Medical cost and issues in China

[danb]

Hello, I was wondering about affordable medical care in China. If I were to decide to retire (part time) in China what things should I consider about getting good and adequate care? How do Ex-Pats retiree's in China get medical care. Normal doctor visits for check ups and minor illnesses ae probably not a big problem. But what about things like long term medicines and major medical illnesses? Say if we decide to split our time between the US and China. Say 50-50 or 35-65 of the time. What do people do? How do you plan for major medical issues? Danb

PS I looked around but did't find this topic.

[Mick]

Dan, I moved to China less than two years after undergoing a quadruple bypass heart surgery. I was fortunate in that during the first year, except for some minor blood pressure spikes, I had no real problems. Starting in my second year, we moved down to Guangdong Province and lived four years in Shantou, which is a mid-sized coastal city and has several good hospitals. I had a great cardiologist who took good care of me the entire time I lived there. It was fairly inexpensive, especially routine office visits, and most of my medicines were very affordable.

 

However, if you get really sick and need to be hospitalized, I hear it can get very expensive very fast. Further, in many hospitals the family is expected to provide basic care like bathing, changing the bed sheets, and even providing meals for the patients. Also, my experience taught me that the level of care is very uneven. It all depends on where you are. Some locations have excellent facilities and docs, while others are sorely lacking. One other caveat, it has been ten years since Li and I returned to the States, so I am sure much has changed in that decade. Sorry I couldn't be of more help, but I wanted to share what little I knew in hopes it might be at least of minimal benefit. Good luck with your move, should you decide to do it.

[Randy W]

As of January this year, the Chinese customs has started requiring a prescription in order to allow the import of medicines ordered overseas.

 

Most everything is available in a local pharmacy, however, either over-the-counter, or what I call "behind-the-counter" - you have to ask a pharmacist, and it is tracked by a computer network. Pseudo-ephedrine has been hard to come by ever since they discovered a lab producing meth from it, although it is still available in multi-symptom medicines like Tylenol Cold. Diazepam (a valium-like drug) is only available at one of the hospitals here.

[danb]

Thank you for your replies. I have been to the hospital a couple of times in China for small problems. The cost was very low but the visits were only out patient visits. And until last year getting drugs seem to be easier and simpler. I didn't know about the rule changes that Randy mentioned.

 

Mick,sounds like your quad bypass heart surgery was a success for you. I am glad for you. I would imagine that your health must have changed greatly. Any idea what that type of surgery would have cost in China vs the US? I am thinking that in China it would have been cheaper but it still must have been expensive. Something that one would not want to have to pay out of their own pocket.

 

Seems to me that whether we chose to live in China or the US or in both country that we will both need some type of medical insurance. In China my Lao Po will have some type of coverage after she retires. In the US after I retire she will not have medical insurance unless she can get medicare but I think she would not be eligible for that for a while because of her age. My understanding is that medicare will not help me (actually for the both of us for that matter) when we are in China. So how do most people provide for medical coverage in both country? Two medical insurances? Is it costly? Danb

[Randy W]

I have some kind of cheap, minimalist, expat coverage that Jiaying says is the best I can get until I get my 5 year brownie pin/green card/whatever they give me at that point.

 

When I was teaching, I had insurance through the university.

[Fu Lai]

I had a tooth implant here that cost me about 50X less than what it cost in the USA. America health care costs are waaaaaaay above other countries in most cases.

[Mick]

Dan, I had my quad bypass in the States two years before going to China. I was covered by insurance so I didn't have to pay, but even back then, the cost was incredible. I received a benefits statement from the insurance company and an itemized statement from the hospital (this was in Miami). The total cost of hospital, surgery, meds, and the doctors came in at a little over 120K. And like I said, that was back in 1996. Lord knows how much it is these days.

 

One thing I do know when comparing China and the States in terms of health care is length of stay. I'll give you an example. I recently had surgery on my carotid artery. I went in the hospital at 6am on Tuesday morning and had surgery at about 9am. I went home about 10am on Thursday. An expat friend of mine had the same surgery about a month later in China. He spent 27 days in the hospital. Whenever I have a routine angiogram I am in an out the same day. Over there, my cardiologist suggested an angiogram at one point and when I asked how long I would be in the hospital he told me " a week to ten days." I imagine in places like Shanghai, Hong Kong, and Beijing there are more western type facilities available. In relation to length of stay issues, I think it will be interesting to see what happens if and when China becomes more "insurance driven" like we are in this country. We are basically at a point where insurance companies determine length of stay. These days open heart surgery bypass patients are typically in and out of the hospital in five days, sometimes four. Back in 1996 I was only in for six days. When I was teaching in China one of the professors in the graduate English department had a triple bypass and he was in the hospital five weeks.

