BEIJING — A friend of mine recently made an appointment for his heart problem at the cardiac unit of a very well-reputed hospital. When he finally managed to see the chief physician, the doctor’s first question wasn’t “What's the matter with you?” or “How long have you been feeling unwell?” but instead, “What guanxi have you got?”

And even before my friend had time to answer, the doctor added, again using the Chinese word for “personal connection,” “Unless you have a direct guanxi, I’m not seeing you.”

This is the most Chinese of expressions. All early Chinese literary classics tell us that China has a society based on “human relations.” In this networked ethos, spanning the arc from close to distant, guanxi is the backbone that defines a person’s position and identity.

If you want to know somebody, you can find more than half of your answer just by figuring out how that person is situated by considering his personal network. You can even apply this test to yourself.

In such a society, a person is somebody’s offspring, somebody’s parents, somebody’s spouse, somebody’s cousin, somebody’s student, somebody’s superior, somebody’s friend, and so on. Without all these relationships, one is virtually nobody. How we treat a person in Chinese society is also determined by the relative position we have with that person on the relation network.

This is a very normal and universal matter all over the world. But the difference is that in China we also place the guanxi at the heart of the most basic institutions of society.

When a doctor asks “What guanxi do you have?” and says he is not receiving the patient unless he is connected to him, this is accepted within Chinese society. But it is also very wrong.

Why? Because we should expect that a doctor has a professional duty, and everyone is equal before the question of health and life itself. A doctor shouldn’t judge whether he is going to treat a patient on the basis of his relation, close or distant, with that person. This should be especially true for a public hospital supported by taxpayers like the one my friend visited.

A public institution that exists in the name of the people and the nation shouldn’t vary its policies from person to person. Everyone is equal before the law, and a bus cannot stop you getting on because you are not the driver’s father.

Under this modern Western concept, relationship should not be important. Or at least the relationship should not be a central part of the system.

Reality matters

Those with anti-Western instincts should not ask whether this was imposed on us by others, but whether it has been commonly accepted by our own society, and whether it is thus regarded by our own people as common sense.

I bet that most people in China today agree that public institutions should treat every individual equally, and that identity and connection should not interfere. We should remember that China’s founding philosophy is socialism, and the most emphasized idea of this political ideology, also from the West, is equality.

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Zhou Wenju's "A Literary Garden" — Source: National Palace Museum

I often say that China’s biggest problem today is not that people lack common sense, but that the common sense is filled with contradictions. Moreover, it is not that we lack values, but a fracture exists between the concept of values and the social reality.

My friend’s hospital experience is but another example that proves this. Chinese institutional design isn’t really in line with its stated philosophy. To put it even more plainly, our society advocates equality but protects the personal network of people with influencial status.

Right from the Yan’an period, just before the Chinese Communist Party took over China in 1949, the rationing system was based on the ranking of each party member. Today’s China operates with a comprehensive identity system. We judge whose son one is, whose father one is, whose colleague one is, and on top of that which “rank” people belong to. If someone doesn’t have a “ranking,” we consider the ranking of their father, son or colleague.

What that doctor meant by “guanxi” and “direct guanxi” is whether my friend had a “direct relationship” with someone of high rank.

But even as the doctor seems to violate the people’s basic belief about equality, he also conforms to people’s common sense that is the sum of their real experiences.

It is undeniable that China’s public hospitals do indeed differentiate according to patient status, and in particular on the material level. Last year a survey conducted by the Chinese Academy of Sciences stated that “80% of China’s health care resources are spent on members of the party and government.” Though the government has denied that this is true, it is somehow incapable of telling people just what the “truth” is.

A year ago the press disclosed photos of the premium hospital wards reserved for senior party and government employees. They are as extravagant as executive-level hotel suites. It is a bitter irony that these luxury accomodations are in Jiling city’s public-run Bethune International Peace Hospital, named after Henry Norman Bethune, the Canadian socialist for whom patient discrimination was anathema.

What could explain today’s China better than this?