Large spike in births following the new two-child policy in China

Large spike in births following the new two-child policy in China

In an effort to reduce China’s ageing rate and combat its shrinking workforce, the Chinese government announced in October 2015 that they would replace their infamous one-child policy with a two-child policy. The new universal two-child policy, implemented in January 1 2016, now allows all couples nationwide to have two children. Health authorities believe this is the main reason why the number of births in 2016 has reached an all-time high this century.

While there has indeed been a noticeable spike in the number of births following the new two-child policy, some argue that this increase can also be attributed to other major factors, such as more parents waiting until 2016 so their children can be born in the auspicious year of the monkey. The increase in pregnancies has also illuminated several maternity-related health challenges, such as more women giving birth in later years. Today, our article takes an in-depth look at what’s causing the large spike in births, and highlights the maternity-related health challenges seen in China.

Background on the two-child policy

Since the one-child policy was first introduced in 1979, a number of adjustments were made to relax this rule. For instance, those who lived in the countryside were long allowed to have a second child as long as they met certain conditions, e.g. if their first child is a girl. Ethnic minorities are often allowed two children or more. In urban areas, couples were permitted to have two children if both parents were themselves only children.

Due to China’s rapidly ageing population and plunging birthrate, a major policy change was implemented in 2013, allowing couples nationwide to have a second child if either parent was an only child. In January 1 2016, the new two-child policy came into effect, allowing all couples to have two children.

Birth numbers since the introduction of China’s two-child policy

A whopping 18.5 million babies were born in mainland hospitals in 2016, representing a near 12% increase from the number of births recorded the year before. In 2017, the latest data available shows that, between January and May, 7.4 million babies were born, an increase of 7.8 percent when compared to the same period in 2016. According to demographer Yuan Xin from Nankai University, the number of births in China is expected to peak to around 20 million in 2017 and 2018.

Proportion of babies born to parents who already had a first child

Interestingly, nearly half of all births in 2016 occurred in families which already had one child. In fact, the proportion of babies born to parents who already had a first child increased from 30% in 2013 to 45% in 2016. What’s more, over half of all reported births between January and May this year involved a second child.

What’s causing the spike in birth numbers?

According to Yang Wenzhuang, a division director at the National Health and Family Planning Commission, the newly implemented two-child policy has proved to be effective in increasing the birth rate in China, even while the number of women of childbearing age is decreasing. Ma Xioawei, a vice-minister of the commission, further commented that many couples from the generation born in the 1970s are rushing to have a second child so that they don’t miss their last chance.

On the other hand, when asked about the 60% spike in demand seen in many hospitals across the country, nurses say that, rather than the policy change, the spike in births was mainly attributed to couples wanting to give birth to their child in the auspicious year of the monkey. In order to ascertain whether the increase in births represents a temporary spike or a steady trend, we will need more time to wait and see, as the new two-child policy has only been implemented last year.

Increasing maternity-related health concerns

The increase in the number of pregnancies has illuminated the rise in maternity-related health challenges seen in China, which is mainly due to a growing number of women giving birth over the age of 35. In fact, it is expected that the number of pregnant women over 35 years old will remain at about 3 million through 2020. Giving birth at a later age can often result in a higher risk of developing complications. For instance, in Guilin 28% of women who gave birth in 2016 were at a higher risk in pregnancy and childbirth, one major factor behind this being age.

The need for maternity insurance

Despite the recent spike in births, fast-rising healthcare costs has meant that many parents out there are still hesitant about having another child or having any children at all. Prenatal and childbirth costs can be astronomical, e.g. a C-section delivery in Beijing can cost over RMB 100,000, and up to RMB 300,000 in Shanghai for a premium C-section package.

With these high costs in mind, having maternity insurance in place when you’re planning to have a baby can really help to offset sky high maternity costs. One thing to note here is that maternity insurance will be attached with a waiting period, usually lasting around 10 to 12 months, which means that securing maternity insurance before conception is key.

To learn more about maternity in China, or your maternity insurance options, why not contact Pacific Prime China today?

