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Health care quality in Southeast Asia: Singapore, Thailand, Brunei, Hong Kong, Vietnam and Indonesia

Driven by an influx of tourist and specialist workers from the West, and the area’s own leading technical developments, this corner of southeast Asia is home to several centres of medical excellence.

It’s an area where private health care is in high demand, as charges can be high and public and universal health care systems are lacking, so comprehensive private medical insurance is worth considering. You’ll find the best hospitals in the cities and tourist areas.

Singapore

Known as a medical centre of excellence in Southeast Asia, Singapore is home to a thriving health tourist industry. For elective, specialist surgery, and emergency treatment, medical insurance providers sometimes choose to evacuate their members to Singapore from other countries in the area. This excellent level of care does come at a price. The mandatory Medicare, and more comprehensive Medishield insurance scheme, are open to those classed as ‘permanent residents’. This does not cover the majority of expatriates or almost any foreign workers, so they might want to consider private medical insurance.

The quality of care is supported by ten high-standard public hospitals, thirteen private and numerous other specialist clinics and treatment centres, in which English is commonly spoken. This is financed by 2.75% of the GDP and staffed by nearly 2 doctors per 1000 population. It’s no wonder Singapore sits at number 6 of the World Health Organization (WHO) World health report, published in 2000 (based on health system attainment and performance in all member states, ranked by eight measures).

Thailand

Thailand’s health care system is delivered across private international and public government-funded hospitals. There’s no access to free health care for non-nationals, so private medical insurance is worth investigating for expats in the country. Many public hospitals will ask for a guarantee of bill payment up front. This could mean providing the hospital with proof of preauthorisation (also known as Guarantee of Payment or Letter of Authorisation) from your health insurance provider.. Private hospitals have excellent facilities, employing many English-speaking doctors, and usually have an International Liaison Department to help foreign nationals with medical insurance and financial matters.

The public system has limited nursing care, with the day-to-day well-being of patients being left to relatives. As a whole, the country is ranked at place 47 of the WHO league table for the performance of its health care. There are just 0.4 doctors per 1000 population with a shortage of general practitioners (GPs, also known as family doctors). The country spends 6.5% of its GDP on public health care (which is at the lower end of the world scale, comparable with countries like Cambodia and Indonesia).

Vietnam

Ranked at 160th place of 191 member states by the World Health Organization, the Vietnamese government has stepped up investment in its health care system in recent years and the country as a whole spends 7.1% of its GDP — more than many of its neighbours. There’s a little over 1 doctor to 1,000 people — which is also a good ratio for this corner of Southeast Asia. In rural areas, standards are lower and you may be required to pay for treatment up front (even emergency care). But in the main cities such as Han Noi and Ho Chi Minh City, you can expect better facilities and English speaking staff. Expats who don’t speak English or Vietnamese might want to consider language support when accessing care or treatment. Before travelling to or relocating to Vietnam, it is could be worthwhile considering private medical insurance. There is no integrated care system (which means that there isn’t an emergency ambulance service) and it’s common for patients to be evacuated to Singapore or Thailand for certain conditions — so it’s worth thinking about investing in appropriate medical insurance for these situations.

Malaysia

With a highly rated health care system across private and publicly funded hospitals, Malaysia’s provision is ranked in 49th place on the WHO league table. Like most countries in the area, the best level of care is available in the larger cities and tourist areas. Recent increased investment in specialist doctors in areas such as cardiology and ophthalmology, has led to the country becoming a medical centre for excellence — with outsiders coming in for routine, emergency and elective procedures, such as plastic surgery.

The country spends 4.2% of the GDP on health care (comparable with India and Papua New Guinea), with a relatively low doctor ratio with 1 practitioner to 1,000 population. For foreign workers, a high level of care is available from good quality private and government hospitals, most with English-speaking doctors. Private medical insurance is mandatory (usually employer arranged) and it’s important to note that you’ll be required to provide a deposit before treatment, if you don’t have adequate medical insurance cover.

Brunei Darussalam

A small but wealthy sultanate, Brunei Darussalam offers a good standard of health care which is free to citizens and permanent residents. The 40% of the population who are foreign nationals on work or tourist visas, however, need to pay for their health care. If you’re relocating to, or visiting the country, you might want to investigate comprehensive private medical insurance. Apart from emergency treatment, hospitals will ask for a deposit or proof of cover before admitting a patient. The country has a major hospital in each of its four districts, the largest being in the capital Bandar Seri Begawan, and two excellent private facilities.

The wider health care system is rated as 20th in the world and is supported by a network of health clinics and a mobile flying service for more remote areas. There are no teaching hospitals, and because doctors are from overseas, foreign nationals are more likely to find a professionals who speak English and other languages. There are 1.4 doctors per 1,000 population, a slightly higher ratio than neighbouring Malaysia.

  • Where are the best hospitals?
  • What access do foreign nationals have to universal health care?
  • What standard of facilities and personnel are available?
  • Access to a General Practitioner
  • Inpatient and outpatient care
  • Specialist treatment for on-going care and emergency health care provision
  • Evacuation or repatriation if the treatment you need isn’t available locally

 

Indonesia

Ranked in 92nd place by WHO and with only 1 doctor per 5000 population, Indonesia spends just 2.9% of its GDP on health care — one of the lowest rates in the world. The government has pledged investment and there is a fledgling universal health scheme but this is not open to expats. As many newcomers find themselves having to look further afield to Singapore and Australia for an adequate level of emergency care and elective treatment, private insurance is worth considering. Expats might also want to organise private ambulance cover, and private medical facilities are more likely to have staff who speak English as well as other languages.

Hong Kong

A wealthy, well-established commercial centre, everything in Hong Kong comes at a premium – including health care. Generally regarded as very expensive, there’s a high standard of health care provision across both the public and private sectors. In public hospitals, which is better for things like general surgery and maternity care, there’s a two-tier system of charging: ‘eligible’ rates and ‘non-eligible’ rates. The difference in cost between them is considerable and expats fall into the latter, more expensive category: non-eligible. Private hospitals also offer an excellent level of care. The island manufactures medical equipment, so it’s no surprise medical facilities feature the latest technology across 12 internationally accredited private hospitals and 41 public ones. There’s also an integrated system of clinics and smaller centres — all equally well equipped and monitored by the Department of Health. Comprehensive health care insurance is worth considering for foreign nationals — even considering the high costs — as the level of care received in return is of an excellent quality.

Note: Hong Kong is recognised as part of China by the WHO and so separate statistics for the territory are not provided in their reports.

If you’re planning to move or travel overseas and need more information on private health care insurance for a specific country, get in touch with one of Aetna International’s expert sales consultants today.

If you’re moving overseas

For anyone considering a move to another country to live and work, it’s sensible to do some detailed research on the health care system.

You will need to find out:

And what about insurance? In most cases, this will be compulsory but, in order to ensure your health and safety, what level of cover will you need? Consider whether you might need:

Choosing the right health care insurance provider can make all the difference. Established systems, networks and relationships create the operational core of a company like Aetna International. For more information, please contact our expert sales consultants. 

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