‘‘During the Mao period, doctor-patient relationships were relatively harmonious,’’ Ms. Chan said. Money was scarce and resources were few, for all. But after decades of market liberalization as hospitals sought to generate revenue, contributing to treatment shaped by commercial rather than medical concerns, trust is gone. ‘‘The conflict really is between patients and doctors,’’ she said.

陈纯菁说，“在毛泽东时代，医患关系相对融洽。”尽管当时也存在经费和资源匮乏的问题。不过，经过数十年的市场自由化后，随着医院寻求盈利，出于商业而非医疗方面的考虑进行治疗，这种信任已经荡然无存。她表示，“这实际上就是病人与医生之间的矛盾。”

The government says 90 percent of Chinese have some health insurance, but underfinanced state programs leave many patients covering the bulk of their costs themselves. One attempt to overcome the inefficiencies of the system and ensure a physician treats a patient well is to give ‘‘hongbao,’’ or red envelopes — bribes.

政府声称90%的中国人都有某种医疗保险，但资金不足的国家医保导致很多病人需要自己支付大部分的医疗费用。要想克服医疗系统效率低下的问题，确保医生认真治疗，一种办法就是送“红包”——贿赂医务人员。

Such payments are illegal. In 2017 the National Health and Family Planning Commission issued its 13th notice in two decades demanding that patients not give them and physicians not take them, Ms. Chan said.

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