[Steve in USA]

Mick,

I believe in the US, the insurance companies are driving new expensive proceedures that are less invasive and take shorter hospital recovery times. Had my gallbladder removed last year and had outpatient laparoscopic surgery. If the doctor had to resort to conventional surgery and resultant large incision, it would have taken 3-6 weeks to recover.

 

Dan,

On my trips to China, I have seen a lot of people with large scarring. Most of which I attfribute to the most basic state of Chinese medicine, by western standards. Several people have shown me ugly scars of removed cancer. One woman I was dating had the most hideous Ceasarian scar I have ever seen. There are better and worse hospitals in China and one should always shop around to find he best closest to you before an emergency happens. Upfront cost of insurance or proceedures is one thing to consider. Quality of outcome of surgery if needed is another.

 

Just my 2 cents....

Edited June 16, 2013 by Steve in USA (see edit history)

[Mick]

Mick,

I believe in the US, the insurance companies are driving new expensive proceedures that are less invasive and take shorter hospital recovery times. Had my gallbladder removed last year and had outpatient laparoscopic surgery. If the doctor had to resort to conventional surgery and resultant large incision, it would have taken 3-6 weeks to recover.

 

Dan,

On my trips to China, I have seen a lot of people with large scarring. Most of which I attfribute to the most basic state of Chinese medicine, by western standards. Several people have shown me ugly scars of removed cancer. One woman I was dating had the most hideous Ceasarian scar I have ever seen. There are better and worse hospitals in China and one should always shop around to find he best closest to you before an emergency happens. Upfront cost of insurance or proceedures is one thing to consider. Quality of outcome of surgery if needed is another.

 

Just my 2 cents....

You make an excellent point about insurance companies and less invasive procedures. Your comments about the scars and the uneven level of care at hospitals in China is also right on the mark. When we lived over there, our across the hall neighbor was a good friend. He began suffering abdominal pain that eventually became unbearable. He went to the hospital and the chief surgeon said it was his appendix and they rushed him right to surgery. Only problem was, when they got in there it turns out his appendix was fine. That was when they began "exploring." The chief surgeon then decided it was his gall bladder and made an incision all the way from his appendix up to his gall bladder, only to find that the gall bladder was also okay. It turned out to be a blockage in one of the tubes leading out of the bile duct and they cut this open and spilled bile all in his upper abdominal cavity. They then proceded to cut open his left side (opposite from the gall bladder) and inserted several drain tubes. They sewed him back up and that was that. He wound up spending six weeks in the hospital recovering from all this, along with a staff infection he picked up along the way. When the guy went in the hospital he weighed 210 pounds and was 6'1". When he was discharged he weighed 160 and looked awful. Trooper that he was, he finished out the semester then flew back home to Canada, where he had another operation to repair the damage done in his previous surgery. It was a true horror story. I am still in contact with this fella and his family. He is doing fine now as it has been about 12 years since his ordeal. This is not to say all Chinese hospitals are bad. But it does support what Steve said about the necessity of checking out who and what you are dealing with. Fareed (that is my neighbor's name) has huge scars running from his appendix to his gall bladder and more on the opposite side from the drainage tubes. On the positive side, as I mentioned the cardiology care I received (at the same hospital) was first rate and, other than a few technologies that were unavailable, it was on par with what I have had in the States.

 

Let me mention one other aspect of Fareed's case. After he was discharged, one of the doctors, a young man, came to see him at his home. He told Fareed that from the outset he felt that it was not his appendix and believed that his tests revealed a bile duct blockage. When Fareed asked him why he didn't stop them from doing the appendectomy, the guy said that he could not contradict the chief surgeon as that would not only be against protocol, but that it would be a huge loss of face for the chief surgeon if he was wrong and an upstart rookie was right. You could have knocked me over with a feather (I was there when Fareed has this visit from the doc). I guess what I am saying is, medical care can be great, as much of mine was, or it can be a horror, as Fareed's was. In a sense, it is a crap shoot. I guess you have to really do your homework and try to increase the odds in your favor.

Edited June 16, 2013 by Mick (see edit history)

[NickF]

I had a tooth implant here that cost me about 50X less than what it cost in the USA. America health care costs are waaaaaaay above other countries in most cases.

ChunMei had one about a year before she came here. Cost about 500 RMB. Last month, while she was in Nanning, the titanium post broke, resulting in the loss of the implant. And the dentist who did it originally had moved his office, and couldn't be located. She had to have another complete implant, this time at a cost of 550 RMB.

 

I've mad an appointment with my dentist for this Thursday morning. My plan is to have a comprehensive exam done, and then get everything fixed that's necessary. Probably take a number of visits, and be expensive, but insurance will cover a lot of it, and I'll feel better knowing that everything is taken care of.

