Posted by
patchy
18 yrs ago
We will be moving to HK and having a baby 6 weeks later. I'm trying to get an idea of how much having a baby costs in HK so I can budget for it. Any advice greatly appreciated. Thank you.
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Hi patchy, if you go public, quite inexpensive, if you go private (fully) F$#)*%^ expensive!! We went fully private and the only reason we could afford it is because we have private health cover through my husband's company. otherwise we would have had to either go back to Australia or go public. All up including appointments, ultrasounds, hospital, cost of delivery, blood tests, absolutely everything, ballpark figure for full private from start to finish around HK$140,000.
You will however, have difficulty getting into a private hospital as you generally have book in the minute you find out you are pregnant. i delivered at Matilda an I booked in when I was 6 wks pregnant and only just came off the waiting list the week before my delivery date!
Have you considered in your country until after the arrival? it may take the hassle out of everything and rushing.
Good Luck!
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"HK$140,000. "
Less than in the US. That wouldn't even cover the actual ("normal") delivery and subsequent hospital stay in CT.
As for costs after birth, it depends what you look at. Certainly many things aremore expensive is general than in, say, the US. However domestic help is cheap in comparison.
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Oh, sorry...I wasn't clear...I already know about the horrendous hospital situation...just wondering about after the birth...the daily cost of living there and raising a baby...
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We raised kids in the US, then moved here. The actual "child" costs differ, but I'm not sure if they're more or less here in total.
- Housing is comparatively very costly.
- If you're into organic food it costs more than in the US or the UK. Food in general is a bit more expensive if you go to grocery stores. The markets are inexpensive.
- As mentioned, a helper is quite inexpensive compared to US/UK, which fixes quite a bit of the childcare and/or housekeeping depending on how you want to play it.
- Good private schools cost much less than in the US or the UK.
- Private doctors are very cheap compared to the US. Less than half of the cost. I'm ignoring insurance for the moment and just talking the actual sum on the bills.
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cd
18 yrs ago
We find HK expensive for kids, although a good place to bring them up. Schools are very expensive, back in the UK we would send them to the local free schools, here we don't have a choice. After school activities are more expensive than in the UK, especially things like football and gymnastics. But there are a lot of sport for them to do once they're teenagers FOC or very cheap. Clothing can be very cheap, less choice of babyfoods but very easy to make your own. Also find Drs very expensive unless you have insurance.
There are plenty of mother and toddler groups around.
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"Schools are very expensive, back in the UK we would send them to the local free schools, here we don't have a choice."
Good point.
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MayC
18 yrs ago
Very expensive compared to Sydney.
ESF, being the cheapest education for expat kids is around HK$6k including bus fare. A helper (levy+salary+food+accomodation+others) is another HK$5k. After school activities another HK$2k (average - swimming lessons + one activity, say, ballet). I agree with CD, visiting a doctor is expensive too. Back home, whenever you're sick, you just go visit a doctor. Now, we go ONLY when it is necessary because it is just too expensive.
My helper goes to the markets to buy food and we only buy international foods from Citysuper a handful of times a month (or not even that). Clothes are cheap during the sales - like right now. So we buy a size bigger for my daughter so she could wear it next year.
My daughter doesn't go to ESF, she goes to a local school - the cheaper option for us. But I must say, HK is expensive for kids and we're not saving much as a result.
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May C, you make an interesting statement "Now, we go ONLY when it is necessary because it is just too expensive." So you previously went to the Doctor unnecessarily? Maybe that's why various countries National Health Systems are straining and taxes are way higher then HK.
Personally, I think the concept of paying to see your local Doctor in the first instance is a good idea, as people ONLY go when it is necessary.
For the OP's benefit, I last went to the Doc's with my daughter, when we both had a cold. Examination and the usual bag of smarties, cost HK$280 total, cold cleared up in a about a week anyway.
A last point, in a similar vein. When appraising whether something is "expensive" many people compare with their Country of Origin. i.e. a poster above said ESF is HK$6k a month, but the UK is free. Well, that's true, but we aren't paying 30% income tax and 10% National Insurance. HK$6k a month is HK$72k a year (assuming it's still paid over 12 months). If we assume, a "typical" expats salary is not less than HK$50k a month, that's 12% of gross salary, excluding allowances.
Income's vary, but I will guess that even when schooling and medical costs are added up (even for the more hyperchondriac amongst us) it equates to a lot less then you would pay in additional income tax, NI and VAT to get those services "Free" elsewhere.
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"we aren't paying 30% income tax and 10% National Insurance. HK$6k a month is HK$72k a year (assuming it's still paid over 12 months)."
Quite true. Taxes are very low in HK. In Sweden, we paid loads of tax to get our "free" health care. On balance, paying up front for health insurance is way cheaper.
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MayC
18 yrs ago
"If we assume, a "typical" expats salary is not less than HK$50k a month, that's 12% of gross salary, excluding allowances".
I wish this was true for me :-(
"Income's vary, but I will guess that even when schooling and medical costs are added up (even for the more hyperchondriac amongst us) it equates to a lot less then you would pay in additional income tax, NI and VAT to get those services "Free" elsewhere."
True, and I suppose it depends on each individual, with some needing to use more "free" services than others so they will feel the pinch more in HK.
"So you previously went to the Doctor unnecessarily?"