Posted by Jess in Maternity Insurance, News
Protecting yourself from infectious diseases in China

Protecting yourself from infectious diseases in China

According to official data revealed earlier this year, there were more than 6.9 million cases of infectious diseases reported in 2016. Of the total, infectious diseases killed over 18,000 people, with H7N9 bird flu, foot and mouth disease, infectious diarrhea, and influenza being the most prevalent causes of death. Most recent outbreaks registered in China are no more than a blip in the news, while others, like H7N9, continue to escalate fear among the whole nation as scientists speculate whether human-to-human transmission of the H7N9 virus is possible. Today, we look at how you can protect yourself from infectious diseases in China.

Infectious disease incidence rates

Following the SARS outbreak in 2003, the Chinese government recognized the need to rethink their “non-collaborative prevention and control approach” and improve the nation’s infectious disease surveillance. This led to the introduction of the web-based Nationwide Notifiable Infectious Diseases Reporting Information System (NIDRIS) in 2004, requiring under the Law of Prevention and Control of Infectious Disease in China that healthcare institutes across the country report 45 notifiable infectious diseases via the internet.

The data collected from the NIDRIS enabled a trend study of nearly 55 million cases of notifiable infectious diseases in China to be analyzed by researchers from Zhejiang University in Hangzhou. Looking at the incidence and mortality trends of 45 infectious diseases in the post-SARS era (between 2003 to 2013), key findings from the study include the following:

The most common infectious diseases

66 percent of all cases reported between 2003 to 2013 were:

  • Hand, foot and mouth disease: A common illness in children that causes sores in the mouth, and rashes on the hands and feet.
  • Hepatitis B: A potentially life-threatening disease that infects the liver. It is spread through contact of an infected person’s blood and body fluids (e.g. via unprotected intercourse, sharing personal items like razors, etc.)
  • Tuberculosis: Compared with other infectious diseases, tuberculosis is the second biggest killer globally, and is an airborne disease that usually affects the lungs. Symptoms can include coughing (sometimes with blood), chills, fever, night sweats, etc.

The yearly incidence of the above diseases were 114.48 per 100,000 population, 81.57 per 100,000 population, and 80.33 per 100,000 population, respectively.

The fastest growing infectious diseases

The fastest growing diseases identified by the study include:

  • Hydatid: A parasitic infection caused by the eggs of a tapeworm called Echinococcus granulosus.
  • Hepatitis C: Primarily spread through blood-to-blood contact (e.g. from poorly sanitized medical equipment), Hepatitis C is a virus that primarily affects the liver.
  • Syphilis: A sexually transmitted disease that, if left untreated, can cause severe long-term health complications like arthritis, brain damage, and blindness.
  • HIV: Primarily spread through unprotected intercourse, HIV is the virus that causes AIDS.

The above diseases were found to increase at an average rate of 24%, 19.2%, 16.3%, and 16.3% per year between 2004 to 2013, respectively.

The rising threat of infectious disease

Researchers from the study identified that certain factors have contributed to the rising threat of infectious disease in China, including increasing antimicrobial (i.e. antibiotics, antimalarials) resistance, changing demographics and behaviours, as well as increased travel. For instance, more and more people in China are moving from rural areas to cities in search of better work opportunities. This rise in mobility is believed to have a large role to play in promoting the transmission of diseases from rural to urban areas.

Protecting yourself and your family

Some infectious diseases can be severe and even life-threatening, so it is important to maintain healthy habits so that you can protect yourself from disease and prevent it from spreading. Here are a few key tips to consider:

Wash your hands often

Handwashing is one of the easiest and most effective ways to protect yourself from infection. Always wash your hands thoroughly with soap before eating food, after using the toilet, after contact with a sick person, and after coughing or sneezing. For those times when soap and water is not available, use hand sanitizer instead.

Avoid touching wild animals

Wild animals sometimes carry diseases that can be transmitted between animals and humans, such as avian flu and rabies, so try to avoid touching them. If you are bitten, it’s best to seek medical attention straight away.

Don’t share personal items

Sharing personal items like toothbrushes, razors, earrings, and nail clippers are an instant no-no. Infections can be passed along toothbrush bristles, viruses can be left behind on razor blades, earrings can carry viruses from the previous wearer, and all sorts of fungus, bacteria, and viruses can be exchanged from nail cutting tools.

Keep up-to-date with all vaccinations

Vaccines can help prevent many infectious diseases, and have helped control a number of diseases that were once common around the world (e.g. polio). According to the WHO, vaccines prevented at least 10 million deaths between 2010 and 2015. To learn more about vaccinations, visit our article on vaccinations and health insurance here.

