By Wang Xiaoping

Agnes, 36 years old was in dire straights. She received several conflicting diagnosis from different hospitals. None completely understood her nor her condition. Even worse, her employer had purchased medical insurance from a local insurer. This restricted benefits according to specific diagnosis, treatments and medications at public clinics/hospitals within China. After 25 years, Agnes had been away from her native Guangzhou and her Mandarin was not sufficient to allow her to adequately communicate with the physicians at some of Beijing's finest hospitals. Her Chinese face left everyone clueless when she always reverted to English when describing her symptoms.

To make matters worse her immune system had already been weakened after four months of Beijing's significantly higher airborne particulate pollution and food borne microbes resulting from sub-standard food-handling sanitation. All were much worse than she was accustomed to in Vancouver where she grew-up after leaving China.

At wit's end, Agnes decided to go to one of Beijing's foreign-managed clinics to see a western doctor even though the 1200 Yuan was more than one month's salary paid to her by the local school where she taught English. The clinic was a welcome site, the familiar look, feel and greetings she received made Agnes feel calm and relaxed. She was interviewed in understandable English by the nurse and doctor about her medical history and recent symptoms.

The doctor examined her in a private room where more confidential questions were asked. Following a thorough examination, diagnostic and laboratory tests, she would have to wait for the results, but the doctor gave a preliminary diagnosis and an explanation of her somewhat unusual condition and the special imported medications she would need. After two weeks, her diagnosis bipolar was confirmed. She would need special, very expensive medication and would also need surgery not covered by her insurance. Even if she could travel back to Canada, she was no longer covered by her governmental plan and would have to wait three months to reinstate it. Even if she could afford an international medical plan upon application, her condition would be excluded as a pre-existing condition. Everything would have to be paid for from Agnes' limited savings or borrowed from family and friends. Her return to the motherland was well planned in most other respects, but Agnes had not thought about getting sick and having major medical expenses.

Expatriates, returnees or anyone needing global coverage and not covered by social or public insurance need to carefully consider the risks associated with living and working in a foreign country. Familiarity with the healthcare system together with a study of the forms and types of coverage available should be done in advance of one's arrival. If you need help, seek professional advice from your doctor, insurance advisor, embassy or consulate, or emergency assistance company. Medical plans are available for almost anyone's budget; having an option is your responsibility.