Jun
27
Recently, many major American insurers have looked to international markets for new customers. Thus far, major insurers have primarily targeted the booming expatriate market as their source for international customers, often times establishing field offices to better serve them. A prime example of this trend is in China, where household names such as Aetna, UnitedHealth Group and Wellpoint have all recently established field offices.
The main reason for a growing expatriate segment in China is that various multi-national corporations are setting up shop to take advantage of China’s booming economic growth. According to Martha Temple, president of Aetna global benefits, China is “…a real hotbed place for large U.S. multinational or multinational corporations [from other nations] to open or expand their offices.” As a result, Insurance companies are cashing in by aggressively targeting expatriates.
However, with the slowdown of the US economy, and China experiencing social changes such as a booming middle and upper class, insurers are now pondering the decision of whether or not to offer insurance to Chinese citizens. More and more Chinese are looking for western “luxuries” such as private health insurance as they experience and enjoy their newfound wealth. Even though China has a basic national health insurance plan, many of the middle class and well-to-do nationals would opt to supplement the national insurance plan with private insurance to have a wider range of coverage. And with a population over 4 times the size of the United States, China may be a much needed supplement to insurer’s US business.
Interestingly, foreign insurers within China must have a field office open in the country for two years before it may start selling its products, as required by the Chinese government. Aetna, which only recently opened its China office, needless to say, will have a lot to think about in this period. Possibilities of what to sell are diverse. Insurers could opt to sell non-insurance products such as wealth management plans, or offer abbreviated services such as case management or diseases management insurance. In any case, the outcome of these insurers’ decision will be an interesting one.
Apr
14
In recent years, China has been facing a health care crisis in its rural regions. During China’s great Cultural Revolution and the several decades following it, rural health care was in prime form. Nine out of ten country people had access to subsidized health clinics run by government sponsored doctors. From 1952 to 1982, the infant mortality rate fell from 200 per 1,000 live births to only 34. Average life expectancy increased nearly doubled from 35 years of age to 68 years of age.
However, after an age of great development in health care, progress in rural China seems to be reversing. China’s nationwide push towards capitalist ideals has been a large cause of this. While China’s cities are developing at incredible speeds, rural China is being left in the dust. But ignoring these rural areas may end up hurting China as a whole if not dealt with soon.
Today, 79% of rural residents have little or no health insurance. With new capitalistic ideals, China’s hospitals have been told that they now need to finance a larger portion of their expenses themselves (previously, hospitals were heavily subsidized by the government). To cope with this, hospitals are increasing fees for their patients. It follows that out-of-pocket spending for country residents on health care is sky-high.
It is no doubt that China’s economy has been booming. A look at almost any economic measure shows significant progress. For the past 20 years, average annual GDP growth has been a stunning 9.7%. According to the World Bank, China has lifted 400 million people out of poverty in the past two decades.
The trends in economic prosperity and health insurance coverage are on a crash course and it looks as if China’s health care problems could overpower China’s economic growth. Many rural residents who fall ill choose not to seek necessary medical attention. This choice is dangerous and often lethal. Oftentimes, many residents who do chose to seek medical care do so at the expense of living above the poverty line. In other words, the out-of-pocket expenses the rural residents pay, when ill, put them back below poverty. There have been numerous reports of rural citizens using education, food, and living expenses towards medical bills.
Furthermore, the traditional Chinese way of borrowing money from friends and family to pay for expensive medical conditions could become difficult. The working population, alike much of the developed world, is ageing fast and according to some predictions, China will have only two working people per person over 60 years old in 2040 – in other words, there will be fewer working people to borrow from. Currently there are 6.4 people for every person over 60 years old. According to a report by the Centre for Strategic and International Studies, China may be the first country to grow old before it becomes rich.
These obstacles have nation-wide, and even global, health implications too. Many epidemics such as SARS, Bird Flu, and HIV are not easily contained in rural China directly because these areas lack proper health care. In a worst case scenario, it is imaginable that these diseases could become more widespread internationally as a result of poor containment in rural China.
The most effective way to curb this dilemma is to offer affordable health insurance in rural China. Increases in national economic prosperity and development can only take China so far. Full development into a mature and well-developed country requires a comfortable lifestyle for all of its citizens, or at least accessibility to it. The inability for so many residents to pay for their own health care and well being does not make for a comfortable lifestyle. Thus providing adequate healthcare to all of its citizens is one area China will need to master before it can be labeled well-developed.
