10 Important Things Expats Need to Know About Healthcare in China

China's growing economy makes it a popular choice for expats looking to relocate – with a wealth of opportunities to teach English, or take up international positions with global companies. According to research conducted by the United Nations Population Division, records from July 2015 show that there were 9,108 expats from the UK and 26,777 expats from the US living in China.

Whether you are considering your options or have already made the decision about relocating to China to live and work, here are 10 things to note about the country's healthcare services.

1. Reform

The first thing to note about China's healthcare system is that substantial plans have been put in place to reform it. China's National Planning Guideline for the Healthcare Service System (2015–2020) is a five-year plan that aims to overcome existing issues within the healthcare sector, such as underdevelopment in rural areas and the shortage of resources. For expats living in highly developed urban areas, this isn't likely to present a problem, but it does offer assurance and is encouraging to know that the government is committed to improving the health of all residents and citizens.

2. Public healthcare

Public healthcare is currently available in China, but it can sometimes be more reliable, reassuring and convenient for expats to have private health insurance. This is because basic medical insurance (known as supplementary health insurance) currently only covers about half the costs of healthcare in China, while patients pay the other half. Public healthcare is also only available for about 50 percent of the population, and in some remote rural areas it can take days to reach the nearest clinic.

3. Private health insurance

The Chinese government does not list private medical insurance as a condition of entry to the country (though there are certain visa types that some Chinese embassies do require proof of health insurance for, such as visas for foreign students). However, due to the current state of the public healthcare system, expats could benefit from having private health insurance. Arranging international medical cover before traveling, rather than purchasing a policy in China, may also provide expats with greater assurance and peace of mind because they would be covered from the point of arrival.

4. Hospitals

In China, all forms of medical care are hospital-based. Whether an expat needs to visit a general practitioner (GP) or other type of doctor, have emergency surgery, elective treatment, or receive traditional Chinese treatment, they will go to the hospital. Some public hospitals have a reputation for poor service, but expats can rest assured that the treatment they provide is usually of a high quality. If they want to visit a private, international hospital that has English-speaking staff and Western standards of care, these are available in major cities like Beijing, Shanghai and Guangzhou. These are far more expensive than public hospitals (at an international hospital in Shanghai, for example, an initial consultation can cost anywhere between US $60 and $120), and do not exist in more rural areas of the country.

5. Costs

Despite China's reputation for varying standards of healthcare, the cost of Western-style care is generally quite high (although costs are falling as local services improve). For serious illnesses and accidents, this is partly because of the expense of getting people to hospital in the first place. Many expats are airlifted to hospitals that will provide them with a better standard of care than local public facilities. That could cost up to US $100,000, although expats with private health insurance in place may have part of that cost covered if not all of it.

6. International wings

In some of China's larger commercial hubs, public hospitals now offer "international" wings. These are wards in the hospital that provide international patients with Western standards of care. They offer a higher quality of service than the public facilities (for example, shorter waits and better customer service), but at lower costs than private hospitals.

7. Hygiene and health risks

Standards vary between hospitals, but may often be lower than you might expect – particularly in public Chinese medical facilities where overcrowding, cramped conditions and staff shortages can be an issue. Initiatives to improve hand hygiene, for example, have been particularly prevalent. There are high levels of pollution in many of China's cities, which could worsen pre-existing conditions. There are also other health risks associated with tap water, so it may be wiser to drink bottled water or sterilized tap water.

8. Traditional medicine and complementary therapies

Traditional Chinese therapies, such as moxibustion (a therapy that involves burning dried mugwort onto the body), are still practiced in Chinese hospitals. In fact, such therapies continue to be taught in Chinese medical schools and may be used alongside Western techniques.

This raises two important points for expats to consider: firstly, understanding what the treatment is (because medicine bottles may not be labeled in English) and secondly, how it compares to Western alternatives. As such, expats who don't speak or read Chinese fluently may want to seek advice from someone who can help them understand the therapy or treatment on offer and how it compares to Western alternatives.

9. Quirks of Chinese hospitals

While hospitals in China are increasingly adopting Western standards for healthcare and customer service, there are some quirks that expats should be aware of. For example, it is quite common for a patient to be left in charge of keeping their own healthcare records, or for patients to be charged a very small amount to visit a doctor.

10. Emergencies

Just like many aspects of China's healthcare system, emergency health services tend to be more efficient in large cities and urban areas than in rural parts of the country. Indeed, in some underdeveloped rural areas, they do not exist at all.

Ambulance services (for which expats should call 120: a free phone number) are provided by the state, and are usually free within the first five kilometers, after which patients might be charged; the exact amount may vary depending on the city. Generally, if they are taken to hospital, expats will need to pay an emergency fee (about US $20), and this might increase depending on the precise care that is needed.

In summary

Healthcare in China is widely available for expats who are staying in major cities and urbanized areas, where the standard of treatment is generally quite high and certain services are very affordable. However, several variables play an important role when it comes to choosing which type of healthcare expats should rely on: the spoken and written language barrier, the efficacy of traditional Chinese medicine, travel time to and from hospital, pollution and underlying health conditions, and whether a Western level of care is available in a particular location.

Disclaimer: The information included in this article is provided for information purposes only and is not intended to constitute professional advice or replace consultation with a qualified medical practitioner. All information contained herein is subject to change.

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18 August 2017
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