Healthcare in China is a significant point of contention for many expats. Treatment is available in public hospitals, international clinics within them or at private facilities that cater to expats. The Chinese healthcare system is hospital-centred, so expats often forego the search for a general practitioner.

As can be expected from such a vast country, the quality of care, the ease of access and the associated costs vary tremendously between different places and institutions. Most expats in China do, however, take out private health insurance and seek treatment at private facilities.

Public healthcare in China

China's public healthcare system is best described as inconsistent. Many cities have direct access to hospitals and a range of medical services, whereas rural areas can be hours away from the nearest clinic. China’s public healthcare system is generally considered to be substandard. While this may not be the case with every facility, the language barrier, slow service and long queues dissuade most Westerners from seeking treatment in a public hospital.

Despite their appearance, the quality of treatment in many hospitals is up to Western standards, even if their methods are different. Expats using China’s government hospitals should expect a few quirks. Patients may be expected to keep their own medical records and some doctors get a commission from prescriptions.

International wings in public hospitals

In an attempt to bridge the gap between the quality of care at costly private hospitals and the bad service at public facilities, some public clinics have opened international wings. These exist as partnerships between the state and the private sector, and aim to provide access to public healthcare with Western standards of healthcare.

Many of these share doctors with public facilities, but don't have the long waiting times. They also have a greater focus on customer care and treatments cost less than at private hospitals. International wings are a relatively new phenomenon, and are only found in China's largest commercial centres.

Private healthcare in China

International hospitals are well represented in larger cities such as Beijing, Shanghai and Guangzhou, but will be absent in most smaller cities and rural communities. While these private facilities often have English-speaking medical staff with Western training, the high standards and service-orientated treatment come at a price and fees are sometimes more than twice those at Chinese public hospitals.

Health insurance in China

Though 95 percent of the Chinese population has at least basic health insurance, coverage isn't as comprehensive as perhaps expected. Public health insurance, for instance, generally only contributes half of the medical bills. Premiums also tend to be high, even for the most basic insurance plans. 

It's therefore essential for expats to negotiate private health insurance as part of their employment package. If this isn't possible, they may want to consider opening a policy on their own. Western companies have been increasing their presence in the country for a number of years, and are a popular source of insurance for expats. Expats should ensure their hospital of choice recognises the insurance policy they hold.

Local providers are another option, although expats should always check whether they are licensed to sell insurance in China, since many are not.

Policies and premiums vary tremendously, and the best option is directly connected to individual circumstances.

Medicines and pharmacies in China

Expats in Chinese cities will have access to the kinds of prescription medicines they're used to, as well as a range of traditional Chinese medicines. Some pharmacists have expertise in both areas and those that do make for a valuable resource.

Expats should also note that not all medicines will be availabile, and some may be prohibited from being brought into China.

Pharmacies are widely available in urban areas and are conveniently organised into different departments. However, most labels are in Chinese, so some assistance from a local friend, colleague or bilingual pharmacist may be necessary.

Health hazards in China

Pollution is a concern in many Chinese cities, and may be an issue for any expats with pre-existing respiratory problems. Expats living in urban areas should make an effort to exercise regularly and use an air purifier at night.

The safety of drinking water in China is another health concern. It's best to avoid drinking tap water and rather consume bottled water.

Different areas pose varying health risks. Regions with higher altitudes, such as Qinghai Province, could cause altitude sickness. It's advised to follow instructions from the Chinese authorities regarding any health alerts.

Emergency services in China

Emergency services in China are provided by the state’s emergency medical services. These are widespread and efficient in urban areas, but are less reliable or absent in rural regions. Ambulances often have a physician on board, but best lookout for and avoid so-called 'black ambulances' – unlicensed, private ambulances that could charge you a fortune.

  • 120 – Ambulance services

  • 119 – Fire department

  • 110 – Public Security Bureau