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China: Working and Living

Education and Pensions

Health Care

China runs a 'polyclinic' system, and by and large it is open to foreigners. You just turn up at a clinic with your residence and health insurance documentation. As everywhere, there may be long lines waiting for treatment; appointments are not possible in public clinics. Although the system has not been privatized as such (there are parallel, completely private and much more expensive facilities), it has been 'marketized', and you pay for what you get. Of course the public facilities are far cheaper than Western equivalents, but the standard of care varies widely. As you would expect, there are better facilities in the major cities. Rural clinics may be very primitive.

Some hospitals have 'VIP' but still public wings in which faster and perhaps better treatment can be bought; at any rate the facilities are likely to be better. Chinese clinics may or may not accept Western insurance policies, and you may have to pay in advance (occasionally with credit cards) and reclaim the costs from your provider.

Of course, if someone has a good health insurance provider, the usual option will be to go to a private sector, perhaps even Western-run clinic where prices and standards may not differ all that much from those in the West.

Emergency services vary widely in availability and cost. The first thing to do, on arrival, is to research the local situation so as to be ready in case of need. Many Western companies have arrangements of their own, either through an in-house clinic, or through a contract with a local public or private clinic.


There are international schools in many parts of China, and they often teach the International Baccalaureate.

Cities with international schools include:

Beijing, Cashan Dongguan, Chaoyang District, Chengdu, Guangzhou, Utahloy, Nanjing, Ningbo, Quingdao, Shanghai, Suzhou, Tianjin and Xian. The cost of attendance at such schools can however be as high as USD25,000 a year.

There are of course much cheaper options for parents who are prepared to send their children to Chinese schools, particularly at a young age, when they will find it easy to learn Chinese, something that can hardly be bad for them in later life. There are private Chinese nursery schools which teach both in English and Chinese (the Chinese want their children to speak English even more than Westerners want sinophone children); the cost might be in the USD200-300 range, per month.

Once a child has a reasonable command of Mandarin, there are a certain number of primary schools open to foreigners, at least in the major cities. The child will need a Chinese health certificate, vaccination certificate and passport, and the parent needs to go with the child to the school to register.


The social security system in China is in a state of flux, with legislation to create a uniform national system in progress; the law, which came into effect in 2011, extends the social security system to resident foreigners. China has a certain number of reciprocal international social security agreements, for instance with Germany.

The mandatory retirement age in China is 60 for men and 50 for women, although as the population ages, these limits are likely to be extended. A trial program is underway in Shanghai.

The bottom line at present is that foreigners in China, even those living there long term, need not look to the Chinese system for any assistance with their pensions, and should make private arrangements if their employers do not provide a scheme for them.

For the Chinese themselves, pension contributions are made under a twin-pillar system, with the employer contributing about 20% of pay to a State pay-as-you-go scheme, and the employee contributing a mandatory 8% to a funded, quasi-private system.



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