China: Working and Living
Health, Education and Pensions
This page was last updated on 29 July 2019.
China runs a 'polyclinic' system which is by and large open to foreigners. You just turn up at a clinic with your residence and health insurance documentation. As everywhere, there may be long queues for treatment; appointments are not possible in public clinics. Although the system has not been privatised as such (there are parallel, completely private and much more expensive facilities), it has been 'marketised', 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. Some rural clinics are very primitive.
Some hospitals have 'VIP' areas that are still in public wings in which faster and perhaps better treatment can be bought. 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 at least two international schools include:
Beijing, Changzhou, Chengdu, Chaongqing, Dalian, Guangzhou, Nanjing, Ningbo, Qingdao, Shanghai, Shenzhen, Suzhou, Tianjin, Wuhan, Xiamen (Amoy) and Xi’an. The cost of attendance at such schools can however be as high as US$25,000 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 a Chinese language, something that can hardly be useful in later life. There are private Chinese nursery schools which teach both in English and Chinese languages (the Chinese want their children to speak English even more than Westerners want sinophone children). The cost is in the USD200-300 range, per month.
Once a child has a reasonable command of a Chinese language (preferably 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. Foreigners in China, even those living there long term, will be wasting their time looking to the Chinese system for help with their pensions. If their employers do not provide a scheme for them, they should seek out private arrangements.
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.