In many ways the Chinese have a much healthier society than Americans. At a time of day when most Americans are hitting their snooze buttons, many Chinese are hitting their local park for tai chi exercises and ballroom dance practice, followed by their daily commute by bicycle. Chinese meals are often high-vegetable, low-meat, low-sugar affairs that keep the cholesterol and the weight down. And traditional medicine shops do a brisk business in dried snake, seahorse, and ginseng root, believed to work wonders for one’s vitality and longevity.

Adopting a traditional Chinese lifestyle may add a few years to your life, but there are plenty of influences that will take away from it as well. Diseases tend to float around rural China with fluidity. Nevertheless, when you need it, you’ll find adequate health care available, from international medical facilities in major cities that employ only western doctors and imported drugs, to inexpensive local public clinics where your antibiotic prescription may come with a few vials of traditional medicine. And if a health situation proves too serious for the local facilities, medical-evacuation choppers offer transportation to the nearest place that can help.

Hospitals and Clinics
Hospitals run by foreigners are the most expensive option for health care in China, but they are also the most trustworthy. You’ll pay dearly for their services, so you’ll want good insurance first. A procedure at an international facility can regularly cost more than ten times the same procedure at a public hospital. Fortunately the international health institutions are more likely to accept your insurance (check first), so you won’t have to pay out of pocket and wait for reimbursement. Some of these facilities also require membership before you can take advantage of their facilities.

Hospitals and clinics that are wholly foreign-owned are typically staffed by expatriate doctors; joint-venture facilities are often managed by a foreign company but staffed by foreign-trained Chinese personnel. There shouldn’t be much difference in medical treatment between the two, but philosophy of practice can differ greatly, such as how much information to give a patient or to what degree a patient is allowed to make choices in their treatment. Staff at foreign-run hospitals and clinics will be fluent in English; they may also speak a variety of other languages. You’ll find several foreign-run hospitals and clinics in China’s biggest cities, though smaller key cities may have just one or none at all.

Any foreigner can take advantage of the public hospitals and clinics in China, paying the same amount as the locals do to get the same treatment. These facilities do not take appointments; just show up and join the waiting crowd. You’ll pay the basic fee when you arrive at the registration desk, then pay again before each test or treatment you require. You’ll have to contact your insurance company later for reimbursement. Fortunately an increasing number of hospitals in larger cities are now accepting credit cards for payment.

Chinese medical care often includes the choice of western or traditional Chinese medicine. If you prefer Chinese medicine alone, most towns have hospitals that are solely dedicated to it, though just about any Chinese doctor at any facility in China can (and will) prescribe a traditional option in addition to his western recommendations.

Be aware of the cultural differences in medical practices between China and the West. Chinese doctors often refuse to supply copies of medical records, lab results, or X-rays. Some have been known to strongly discourage patients from seeking a second opinion, and refuse to listen to requests from patients concerning their own treatment. While domestic-run health care can be a bargain, you might pay for it in lack of service-oriented professionals.

Public city-level hospitals are thought to offer better overall medical service than the smaller district-level clinics. They keep advanced and specialized medical equipment and prescription medications. Some also offer VIP wards (called gaogan bingfang), where you can pay extra to be treated in a comfortable private room with English-speaking staff more attentive to your needs. In fact, foreign medical firms like Global Doctor run clinics in many of these VIP wards. Though the doctors are often still Chinese and have a Chinese way of doing medicine, they will be thoroughly western trained. You’ll get sound medical care, but you may not get the autonomy we enjoy in the United States, such as the ability to make your own decisions about childbirth methods.

District-level clinics offer the convenience of being close to your neighborhood and having much shorter wait times than larger hospitals. A typical visit at a district-level facility, such as a check-up or minor ailment, should only take 10 or 20 minutes, whereas visiting a city-level hospital for the same reason could take three or four times longer. Fees are less at your local clinic, though so will be the amount of English spoken. If your ailment is more complicated than a simple cold or rash, you should go directly to a city-level hospital with more advanced technology.

