Journal of a French Guy living in Hong Kong

Since I arrived in Hong Kong, I never really had to focus on healthcare since I have been lucky enough not to need a doctor. The only thing I needed was a checkup at the dentist and I just went when I was back in France this summer. But yesterday, my girlfriend had a problem, and I was given to observe what is right / and wrong, with healthcare system in Hong Kong.

First, let me give you a brief explanation of how things work in France. We have a very generous healthcare system, that has been rated best in the world by the WHO a few years back. Basically, everyone is covered by a nationwide system called “Social security”. This include hospitals, and pays for a significant part of your doctor fees,  and drugs. But this does not cover 100% of the cost, the remaining is covered either by : Your work insurance if you have a job / your student insurance if you are a student / your retiree insurance if you are retired / a special system if you are unemployed. So basically, everything you need is free of charge. You can go to the hospital and get a heart transplant for nothing etc. It sounds great right ? Well, except that it has a cost, France has the highest level of taxes in the world, and on top of these taxes, there is a significant part of everyone’s income that goes to social security. Part of the reason for this high cost is that since it’s free, people abuse the system, old people get entire bags of drugs for no real reason other than being old means not having good health, people go to the doctor for everything even if it is not really necessary. And even given the high level of taxes, the system is still not financially stable and many fear it might go bankrupt.

Things work very differently in Hong Kong. There are indeed public hospitals, open to all Hong Kong residents (not just it’s citizen, but all those who have a Hong Kong ID card). These are basically free (only a 100HK$ charge, about 10euros). But for all the rest, you have to pay. If you have a job, things might be included on the insurance provided by your employer, but it varies a lot and some policies don’t cover much. And if you are retired or unemployed or not covered by your work insurance, you have to use the public facilities that are in very high demand. For non urgent matters, the waiting time could be up to a year.

The result is that old people  instead of relying on drugs rely on having a healthy lifestyle. Just go to any park in the morning to see hundreds of old people doing Tai Chi, and they play Mahjong which trains their mind. They also watch their eating habits and as a result Hong Kong has the highest life expectancy in the world.

So let’s illustrate this with my girlfriend’s story. Her wisdom tooth was starting to hurt. She called a public hospital to see if they could take care of her but the waiting time was 1 year. She then called one of the doctors covered by her work insurance, and the waiting time was 1 month, she took the appointment anyway, and started waiting. But everyday was more and more painful, until she went to see a private dentist. The consultation fee was actually quite cheap, only 80 HK$, and consultation fees in Hong Kong include the drugs which are provided by the doctor directly (in France they are provided by the pharmacy). He sent her to get X-Rays at another place, which cost her 360HK$ and made an appointment two days later. But she was feeling more and more painful and decided to go to another dentist who performed another X-Ray, and surgery, for 900HK$.

The other solution would have been to try her luck at the emergency room of the public hospitals but she would have to wait for hours and she was not sure they could take care of her and consider this matter urgent.

Anyway, it’s hard to tell which system is better, I tend to favor the HK one because even if you sometimes have to pay extra, the tax burden of the French system is enormous and it will eventually go bankrupt or have to change and become less generous. But of course, the system favors those who are in good health, which is not entirely fair. In HK there are lots of facilities run by charities though, and especially the Hong Kong Jokey Club (the legal gambling institution in HK). So I don’t think HK’s healthcare if  bad, as far as Asia is concerned it’s actually pretty decent but has you can see, it has it’s flaws.