Wednesday, August 4, 2010

Medical Care without Health Insurance

Last week I started to come down with something and I decided perhaps hoping it would go away was the best choice for about a week. However, as breathing became more and more difficult, I began to realize just how important being able to breathe was for my ability to continue living. However, as the insurance I had in China stopped with my last contract and I assume my new health insurance won't pick up until I actually start working with my new contract, I am currently uninsured. Unless I die or get injured, and then I have insurance through the British Council (I think)!
So today, I went to the doctor without insurance. I told Meng that I thought that was scarier than going to a doctor in China with or without insurance. The result was not as scary as I was expecting. I knew exactly what was wrong with me; however, I was not sure how much it would cost to make it better. The problem was a asthma flare-up. My symptoms are generally non-existent unless I am exposed to too much dust or I get an infrequent wheeze which is cured by a single puff on a long-acting inhaler. However, when we left China, I thought that my inhalers have very little medication left and they are getting old and that since I will have medical insurance in the US, I would be able to get replacements shortly. Turns out I needed those earlier than I expected. The total cost for the trip to redi-care and the pharmacy was $110.00 for the office call and less than $13.00 for the antibiotic and asthma medication. Which brings the grand total to a whopping 123.00 (or 836 RMB). Now for a little perspective.
The whole time we were in China we made what I think were few visits to hospitals (they do not have doctor's offices or clinics there unless you are going to what is now called Parkway Health). The first visit to a Chinese hospital was when Hudson was 4 years old and he shoved a peanut up his nose. (We annoyed him by calling him peanut nose for weeks). As Meng and I lacked the necessary training to extract the peanut from our son's nose, and we thought that a peanut should not live in his nose until grows big enough that it eventually falls out, we decided to take him to the emergency room. The taxi ride to the emergency room at the best children's hospital (or what Meng claimed to be the best Children's hospital--on Ruijing Rd) cost us nearly 30 RMB ($4.41). When we got to the hospital, we had to choose between 2 waiting areas (and lines). The first was the common waiting room (15 RMB/$2.20) and the other was the VIP room (45 RMB/$6.60). We opted for the latter as the wait was about three hours shorter, and in reality, there wasn't a wait. Essentially, removing the peanut with transportation there and back was less than $20.00. That was my first encounter with a chinese hospital.
The second encounter was also Hudson related, and at the time I really wondered if someone had better call child services on us as we did seem to have a child who found his nose in many "accidents". This accident was bike related. He was riding in the child seat on the back of my bike, and he carelessly put his foot in wheel of the bike. He cried and screamed and I was worried if it was broken or what, so we locked the bikes and took a cab to the hospital. (We had actually tried to get foot stands for his feet, but out bike guy was out and told us to come back the next day, and we made the decision to continue with our bike ride as planned--the moral of this story is always if you can imagine something bad happening and something could be done to prevent it, don't wait a single minute to take those cautionary measures). At the hospital, the checked his foot, gave him a shot , did ex-rays, showed us how to care for his foot and gave us all the necessary bandages that we would need. The total for the emergency visit about 200 RMB ($29.41). Yingna helped to watch Hudson while Meng and I went back to retrieve our bikes.
The third time we had to use medical care was when I was experiencing just about the same symptoms I currently have. I was really scared about going to the Chinese hospital, so Meng made an appointment for me at the best adult hospital (Huashan Hospital) and it was in the foreigner's section where the doctors could also speak English. That appointment with drugs ended up costing less than 500 RMB ($73.11). My insurance from the university did not cover this kind of fancy treatment, so I paid out of pocket happily.
Much of the time when I got sick in China and I predicted I would need the use of an antibiotic, I would send Meng to the drugstore. Most of the time it was not difficult to get azithromician or any other prescription drugs I would want. Sometimes pharmacies would turn him away, but he would just go to the next one. The most he ever had to go to was 3 pharmacies.
Those are really the main memorable doctor visits we had that were experienced in Chinese hospitals. For 2 glorious years, when Meng was working for Expedia we were covered by HTH insurance and it paid for us to go to PARKWAY Health!!! Parkway health seems luxurious. You call ahead and make appointments, and more importantly they have a fancy coffee machine in their lobby as well as English materials for browsing, and one of the locations even has a fish tank.
This reminds me of a time when a person came for a visit, and that person was quite sick (so sick that that person was willing to go to a Chinese hospital) I am not sure what the cost of that person's appointment there was but I am guessing it was in the neighborhood of 1200 RMB ($176.00) for just seeing the doctor, and I do not recall the visit providing much relief.
Clearly, medical treatment in China has different levels of prices for different people. The sad thing is not everyone can have access to the best treatment. Much of gaining access to the best doctors means already having some kind of connection to the doctor. Connection can be made by actually knowing the person or perhaps though paying a bribe. Unlike Americans, Chinese doctors are paid quite low and it is not really considered a profession people go into for making piles and piles of cash. However, by paying the doctors so little money, you find that the care is quite poor and drugs are overprescribed.
Being uninsured in America is far scarier than being uninsured in China, but being treated in China certainly seems to have more problems than in the US. They still lack the facilities for hospitals in many rural areas, and few people trust rural hospitals if they have a more serious medical condition. Also, while the cost of some treatment may seem quite low, the reality is that there are many people in China who cannot afford the cost. There is no system for old retired people either. If they get ill, they will be expected to cover most of the cost (some money will have been put into a medical fund--but it is only enough to cover moderate problems. A serious illness can potentially be a huge setback for a family).
I suppose all I can really say is that I hope the treatment I got today will work (I did empty the contents of my stomach shortly after taking one of the pills, so I am hoping to find a way to not make that happen again tommorow), and that we will all be insured soon.

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