Yes, and unfortunately I still do to save on costs. I don't usually see a doctor when I have colds/flus - I only do when it turns into a fever or I haven't recovered after days of being ill. This I agree, isn't ideal. But last week, my daughter and I visited a doctor. Our bills came up to HK$800. She saw the doctor twice (due to frequent vomiting - I don't stinge on her, just on myself) and I saw the doctor once with a 5 day course of antibiotics.
I agree that taxes are lower in HK, however, the outcome is a bit unequal. The average expats can afford many things here on higher income, but those who REALLY need help have to fork out quite a lot of money. I trust I'm not the only one who self medicate to save on costs - eg. by going to Mannings to buy antibiotics when I clearly know that this would not have been allowed in Sydney.
The majority of my friends would not bat an eye when they have to pay HK$250-300 over dinner but for me, I'm thinking at least 5-6 days worth of food to feed 4 (including my helper & child).
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"Our bills came up to HK$800. She saw the doctor twice (due to frequent vomiting - I don't stinge on her, just on myself) and I saw the doctor once with a 5 day course of antibiotics."
I must say that compared to seeing a doctor in the US that's dirt cheap.
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Yes it is cheap compared to America, which says a lot about the concept that free markets always lead to lowest cost solutions and the most efficient allocation of resources. That has to be one of the greatest myths perpetrated on the rest of the free world since the collapse of communism.
MayC not being funny, obviously you previously lived in a system where there is some degree of nationalised health care. I understand the desire to perhaps get the most out of your tax dollars, but going to the doctor every time you come down with something that you say yourself is not serious, is a waste of resources don't you think. That kind of behaviour gives every right wing hick out there license to ridicule socialised health care systems where there is government intervention. Perhaps it is good you now live in a system now where you have to pay for each visit and you only go when necessary now.
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MayC
18 yrs ago
" I understand the desire to perhaps get the most out of your tax dollars, but going to the doctor every time you come down with something that you say yourself is not serious, is a waste of resources don't you think."
Yes, I agree totally, and even in Sydney, I don't usually go if it's something that is not serious. However, when I realise that my mucus has turned yellowish (sorry to sound so gross), I would go but I am talking about right now, I only go when I am too weak to get out of bed.
Putting me aside, what about those here that do not go visit the doctor when it is clearly something serious? Say, a UTI that turned into kidney infection because the lady thinks she should save?
I agree that it is a waste of good resources for doctors to be entertaining those who really do not need to see a doctor but the sad fact is, there are people like me in HK, in fact, plenty (more unfortunate) who don't see a doctor for things you and I would consider serious.
I have not lived in the US or UK, so maybe things are cheaper here compared to those countries, but I think I'm starting to appreciate what I had in Sydney. It's not just the health system but the overall support for children that we get over there.
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cd
18 yrs ago
If you only paid $800 for 2 drs visits plus medicine, thats good, Our doctor charges $500 for a consulation, plus medicine, most visits come to $1000, or close to, any other simple tests and the price goes right up. Luckily we have insurance, but I still don't go often, maybe once a year.
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MayC
18 yrs ago
3 visits actually, 2 for my daughter and one for myself, the first I've been this year that's not related to my endometriosis.
Wow, 1k per visit.. that's quite a lot. I'm in NT, so that's most probably why there's such a big difference.
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Trust me, it is a lot lot worse in America. A large percentage of people are uninsured because for them insurance is just too expensive, there are government programs like medicare and medicaid, but that excludes a lot of people who are working and might not necessarily qualify and the cost keeps going up. This has lead to people obtaining their primary healthcare through emergency rooms, i.e. they have delayed going to see a doctor for so long that their condition is now life threatening and they have to go to the ER and by law the hospital must treat them. Which leads to higher costs for everyone else because the uninsured are free riding, leading to higher premiums for everyone else and it goes on and on and on.
Delaying going to see a doctor until your condition is life threatening is extreme, but I do hope in the future when you move back to Australia if that is what you end up doing, you put off going to a doctor just because you feel cak for a few days.
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"Yes it is cheap compared to America, which says a lot about the concept that free markets always lead to lowest cost solutions and the most efficient allocation of resources. That has to be one of the greatest myths perpetrated on the rest of the free world since the collapse of communism."
Oh indeed.
However to paraphrase Churchill: "Capitalism is the worst system, except for all the other ones."
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cd
18 yrs ago
To May C, I'm sure there are cheaper ones, especially in Sai Kung, but our insurance has a list of Drs we can see, (i.e Quality Healthcare), if we see the others, even though they're cheaper, we wouldn't be able to use our insurance.
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On the flip side, I was surprised at the cost of a doctors visit in Australia (compared to HK). My baby and I both saw a doctor while in Australia on holiday. We were charged A$70 each excluding prescriptions (akin to a little over HK$1000 for both of us) - in with the doctor for 5 minutes each. Maybe that was some crazy fleecing tourist price and you may get a cheaper price as an Australian passport holder/resident but even in my industry, that is a pretty good charge out rate for 10 minutes work!!
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it all depends where you coming from - in UK visits to doctors are FREE! hence, I am totally horrified every time we go to a doctor here - thank God for insurance is all I am saying... As for general costs of raising kids in HK - again - i think it is more expensive than UK - everything, food, kids things (apart from clothes - Stanley market is great), education etc....
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MayC
18 yrs ago
"I was surprised at the cost of a doctors visit in Australia (compared to HK)."
I'm afraid I have to agree with this one. For tourist, the cost of a visit to the doctor's is astronomical. It's free for Australian residents.
ldsllvn, yup - same for Australia.
