My first advice to anyone moving to mainland China is: Buy the best health insurance possible, preferably a policy that will airlift you to Hong Kong or beyond if you get really sick.
Anyone who has been unfortunate enough to spend any time in a Chinese hospital will agree the country’s health system is in a perilous state.
The de facto privatization of much of the state-funded health apparatus has left looming funding gaps, which hospitals and doctors are forced to fill by resorting to predatory practices that exploit the vulnerable. It is common for doctors – looking to supplement their meager incomes – to request unofficial payments from families in return for promises of “special care” for their ailing loved one. Unsurprisingly, most families dare not refuse.
My wife recently had a baby in Beijing and in the months leading up to the event I was regularly advised by Chinese parents on how much cash I should put in the hong bao (red envelope) required before the birth by the doctor, mid-wife, anesthetist and nurses to ensure a safe delivery.
Even the most dilapidated, grimy hospitals are equipped with state-of-the-art MRI machines, because patients can be charged huge fees for scans, necessary or not, that allow a hospital to quickly recoup its investment. Arbitrary over-prescription of expensive Western medicines, particularly antibiotics, is a chronic problem and stokes fears over the rise of drug-resistant super-bugs.
Even for the well-insured or the very rich, the options are limited. A number of private, high-end “international” hospitals and clinics have sprung up to cater to expats and affluent locals. While their facilities are positively luxurious and patients don’t have to worry about bribing their doctor, the level of care they provide hardly warrants fees of at least 10 times that charged by local hospitals.
In the end, thanks to excellent insurance, my wife and I opted for the top international hospital in town, which specializes in delivering babies.
During the labor my wife was given an epidural, but when the anesthetist checked his handiwork he found he’d only numbed her from the knees down. His panicky reaction was to keep adding drugs and say he was going to administer another epidural. All he did was roll her on her side and jiggle the cord he’d already injected in her spine.
By then, the baby was coming and the anesthetist disappeared, replaced by a nurse who grabbed my wife’s finger, dipped it in red ink, blotted it on a piece of paper and then ran from the room before we could find out what it said. We can only assume it was the hospital’s indemnity form.
Two days after the birth of our daughter, my wife found she couldn’t lift her right leg and had shooting pains in her lower abdomen. Back at the hospital she was put through a series of (expensive) tests. Three hours later, a doctor finally recommended she bend at the waist and wiggle her hips in order to realign her internal organs.
The following week we returned to the hospital and were told by another doctor that the problems were most likely the result of nerve damage in my wife’s spine, caused by the useless epidural.
May I remind you that this is the best (or at least the most expensive) hospital in Beijing, if not the country. I have experienced first-hand some of the less reputable corners of the Chinese health system and can attest that the situation is infinitely worse elsewhere.
Chinese citizens live in fear of being struck down by a major illness, which will go untreated until they or their families come up with a cash deposit covering the entire estimated bill. Indeed, the lack of a credible health system is one of the major reasons for China’s unusually high savings rate.
After decades of dismantling the welfare state it had constructed under communism, the Communist Party now realises that health care for its citizens is a social stability issue.
In March, Premier Wen Jiabao pledged to increase the central government’s spending on health care by 25% this year. This follows a quadrupling of spending in 2007 over the previous year, which brought the national health budget to just US$9.5 billion – about the same as the country’s newly-established sovereign wealth fund has to spend on its first batch of offshore acquisitions.
No wonder the long-term outlook for China’s insurance industry looks so bright.