Having the right health insurance plan

Having the right health insurance plan will ensure that, should you require medical treatment from contracting an infectious disease, you can access the best healthcare facilities in the country without worrying about your medical bills. While in most cases a vast number of infectious diseases will be covered provided that it’s not a pre-existing condition, there may be several stipulations in your policy concerning such diseases. For instance, some plans (usually the cheaper ones) may exclude coverage of epidemic diseases (like the Zika virus). Sexually transmitted diseases are also often listed as an exclusion in plans.

As such, it often pays to speak to an experienced insurance broker like Pacific Prime China, who will be able to sift through the hundreds and thousands of health insurance plans on the market to find the best fitting policy for your specific needs. To learn more about your options, or to get a free quote, contact us today.

Posted by Jess in Health Insurance
Family health insurance in China: 10 tips on getting the right plan

Family health insurance in China: 10 tips on getting the right plan

Protecting the health and wellbeing of your family with the right family health insurance plan will give you all much-needed peace of mind and financial security should any unexpected illnesses occur. Those looking for a family plan will quickly discover that there’s no such thing as a one-version-fits-all health insurance policy, as the right coverage will depend on your family’s needs. To help, we’re going to cover the following 10 most important things to consider when it comes to securing the right health insurance plan for your family.

1. Choosing the right level of coverage for your needs

When finding a family health insurance plan in China, one of the most important things you will need to make a decision on is your family’s required level of coverage. Coverage levels vary significantly between different insurers and plans; Some plans will only cover basic hospitalization fees, whereas more comprehensive plans will cover GP visits, checkups, vaccinations, maternity, etc. Below are the three main levels of coverage:

Inpatient only

Typically speaking, inpatient plans cover any treatment that the patient is admitted to hospital for, i.e. treatments that involve a stay at the hospital. This includes coverage for expenses like surgery charges, ambulance, operating theater fees, anesthetist charges, etc. Inpatient plans from reputable insurers will tend to also include cover for emergency evacuation, cancer coverage, emergency cases of chronic conditions, etc. When securing health insurance for your family, we advise that you at least get inpatient coverage, as these treatments can be extremely expensive in China.

Inpatient and outpatient

The outpatient benefit is an optional addition to inpatient coverage, and covers medical treatment that does not require hospitalization, eg. day to day doctors, specialist visits, and prescription medication. Sometimes outpatient coverage will also include physiotherapy and chiropractic treatments as well as Traditional Chinese Medicine (TCM) treatment, e.g. acupuncture.

Full coverage

For more comprehensive coverage, there’s also the option to include extra add-on benefits in your plan for maximum protection. These add-ons, often referred to by insurers as “riders”, include options such as maternity, vision, and dental coverage.

Know this about maternity insurance

For those thinking of welcoming a new addition to their family, it can’t be stressed enough how important it is to plan for the future and secure maternity insurance well ahead of conception. This is because maternity plans tend to come with a waiting period of around 10 to 12 months (and sometimes even longer), meaning that you’ll need to wait that period of time before you can receive any reimbursements on claims made against that benefit.

2. Deductible and copayment options

Cost sharing options such as introducing a deductible or a copayment to your plan can be a great way to get a discount on your premium.

A deductible is the amount of money you must pay first, either on an ‘annual, per person’ basis or an ‘annual, per medical condition, per person basis’, before your insurer pays anything. As a general rule of thumb, the higher the deductible, the lower your premium will be – and vice versa. It is often advised that people choose to have a higher deductible on their inpatient coverage and a lower one on their outpatient treatment (if applicable), as it is much more likely that you and your family will be using the outpatient benefit.

On the other hand, a copayment is the amount you pay each time you submit a claim after the deductible has been met. As with deductibles, introducing a copayment to your plan can help reduce your premiums, but it can be risky for those of you on a tighter budget, especially if you have a large number of doctor visits in a year.

3. What you need to know about ‘High Cost Providers’

Hospital costs vary significantly in China, with some hospitals charging very affordable fees, and other more well-known private hospitals in major cities with English speaking doctors generally charging a lot more for care. These more expensive facilities are referred to by insurers as ‘High Cost Provider’s (HCPs).