I guess from all the discussions, what it's telling the original postor is that how "expensive" or "cheap" Hong Kong is, is dependent on many factors. Your income, your ability to save - or rather your spending pattern, where you previously lived before, your expectations etc etc etc.
My Malaysian friends would argue that HK provides a much higher living standard compared to Malaysia, and my Aussie friends who are on expatriate packages would say the same thing.... others, for example, expatriate teachers may not earn as much (with a salary ranging between HK$13k - HK$28k per month).
It really depends on the individual's situation.
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"it all depends where you coming from - in UK visits to doctors are FREE!"
They are most certainly not free. You're just paying through a different mechanism, one which typically involves quite a bit more costly bureaucracy. If I had to place bets, I would wager that if you tally it all together, medical care costs less in HK than in the UK. Staff costs are way lower here.
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You would have to look at total healthcare spending as a proportion of GDP to make any useful comparison, then there are intangibles like how long it takes to see a GP or a specialist in the UK compared to Hong Kong which are not obvious financial considerations. I cant see a doctor in Hong Kong making less than a doctor in Leeds for example nor can I see nurses being paid that much less either. Hong Kong is a hybrid system anyway, there is the public health care system and then there is the private sector, which sector are you comparing.
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I agree with you. The analysis isn't clear cut. I mainly have an issue with statements like "in country x, healthcare is free". There is no such thing as a free lunch.
"I cant see a doctor in Hong Kong making less than a doctor in Leeds for example nor can I see nurses being paid that much less either."
However other staff costs are lower. Also many HK doctors and nurses work 6 days a week and I'm guessing the salaries aren't 20% higher to compensate.
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Well it really depends on what the doctor does and seniority level, I have friend of the family who is a resident in the UK specialising emergency room medicine (he has never exactly told me why he chose that and I didn't even know it was a speciality ) he has brutal weeks in terms of the number of hours he has to work, he is always on call and to be frank though he doesn't disclose, he says the pay is not great, especially if you were to break it down on an hourly basis. Its very difficult to say how much a doctor works, there are no averages, a resident spends a lot of time at work wherever they are. Nurses, as I understand it, there is a shortage of them globally, the UK and Hong Kong are both migrating more in as is Australia, Canada and pretty much every country that can afford to. Hard to see them having any worse conditions here then what is available in other countries.
It also really depends which sector you are comparing, Hong Kong has a parallel private system to the public system, very few countries have both systems to the degree that Hong Kong does. Are you comparing the Average NHS salary to the hospital authority salary and what does average mean, its very complicated and you can only really compare like for like.
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cd
18 yrs ago
Agree with dadda, having a baby is cheap, clothes are very cheap, homemade baby food cost is cheap, private drs are expensive as are immunisations, but the government mother and baby clinics are FOC, just expect a bit of a wait, but they will do all childhood vaccinations free. Even places like Disney and Ocean park are free for babies and toddlers. The real expense start once they start Kindy or school. Going on ESF prices kindy is $4,500 a month, primary $6,000 a month. 1 ballet lesson a week is between $1400 and 1900 a term depending on length of term. Football the same. For gymnastics I pay $165 for a 45 min lesson. Art and drama clubs very expensive too. Beavers/cubs is a cheap activity as is mini rugby, around $400 for the season. Once they get to secondary most sports have no cost, or minimum.
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axptguy, sure - we pay 40% tax in UK and hence of course the health services are not totally free - we paid with our taxes for that. However - I am here on a local package and am paid WAY, WAY less than i was in UK - even taking the taxes of 17% in consideration... I am not at all better off financially being in HK - but we are here for different reasons, not necesserely money at all.
The huge thing that makes all the difference in raising children is childcare here - where else would you get a full time nanny/child carer to look after your kids for less than HK$4,000? That's what makes all the difference - in UK half of my monthly salary would have been going on a nanny - and we are talking 9am-6pm nanny only!
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and Cd - home made food is not cheap if you are trying to cook organic for your baby - the prices for organic stuff here are outrageous...
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"The huge thing that makes all the difference in raising children is childcare here - where else would you get a full time nanny/child carer to look after your kids for less than HK$4,000? That's what makes all the difference - in UK half of my monthly salary would have been going on a nanny - and we are talking 9am-6pm nanny only!"
Certainly very true. Also a helper can do much more than being a nanny.
"and Cd - home made food is not cheap if you are trying to cook organic for your baby - the prices for organic stuff here are outrageous..."
I second that.
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Before this thread degenerates into an unthinking reiteration of Moore's film, Sicko, we should keep one variable in mind: healthcare productivity as measured in mortality rates. Doctors will tell you that, all the problems of US healthcare aside, the mortality rates and recovery rates are the lowest and highest in the world respectively. Sometimes you do get what you pay for.
Anyone waxing lyrical about socialised medicine should spend a day in a NHS ward - it's filthy, with blood and excrement on beds, etc.
To reply to the original thread: if you can afford it in HK, please go private (why compete for subsidies with HKers and others who need them more?) - in fact, your employer should cover you for private medical expenses.
As for costs of raising a kid - I'm no expert, being childless - but you can cut down alot if you don't try to substitute your time/concern with expensive trinkets. Give your child cuddles, go to the park/beach (HK has great ones) instead of some plastic contraption (something to avoid in HK is the unrelenting commercialism).
Good luck!
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HKhereIcome - would be good to see whether your opinion still stands once you have children - as much as you can try, your cuddles will go only that far with your child on a rainy day (ditto walks in the park) - and I am afraid, there is no way around buying toys for them... Sure you can collect toilet paper rolls and shoe boxes and built things with those, but that will get that only that far as well....
