A recent question on Zhihu drew wide discussion: US health care costs far more than China’s, so why does Chinese state media focus on crime in the US while almost never mentioning problems in its health care system? The question was pointed, but one respondent, writing under the name “Xiete,” argued the premise itself rests on a double misunderstanding of both systems.
In reality, each country’s health care system has strengths and weaknesses, and a simple “which is worse” comparison misses key details. For ordinary earners, minor illnesses are indeed more convenient and cheaper to treat in China. But for serious illnesses or chronic conditions that require long-term spending, the US safety net may actually offer more protection. Behind that difference lie distinct system designs, insurance models and media priorities.
Minor illness: quick in China, slow to book in the US
In China, seeing a doctor for a common illness such as a cold or fever is simple and transparent: register, get examined, pick up medicine, and recover within days at a cost most people can afford. In the US, patients usually book an appointment with a primary care doctor in advance and may wait days or even weeks. For a self-limiting illness like a cold, the symptoms often ease before the appointment arrives. The appointment culture keeps medical resources organized, but it slows care for minor problems.
Private US hospitals are also far more expensive than Chinese ones. Without insurance, a single routine outpatient visit can cost hundreds of dollars. Most Americans do have health insurance, however, and their out-of-pocket share varies by plan, so not everyone faces sky-high bills.
Serious illness: stronger US protection, heavier pressure on Chinese families
For major illnesses such as cancer or rare diseases, the picture reverses. In China, although insurance coverage keeps expanding, treatment costing hundreds of thousands or even millions of yuan can still push many families into hardship. The original author described seeing a father kneel at a hospital entrance to beg relatives for loans, and watching a child die for lack of money. Such extreme cases are not the norm, but they expose gaps in protection for serious illness.
In the US, Medicare, Medicaid and employer-sponsored commercial insurance form a multi-layered safety net. Low-income residents can also turn to state assistance programs. Although total US health care spending is high, insurance and public programs often absorb much of the individual burden. For serious illness in particular, US hospitals generally treat first and bill later, and do not refuse emergency care because a patient cannot pay upfront.
Media focus: why crime over health care?
Returning to the original question: why does state media rarely criticize US health care? The answer may lie in news values. Crime incidents such as shootings and robberies are sudden, visually striking and emotionally charged, making them easy material for international coverage. Health care problems involve complex institutional background that is hard to explain in a short report, and US health care is not without merits, so one-sided criticism could invite controversy.
China’s own health care reform is also a work in progress. When covering other countries’ problems, official media often favor topics that contrast with the domestic narrative. Crime connects directly to the universal theme of personal safety, while health care coverage can prompt comparisons with China’s own system, requiring more caution.
Conclusion
Each system has strengths and weaknesses, and arguing over “which is worse” easily becomes emotional. For ordinary people, convenience for minor illness and protection against catastrophic costs matter equally. Rather than dwelling on why state media stays silent, the more useful question is how both countries can close their gaps, because the quality of a health care system is ultimately judged by each ordinary patient’s experience.
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