Healthcare guide for expats moving to China
The health system in China has developed rapidly, reflecting the structural changes China has undergone in the past 30 years. Successive health reforms were put into place up to 2011 in order to provide the population with universal medical cover. However, the medical sector is often over stretched and lacking resources due to the demands of such a large population and the quality of care is often below Western standards. Infant mortality in China is 14 per 1000 births – an indicator of the sanitation problems within the country.
Due to these reasons, it is recommended to seek treatment within the public sector or request VIP treatment with a public hospital. For certain specialised treatments or for certain medical conditions it is recommended to seek treatment outside of China, and herein lies the importance of an international medical insurance.
- Total Population: 1,393,337,000
- Gross national income per capita (PPP international $, 2013): 11,850
- Life expectancy at birth m/f (years, 2013): 74/77
- Probability of dying between 15 and 60 years m/f (per 1 000 population, 2013): 103/76
- Total expenditure on health per capita (Intl $, 2013): 646
- Total expenditure on health as % of GDP (2013) 5.6
The Chinese healthcare system
The Chinese health care system is divided between two sectors: rural and urban. Subscribing to a basic medical insurance is compulsory for salaried urban workers as well as their employers. The insurance is financed by the contributions paid by the employer and the employee which are then subsidised by the state. City residents that do not work (unemployed, retirees, children, etc.) have a medical insurance funded in part by the government and in part from the contributions paid by the working community, whilst the healthcare of citizens in rural areas is handled by the “New Rural Cooperative Medical Care System (NRCMCS)”.
Today, more than 90% of the population is covered and the aim is to offer a basic medical insurance to the whole population by 2020. However, the medical system is not sufficiently developed and there are large disparities between urban and rural areas. The healthcare infrastructures are, on the whole, well developed in urban areas, but in rural areas access to healthcare can be limited. There is a lack of health infrastructure and services, while also being the most affected by problems such as malnutrition, infections, hepatitis B etc.
Hospitals: the heart of the healthcare system
In China, healthcare is very ‘hospital-centric’: the consultation of both a GP and a traditional Chinese practitioner is done solely in a hospital. Home visits are not at all available.
Public hospitals in China are massive establishments, often divided into two distinct departments: one for the locals and another for foreigners/VIPs, with English-speaking doctors. The cost of consultations are more expensive in the latter department. The two-tier system of operating was borne from the need to offer a Westernised service for the expatriate community -shorter waiting periods, and individual consultations offering a greater degree of confidentiality. There is, in effect, a cultural difference in the way healthcare is delivered in China. For example, as there are no consultation rooms, the doctors examine their patient in view of those waiting for their own consultation.
Private and international hospitals
All major cities now have ultramodern international hospitals with international staff. They offer westernised consultations which are better adapted to the expatriate community. The cost of the service is significantly higher and it is often requested that payment be made in advance. When going to hospital, it is advised to always carry with you either a credit card, or cash.
International health insurance
For China, it is strongly recommended, before your expatriation date, to subscribe to an international health insurance including medical evacuation.
An international insurance also offers you the freedom of your choice of doctors or medical centre, and the possibility of being covered internationally. If you prefer to be treated in your home country or in another country within your zone of cover your medical costs will be reimbursed by your insurance company (within the limits of your policy). Moreover, if you leave China and move elsewhere your international insurance may be able to follow you.
It is always important that your medical insurance complies with local legislation. As an expatriate in China, subscribing to an international health insurance does not exempt you from signing up to the local health care system; in this case your international health insurance would top-up your state healthcare.
If you would like to insure yourself and your family more fully, Expat Assure can also advise you on life insurance and income protection. To find out more, please, read our Protection page.
Which expat insurance should you choose?
We can help you decide which international health insurance or protection plan is best suited to your needs. Don’t hesitate to contact us to request your insurance comparison.
Example medical costs
- In the private sector:
Consultation with a GP: The cost of the consultation is between 300 and 1200 yuans (£31 – £125 / 42€ – 168€), dependent on seriousness/urgency and the condition of the patient.
Consultation with a specialist: 600 – 2100 yuans (£62 – £219 / 84€ – 294€)
Overnight stay in a hospital: around 5500 yuans (£572 / 771€) for a private room
Dentist: 260-460 yuans (£27 – £48 / 36€ – 64€); fitting of a crown: 6300 – 7200 yuans (£656 – 749 / 883€ – 1009€)
- In the public sector:
An appointment with a GP in a public hospital is only 15 yuans, the equivalent of £1.55 or 2.11€! However, as explained above, the quality of service often falls short of western expectations.
In regards to private rooms for foreigners in public hospitals, prices can vary from between 180 yuans (20 euros) and 1500 yuans (174 euros) in relation to the type of room chosen.
*Exchange rate February 2015
Be sure to have your immunization schedule up-to-date (diphtheria/tetanus/polio).
Other vaccinations also recommended by the NHS Fit-For-Travel website as well as the Pasteur Institute are: cholera, hepatitis A and B, Japanese encephalitis, rabies, tetanus, tick-borne encephalitis and typhoid.
A yellow fever vaccination certificate is required for travellers over 9 months of age arriving from countries with risk of yellow fever transmission and for all travellers having transited through the airport of a country with risk of yellow fever transmission.
Emergency phone numbers
Fire brigade: 119
General number: 999
Traditional Chinese medicine
Traditional Chinese medicine remains very established within China and the government encourages its modern development and integration into the healthcare system. It is a part of everyday life, whether through hospital prescriptions or through the consumption of medicinal drinks (herbal teas) taken as a preventative measure when sensing a cold, for arthritis or for any other everyday ailment.
Often you will be asked in the pharmacy if you prefer a traditional remedy or modern medicine.
China has severe problems in regards to water pollution. Nearly half of all the large cities in China do not reach the national norms for the quality of drinking water. As such, it is generally advisable to drink either bottled or boiled water.
Beijing and a number of other cities in the north and in the centre of China often suffer from extreme spikes in pollution. This has repercussions in relation to health: respiratory problems, memory loss, and an increased risk of lung cancer. The polluted air levels can equally cause eye irritations and can compromise your immune system. Those most susceptible are the elderly, children, as well as those who suffer from any chronic disorders such as bronchitis, asthma, emphysema or heart problems. The only way in which to minimise these complications is to limit your exposure to the pollution, in particular those who are in high risk categories.
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