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"you can cut down alot if you don't try to substitute your time/concern with expensive trinkets. "
Very well put.
Idsllvn, I really don't think that HKhereIcome meant the children should play only with sticks and rocks. Simply that there should be limits to things. I have certainly noticed the difference between our house, with some toys, many of which are handed down from me, and other houses where the toys are taking over.
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Who said I was using the UK model as an example of what socialized medicine should look like. Using mortality and recovery rates of the worlds largest and richest economy doesn't say a lot about whether privatised health care as a system works. Would you use Burkina Faso as a place to obtain your statistics from, that is a country that has almost no government intervention in healthcare or any other market for that matter. Obviously not, it would not suit your purposes.
I'm hardly Michael Moore, I never went to see Fahrenheit 911 or sicko for that matter. The point I made is that free markets and competition (especially in Insurance or for public good provision) Do not always lead to the most efficient allocation of resources or the lowest costs. That it does is simply conservative right wing dogma and its simply not true.
http://www.oecd.org/dataoecd/29/52/36960035.pdf
Using health care as an example, you look at total spending as a proportion of GDP for the US which has perhaps the most competitive markets in healthcare compared to all other OECD nations, not only do they spend more per capita, but the figure is growing faster then everyone else's and based on almost every other metric, they do poorer then everyone else. I am not even going to begin talking about the quality of health care received and the cost to the average person being out of range. The data is from 2006.
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Ed
18 yrs ago
Interesting comments and conversation...
"Doctors will tell you that, all the problems of US healthcare aside, the mortality rates and recovery rates are the lowest and highest in the world respectively. Sometimes you do get what you pay for."
Can you qualify this with a source? Perhaps at the top end of the scale those comments might hold water but I can't imagine that overall that the US health care system delivers on those claims... Don't recall the source but I recently saw some info that indicated the US was way way down the list (60+ on most measures?).
My impression of the US health care system is that if you have lots of cash you will get very good - but extremely overpriced service... and if you get really sick and your insurance runs out you go bankrupt and die...
I come from Canada and we have health care for all that we pay for with our taxes. There have been abuses (including Americans showing up free clinics in the past to get treatment) and I think they have implemented a minimum user fee to discourage social visits to the doctor - but overall I my experience with the system no way things resembles a scene from dante's inferno as depicted in the public health system in the US..
Generally you get extremely good care in the provincial health care system regardless of if you are wealthy or poor.
In Ontario Canada you will not see your mother turned away and refused the best cancer fighting drugs because she cannot pay for them.
I dunno, but I think that's quite a good thing... I have absolutely no problem with subsidizing two things in a society - universal quality health care - and universal quality education.
Before commenting on both these concepts think about things from the other side of the coin... not everyone is born into privilege - and many people simple do not have the ability to go beyond a low paying job. So should we sweep such people into the gutter when they become gravely ill?
In the immortal words of Warren Buffet (I will paraphrase) 'I was born into a fortunate environment, and I was lucky to have bit of intelligence - and thats why I am where I am - a lot of other people with far greater ability were born into less fortunate circumstance...'
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To be honest, I would be interested to see the source of those statistics myself. Not that it would change what I was saying. There are many arguments against universal healthcare. Personally speaking I am a social liberal and economic conservative, so I can see the validity of a lot of the arguments made and empathise. To argue though that competition in health care and their derived insurance markets results in efficiency and cost savings is simply not true. Pulling out the odd unsourced statistic where America supposedly does better then its peer's really doesn't alter very much.
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I'm a Londoner, so my views about socialised medicine are based on actual experiences of mine and of friends.
I can't speak about Canada, but Ed wrote:
"Generally you get extremely good care in the provincial health care system regardless of if you are wealthy or poor.
In Ontario Canada you will not see your mother turned away and refused the best cancer fighting drugs because she cannot pay for them."
Good for Canada - but if you read The Times of London, you will see that a huge debate in UK now is why the NHS only allows SOME cancer drugs (usually those based on old research, not the latest and best drugs). And of course, the reason is cost - "if everyone can't get it, no one should". If socialised med works, it works in Canada, but not UK. my point is that socialised med has a checkered record too (like free-market med).
My data on mortality rates are based on cancer survival rates (not broken bones etc): Arduino Verdecchia et al., "Recent cancer survival in Europe : a 2000–02 period analysis of EUROCARE-4 data," Lancet Oncology, 2007, No. 8, pages 784–796
(for more stats, see the American cancer society, but of course they could be biased)
They are confirmed by my doctor friends around the world. This is not a matter of ideology; it's simply that US has the cutting-edge medicines because of a free market in phamaceutical research (healthcare can't be discussed separately from med research), as well as shorter waiting times. Cancer is a great unknown so the disparity is great. I suspect that for problems like broken bones, there is little to separate socialised med from free-market med.
Of course, many cancers are genetic. Just talked to people and found out that nose cancer is prevalent in SE Asia, but rare in the US. So if anyone I know has that kind of cancer, I'd say, go get treated in HK or Singapore if you can, not the US, simply because the expertise/experience are here.
The point about US being great only if you have insurance is well-taken. No point having a great med system if you can't access it, but on the other hand, if you have unlimited access for all, everyone suffers. There is a trade-off, not some nirvana state.
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ldsllvn - touche :)
My point was actually motivated by a parent I know who earns HK$15,000 a month by working 12 hours a day, but spends HK$15,000 a month on toys. In my opinion that's a calculation that does not make sense.
