Home » Expat Focus International Healthcare Update December 2023

Expat Focus International Healthcare Update December 2023

Medical Authorities Warn of New Health Concern in Europe

Recent reports of a pneumonia outbreak in China, primarily affecting children, have raised concerns among European health authorities regarding a potential future epidemic in the EU. The Netherlands Institute for Health Services Research (NIVEL) has observed a higher-than-expected number of patients seeking medical attention for pneumonia, an inflammatory lung condition often caused by bacterial or viral infections. Typical symptoms include coughing, shortness of breath, and fever. NIVEL’s data revealed a significant increase in pneumonia cases among children aged five to 14, with 103 cases per 100,000 compared to 58 cases per 100,000 at the peak of the previous year. The exact cause of this surge remains unexplained, but it coincides with a rise in flu, COVID-19, and RSV cases, all of which can lead to pneumonia.

The World Health Organization has issued guidance to people in China, urging them to:

  1. Maintain distance from individuals who are unwell.
  2. Stay home when feeling unwell.
  3. Seek testing and appropriate medical care when necessary.
  4. Wear masks when appropriate.
  5. Ensure proper ventilation.
  6. Practice regular handwashing.

Japan Introduces TB Screening 

Meanwhile, Japan is set to implement mandatory pre-arrival tuberculosis screening at airports for citizens arriving from certain countries, primarily in Asia, if their intended stay in Japan exceeds three months. Currently, this measure targets nationals from China, Indonesia, Myanmar, Nepal, the Philippines, and Vietnam, reflecting the demographic of patients with the disease admitted to Japanese hospitals.

Takemi, the Minister of Health, Labor, and Welfare, has announced that the new system is scheduled to be introduced at the beginning of April 2024. Tuberculosis, a disease that can be both prevented and cured with antibiotics, ranks as the second largest infectious killer worldwide, according to the WHO, with 1.3 million deaths attributed to it in 2022. Although rates of tuberculosis are low in Japan, the authorities are determined to keep it that way.

Heatwave Deaths in Europe

The Barcelona Global Health Institute (ISGlobal) recently revealed findings from its report on the 2022 heatwave in ‘The Lancet Regional Health-Europe,’ showing that the increase in temperatures over the hottest summer on record (and the fifth hottest year on record) resulted in around 70,000 deaths. The research is based on a study of daily temperatures, from 147 regions across 16 countries. 

Joan Ballester, the lead researcher from ISGlobal and head of the European Research Council’s EARLY-ADAPT project, told the press:


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The use of aggregated monthly data does not allow us to estimate the short-term effects of temperatures. On the other hand, weekly data offers sufficient precision in mortality estimates to be used in real-time practice in epidemiological surveillance and for public policies.

The highest summer heat-related mortality figures were found in Italy (18,010 deaths), Spain (11,324) and Germany (8,173). Women were affected more adversely than men and there was also a correlation with age; with the elderly found to be at a higher risk of being adversely affected by the heat. Ballester’s research team states:

Our results call for a re-evaluation and strengthening of existing heat surveillance platforms, prevention plans and long-term adaptation strategies.

The team described Europe as a ‘major climatic hotspot’ and says that the problem is going to get worse unless action is taken. They also warn:

Although there is some evidence that heat prevention plans, including preparedness and response strategies, intervention actions and heat-health early warning systems, can reduce the health burden of ambient temperatures, the evidence of their effectiveness is still limited.

Best (and Worst) European Cities for Healthcare: 2023

In the latest InterNations Expat City Ranking, the annual report covering a variety of factors for expats, the top three destinations this year are Málaga, Alicante, and Valencia, with Milan (49th), Rome (48th), and Vancouver (47th) ranking bottom. Valencia also ranks highest in regard to healthcare, both in terms of affordability and accessibility. Taiwan – which has featured in the top five cities for healthcare since 2016 – also ranks highly for healthcare in 2023. The report says that 9 out of 10 expats are pleased with the affordability of healthcare in Taiwan and 3 out of 5 expats rate its quality highly, too. 

The top ranking countries for healthcare are as follows: 

  • Taiwan
  • South Korea
  • Qatar
  • Spain
  • Luxembourg
  • France
  • Japan
  • Austria
  • Thailand 
  • UAE

In the bottom 5 for healthcare, in descending order, are: 

  • Kuwait
  • UK
  • Indonesia
  • USA
  • Ireland

Conversely, Ireland scored bottom for healthcare due to high costs, poor availability, and low quality. Expats also found healthcare costs in the USA to be challenging, hence its low ranking here, whereas accessibility affected the UK’s healthcare rating – for instance, difficulties in getting an appointment with a specialist. 

Researchers also pointed out that, post-pandemic, social attitudes have changed in relation to changes in technology, such as the use of telehealth. More people are using medical technology, such as online appointment systems. Increasingly, insurance companies are looking at digital solutions, too, and are realising the importance of supporting clients in the navigation of the healthcare systems in their adopted countries. 

Reminder to Expats in the Netherlands

If you’re an expat in the Netherlands, don’t forget that you have until December 31st to switch providers or change your existing plan – after that date, it will be too late.