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Expat Having a Baby in Hong Kong?

Depending on the situation in your country of origin, you may find several pleasant surprises related to medical care in Hong Kong. Quality is high and costs can be quite low relative to other developed countries. Public options are very affordable and luxurious private options are available for a hefty price.

If you have a Hong Kong ID—and all resident expats must have one—you qualify for public healthcare. This means you can use clinic and hospital facilities across Hong Kong. There are 41 hospitals, 49 specialist outpatient clinics, and 74 general outpatient clinics organized in seven clusters in Hong Kong, Kowloon, New Territories, and outlying islands.Using the example of obstetrics, the public healthcare fees are unbelievably low. A typical childbirth for a Hong Kong resident costs $200HK ($11US) for prenatal care, the birth, and a three-day hospital stay—less than the price of two supersize meals at McDonald’s! The Hong Kong healthcare policy is one of “ensuring that no one is denied adequate medical treatment due to lack of means.”

However, fees increase dramatically for non-eligible mothers, those without Hong Kong IDs. A prearranged birth with prenatal care costs $39,000HK ($5,000US) and a non-booked birth without prenatal care is $90,000HK ($12,000US). These stiff increases were put in place in the last decade with two purposes: first, to improve mother and child healthcare by reinforcing prenatal care; and second, to reduce the influx of pregnant women crossing the border from China days before delivery in order to give birth in Hong Kong.

Public clinics and hospitals are staffed primarily to serve local Chinese people as efficiently as possible, so English language capability in the staff is limited, the biggest barrier to expat usage. Hospital food is Chinese, rooms are multiple occupancy (e.g. up to six moms in a post-delivery sleeping quarters), visiting hours are limited, wait times are rather long, and you’ll be assigned a doctor at random rather than having a personal physician.

Quality of care, however, is excellent. In fact, the public Queen Mary Hospital in Pok Fu Lam is the primary site territory-wide for complicated births. Even private hospitals may refer twins or other potentially risky births to Queen Mary.

The private alternatives have major contrasts in price and amenities. As an example, Matilda International Hospital, located near The Peak, has long been a destination of choice for expat mothers-to-be. The delivery stay is disguised as a luxury hotel visit, with private rooms, views of the South China Sea, and options for in-room stay for your partner. The full service meal menu rivals that of the best Hong Kong hotel restaurants.

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All of this pampering comes at a steep price. The private room option for the three-day maternity package is close to $200,000HK ($25,000US). Matilda does align with many international insurance carriers including Aetna, Mass Mutual, and Metlife, so some of these costs may be able to be reduced significantly if you carry healthcare insurance with you to Hong Kong. You will be able to have your personal obstetrician do the delivery unless conflicts arise.

As with the international school systems in Hong Kong, international hospital space is limited. In order to give birth in an international hospital you must reserve a spot early in your pregnancy and pay a down payment. Even with this payment, there is not 100% guarantee that you will have a spot on your actual delivery day if births are particularly high and there are no beds available. If that happens, you’ll be sent to a public hospital where staff will always make room for one more.

A unique phenomenon in Hong Kong can influence level of births on specific days. Many Chinese parents try to schedule their child’s birth for a day that is auspicious according to feng shui, Chinese calendar, or other considerations. For instance, December 12, 2012 (12-12-12) was such an unusual occurrence that Chinese births were particularly high. This birth date selection is accomplished through planned date of conception and scheduled delivery by Caesarean section. This phenomenon is not a minor issue. While world level of Caesarean births is 21%, the Hong Kong average is 40% and the Hong Kong level in private hospitals is 60%, the high level from patient preference rather than doctor recommendation.

Both private and public hospitals and clinics in Hong Kong practice Western medicine. Most doctors attend Hong Kong’s two medical universities, both highly recommended. Some physicians study in top international universities. Quality of Hong Kong healthcare is excellent. In fact, Hong Kong life expectancy, at about 82 years, puts it in the top ten countries of the world for this human development metric.

This good health performance may be related to the fact that Hong Kong also offers options to complement Western medicine with traditional Chinese medicine. Practitioners of TCM must be academically trained and licensed. Elements of TCM include exercise in the form of tai chi and qigong, acupuncture, massage, herbal medicine, and healthy diet. These techniques of preventive and maintenance health care are contributors to the general good health of Chinese locals and are worth investigating while you are in your new country.

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