Would the child be better off with the parent's 12 hour daily guidance instead of those toys? the answer will depend on whether you liked your toys or parent better in childhood - hee hee :)
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So what you are saying is your mortality and recovery rates are confined to a single disease in America rather than symptomatic of the system in general. There is a trade off but there is a trade off for every decision we make. The choice is fairly simple, do you ensure that everyone in your society is afforded health care or should we only make it available to only those who can afford it. If you go to the WHO website and have a look at their rankings of various countries health care systems, you will see how poorly the US which has the most competitive market in health care provision performs in almost every benchmark compared to countries which have socialised medicine. Your personal experience with the NHS has biased your thinking, which is fair enough, but the UK is not the only way a socialised medical system can be run.
A common argument made to support right wing dogma that competition is always best and that there is something fundamentally superior with the American health care system is the size of their pharmaceutical industry the amounts they spend on R&D developing life saving drug. That medical research and health care provision are somehow synonymous. I don't see how. They are related industries much like fertilizer manufactures are related to farmers, though they affect each other, and depend on each other, they are completely different business's and should be regulated accordingly.
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"the size of their pharmaceutical industry the amounts they spend on R&D developing life saving drug"
In any case a lot of that is testing and paperwork.
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Back to the basic principal, arent we comparing an apple with a pear? A tiny city like Hong Kong with almost the richest country in the world!!
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"Back to the basic principal, arent we comparing an apple with a pear? A tiny city like Hong Kong with almost the richest country in the world!!"
Almost?
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I don't think so Mighty, Though Hong Kong because of its smaller population has some options available to it that more populous countries do not have, the ideological arguments for either system is the same regardless of where you are. Interestingly Hong Kong has a hybrid system, which seems to work for everyone (everyone except the doctors that is who are not particularly happy). All Citizens and PR's are entitled to access to public health care through the hospital authority, If you can afford it however there are also plenty of private hospitals as well. Its not as if we are taxed heavily either to be able to offer such provision. Treatment is not completely free but it is heavily subsidized and comes with the ususal complaints of waiting lists for procedures etc etc.
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Well, DB, you have your point. I also wonder sometimes where the money comes from to support so many public hospitals in Hong Kong, as we are not heavily taxed (comparably).
axptguy38, yes i used the word 'almost'. Just a naive question... how do you rate a country whether it is rich or not? GNP or revenues? I like watching animal programmes and I see most of time people get caught by SPCA for abusing animals live in very filty conditions... I am talking about programmes in the States. They speak Spanish though so I guess they are new immigrants? Well I guess no matter how rich the country is, there bound to be some poor.
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"how do you rate a country whether it is rich or not? GNP or revenues? "
Unless I have totally forgotten my economics, GNP or revenues are by definition the same.
Anyway one measure, and probably the easiest one, is GNP/capita. The US tops that.
"Well I guess no matter how rich the country is, there bound to be some poor."
Of course. The US, while "the richest country in the world" has plenty of poor. Poor is a relative term of course. There aren't any people starving (or at least very few). Being poor in the US is hardly like being poor in some central African country.
Many economists will tell you that, from a wealth generation standpoint, "overly" egalitarian societies that redistribute income aggressively are not ideal. The US has a big divide between rich and poor, but on average the income is very high. A country like Sweden has a relatively small divide, but in comparison to the US average income is rather low (for an industrialized country). Whether those economists are completely correct is another matter.
"They speak Spanish though so I guess they are new immigrants"
Spanish speaking immigrants are hardly a new phenomenon. Puerto Ricans around New York, Cubans in Miami, Mexicans in Texas and California. Many Spanish speakers are second or third generation. If I went to my local Home Depot (in white as snow Connecticut) the signs were bilingual. When I lived in the LA Basin, half the people I talked to were Latino.
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GDP per capita is used rather than GNP, there are small differences, not that important, but it seems that is the National Income measure that is preferred, using GDP per capita however would result in Luxembourg being the wealthiest nation in terms of citizens. If you use the measure GDP alone then the US is the worlds largest economy. As axptguy38 says though, these measures say very little about income distribution, equality and inequality. Economists have different opinions on inequality, there is by no means a standard view.
"I also wonder sometimes where the money comes from to support so many public hospitals in Hong Kong, as we are not heavily taxed"
All money used to fund public goods and services in Hong Kong comes from taxation revenues. Other than a few years Hong Kong rarely suffered any budget deficits, enjoying surplus in most years. There is probably almost no official government debt, if there is it is simply to establish a rating. I think there is quasi govt debt in the form of MTRC Bonds and KCRC bonds, but Hong Kong is a walking advertisement for low flat tax structure and what it does for revenue collection. It also helps that we have never had to spend money on defence.
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"Economists have different opinions on inequality, there is by no means a standard view."
Certainly. As a vaguely interested economics student, I learned that for eveyr economist who claimed x, you could find two others who said x was "right wing propaganda" and "left wing absurdity" respectively. ;)
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Digital Blonde,
It also helps that the Government was historically able to raise revenue by selling land......lots and lots of land, lots and lots of dollars.
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True, but you will find a unified view that free markets and competition do not always lead to efficient outcomes (market failure and imperfections). The degree with which we should regulate depends on the individual opinion however. What I am referring to in my posts and what I rail against is conservative right wing dogma from people who know little or nothing about economics itself that insist that the market is the solution for every issue we face.
