Science and Technology in NYC

Looking for justification for Chinatown’s uninsured rates at the crossroads of traditional and western medicine.

There is an undeniable allure to traditional medicine: a mixture of herbs to relieve aches or stress instinctively seem more reliable than the manufactured little white pills, the front-men of a stigmatized industry. There are few places in the city as synonymous with traditional medicine as Chinatown, where surprisingly attitudes towards treatment methods are mixed and the rate of uninsured offers little insight to local preferences.

Currently, 13-17% of Chinatown’s 164,000 people are uninsured, according to the NYC Department of Health and Mental Hygiene.  To the observer, a number of reasons for this can come to mind: the undocumented residents don’t have eligibility, young people see it as an unnecessary expense, language barriers prevent recent immigrants from access to information about their options, or that there is a predisposition among a sector of the population towards traditional medicine.

Anyone who’s ever walked along East Broadway – on any day of the week – has probably noticed the brightly-colored health insurance vans, with smiling faces painted on their sides, or tables on the sidewalks, piled with pamphlets of information about insurance plans. Sometimes there’s no one standing by the tables at all, so any questions can be addressed to phone numbers on business cards. In any case, health insurance companies make their services accessible in Chinatown. Yan Zhen Lin, facilitated enroller for healthfirst, the only non-profit health insurance provider for lower-income families explained, “Many people in Chinatown are uninsured because of language barriers: they don’t know the prerequisites, so we are here on the streets to help them.” This aid is not limited to providing them with healthfirst’s coverage, but also helping people fill out Medicare/Medicaid forms.

One of the most important prerequisites for health coverage, however, is American citizenship. Each enrollment station carries a manual describing the sort of documentation required for coverage. According to Run Biao, facilitator for AmeriGroup Community Care, the only sort of coverage extended to undocumented immigrants is for pregnant women and children under the age of 18 (by Child Health Plus). This limitation does not prevent them from receiving any sort of medical care, “The undocumented still go to doctors if they are very sick – not for check-ups. Or they can go to the emergency room and not be turned down.” Apparently, legal status has a very limited effect on what method of treatment Chinatown residents seek. Federal law prevents emergency rooms from turning away patients and high medical fees do not discourage them from getting the emergency care they need. This means that illegal immigrants do not rely solely on traditional remedies found at the local herb shops, and generally receive medical attention when it is necessary.

Another misconception about New York’s Chinatown is that western medicine and traditional medicine are two separate spheres that exist almost independently of one another. Chinese immigrants bring with them a heritage of traditional remedies that from the outsider’s perspective characterize their culture. Yet this mindset is paradoxical when you consider the thousands of licensed medical doctors in the neighborhood. According to Dr. Ng Yat Fai, 63, acupuncturist and herbalist, who was a general practitioner in China; the two schools of medicine are quite interlinked. Many drugs manufactured by large pharmaceutical companies are derived from herbs and doctors sometimes refer patients to alternative treatments. Dr. Ng explained, “Many of my clients are referred to me by doctors from all over the city and hospitals who could not help them with nerve and muscle pains.”

Other than specific referrals, traditional medicine practices are directed at disease prevention, rather than treatment. They provide a buffer for the lack of preventative medical care undocumented immigrants receive. Since doctor visits for the undocumented are generally seen as a last resort, preventative measures, like check ups, are infeasible. Therefore the availability of herbal remedies helps control the development of various diseases. However, even ailments like the flu are seldom treated with herbal remedies in Chinatown, especially with the presence of low-cost over-the-counter medicines like Tylenol. Instead, the presence of commercialized stress-relief acupuncture clinics inflates the sense of traditionalist practices in the neighborhood.

Chinatown’s health care culture is obscured by vast cultural differences and long-standing stereotypes. While the Chinese have had a history of practicing herbal treatments, even the more elderly, traditionalists do not hesitate seeking licensed medical help when needed. At the Mannings Pharmacy Corp. in Chinatown’s Elizabeth Center, geriatric patients bring prescriptions for universal ailments like high blood pressure, diabetes and hypertension. In an interview regarding local medical practices, Linda Yee, Pharmacy Intern, explained, “We don’t carry or recommend herbals because all of their properties and effects on the human organ systems are not known and they are not FDA approved. I think that the popularity of herbal remedies has been affected by marketing, because in the past their demand was not very high.”

Contrary to popular belief, the presence of Asian medicine does little to alter the neighborhood’s reliance on modern medicine. Instead, the two complement one another on a case-by-case basis, leaving treatment options for those with limited finances or lack of health insurance.

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