I'm an American who has been living in China for the past seven years. Prior to moving to China, I never really thought much about the costs of health care. We had good insurance and that was that.
We still have good international insurance, but have saved it for catastrauphic events. In other words, we've paid out-of-pocket for preventive care to avoid making claims. I've had my annual check-ups and mammograms over the past seven years, but never claimed them on insurance.
In January, I was diagnosed with breast cancer. I had seen a general surgeon in Hong Kong about a painful lump that had appeared in late October. I also had skin redness. He diagnosed non-lactational mastitis and prescribed antibiotics. However, the mammogram showed a suspicious area and two days later, he performed an ultrasound guided core needle biopsy. The pathology report gave the diagnosis of invasive ductal carcinoma.
I immediately switched to a breast specialist in Hong Kong. I had another core needle biopsy (different area). Had a PET scan. Had an EKG. Had extensive bloodwork. Had chemosensitivity testing. Had the FISH testing. Several consultations with the specialist. Started neoadjuvant chemotherapy on Feb 14, only two weeks post initial diagnosis. Four cycles AC followed by four cycles Taxotere.
I commute to Hong Kong every three weeks for my treatments (three hour flight to southern China and 1.5 hour bus ride into Hong Kong). Because I live in a lesser developed area of China, I receive the Neulasta shot to help my white cell count. Cycle 1 was uneventful with just minimal vomiting. Cycle 2 was horrible with severe vomiting and severe nausea. Cycle 3 was much better with the addition of Emend to control the nausea.
I just filed the paperwork for insurance reimbursement for all the visits with the breast specialist, diagnostics, testing, pathology, bloodwork, two cycles of chemotherapy, support drugs and two Neulasta shots. The total we've paid so far was $9400 US. Yes, less than $10,000 US!!!! I'm receiving top of the line care (with everything being reviewed by a medical oncologist friend in the US) for a fraction of the cost it would be in the US. I'm going through the private system in HK since non-citizens are not eligible for the public (universal) care.
I'm at a loss at the huge cost differential. It's not as if Hong Kong is an undeveloped city. In fact, it's one of the most advanced cities in the world. Real estate is ridiculously expensive! My doctor graduated from Hong Kong University and had training at the Sloan Kettering Cancer Institute, as well as at Yale and UCLA.
The one "down-side" to this is that we pay everything up front and file for reimbursement. We've spoke to the insurance company up front and they indicated that everything was standard procedure. I've received acknowledgement from them that our claim is being processed. (I will then file for the chemotherapy treatments that I've completed and then file for each one as it is completed.)
Why are the costs so different? I'm receiving the exact same drugs that I would in the US. We will be relocating to the US the first week of July and I will have my last chemo and my surgery there. I'm already dreading the costs that will be involved with that part of my treatment as our deductables will begin all over again for US coverage.
(By the way, when I refer to "we," I'm referring to my husband and to myself. We did not claim the fees from the general surgeon and the tests he ran in order to keep things clean and simple. His total was less than $2,000 US.)
"Today is the day!"
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Diagnosis: 1/31/2012, IDC, 5cm, Stage IIIb, Grade 2, ER+/PR+, HER2-