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woods99 erm yeah that too, easy to forget land sales is an important revenue source, the government suspended them for a few years. Though it has resumed them, it is not like it was prior to the handover.
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May be now before you can sell any land, you need to somehow 'consult' the Chinese Govt first so everything gets slowed down.
To me, it is just the image and I have no data to support nor any knowledge on the economic side either, Northern Europe (Norway for example) is very 'rich' in a sense. Every one's worth seems very equal there. A bit like a real (not like China) and ideal communist country.
"Unless I have totally forgotten my economics, GNP or revenues are by definition the same". Ooops, I meant to type reserves!!
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"Northern Europe (Norway for example) is very 'rich' in a sense. Every one's worth seems very equal there."
In a sense yes. However many Norwegians jokingly refer to it as "collective poverty". The state is certainly very rich, in no small part due to oil revenues. Individual Norwegians are certainly not poor, but if related to cost if living, the average household income is way below the US. Then again, you don't get the same extremes of rich and poor as in the US.
As I see it, there is no "correct" answer. After becoming an adult in Sweden, I was increasingly unhappy with living there. So was my wife. And so we moved. Most of our Swedish friends would never do that. There is no perfect country and no country is good for everyone. And it's not just economic factors. Climate, natural environment, attitudes, these things all play into it.
When we did decided to move out "permanently", I told all my friends that they weren't allowed to complain about the Swedish government anymore. "You can always move if you don't like it!" I told them. :)
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Hi everyone,
I am totally overwhelmed by the response of messages to my original enquiry and amazed at the direction the "conversation" has taken. By all means, please feel free to continue to discuss and debate...however, thank you dadda, HKhereIcome and cd for you practical tips and advice (Stanley Market, Wellcome, HSBC health insurance, government clinics for free vaccinations). To be honest, practical information like that is what I was really looking for. If anyone can add to that (best place to get this or that for good qualilty but not too expensive), please do!
Regarding health insurance: my husband's employer has agreed to get us "good" health insurance for "the whole family" but is being very lazy about actually doing the research and coming up with some proposals. Does anyone know of a plan that might even cover the expenses of giving birth in a private hospital (remembering that I am now 21 weeks pregnant and will be arriving in HK in October, due Dec 11)? If not, that's ok, most important is that we get a really good plan for after...any other suggestions besides HSBC?
Thanks!!!
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PS - Could anyone recommend a lawyer (good, but won't rip me off!) to help me write a will and deal with some other matters? THANKS!
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Do you expect to have the baby in Hong Kong. I am no expert, but I was under the impression it was tough to get a hospital bed, public or private. If there is someone out there that would correct me or clarify please do.
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Yes, it is very difficult (basically you have to register at a hospital the second you get pregnant in order to definitely have get a "reservation")...I was there (HK) in June and found a doctor (Dr.Lucy Lord) who has put me on the waiting list for the Matilda and Adventist (yes, I know how expensive they are but I really want "natural childbirth" in an English speaking setting - at all costs). This is also why it would be great to find insurance that would cover the birth...though hubby's employer has agreed to pay for half of it himself.
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Public is not hard. I mean you are guaranteed a bed, just not the specific hospital.
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"PS - Could anyone recommend a lawyer (good, but won't rip me off!) to help me write a will and deal with some other matters? THANKS!"
Tracy Lau at Haldanes: 28681234
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MrsC
18 yrs ago
"I understand the desire to perhaps get the most out of your tax dollars, but going to the doctor every time you come down with something that you say yourself is not serious, is a waste of resources don't you think."
The majority of the health budget in western countries is spent caring for people with preventable or 'lifestyle" diseases. Primary prevention (ie preventing disease before it manifests) is the goal of most health systems. Discouraging "well" people from visiting health professionals results in less screening for cardiovascular disease, obesity, diabetes and cancer and costs much more in the long run.
Anyway - back to Patchy's question
On balance, the cost of raising a child will probably be about the same in HK as elsewhere. Clothes are definitely cheaper, food is about the same, (expensive in UK and Aus too now) transport is much cheaper, and a helper is much less expensive than full-time day care. If you have private health insurance, check which hospitals and doctors are linked to your plan - there are some that pay direct and others you have to send away a claim for.
HK park and zoo are great, South Bay beach and Shek O are a great day out (and free) and the annual pass to Ocean Park has to be the best value for money anywhere in HK.
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There is a massive difference between visiting a doctor for a regular check up to get tested and visiting one just because you happen to feel under the weather and its free to do so. The latter is not preventative its just wasteful.
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MayC
18 yrs ago
I think I may have worded things wrongly before. I do not mean, seeing a doctor even when it is "not necessary". If it isn't necessary, then why bother making a journey all the way to the clinic, then waiting for hours to see a doctor?
Let me reword. I meant to say I would SEEK help SOONER.
For example, say, I feel uncomfortable and I think I may get Urinary Tract Infection. In Sydney, I'd go to the doctor's immediately to get my medication. I take it and I feel better instantly. In HK, due to the costs, I feel uncomfortable but I don't go until it's so bad it is stinging and I am in agony... and every minute I'm at the doctor's office, I'm hopping up and down in pain. Why don't I go? Well, I'm hoping that with drinking lots of water, the discomfort would leave.
Another would be ingrown toenail. In Sydney, I may have gone to get help sooner than in HK. In Sydney, I get treated early and it lessens my discomfort. Here, due to the costs, I waited and then it got infected with pus and I needed to go on antibiotics, plus have a surgery where I was put under. My doctor said I shouldn't have left it so late, then I wouldn't have needed the surgery or the antibiotics.