Other Clinics
By the looks of some Chinese smiles, you might think that there are no dentists in China. On the contrary, whether or not the locals choose to take advantage of them, China has many fine dental and orthodontic services, often charging a small fraction of the cost of their American counterparts. Many large hospitals include dentists and orthodontists, as well as other specialists such as ophthalmologists. Major cities offer eye-care centers with western-trained professions; some cater specifically to English speakers.

If you will be working for a Chinese employer who is providing health benefits, check to see if they require that you use a specific facility. If you would prefer to not use their choice, be sure you are aware of the financial consequences of using a different facility.

When you’ve decided which health facility to primarily rely on, be sure to keep their business card in your wallet. In an emergency, you’ll want it to show a taxi driver to get you to your hospital. Don’t bother waiting for an ambulance to take you there; ambulances in China do not come with sophisticated medical equipment and the drivers often have no medical training.

Insurance
Currently China has no uniform system of private health insurance, so you’ll want to make sure you are adequately insured prior to your move to China. Many U.S. policies do not cover services received outside the United States. If your insurance does cover Chinese medical expenses, you will typically have to pay up front and file for reimbursement later, though foreign-run hospitals may take your insurance.

You’ll want to make sure that your insurance policy covers emergency medical evacuation, since it can cost well over $50,000 should you need it. Check your policy for psychiatric treatment as well, since stress and depression are common among expats as they learn to adjust to a new environment without their close friends and family nearby.

You may consider choosing a provider that includes the services of SOS International. As the world’s largest medical assistance company, SOS maintains relationships with over 150 hospitals across China that they have approved for treatments of foreigners, as well as the Chinese military and commercial airlines to arrange for a medical evacuation when needed. Their convenient 24-hour hotline operators can answer medical questions and recommend where to get quality medical assistance in any corner of the nation. For those who will not be covered by insurance offered by an employer, you can buy a personal SOS membership with the option to add travel insurance as well as expatriate medical insurance or study abroad medical insurance. You can also buy a one-week SOS membership for one of their half-dozen clinics just when you need it most.

Pharmacies and Prescriptions
You shouldn’t have to walk far to find a pharmacy in China. In most cities you’ll find one every block or two, marked by a green cross. You can also pick up medications at hospitals and foreign health clinics, both of which charge more but have stronger safeguards against the possibility of getting counterfeit medications. The foreign clinics will carry the imported medications you are used to, but you’ll pay much more for them than you would back home. On the other hand, many common Chinese medications (even prescription drugs) sell for just a few dollars.

Finding a pharmacy may be easy, but finding English in that pharmacy will not be. You’ll be lucky to find one that keeps a bilingual medical dictionary, or that has any staff who can speak a word of English, let alone medical terms. Fortunately many of the Chinese medications will have the drug’s generic name in English on the box, although all directions and precautions will be in Chinese. When you do find the drug you need, be sure to keep the box to show it to the pharmacy the next time you need it.

The process of getting prescriptions filled in China is similar to what you would expect in the United States, except that it is solely paper-based. You’ll need your doctor in China to give you a prescription paper, which you will then take to the pharmacy (no computerized records of prescriptions are available, and don’t expect to have your doctor call in a prescription for you. Chinese pharmacies will not recognize a prescription brought from your home country; you’ll have to take that prescription to a local doctor to obtain a new Chinese prescription.

Pharmacies can help diagnose basic medical symptoms and prescribe over-the-counter medications. Unless you already speak Chinese, the trick will be in how to communicate your symptoms, and how to know for sure that the pharmacist has understood you correctly. A pharmacist’s advice is best sought for ailments that are visual, such as rashes. Better yet, just bring a bilingual friend with you to translate.

U.S Centers for Disease Control – www.cdc.gov
English-Chinese Medical Dictionary – www.esaurus.org
World Health Organization – www.WHO.org
Medaire (Global Doctor insurance) – www.medaire.com
SOS – www.internationalsos.com
Global Doctor – www.eglobaldoctor.com

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