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Moving to China

Vox Populi

Category: Vox Populi

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  • Get medical insurance.
  • www.medibroker.comThese guys will find you an insurance company and plan to suit your needs.
  • Ask your employer about your medical insurance. You need to understand how much they pay. Each employer's medical plan is different.
  • If your employer says "don't worry"...start worrying.
  • Hospitals do nothing until you show the money. Time is on their side.
  • You need to haggle prices with the doctors. Not a nice thing to do when your friend is dying, but time is on the doctors side.

China is a great place full of fantastic people. For almost all who come here, they leave with amazing, and positive memories.

Sadly, things can go wrong. And when they do go wrong, a China experience becomes a nightmare, and a harsh awakening into the realities of life here. 

All employers must provide medical insurance, and legitimate schools in Changchun will explain their medical insurance coverage to you before you start. This will be very basic coverage, nothing fancy, but legal. With most english teachers being young, healthy and invincible, it’s good enough. Some schools will also cover family members, but not all. It's very important to clarify if your employers plan covers spouses and dependants (and to what age). Smaller schools and part time employers probably won't. There’s also a lot of teachers out there working freelance, or for smaller schools that may “say” they are insured, but not really. Without trying to go into the sad and tragic details, here is a brief summary of the health care system in Changchun.

Changchun has some very modern hospitals. While some parts of the hospital (re: service) might appear shabby, some of the equipment and facilities are very modern. Sadly, this doesn’t come cheap, which explains the biggest problem with Chinese hospitals.

Dead people don’t pay bills, so everything needs to be paid up front, in cash. A friend commented the other day on how rare it is to see ambulances on the street in Changchun. When calling for an ambulance, the first question they ask is “who is paying?” Ambulance drivers prefer payment in advance. The price will depend on the seriousness, painfulness or demand for their services. You could be better off in a taxi (if you can find one).

It’s the same at hospital. If it’s an emergency, the patients who pay the fastest get the quickest treatment. This can be the most distressing time, as you or your loved one is critically ill, and needing immediate assistance, while you frantically phone around looking for money. ¥10,000 - ¥20,000 should be enough to get initial treatment, but this won’t last long, and you’ll be needing more money soon after, and the hospital won't hesitate to pull the plug when the money stops. This was a very stressful time for the people involved. Although we were covered by medical insurance, payments weren’t instant. We had people haggling and pleading with the hospital, assuring them the insurance was good. All the time in hospital, we were reminded our funds were running low, and needed to be covered, or else treatment would cease.

Price, like everywhere is China, is a fluid concept. It all depends on the doctor's whim, and how much they think they can milk out of you. They'll take full advantage of the situation. The more critical, or painful your condition - the more you'll be charged. Worst case would be a busy day, where it can come down to an auction, to see who gets treated first. Don't expect any discounts if you're a foriegner.

A teacher in Changchun just recently needed medical treatment. The bill was going to be around ¥35,000. His university's insurance required them to pay 60% of the costs (which they never honored). This left him needing ¥14,000 for the treatment, which wouldn't start until a payment was made. The next day, the hospital said the operation would actually cost more money. 

Intensive care costs about ¥14,000 a day, and needs to be paid in advance. The family is expected to camp at the hospital in case anything is needed to be bought. It’s like a little community outside the IC rooms. People live on seats. Bunk beds can be rented. There is a camaraderie amongst the families outside the ward. Most of the day is boring, nothing to do but wait. Then the nurses call out a number, and there’s a few moments of frantic emotions. Sadness, joy…but mostly anxiety. Then it’s back to the waiting, all day and night. Treatment ceases if payments fall behind.

Waiting in the ward, I could see, and hear the distrust, dislike and disgust for medical staff. Guards are needed to protect medical staff. Hospitals need to make money. The more money they make, the more doctors can make. Attacks on hospital staff have occurred, doctors have been killed, but public sympathy is often with the perpetrators . 

Basic health insurance does not cover the cost of returning a body back to the home country. This will cost at least ¥100,000. Only religious minorities are allowed burial, so it’s cremation - the quicker the better. This is the families responsibility.  If no family, then responsibility lies with the work unit. While the morgue will provide storage the cremation service (burning), it’s up to the family/work to do everything else.

A heart attack costs around ¥80,000, An operation to remove a cancer cost ¥50,000. Although the costs are high, the medical standards are to an extent, equitable with the west. People who have undergone this treatment have been very satisfited with treatment, care and facilities.

So, if you’re not sure if your company has you insured - ask, and ask again. If they say yes, but can’t give any details, then be worried. If you’re working part time, you’re probably not covered. If you’re a freelance teacher,  you need to get insured. Chinese companies can insure expats, but I found the process confusing and frustrating. I ended up using a medical broker at . My basic coverage is costing around US$900 a year. This will be cheaper for youngsters, dearer for smoking elders. Even with this insurance, I know it will take time for the money to come through. I've always got some money in the bank...just in case. If you have the money, then your treatment will be ok. Capatilism...aint it a bitch.

In defence of the hospital system, doctors and nurses constaintly complain abou the volume of patients they have to deal with, and the pressure on them to see as many patients in a day as possible. This is true. Chinese hospitals seem almost as busy as train stations. Also, China is still a developing country without the resources and trained practitioners to cover the high demand for medical treatment. 

It’s not a nice thought, but medical insurance is essential. Otherwise, make sure you always have at least ¥60,000 in savings at any time. 

I’m hoping it’s never needed, and we can all keep enjoying our fabulous China experiences.

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