It may be the case that the overall employment package offered by a particular employer is so attractive that despite the insistence on a homeland medical a jobseeker decides to accept the job offer. The high cost of a homeland medical pales into insignificance compared to the benefits of working for said employer. As I have already stated, the Chinese visa regulations do not require a 2nd medical to be taken in China if your homeland medical is satisfactory and within date, that is, not more than 3 months old.

When I first came to China, in 1994, the public college tried to pull that 2nd medical stunt on me. I refused, got my RP, and taught there for 2 years, 2 separate 1 year contracts, btw, without undergoing any new medicals, Chinese or homeland. In those days, everyone had to undergo a homeland medical first before going to China. These days, some provinces/employers still insist on it. If the job pays well, you might agree. But once in China you should refuse a 2nd medical in principle.

One needs to get 'bolshy' as u say, to let 'em know you have balls! Or they will take more liberties with you. Know your rights, and ensure the other side applies them to you. In my case, the trouble I made by refusing to take a medical in China had no negative repercussions, as I was offered a follow-on contract. So I had no regrets whatsoever about refusing. BTW, I was an independent hire unlike VSO teachers in that province at that time. They all took 2nd medicals so as not to rock the boat. Good for them! LOL!!

End of story!