Thank the doctors who saved you — send thank-you letters, banners, or satisfaction ratings instead of cash gifts. The rules prohibit money, not gratitude.” to Future Me's calendar

The routine already works until the day the source says it may not.

Today I keep a few minutes and avoid interrupting my default routine.

Read the source and trade-off
24-012
Evidence AmoneySource-sensitive

Before dental implants, check what the bundled price includes and verify the clinic's pricing commitment

种牙之前先问清包干价含哪些项目，优先找承诺参与价格治理的机构，别信低价广告

After China's centralized procurement, the cited source reports lower average prices for routine implants. The advertised bundle may exclude extraction, bone grafting, or other procedures.

Open the low-ROI detour

Move “Before dental implants, check what the bundled price includes and verify the clinic's pricing commitment” to Future Me's calendar

There is no immediate alarm, so the sensible choice can wait for a less busy week.

Today I keep a few minutes and avoid interrupting my default routine.

Read the source and trade-off

Source snapshot: a994b6a0c90598b0fe15cb837343f438dbf7b95d. Every original stays available in Chinese alongside the English edition.