Apr
11
Xiamen is one of the oldest trading ports in China. First used by Europeans in 1541, it was the primary source of Chinese tea to the west. When China went through a period of isolation it was Xiamen, along with 4 other major cities in China, which reopened the country with the Treaty of Nanjing following the Opium wars in 1842. All of this has contributed to the global feel of the city and is one of the reasons that in this new age of Chinese prosperity more and more foreign nationals are choosing to relocate to Xiamen on a permanent basis as expatriates.
One of the major concerns facing many individuals who have newly arrived in Xiamen is in regards to the state of healthcare in the city. As a Special Economic Zone (SEZ) Xiamen has some major differences from the rest of the PRC, mainly with regards to the standard of living and the way that the local economy works, however the healthcare system in the city works along very similar lines to the system of care throughout the rest of the country with only a few minor differences.
Public health is a major concern in China. Since the founding of the People’s Republic the provision of quality healthcare to all citizens has been a major concern for the government. The main emphasis of the Chinese healthcare system has always been towards preventative care, and this is no different in Xiamen. With stress being placed on adequate sewage services and primary care points, the Xiamen healthcare service aims to prevent disease before it starts. Sanitation, hygiene, and the irradiation of the four major Chinese ‘pests’ (mosquitoes, rats, flies, and sparrows) have all contributed the health of the Xiamen population as it exists today.
Despite a number of failed public health initiatives, including the unsuccessful ‘barefoot doctor’ scheme, many of China’s major cities have managed to provide healthcare services on par with a majority of 1st world countries. In Xiamen, partly due to its status as an SEZ and the fact that so many expatriates reside there year round, the city has realized the development of a number of VIP medical institutions, known colloquially as gaogan binfang. While these ‘VIP’ hospitals and medical clinics do not typically offer services that are easily affordable by many Xiamen residents, they will provide the services and treatments demanded by expatriates throughout the city, although at a much higher cost than any of the cities many public hospitals.
Chinese hospitals are all ranked based on the quality of treatment and the types of services that they provide. The ranking system will assign a number (1 – 3) to a medical facility, and under this ranking a hospital or clinic with the number 3 attached to it will always offer the best services; a rank of 1 is extremely low, and these facilities may not offer services outside of immediate emergency care. Under this numerical ranking system each hospital will also receive a letter grade of A through C, 3A hospitals will always provide the best medical services while 3C hospitals will still provide good, if slightly limited, care.
Xiamen has over 1000 medical facilities, although not all of these will be able to cater to foreign patients, mainly due to language barriers. In order to resolve this situation Zhongshan Hospital created a special ward specifically targeting foreign nationals with doctors and nurses who are fluent in English and afford patients fast and efficient care. In addition to this the Xiamen Chinese People’s Liberation Army Hospital also has an excellent reputation among the Xiamen expatriate community, especially with regards to maternity and dental treatment.
For foreign nationals in China the local healthcare system essentially boils down to finding a medical facility that is trustworthy and able to provide a high standard of care. Some of the better medical facilities in the city catering to expatriate needs are:
Zhongshan Hospital
201 – 206 Hubin Nan Lu
Tel: 2212328
Email: admin@xmzsh.com
Xiamen #1 Hospital
Zhenhai Lu, #10 Gujie
Tel: 2137275
Email: yb@xmfh.com
Chinese People’s Liberation Army Hospital
94 – 96 Wenyuan Lu
Tel: 6335500
Email: info@xm174.com
Xiamen University Hospital
172 University Road
Tel: 2186203
Outside of these main medical facilities are a number of primary care (out-patient) clinics, and every neighborhood will have a number of doctors providing out-patient services. In addition to this Xiamen is able to provide Traditional Chinese Medicine (TCM) treatment and there will typically be a traditional ‘pharmacist’ or practitioner in every district.
Healthcare in China can be a scary proposition to expatriates who have recently arrived in the country; however the country is able to provide world class healthcare services. For anyone arriving in Xiamen, get involved in the community and find the medical facility that is right for you and your loved ones, it could be a more important choice than you realize.
