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China’s vice health minister, Chen Xiaohong, voiced concern last week that in 2006 over 5,500 medical personnel were injured in nearly 10,000 attacks by patients’ families and friends. Some doctors are now afraid of conducting certain operations that carry higher medical risks for fear of reprisals. “The number of violent disputes has been on the rise in recent years, as misdiagnosis and operation frauds repeatedly occurred in some local hospitals and clinics,” according to Chen . Hospitals are also typically short of security personnel and lack plans to handle these situations, he said. The vice minister is currently on a “peaceful hospital” campaign to address the issues involving medical ethics, bribes and malpractice as well as security.

Incidents of social unrest connected to dysfunctions in health care are not news in China. Unfortunately the growing numbers are. An earlier post mentioned the positive role malpractice insurers possibly could play in helping mitigate these disputes. The same goes for health insurers. In the U.S., for example, health plans often become involved in resolving quality of care complaints between their subscribers and providers.

But let’s step back for a moment. These roles for insurers are part of, and the result of, the efforts of activist organizations — that panoply of independent non-profits, NGOs, advocacy organizations, mutual benefit associations — we see everywhere in the U.S.. These organizations make up a dynamic public service sphere that exists in the critical space between local communities and government. This is where the everyday work of reducing social conflict and managing change really takes place.

It’s clear to me that an activist public sphere that is squarely focused on health care needs to be mobilize in China. Oddly enough, given the current health reform momentum coming from Beijing, health plans could play a catalytic role there much as they did in the U.S. when originally conceived following the Great Depression. At that time, non-profit health plans were an important product of the American grass roots social insurance movement of the 1930s along with Social Security. In what could be a “Back-to-the-Future” scenario, China’s challenge may also be a opportunity for health plans to look to their own history for lessons on how to be relevant today.