Whether you’re relocating overseas for a short-term placement or for the rest of your life, there’s a lot to think about when you move, writes Andy Edwards, global head of international health insurance at Axa Global Healthcare.
One of the most important things to consider is how you might access healthcare services when faced with a medical emergency in your new home.
No two healthcare systems are the same, and the cost of different treatments, services and operations can vary wildly depending on where you are.
It’s important to understand how much certain services can cost, and what might affect them, so you know what level of healthcare cover you need.
Is healthcare expensive overseas?
As with almost all products and services, the cost of healthcare depends on where you are and what kind of treatment you need.
The word ‘healthcare’ can refer to anything from a check-up with a GP to a significant operation, like heart bypass surgery. And whilst a routine appointment will usually be relatively cheap compared to a major operation, you might be surprised by how much certain costs can be and how much they differ from one country to another.
Research conducted by Axa Global Healthcare in 2018 indicated that 24% of expats worried about the cost of medical treatment in their new country.
Furthermore, almost a fifth (18%) said they’d consider travelling to another country to receive treatment because the costs were too high in their new home.
How much does the cost of surgery differ between countries?
Whether you’re looking at a minor outpatient procedure, an overnight stay or a major operation, you’ll find that the cost of healthcare varies significantly depending on where you are.
It’s impossible to guess how much you might pay for medical treatment in your new home, so you should do some research and find out how much things cost and whether there’s any kind of public healthcare system available to you as an expat.
For example, the average cost of surgery to remove the gall bladder was $19,288.40 (£15,468, €17,987) in Nigeria in 2022. The same operation in India, however, was a fraction of that amount at around $2,600.
On the other hand, for something like an elective caesarean section, the comparison is as stark. In New Delhi, the operation would cost an average of $2,146.61, while in New York it’s $18,543.73.
Widening the comparison into Europe, the same operation in Belgium would be an average of $5,251.65, while just over the border in France, it’s around 10% less at just $4,726.19.
How about an overnight stay in hospital?
When it comes to spending the night in hospital, whether it’s elective or unplanned, you might be surprised by the amount it could cost.
In Europe, the average for a one-night stay in hospital can be anything between $330 in Belgium and $100 in France.
It’s easy to see how bills could add up if you needed to spend a few nights, or even weeks, in hospital.
What if the care I need isn’t available in my location?
Whether specialist care is needed for a more serious accident or illness, or the cost of healthcare is simply too expensive where you are, you might find that the care you need is an international flight away.
As with all healthcare services, the cost for such a service differs significantly depending on where you are. For example, one of the shorter evacuations that Axa organised for a customer in 2022 was from Jersey to mainland UK, which cost $14,498.
In the same year, a long-haul evacuation from China to Belgium cost $28,667.
While this is almost twice the price, the journey takes more than ten times longer and is nearly thirty times as far.
Why are costs so different?
These are just a few examples of how costs can differ between countries. Additionally, this isn’t necessarily reflective of the quality of care, or the qualifications of the surgeons involved.
The nature of the overall healthcare system within a particular country can lead to cost discrepancies for healthcare services. Some nations have universal healthcare, which often means social security payments and taxes contribute heavily to government healthcare spending.
Inflation, the cost of living and the strength of a nation’s economy can also play their part. In recent years, these outside influences have heavily contributed to the rising costs of healthcare across the globe.
How are costs changing?
The amount healthcare costs rise varies depending on where you are and what treatment or service you’re looking at.
Using the example of a major operation such as hip replacement, we can see that costs have risen in most countries, but have also decreased in some countries over the last few years.
What else is impacting healthcare prices?
Covid-19 had an immediate, tangible impact on the cost of healthcare, and the cost of living in general. It has also brought positive change in some countries, where healthcare services have undergone reform or made improvements.
In Nigeria, for example, the average cost for a hip replacement was $24,742.78 in 2019 and $19,482.50 in 2022, showing a reduction in price of around 21%.
But there are other factors that continue to have an impact. Inflation, for example, is the highest it’s been for decades in most economies.
It’s being driven by rising fuel, energy and food prices, caused by a number of factors including both COVID and the war in Ukraine. This has seen the cost of healthcare increase to keep up with inflation in economies throughout the world.
Another factor that has always contributed to rising healthcare costs is the growing world population. With almost twice as many births per year than there are deaths,4 demand is increasingly outweighing supply. This means that costs continue to rise as healthcare providers try to keep up.
At the same time, the world’s population is ageing. Between 1960 and 2020, the global average life expectancy rose from around 51 years to just over 72.5 As people get older, they tend to experience more health concerns, requiring more involved, complex or specialised courses of treatment. An ageing population means the scales of supply and demand are tipped even further and the cost of healthcare rises, not only to keep up with demand but to deliver the complex care required.
What does the future hold?
Since the pandemic, there has been a paradigm shift in the cost of healthcare across the globe. As different economies and different healthcare systems adjust, there’s not a clear pattern to these increases, and it’s not easy to see what the future might hold.
This means it’s important to familiarise yourself with the healthcare system and costs in any country you visit. It’s vital to ensure you have the right healthcare cover, wherever you’re going and however long you expect to stay. Plans are designed to cover you for all kinds of eventualities, whether you’re on a short-term visit or moving overseas permanently.
There’s also been a shift in the way people access healthcare. During the height of covid-19, when resources were stretched and people couldn’t visit doctors or book procedures, healthcare providers sped up the development of online healthcare services. They introduced or improved platforms where patients can see a GP, specialist or therapist without having to leave the house.
The digitisation of medical services makes accessing healthcare simpler and more cost effective, and the technology is here to stay. In the future, we hope these developments will facilitate an increase in the number of people seeking medical care without hesitation worldwide.
This article was written for International Adviser by Andy Edwards, global head of international health insurance at Axa Global Healthcare.