Some plans will give you the option of excluding or limiting coverage at HCPs, e.g. a 20% copayment on treatments received at HCPs, which would mean your insurer would pay only 80% of the cost. This can be a great way to reduce your premium, but please bear in mind that making a copayment of 20% at HCPs can still be very expensive, especially for an inpatient procedure.

4. Area of coverage

Are you looking for family health insurance that covers you in China only, or one that covers you overseas as well, including your home country? In terms of the area of coverage, we would recommend expats living in mainland China to obtain a plan that covers both China and Hong Kong, at the very least. This is because Hong Kong has some of the best hospitals in the whole of Asia.

On the other hand, you may also want to consider an international health insurance plan. Covering your family both in China and overseas, these plans are globally portable, meaning that if you relocate to another country in the future, or return to your home country, your plan will protect you wherever you go.

Does international health insurance include USA coverage?

Most international health insurance plans will exclude the US as an area of coverage, mostly because of the high cost of healthcare in the US. If you wish to have USA coverage, you may do so by:

  • Choosing a plan that covers elective treatment in the US, if you can afford it. This option allows your family to travel to the US for planned surgery. That being said, this option is very expensive, and can cost 1.5 times or more than the cost of a worldwide plan that excludes the USA.
  • Opt for emergency USA inpatient coverage – this will ensure your inpatient emergency costs are covered, but your outpatient emergency costs won’t be covered.
  • Another option is to purchase a comprehensive annual travel insurance plan that covers you anywhere up to 30 days outside of China. These plans are a cheap option for short term travelling, although they do not offer the tax receipt that most companies will require for reimbursement in China, so this may need to be paid for out of pocket.

5. Do you or your family members have any pre-existing conditions?

Do you or your family members already have, or previously had any illnesses, ailments, or injuries? These are considered pre-existing conditions, and you’ll often see it excluded in health insurance plans. That said, some insurers will cover certain pre-existing conditions. They may cover these conditions by either placing an additional premium on your plan, while others will offer the option of placing a waiting period on that particular condition.

If you are lucky, in some cases these conditions may even be covered at no extra cost. To ensure you get the pre-existing condition coverage you need, it’s a good idea to talk to an experienced broker like Pacific Prime China for more information.

6. Can I get an individual health insurance plan for my child?

If you’re looking to secure separate health insurance coverage for your child instead of obtaining family health insurance, you may do so. However, please bear in that mind that almost all insurers will not offer this option. That said, there are ‘child alone’ options available, with some costing only RMB 9,000 annually.

7. Is the insurer reliable?

When purchasing health insurance, it’s also important to consider the reputation, service, and reliability of the insurer. Generally speaking, the cheaper the insurance plan, the less reliable on claims they are. This is why it’s so important to choose a reputable insurance company, so that you can have an insurance plan that you and your family can count on.

8. How often do you want to pay for your family health insurance?

Most insurers in China require annual payment, but some will allow you to make semi-annual or sometimes even monthly payments. However, the latter options will carry a surcharge. Another thing to be aware of is that Chinese regulations will not accept international credit cards for monthly payments.

9. Will there be annual premium increases?

When it comes to renewing your family health insurance plan for the following year, it’s important to know that paying increased premiums is inevitable. As a general rule of thumb, smaller insurers with less financial stability will have less stable, more erratic increases, whereas large reputable insurers will tend to have more gradual premium increases (based on medical inflation, age increase, etc).

10. Consult an experienced broker

Some people believe that insurance intermediaries charge higher premiums for insurance. The truth is, reputable insurers like Pacific Prime China offer the same rates as the insurers we work with. Not only will you be getting the same rates, but you will also benefit from extra services such as our expertise in finding the best plan for your needs, as well as additional help on your renewals and claims submissions.

For more information on finding the best family health insurance plan, be sure to contact us today for impartial advice, as well as a free quote.

Posted by Jess in Expat Health Insurance, Health Insurance
China to make pollution insurance mandatory for eight polluting industries

China to make pollution insurance mandatory for eight polluting industries

On 9 June, 2017, China unveiled a draft regulation for public feedback, which requires polluting industries to have pollution insurance (or in full: environmental pollution liability insurance).