With my flu. I knew I had a bad flu. In Sydney, I would have gone quicker than I did two weeks ago. The minute, I detected yellowish mucus that had not gone away for 2 days, I would visit a doctor. Here, I waited until I could barely get out of bed with a fever before I went to see. My doctor said I should have gone sooner, that my body was not able to fight the bacteria.
These are only three recent examples (within the last few years).
DB, feel free to go the minimal amount of times that you do to seek medical help. I for one, when I go back to live in Sydney, will continue to make sure I seek help early. At the end of the day, it is my health and I believe I was sensible whenever I visited the doctor at the time plus you weren't there to judge my condition so...... And I may add, at the time, I was at the highest tax bracket - 47cents in every dollar.
The thing is, in every economy, there are those who will be satisfied and those who won't be. That's how it works. They all have their good points and bad. Some benefit from a certain system, some won't from the same system. For Hong Kong, the only thing I wanted to point out to Patchy was that, yes, you can be VERY comfortable living here, and most expatriates ARE living comfortably here and they would not wish to return home. Everything's dead cheap for the rich expatriates. However, there are those expatriates at the other end who do not enjoy such luxury. So Patchy, so sorry that a lot of our comments haven't been helpful.
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No worries...it's been fascinating to read!
:)
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If you have a valid reason to go see a doctor, no one is going to question how often you go, nor should they, but the way you worded it, it sounded frivolous, like you went to a doctor at the slightest, just because its free to do so rather than you had an actual issue that requires medical attention. Surely you can understand why I would take issue with that kind of behaviour, and I am glad you cleared it up for me.
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"Everything's dead cheap for the rich expatriates. However, there are those expatriates at the other end who do not enjoy such luxury."
And then there are the rest of us who are somewhere in between. ;)
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hat I am saying is that every system has its problems, and it is no point damning the US one since the alternative of socialised med isn't rosy either.
patchy, good for you for having health insurance. It is my personal opinion that expats - those who just arrive and do not intend to stay in HK for long - should use private hospitals or pay the full rate at public hospitals. My reason is simple: we have not paid into the system enough to have an ethical claim on the subsidies. True, in HK with its low taxes, public hospitals are paid by land sales - but the principle still applies, 'cos foreigners have no moral claim on HK land. If one gets a HKID on arrival and enjoys the subsidies, it might be legal, but I'd suggest it is taking w/o contributing (which makes us rather rude guests, don't you think?). I include so-called "poor" expats, but exclude those who make HK their permanent home.
If an expat says he pays >$100K in taxes every year and so has a claim on subsidies, I'd say, if you pay >100K in taxes, you must make millions, in which case why not leave the subsidies to others?
On a more practical level, health insurance sometimes do not cover pregnancy and almost all do not cover existing conditions (including pregnancies). So you might want to check the terms carefully and perhaps buy a "rider"/supplement. Depending on your citizenship, you might want to have your baby at home to avoid immigration problems (in immigration terms, there's no advantage in having the baby in HK 'cos HK doesn't grant citizenship based on place of birth, unlike US). You should also check with your country's embassy's website in HK to what is the process for registering your child's birth/citizenship. Good luck!
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I think MILLIONS of people who cannot afford medical coverage because it is simply to expensive for them, who end up increasing the cost for everyone that does buy coverage or are covered by government programs by seeking primary health care through emergency room treatment once their condition is sufficiently serious, is pretty damned if you ask me. Interesting fact pointed out by Fareed Zakaria in his latest book The Post Amercian World. US car manufacturers have a built in health care cost of approximately US$6,500 per vehicle produced from their legacy labour contracts. So they are moving manufacturing to Canada instead, where their taxes cover the cost of health care and the cost per vehicle comes down to US$800. Forget about the morality of having uninsured in your economy or the fact that empirically competition has not led to lowest costs or the most efficient allocation of resources. Privatised health care in America has made American companies less competitive then they could be. If I was a raging conservative, that would outrage me.
There are versions of socialised healthcare that outperform America using almost any benchmark you take, and if you rank America in the grand scheme of things, it performs poorly against every other OECD country using almost any metric. It not that socialised medicine is perfect or not flawed, it is just less imperfect and flawed then the system of competitive markets in place in Amercia right now. If someone comes along and shows us all how it should be done I'd be the first to jump on the bandwagon and shout the free market from the tree tops.
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"If an expat says he pays >$100K in taxes every year and so has a claim on subsidies, I'd say, if you pay >100K in taxes, you must make millions, in which case why not leave the subsidies to others?"
Well, where is the cut-off point. Who is "rich enough" not to need the free stuff? Once you start regulating that sort of thing, the system risks devolving into a mess of progressive taxes and income equalization. Better to let the system regulate itself. "Rich" people will tend to use private healthcare anyway.
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DB - your posts are one-sided. I wanted to give the other side. Your stat about car production in Canada ignores the higher corporate/personal taxes required to fund socialised med. A car produced in Canada is basically subsidized by taxpayers when the labour cost paid by the firm doesn't include the true cost of health services.
The cut-off point is moral, not legal - it's up to the individual not to overuse shared resources (applies to the green agenda too). I'd far prefer appealing to the better sense of folks, than to impose a legal cutoff, in this case.
