China
How the Medical system works in China
The Chinese Act on the implementation of a unified social insurance system is fairly recent and came into effect on July 1, 2011.
This new social insurance system provides basic coverage to Chinese nationals and expatriate employees with work permits. This coverage includes basic old-age pension and medical insurance, unemployment insurance, work-related injury insurance, and maternity insurance.
This system has been progressively implemented and is being extended to the Chinese population as a whole, both urban and rural. As this is not a national system, provinces, prefectures and districts are responsible for applying the central government’s directives.
In general, China maintains a good healthcare system and provides quality medical care.
Visiting a doctor in China
In China, Traditional Chinese Medicine is very common although Western medicine tends to be increasingly used. Consultations with Chinese GPs or specialists only take place at the hospital. Homecare does not exist. Consultation fees vary from one doctor to another and can reach RMB 3000 (around USD 500) in private hospitals.
Being admitted to hospital in China
Chinese public hospitals:
Some public hospitals (large facilities) in Tier 1 megacities, such as Beijing, Shanghai, Guangzhou, Shenzhen and Chengdu have two different departments: one is intended for local residents, who are covered by Chinese social insurance while the other one is dedicated to foreigners and VIPs who pay their consultations themselves or are covered by a commercial health insurance plan. Consultation fees are not the same depending on the department consulted: around RMB 50-100 for a consultation in the case of a local resident and up to RMB 1,300 for an expatriate covered by a commercial insurance plan.
Please note that consultations are not conducted in the same way in the two departments: it is not unusual to see locals enter a room without knocking on the door and even take part in your consultation. As we are not used to such practices, we may find them disrespectful, but this is totally natural for Chinese people. This would not happen in the VIP/International department where medical confidentiality is respected. Furthermore, doctors often speak English.
Chinese medical centers for foreign people (international facilities):
There are many ultra-modern international private facilities intended for foreigners who can either afford this type of medical care or are covered by health insurance. Prices of consultations are much higher than those in public hospitals but the hospital environment is more welcoming and provides international staff.
Doctors have the same expertise level as those in public hospitals but consultations are more Western-inspired and much more tailored to expatriates.
Emergency services:
Emergency services in public hospitals in Tier 2 and3 are open 24 hours a day, but they are often filled to capacity with local residents. In very large facilities, you can find 200 people waiting before you. As for expatriates or VIPs, waiting times are shorter due to higher prices. The same applies to private medical centers.
Buying medication in China
The most common drugs are available in pharmacies or online with a doctor’s prescription. Under social insurance coverage, drugs need to be prescribed by the hospital’s doctor and must be bought directly at the hospital’s pharmacy, whether they are Traditional Chinese Medicine or Western medicine drugs. Health administration also offers remote consultations (video or telephone) in some hospitals to make drugs for chronic illness more accessible.
Health system innovation
The difference in medical resources is still very significant between megacities and other areas, as high-quality health services are concentrated in Beijing and Shanghai. As a result, the number of private healthcare facilities is increasing quickly to make access to high-quality care easier, but at a higher cost.