Public vs Private Healthcare in China: What Are The Pros & Cons?

In China, there are mainly 2 types of healthcare: public healthcare and private healthcare. Public healthcare facilities are those operated by the government, including public hospitals and community clinics.

Private healthcare facilities on the other-hand, are privately owned, which includes private hospitals and clinics.?

What are the differences between public and private hospitals in China? What would you expect when you visit a public or private hospital?

As a foreign national living in China, it is important to know the pros and cons of public and private hospitals in order to determine which one you should visit according to your circumstances.

Pros on Public Healthcare:

Cost. Since public hospitals and clinics are operated by the government, they have the lowest costs among all kinds of healthcare systems in the country.

For example, for consultation fees, it would typically ranges from 50-100 RMB, and majority of tests and medication fees will only add up to a few hundreds at most of the time.

If you do not have any medical insurance cover in China, or if you are only insured with the social medical insurance and your priority concern is cost when you visit a hospital for healthcare, public hospitals might be your best bet.

Doctors. Most doctors whom are chief or associate physicians and above often possess extensive clinical experience due to large volume of patients daily, where they can diagnose you accurately and give accurate medical advices. Surgeons at major public hospitals are often very clinically experienced and could tackle various issues in the operating room.

Online services. Believe it or not, online services at most public hospitals are quite advanced and are available in the form of an app or WeChat mini program, where you can easily make appointments, payments and book for major tests online. There are also kiosks at the hospitals for you to access those services. The downside is that they are only in Chinese at most of the time.

Cons on Public Healthcare:

Language barriers. This the top hindrance for foreign nationals visiting public hospitals whom do not have a good command of Chinese. Most signage are in Chinese only, and the procedures can be quite complicated and challenging even for a local at times. You would most likely need to bring a Chinese person with you when visiting a public hospital unless if you are very familiar with the system and procedures.

Crowdedness. The daily volume of patients visiting public hospitals is enormous, therefore expect it to be very crowded and chaotic at times at a public hospital. Sometimes it can be a bit overwhelming when finding your department, or looking to get your tests done.

Long queues for appointments. Due to the large volume of patients at public hospitals, the waiting queue at public hospitals can be quite long. It is almost impossible to make an appointment in the weekends, and appointments for major tests including ultrasound or MRI would take up to a month at times.

Does not work with private / international health insurance. Public hospitals in China only work with social medical insurance, meaning if you are not a social medical insurance holder, you will have to pay upfront and file a reimbursement claim later to your insurance company, though most private or international health insurance companies could automatically cover the public hospitals in China (unless stated otherwise depending on the insurance policy).

Pros on Private Healthcare:

International patients friendly. Although this is not always the case, most international hospitals in China are privately owned hospitals, where they offer a comprehensive range of English services from staffs to the doctors, where you could visit them with zero issues even if you speak zero Chinese.

Those with online services, including apps or WeChat mini programs, often come with an English services where you can access their online services with ease as a foreign national.

Smoother consultation experience. If you have experienced the going up and downs at a public hospital for finding your doctor, places to get tests done that felt like a nightmare for you, at most private international hospitals it is a much smoother experience: you could see your doctor, get the tests done, and grab your medications at the same place, without having to go up and down too much.

Shorter queues. The queues at private international hospitals are much shorter compared to the public hospitals, where you could get your tests done on the same day at most of the time, and get your surgical appointment as early as possible. This is exceptionally helpful when you need to get your tests or surgery done as soon as possible in order to not prolong your illness.

Accepts Private / International Health Insurance. Most private international hospitals work with private health insurance companies, where you can enjoy direct-billing access at those hospitals without having to pay upfront if you are a private health insurance holder. Of course this would depend on the specific coverage terms of your plan, and whether if this hospital has direct-billing partnership with your health insurance provider.

Cons of Private Healthcare:

Cost. Again, contrary to the public hospitals for charging a lower fare in general, private hospitals are often much more expensive if you are a self-paying patient and do not have a private health insurance policy, or the hospital you visit is not covered by your insurance company. The costs can add up pretty horrendously especially at the international hospitals, and it is generally not recommended to go there if you do not have insurance, unless if you are financially capable.

Availability. Most private international hospitals can only be found in 1st tier cities in China, and if you happen to live in a smaller city, chances are there may not be much English service healthcare options available. Especially if you live in a city that is far from a major city that has international hospitals, you will have to travel a long distance every time you wish to see a doctor.

Even if you are living in a 1st tier city, the travel distance can be challenging as well if you live in a relatively remote area. For example in Beijing, where most private international healthcare providers are in Chaoyang District, it would be difficult for a resident living in Mentougou or Shijingshan to visit a doctor in Chaoyang.

Insurance company exclusion. Though most private hospitals have direct-billing partnership with private health insurance companies, it is not always guaranteed that the hospital you visit will be covered by your insurance provider.

For example, if this hospital is considered a high-cost provider, your insurance provider may not be able to cover it unless if it specifically stated that high-cost providers will be covered. Or if you are visiting the hospital to consult on a pre-existing condition, which most insurance companies will not cover (unless if your insurance company uses a different underwriting method), chances are you will have to pay the expensive medical fees out-of-pocket.

Apart from regular public and private healthcare, there is also one type of healthcare that is in between them called the international department or VIP clinic, normally attached to a major public hospital. Although it is still part of the public hospital, it operates independently like a private hospital and does not accept social medical insurance, while accepting various private or international health insurance.

About the author

I'm an insurance broker at Mingya Insurance Brokers based in Beijing, and my company works with multiple insurance companies in China providing insurance plans eligible for expatriates in China. Our insurance partners include AXA, Allianz, AIG, Bupa, Cigna, GBG, MSH, Medilink, Ping An etc.

I specialise on insurance solution planning for expatriates in China, particularly health insurance. I have been assisting expatriates in China with their insurance solution planning since 2018, as well as group insurance planning for corporates and institutions' foreign employees. Currently our clientele includes international schools, foreign enterprises, embassies and so on.

I was born in Beijing, and am able to communicate in fluent English and Mandarin. I held a financial advisor's license issued by the Monetary Authority of Singapore (MAS) for 2 years, and I am currently holding an insurance broker's license issued by the China Banking and Insurance Regulatory Commission (CBIRC) since 2018.