[Fu Lai]

Mine was about 300rmb and has held strong for five years now... in the USA they wanted the equivalent of 20000rmb ( and that was the cheapest I could find)

 

 

I had a tooth implant here that cost me about 50X less than what it cost in the USA. America health care costs are waaaaaaay above other countries in most cases.

ChunMei had one about a year before she came here. Cost about 500 RMB. Last month, while she was in Nanning, the titanium post broke, resulting in the loss of the implant. And the dentist who did it originally had moved his office, and couldn't be located. She had to have another complete implant, this time at a cost of 550 RMB.

 

I've mad an appointment with my dentist for this Thursday morning. My plan is to have a comprehensive exam done, and then get everything fixed that's necessary. Probably take a number of visits, and be expensive, but insurance will cover a lot of it, and I'll feel better knowing that everything is taken care of.

 

[ama537621]

Quality also depends on who you know.

 

Yuan insisted on staying with her parents until after the baby was born, and she is still there.

I was a bit miffed until she dragged me down to the hospital to introduce me to her cousin, the president of the local woman's and children's hospital. Needless to say her quality of care was extremely good. On our visit her cousin walked with us to the hearing exam room and let us in before the other 20 people waiting, then did the same thing with the washing/swimming area, which was a bit weird but hey Emily liked it. She also was there when she had the C-section and sowed hew up herself. She might not even have a scar when she finishes healing up.

 

Who you know means more in China than money (sometimes)

[danb]

When I first started this thread I was thinking mostly about the cost and the affordability of good health care. (Mostly in China) After reading your replies and thinking about the whole thing I am starting to realize that there are many aspects of medical care that should be considered. I have been to hospitals in China perhaps only 3 or 5 times. In some respects the hospitals are different than in the states. In the few hospital that I have been to in China there seems to less high tech equipment. Most of the equipment was older. The hospitals were also older looking. Not so modern looking. No fancy wallpaper and fresh paint. Also much less light. A lot less bright and cheery. Albeit these things do not directly show where better health care can be had.

 

I visited someone who was in the hospital for an extended period of time. She was sharing a room with 3 or 4 other patients. It was very crowded in that room. Her relatives took a very active role in her care. I did see a couple of nurses but they were covering about 8 or 10 rooms. I don't recall seeing any doctors. These hospitals were in Nanning. I haven't been to any other hospitals in China. I know that there are other hospitals in that city. I wonder if there are different tiers of quality of care in hospital in Nanning and in China. Would an unescorted westerner end up in only a "fancy" tier hospital? Danb

[Hunter68]

I was to move to Shenyang last year when I found out I had cancer. Decided to stay in the US to have the tumor removed and do my radiation and chemotherapy in Houston. I still haven't left the US because I am worried about future cancer and teatments in China. The only good thing a good friend is a doctor in Mudanjiang, but they are gyneicologists. But they have helped my knowledge to know I do not want to have my care in China until I have one year of being in remission.

 

I have priced health insurance for China. It will run me about $250.00US per month. And any previous illness is not covered for the first two years of having the policy.

 

As to cost. My insurance here was billed $120,000.00 for my stay and operation to have the tumor removed for seven days. They only paid the hospital $19,000.00. Radiation and chemotherapy they where paying about $50,000.00US per month. I found out why som many people end up going bankrupt in America because of medical cost. My out of pocket was only $5,000.00.

[danb]

Hello Hunter68, Without some form of insurance not many people would be able to afford a major medical issue such as you. I hope your treatments are done soon and that you can move over to Shengyang soon.

 

I was looking for some info on the cost of medical insurance. I found some information but not much about the cost. There were some companies that advertise insurance plans for China. They asked for some information about yourself and said that they would send a quote. Some of the names of the companies were Bupa, Aetna, Cigna and there were others companies listed as well. Some sites offered some advice and other didn't. Here a link to a news article from the UK that offer some insight on the subject that I thought was interesting:

 

http://www.telegraph.co.uk/health/expathealth/8186239/Expat-guide-to-China-health-care.html

 

At my workplace there are many people that are at or near retirement age but many are reluctant to retire early. The major reason is the cost of medical insurance. They are waiting for medicare to kick in. Pre-medicare cost of insurance is high. I am hearing prices of between $6500 to 8000 per person per year.

 

I searched for "expat medical insurance cost in China." I wasn't sure if that was the results were guiding me to companies that was gearing toward western customer's who could more afford to pay those prices. I wonder if I could worded my search differently. Those prices are scary. But not have medical insurance for major incidents is very scary also.

 

Thank you for posting your info. Hope to hear about you moving Shengyang real soon. That is in the northeast part of China, correct? I have been to Harbin( perhaps a bit farther north than Shengyang) once in the winter time. It was very cold. How is Shengyang in the winter? Danb