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It is not a subsidy at all, not even close. What you are suggesting is that all goods and services produced in Canada are subsidized because they have lower health care costs because they run a universal health care system and this means despite companies paying their taxes and contributing to the cost of provision, they are somehow receiving a subsidy. I really don't think so somehow, and I think you would have a hard time convincing a Canadian company that they are in fact receiving subsidies compared to an American competitor producing the same product.
There is a very good reason why the built in cost of health care for a car in Canada is almost 90% cheaper than in the US (even if we agree that your argument re subsidy is valid, the tax differential between the two countries is simply not that great to account for such a large difference), health insurance premiums under a privatised system end up costing far more then under a universal single payer health care system. Its simply because it is cheaper to run for a variety of reasons and That is why I rail against it, it simply does not lead to the lowest cost outcome. I'm not some Michael Moore type liberal crying wolf.
Without going into to much detail, because there are actually a lot of reasons why health care costs more in America then anywhere else in the world and confining my arguments simply to insurance and the way it is marketed. The principle of competitive markets in health care provision works like this. Private insurers who have a profit incentive enter the market to provide coverage. What happens is young people and those individuals who don't have a propensity to become sick tend not to purchase insurance, they have no reason to (that is a generalisation, but that is what insurers will look at, general trends when assessing the impact on the bottom line). This leaves people who are older and have a propensity to be sick the main buyers of health insurance (information asymmetry and adverse selection), which means that insurers end up having to pay out claims more often then they don't, which has a negative impact on their bottom line, resulting in higher premiums being charged to everyone else which results in fewer healthy people wishing to purchase the product because it now costs more. People stop buying insurance because it becomes to expensive (there is data out there which suggests it is extremely price elastic) and then start seeking primary healthcare through emergency rooms free riding off everyone that does pay for it, and this raises the cost even further and it goes on and on and on, until you get to the point where Ford is paying out US$6,500 per unit in health care costs.
The simple solution is to socialize it, make everyone pay for health insurance either through taxation or legislation, whether they are sick, young, healthy or aged, and you end up with per units costs which are far cheaper. Hillary Clinton argued for mandating during her campaign, the Obama campaign ran the bogey suggesting she would force individuals to buy it, without telling the full story that she would cap payments made as a percentage of income. Obama's plan is donut shaped, that is to say there is a massive hole in it, He says he will make insurance cheaper, but doesn't say how, and he refuses to mandate. If people aren't mandated and they don't already buy insurance, reducing the price for them may induce some people to buy but certainly not all and you have the same issue yet again.
The Republicans or John McCain would argue that less intervention is required not more, and to some extent they are right, the current system in America is a mess, medicare and medicaid are massive government programs and of every dollar spent on health care in America 45 cents of it is spent by the government and it is warping the private market for health care provision.
Whatever you may believe, ultimately the point is this, the US has perhaps the most competitive market in health care provision amongst all OECD countries, yet it spends more as a percentage of GDP and per capita then any other country on the planet, some US$2.3 trillion in 2007, 16% of GDP in 2007, set to rise to 19.5% of GDP in ten years by 2017. That is a huge increase in costs set to occur in a very short period of time, faster than inflation or wage growth. There are already close to 50 million people uninsured in America either because they cannot afford it or feel it is to expensive already. What do you think that number is going to look like in ten years time. Suddenly even the NHS with all its draw backs starts looking appealing, and I say this as a British citizen, who gets treated up at the Adventist hospital when I have an issue rather then go to a public hospital in Hong Kong which costs little or nothing so you can accuse me of hypocrisy if you wish.
To say that in Canada they are receiving a subsidy because they have rationalized, done away with insurers and adopted a single payer system with all the benefits that comes with along with its draw backs, for a start it’s not very fair to the Canadians, and more importantly its just not true. The Americans need to reform, if they are going to compete in the long run. I'm not averse to seeing a free market solution work, in fact I would prefer it, but all the evidence so far, well it suggests to me that it’s just not possible
http://www.dollarsandsense.org/archives/2008/0508harrison.html
The link is an article written in 2004 explaining where the money is spent and expands on why it costs more in America then anywhere else without confining it to insurers, though that is the bulk.
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patchy, where are you moving from?
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Very Interesting discussion, the point about Canada having higher corporate tax however is not correct, The US has the highest corporate tax rate amongst all OECD countries, then followed by Japan.
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We are moving from Singapore, where we have been for the past year. I'm American (USA) and my husband is Italian.
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Tax rate differentials could not account for the nearly 90% difference in per unit health care cost in any case.
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lmcf
18 yrs ago
Patchy, I have a few recently arrived friends who looked for medical insurance for current pregnancies. No one found such a policy, and were told the minimum waiting was 10 months from policy start. If all goes according to plan and you deliver naturally, the cost may only be HKD 100,000+ at private. However, if you require an emergency C, and this occurs after 5:00 pm, your bill could be over HKD 200,000. If $$$ are a concern, you should book semi-private or ward, since unlike the US ALL fees (delivery, room, medicine etc) charged are much greater when you stay in a private single room.
We find the costs of raising children in HK very similar to Singapore except for housing, and some activities are more expensive (excluding the local community/ government programmes).
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That my friend, is twisted logic, I can see what they would be saying from their point of view, but it doesn't make an awful lot of sense. They should actually pay for it, in insurance parlance, someone who goes to a country like India for example, and doesn't bother to take malaria tablets, and is insured is in actual fact engaging in what insurers call moral hazard, people engaging in risky behaviour simply because they are insured. They know it happens, and to counter it they should encourage people who take preventative action, and to some extent they do. Not paying out on Malaria tablets though seems a little silly to me.
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