According to the draft guideline, jointly released by the Ministry of Environmental Protection (MEP) and the China Insurance Regulatory Commission (CIRC), companies in eight sectors – including:

  • Oil and gas exploration
  • Those involved in processing hazardous materials or chemicals (including radioactive waste) and,
  • Those involved in the production of active pharmaceutical ingredients

will need to buy compulsory environmental pollution liability insurance.

This draft regulation is open for public feedback until July 10, 2017, and will need to be approved by the State Council, China’s cabinet. Read on to learn more about pollution insurance and the new draft guideline.

What is pollution insurance?

Originally introduced in industrialized countries in the 1960s, pollution insurance covers costs related to pollution, e.g. brownfield restoration and cleanup, and liability costs for pollution-related injuries and deaths. This type of insurance was originally introduced with these three main objectives:

  • Protect companies from bankruptcy by spreading the risks of environmental pollution
  • Compensate victims of pollution
  • Incentivize polluters to reduce and prevent environmental damage through lower premiums

At present, pollution insurance is applied in many countries to control environmental risks. That said, the implementation of this type of insurance is especially prevailing in developed countries like the US, and the UK.

Why it’s important to consider pollution insurance

Not having an environmental pollution liability insurance policy in place can leave your business vulnerable to a myriad of pollution liability and environmental risks. Aside from the impending rules, it’s important that you consider securing a comprehensive pollution insurance policy for your business to ensure you have the right protection to address all pollution-related risks.

Key coverage elements

When buying an environmental pollution liability insurance policy from Pacific Prime China, you can expect the following main policy coverage elements:

  • Accidental damage to the environment
  • Bodily injury or death
  • Financial loss due to the investigation, examination, cleanup and control costs of environmental damage
  • Litigation from other businesses or persons
  • Liability coverage against financial losses incurred from lawsuits

For more comprehensive protection, businesses can also opt for additional coverage elements, such as:

  • Costs incurred from being sued for mental and emotional damage due to pollution
  • Extend coverage to surrounding areas by up to X km (to be defined by either the business or insurer based on needs)
  • Liability caused by natural disasters (excluding earthquakes and tsunami)
  • Costs associated with cleaning the insured site

New mandatory pollution insurance requirements

The new guideline regulation by the MEP and CIRC requires environmental pollution liability insurance to cover bodily injury or death, property damage and environmental impairments, as well as emergency treatment and clean up costs. Insurers will be exempt from covering damages caused by natural disasters, environmental pollution crimes, illegal discharging of pollutants, as well as unaddressed environmental safety hazards.

Companies that fall under the eight sectors who fail to buy mandatory pollution insurance could face hefty fines starting at RMB 30,000. The guideline also requires insurance companies to issue an environmental risk assessment report before signing insurance contracts. This new implementation plan comes at a time when the Chinese government is looking to step up their efforts in fighting pollution nationwide, amidst ever-increasing pollution-related costs of up to 3% of the country’s GDP each year.

The need for environmental pollution liability insurance in China

Since 1980, China has experienced a rapid economic growth with an average annual Gross Domestic Product (GDP) increase of over 9.8 percent. During the same time period, there has also been a rapid increase in environmental management problems and environmental pollution accidents, caused primarily by the inadequate control of pollutants. As a result, China is now home to 7 of the 10 most polluted cities in the world. In 2012 (the latest figure available), China lost RMB 1.2 trillion due to environmental pollution.

To solve the nation’s pollution problem, China has been searching for different ways to better manage the environment, including the introduction of environmental subsidies, emission trading, and most recently pollution insurance. The Chinese government first introduced the idea of environmental pollution liability insurance in 2006, and launched pilot projects covering a number of sectors such as heavy industry, and heavy metals. According to Wang Guojun, an insurance professor at the University of International Business and Economics in Beijing, the pilot projects, which required businesses to buy pollution liability insurance in some regions from 2013 onwards, have yielded positive results.

The 2015 Environmental Protection Law

In 2015, the Environmental Protection Law came into effect, and has a clause stating that businesses are “encouraged by the state” to have pollution liability insurance. Despite this, many businesses are arguing that there’s no legal mandate to impose such policies. The renewed push in 2017 for pollution liability insurance shows enhanced realization among key policymakers for the pressing need to protect the environment instead of solely prioritizing economic growth.

Looking for the ideal environmental risk management solution for your business? To learn more, be sure to get in touch with the experienced advisors at Pacific Prime China. Our team of experts are on hand to provide their unbiased advice on finding the best plan for your needs, as well as give you a free quote.


