Things That Cost More Than A Trip To The Best Western-Style Hospital in Shanghai

My friend Rob does a lot of business abroad, especially in China, and when he started to tell me a story about how much it cost him to go to the ER in Shanghai, I decided (with his permission) to put him on tape. Here is a transcription of our conversation.

Rob! You’re going to tell me about the time you went to the hospital in China? What happened?

I was feeling very exhausted and run down and suspicious of who knows what but specifically dehydration in the middle of the night. The more I drank, the thirstier I was getting. So my Shanghai friend took me to the hospital at 1:00 in the morning, a Western teaching hospital, the best hospital in China, aside from Herbology stuff, which they prefer.

It’s empty, absolutely empty. You check in at the counter and you have to pay money before you do each service, so you get your bracelet. [ed note: like at Spa Castle!] Then you go to triage. As soon as you’re seen in triage, they give you a bill, and you have to immediately go settle the bill at the cashier out front.

My god.

You don’t have to go yourself. You friend can go with the money. But the bill has to get paid before you go to the next service.

So you’re paying in advance for each service?

You’re paying immediately after so as to do the next thing. But you have to have paid for each thing to go to the next thing.

Do they tell you in advance how much each thing is going to cost and get your approval?

No, they did not. But the total cost for the night was $36.


I was warned not to be worried. But this was the best Western hospital in Shanghai. Doctors saw me, sent me to blood work. To get the blood drawn, I had to get the receipt, and I had to pay it before he would run the analysis on it. He had a very modern lab right there. And then to get the results, I had to pay that. So every little step, you had to pay. They did not pre-charge you. But it was minute by minute.

Did you feel like you got your money’s worth?

I very much feel like I got my money’s worth. I was on the border of dehydration and they sent me home with antibiotics, which made no sense, and a packet of rehydrating salts, which were … rehydrating! Revitalizing, lovely. So I now buy them from Amazon for less than $36 and carry them with me when I travel.

That’s very smart. Was that the most expensive thing you did while you were in China, go to the hospital?

No, not by any stretch.

What were some of the things you did that cost more than your trip to the hospital?

Let me think about that. Um. Cappuccino was up there.

One Cappuccino?

Yeah, the Starbucks is still pretty expensive, Western prices. $6 for a Cappuccino vs $36 for blood work and medicine …

Got it, so proportionally …

Yeah. What would you imagine: I think $1000 to $1500, just to walk into a hospital [in the States] with insurance, typically? Yeah.

Can you think of anything else you did that cost more than $36?

Train ride to another city, bullet train, that kind of thing. Western meals cost close to Western prices. Hotel rooms, one night at a hotel. One night at a business-class hotel here is like a fifth or a fourth of a night at a hospital; there it’s like the other way around. And keep in mind, just in general, my understanding is there is no socialized health-care. It is just a pure market system. A minimal percentage of the working population has any kind of health insurance so most health care is cash and carry. I understand this is changing and I don’t know how quickly or how far, but they don’t have a system of health insurance. It’s just opening up.

I wonder how doctors do. I wonder whether they make a comfortable living.

That’s a good question. Another related question: What about the health care of the elderly? I saw a TV show that said that the retirement law for the elderly is that the children are required by law to care for them.

Wow. But what happens if you can’t afford to pay for whatever health care your parent needs? Do you get thrown in jail?

I think you just don’t get the care.

That sucks. Well, I’m glad you could afford to get the care you needed. I’m glad you’re doing well.

Related: If restaurants billed like hospitals, you’d probably stop going out to eat.

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