Healthcare in China: Fostering quality outcomes
Obtaining quality healthcare in China might be a challenge for many visitors and expatriates.
While China’s overall public healthcare system has seen improvement, most foreigners prefer private clinics and hospitals that offer an international standard of care over care from public facilities. Public hospitals may be less expensive but they also can be overcrowded, have long wait times, offer limited language capabilities and often require immediate cash payment. Nurses, rarely trained to western standards, also may present communication hurdles.
Private clinic quality is very good and our general experience is that expatriates are very satisfied with it. Typical in developing countries, expatriates tend to use a small available provider subset. In Beijing, for example, 80% of our claims in 2012 from expatriates were paid to a single hospital and 90% paid to six providers. In Shanghai, 80% of our claim costs are with 15 clinics and hospitals. Clearly, having the right providers and relationships with those desired facilities is a critical core competency for any insurer.
Outside the cities of Beijing and Shanghai, most Chinese healthcare facilities expect immediate cash payment. However, several private clinics and hospitals in China (and a few public hospitals with VIP sections) have entered into direct settlement agreements with international insurers. These agreements can minimize an expatriate’s out-of-pocket payments. MSH China, MetLife’s regional service center administrator, is a leading high-end insurance administrator in China and holds these agreements with more than 500 clinics and hospitals in 30-plus cities across the country.
Preparing for your healthcare
In unfamiliar surroundings, expatriates and their families understandably worry about their health and well-being. But using common sense practices can reduce much of the fear and anxiety. Ways your expatriates can manage these concerns include:
- Identifying and visiting facilities in advance - At the earliest opportunity, an expatriate should visit and compare reputable clinics and hospitals as well as interview practitioners to ensure pediatricians, internists, ob/gyns and other doctors speak the expatriate’s language, have good communication skills and are prepared to provide expected personalized care. MetLife publishes a list of hospitals and clinics on our website for existing customers to assist in selection. Furnishing medical insurance details to the admissions/registration desk in advance minimizes administrative annoyances and also may allow the provider to contact the insurer for eligibility and coverage provisions. This is particularly important for family members with asthma or other respiratory issues that can worsen quickly as a result of poor air quality in parts of China.
- Planning for emergencies - This includes practice driving the route, knowing where to park and how to locate the emergency entrance. If you don’t own a car, have the hospital’s address written in Chinese for a taxi driver. Note that public ambulances may be required to take you to the nearest public hospital, not necessarily to the one you prefer. Keep your insurance provider’s number visible to all in your home – MetLife provides on-demand, toll-free 24/7 telephone access to medical professionals familiar with China’s healthcare environment.
- Confirming medical treatment options - Expatriates in China often want to ensure they understand treatment options and already have a sense of how “doctors at home” would treat a similar issue. With MetLife, there is 24/7 access to an experienced team of medical professionals across China. The team will provide guidance on the appropriateness of a treatment plan and monitor complex care. Additionally, for certain serious longer-term conditions we offer a service (delivered through Worldcare) whereby expatriates can get a second opinion from multidisciplinary teams from five of the top 10 “Best Hospitals 2013-2014” according to the ranking published by US News & World Report.
It is very critical to stress how important these suggestions are to expatriates, something that MetLife does personally during our onboarding process. MetLife offers new clients customized webinars that help prepare expatriates for their coverage under the MetLife program.
Whether it means offering readily available and actionable healthcare information online, providing immediate medical guidance and support, or settling bills directly with clinics and hospitals, MetLife has the appropriate experience to help you and your globally mobile employees obtain satisfactory outcomes and lessen the initial anxiety about receiving health care in China.
1Statistics based on internal MetLife claim data from 2012.
2REGULATION (EC) No 593/2008 OF THE EUROPEAN PARLIAMENT ANF OF THE COUNCIL of 17 June 2008 on the law applicable to contractual obligations (Rome I)
3Duarte v. Black & Decker Corporation and another,  EWHC 2720 (Q.B.),  All ER (D) 378 (Nov); Samengo-Turner and others v.J & H Marsh & McLennan (Services) Ltd and others,  EWCA Civ. 723,  All ER (D) 196 (Jul).