Posted by Jess in Health Insurance
An expat’s guide to medical emergencies in China

An expat’s guide to medical emergencies in China

From car accidents to severe food poisoning and heart attacks, medical emergencies can happen to anyone, anytime and anywhere. As an expat, it’s important that you are aware of how medical emergencies are dealt with in China, and how to prepare yourself in case you come across any unforeseen events. To help, we’ve created this informative guide containing key tips on preparing for and dealing with medical emergencies in the middle kingdom.

Know your hospital

It’s always important to know where your nearest hospital is located, and whether they provide accident and emergency services.

Public hospitals

Public hospital treatment in China is very affordable, but the quality of care, service levels and cleanliness standards can vary significantly. Expats who wish to utilize the public system should be aware that you should be able to communicate in Mandarin, as most of the staff will not be able to speak English.

VIP clinics

Big Chinese public hospitals like Zhongshan in Shanghai have VIP clinics (gaogan bingfang). Most VIP clinics will have English speaking doctors, offer more privacy compared to public hospitals, and will recognize many insurance companies. That being said, prices are much higher in VIP wings, e.g. staying in a VIP room will set you back by RMB 800+, whereas staying overnight at a “common” room would cost only RMB 15 to 20.

Please keep in mind that a lot of urgent VIP clinics may only operate during regular working hours, so you may end up in the local emergency room if you require emergency medical attention outside of these hours.

Foreign-run hospitals

Foreign-run hospitals are generally the most expensive option, as they offer a very high quality of medical care, comfortable rooms, and are often equipped with better technology. Medical staff in these hospitals are able to speak English and sometimes can also speak a range of other foreign languages. However, for medical emergencies you should check beforehand whether the hospital has an emergency department, as not all foreign-run hospitals will have one. Also be sure to check whether the ER runs on a 24-hour basis.

While the many perks offered by foreign-run hospitals are indeed attractive, the price tag can easily cost over ten times the price charged for the same procedure at a public hospital. For instance, an emergency surgical procedure can cost as much as RMB 50,000! With this in mind, relieving potential financial burden with a comprehensive health insurance plan is essential.

The ambulance system

The number to call for an ambulance in China is “120”. Ambulances from public hospitals are often not equipped with comprehensive medical equipment, and the personnel as well as the 120 line operator will generally speak little to no English. Response times will vary, e.g. sometimes the ambulance will come in under 15 minutes and sometimes you may need to wait over an hour due to adverse traffic conditions. In many cases, taking a taxi, or asking a loved one or a friend to drive you to the hospital may be a better, faster alternative.

Bring someone with you

If possible, it’s a good idea to find a bilingual friend to accompany you to the hospital, especially if you’re going to a local facility, as they can help talk to the medical staff on your behalf. If you do choose to avail yourself of the ambulance system, they can also help you by communicating with ambulance personnel (e.g. requesting the ambulance to go to a particular hospital). What’s more, having someone there with you can really speed up the whole medical emergency process, especially if you’re in great pain and finding it very difficult to collect your own medication.

Bring cash

Most foreign-owned hospitals are equipped to bill international insurers directly, so many expats prefer to hold an international health insurance plan to make medical billing easy. In many public hospitals however, a direct payment may not be accepted. If you don’t have any cash on you, Triple A rated hospitals tend to have what’s called a “green lane” that treats the patient if the hospital’s director signs off on it – usually if you’re someone “important” or if they believe that you will be able to pay them back later. In lower tier hospitals (usually in smaller cities), they may reject you if you have no money on hand, even for medical emergencies. No green lanes here.

Medical emergencies and your health insurance

Understanding your health insurance policy is a very important aspect of preparing for medical emergencies in China. Know where the nearest emergency facilities are near your home, office, and your child’s school, and be sure to ascertain whether they will accept your insurance plan or not. Working with a broker and insurer who has a Chinese Insurance Regulatory Commission (CIRC) code (like Pacific Prime China) will also help drastically decrease the chances of your insurance being rejected.

Looking to learn more about medical emergencies and your health insurance in China? Be sure to contact us today, and our experienced experts will be more than happy to offer impartial advice for your needs, as well as a free quote.

Posted by Jess in Expat Health Insurance, Health Insurance