Health care quality in the Far East: China, Japan, Philippines, South Korea and Taiwan

With its mix of developed and developing nations, health care provision varies wildly across the Far East.

In Japan, you’ll find clean, effective medical facilities, efficiently managed by the government. In other countries and territories, expats may only find these high standards in private facilities and you may need to be evacuated to another region for treatment if the local facilities don’t have the equipment or skills to meet your health care needs. Wherever your destination, private medical insurance is worth thinking about, along with access to further funds, just in case. The same is true for employers who may want to invest in private medical insurance for their international employees.

Japan

Japan spends a very healthy 8.2% of its GDP on health care (roughly the same as Canada and the Netherlands), has a good ratio of doctors to population (nearly 3 per 1,000 people — similar to the UK), and the performance of its health care system places it at 10th place in the world, according to the World Health Organization (WHO) World health report published in 2000. These statistics are reflected in the high standard of care available to both nationals and foreigners in the country, which is paid for through a mandatory health scheme — either through the employer or directly by the individual.

Resident expats are required to enrol on either one of these schemes, whether or not they choose to top this up with private medical insurance. The employer-based scheme only covers some of the cost of treatment (in the region of 70% to 80%, depending on what the treatment is for and who is being treated), and covers the worker and their dependent family. Until this cover is arranged, private health insurance can be reassuring. In large cities with established expat communities, it is possible, with a little effort, to find English-speaking doctors, dentists and pharmacists: in other areas, it may be necessary to take someone with you to act as a translator if you aren’t fluent in Japanese.

China

With inconsistent standards between rural areas and the big cities, the health care system in China has been rated as 144th in the world by the World Health Organization. The country spends 5.5% of its GDP on health and has a relatively low number of doctors (1.6 per 1,000 population). With the largest economy on the planet, it attracts workers from all over the world: many of these find the right standard of care in the major hospitals of Beijing and Shanghai, but it’s useful to take a companion who can translate for you if you don’t speak a local language such as Cantonese, Hanyu, or Putonghua.

U.S. and other international hospitals offer a better level of care and English-speaking staff. However in rural areas, medical centres can be sparse and poorly funded, and staffed by staff speaking one of the languages of China. Newcomers might want to consider comprehensive private medical insurance cover from a reputable broker or company before they enter the country.

South Korea

Health care in South Korea is of a very high standard. With just over 2 doctors per 1,000 people (similar to neighbouring Japan), the country’s health care system is ranked as 58th in the world by the World Health Organization. Modern and efficient, both Western and traditional Eastern medicine is covered by the government’s health insurance scheme. Employed expats will be covered through their employer, while the unemployed and self-employed need to enrol through a hospital, with costs varying according to income.

Not all services are covered, and for some treatment a premium will be payable. If you’re referred to a hospital or specialist clinic, find out first whether a cash deposit is payable and contact your health insurance company for more information about how your treatment will be handled. In major cities, it shouldn’t be too difficult to find an English-speaking doctor and, in some places, you may find an international clinic where other languages are spoken. Health care assistants and nursing staff are less likely to speak English, so you may need to take an interpreter friend with you, if you don’t speak Korean.

Taiwan

Health care facilities in urban Taiwan are considered to be of a very high standard, easy to access and affordable. Expats living and working in Taiwan will be enrolled onto and subsidised by their employer for the public health scheme, while resident dependants should register at a hospital. The scheme’s associated health insurance card needs to be shown when you see a doctor. You don’t need an appointment to see a general practitioner (GP, also known as a family doctor) and it is possible to make an appointment with a specialist without a medical referral.

Many physicians have been educated overseas and so may have a good knowledge of English and, in some areas, there are specialist clinics set up to cater for English-speaking expats. Aside from the public facilities, there is a private system offering shorter waiting times and better facilities. Whether or not you choose to upgrade, private medical insurance is worth considering as certain treatments for serious complaints are capped under the national scheme and there are circumstances where repatriation may be necessary.

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

The Philippines

The standard of health care available can vary wildly across this archipelago of 7,000 islands. To the north, large cities like the capital Manila are home to well-equipped and staffed facilities. Other areas are sorely under-resourced, and the Mindanao Island to the south is generally considered off-limits for foreigners for safety and security reasons. Even though the country is one of the largest exporters of medical personnel in the world, it has a doctor ratio of just 1 per 1,000 population — which is well below that seen in many developed countries. That said, most expats find it easy to locate an English-speaking doctor.

For citizens, health care is intended to be free at point of access through the PhilHealth scheme, but the scope of this can be limited. The public programme is financed through the wage packet, government subsidy and employer contributions. There are roughly 1,700 hospitals in the country, 40% of which are state operated. Private hospitals offer a good level of care and, although costs are high by local standards, they are low when considered on a worldwide scale. For foreign nationals, private medical insurance is worth thinking about and some private facilities may expect an upfront cash payment before providing treatment. On the whole, the country spends 4.7% of its GDP on health care (slightly more than nearby Malaysia and Thailand), and its health care system is ranked as 60th in the world for performance by the World Health Organization.

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 our expert sales consultants today.

If you’re moving overseas

What is the advice for anyone considering a move to another country to live and work? Consider doing some detailed research on the health care system.

You will need to find out:

• Where are the best hospitals?
• What access do foreign nationals have to universal health care?
• What standard of facilities and personnel are available?

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:

• 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

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. If you’re looking for expat insurance you can get a quote here.

If you’re an employer or broker looking for international Private Medical insurance for clients or staff, you can call us to discuss your needs. Get the right telephone number for your area, here.

Source material and further reading:

https://www.gov.uk/foreign-travel-advice/japan/health
https://www.expatfocus.com/japan/health
http://www.expatarrivals.com/japan/healthcare-in-japan

https://www.gov.uk/foreign-travel-advice/south-korea/health
https://www.expatarrivals.com/asia-pacific/south-korea/healthcare-south-korea

https://www.gov.uk/foreign-travel-advice/taiwan/health
https://www.expatarrivals.com/taiwan/healthcare-in-taiwan

http://www.telegraph.co.uk/news/health/expat-health/9195995/Expat-guide-to-the-Philippines-health-care.html
https://www.gov.uk/foreign-travel-advice/philippines/health
https://www.expatfocus.com/philippines
http://www.expatarrivals.com/philippines/healthcare-in-philippines

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