Surgery and hospital treatment

[joshuawbb]

Before I start, I'd like to mention I may be making myself look silly here, as I may just be entirely misunderstanding the concept of medical insurance. I stand to be corrected by anyone I suppose this is also a general question, as opposed to strictly concerning China's healthcare.

I have health insurance here of course, but a curious question crossed my mind. As far as my understanding goes, if you are say, in the US and require emergency surgery, you'll get it done first and sort out the bill later with the insurance, etc. Is it right to assume the same in China? I.e. surgery first, insurance picks up the bill after.

My impression is that for those with no insurance, etc, in China, a hospital will not perform a medical operation unless that person has sufficient funds. Is that generally correct? Just an assumption based on what my girlfriend said to me. If I am correct in saying that an insurance company will foot the bill after your emergency procedure, which way does getting surgery in China work? You have the procedure and the hospital waits for the insurance company to pay up, or you pay first or immediately afterwards yourself and the insurance reimburses you? Sorry if this is a bit of a silly question. I'm asking more about the policy of a Chinese hospital, not the policy of an insurance comopany about when it will pay.

Let's say one is unlucky enough to need immediate surgical treatment - for example an appendectomy for appendicitis (removal of the appendix in your lower-right abdomen; this is considered a medical emergency), and the procedure will cost some few thousand yuan. You're running low on your monthy funds and probably couldn't pay it up front, but you have insurance of course. Will a hospital accept that the insurance will pay afterwards, or will you have to produce the money first and have it later reimbursed? Will you be really refused treatment until you have the balance at hand?

As I said, this is just a curious question, from my girlfriend telling me a hospital would not usually perform a procedure unless sufficient funds are proved. This may be wrong or right, and I may have simply understood the way medical insurance works.

[abcdefg]

I think your girlfriend may be right about the hospital requiring treatment money up front even in case of emergency. The insurance company then later reimburses you (if they cannot find some legal loophole which allows them to deny part or all of the claim.)

Here's a quote from the US Department of State on the subject:

Cash payment for services is often demanded before a patient is seen and treated, even in cases of emergency.

http://travel.state.gov/travel/cis_pa_tw/cis/cis_1089.html#medical

Fortunately, I have not had any first hand experience in this area and I would also like to learn more about how it really works from those with "in-country" experience.

[gerri]

Haven't had that situation, fortunately.

I think there's a chance they would treat a foreigner on the basis of them holding a credit card. If you get lucky.

I'm at a university and part of the contract is that I would get free treatment at the university clinic - which, thinking about it, makes me happy I still have insurance which would cover emergency evacuation, though it's a financial drain...

At expat clinics, there are contracts for direct payment with some insurance companies. I.e., you tell them your insurance policy, they send the bill to the insurer. I had to pay myself and get it back... and was pretty careful not to run up a tab higher than what my credit card could be used for...

I know Chinese students had to pitch in to get a roommate of theirs (who collapsed) admitted to hospital. And one common scam seems to be that people call somebody, say their child/parent was in an accident and needs emergency treatment, and they should transfer money *immediately*...

[joshuawbb]

Thanks for the help and replies

Ouch, sounds a bit scary to me, I'm glad at least to see it how it is most likely to be though. I'll get my parents to look at this page and have a think about it. Furthermore my girlfriend and I will be asking around a few hospitals about what the policy would be with me and my insurance.

I too have the university program insurance, which gives me free basic treatment at the university hospital close to Xiamen University's campus. That doesn't reassure me much though, considering its standards are far lower than other hospitals in the city. I had to make my own requests to the doctor for penicillin for strep throat, emphasising I would need 10 days worth, as he didn't know what to make of it. A drip was offered. Xiamen's best hospitals are supposedly the Taiwanese-run hospital here somewhere and Zhongshan Hospital.

Maybe asking around hospitals and discussing the financial details is being a bit too careful, but I am going to be here long term, and you can't exactly predict your next hospital visit *touches wood*. It's apparent that a financial problem may arise if an expensive emergency occurs, so it's worth being planned for.

I'll let you know what the doctors said. Thanks again for the help

[Guest realmayo]

A drip was offered.

I may have misunderstood your post, but I think it's standard practice to offer antibiotics via a drip: when I've said that in the UK they're almost always given as pills I've been told more than once that that's impossible, a Western country wouldn't be so backward....

[gerri]

I honestly don't know what would be more modern, but I see one problem that I know to be rampant (and not just in China):

Antibiotics are NOT a one-shot solution.

So, the drip you may be given in the hospital is, in effect, breeding resistance into the bugs it's meant to kill, unless you come back every day for a certain time.

Hence, the use of pills, and the warning to take them for a certain length of time (typically 10-14 days).

It's a big problem everywhere: in developing countries, the pills are expensive and so people don't take/get them more than once or a few times; in developed countries, people think they know everything and stop taking them once they feel better.

That (along with feeding antibiotics to animals in feedlots) is among the major reasons why hospitals produce "superbugs" with multiple antibiotic resistance...

[abcdefg]

It's apparent that a financial problem may arise if an expensive emergency occurs, so it's worth being planned for.

Keep some reserve funds in a Chinese bank that you can draw on at the hospital if you need urgent treatment. A hospital will usually accept a Chinese bank debit card (even if they won't accept an international credit card.)

[Guest realmayo]

unless you come back every day for a certain time.

In China it seems you go on the drip once or twice a day for several days. There are plenty of small clinics dotted around whose main function seems to be providing drips.