10 things you need to know about the global cost of healthcare

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.

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.

1. Is healthcare expensive overseas?

As with almost all products and services, the cost of healthcare entirely 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 while 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.

Independent research we conducted in 2018 indicated that 24% of expats worried about the cost of medical treatment in their new country. And 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.

2. 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.

We’ve gathered data from 2022 (through AXA Global Healthcare’s AXA Select network) to give you an idea of how much healthcare costs can differ and how extreme the differences can be.

For example, the average cost of a laparoscopic cholecystectomy – a minimally invasive yet major surgery to remove the gall bladder – was $19,288.40 in Nigeria in 2022. The same operation in India, however, was a fraction of that amount at around $2,600. Likewise, for another significant procedure like a hip replacement, the average cost in Luxembourg was $27,428, while in India it was around $5,200 – that’s a difference of $22,228!

These are extreme examples of how costs can differ. For something like an elective caesarean section, the comparison is slightly more balanced. 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 was around 10% less at just $4,726.19.

3. How much is 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 2022, the cost (through the AXA Select network) for a one-night stay in a European hospital was around $157 in Belgium or France and around $315 in Luxembourg. In Nigeria, meanwhile, it was as high as $372. It’s easy to see how bills could add up if you needed to spend a few nights, or even weeks, in hospital.

A night in a hospital bed is all about recovery. The last thing you need is to worry about how much it might all be costing. That’s why all our international healthcare plans include emergency cover to ensure unexpected overnight hospital stays are covered.

4. What about emergency care?

The rising costs of healthcare, and the constant advancements in medical training and technology, mean that there are some parts of the world where certain experts or facilities might not be available. This could mean that, in an emergency, you may need to be evacuated to another city or country for treatment. But the cost of doing so can be more than the cost of the treatment itself.

As with all healthcare services, the cost of an evacuation differs wildly 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 $14,498.1 In the same year, a long-haul evacuation from China to Belgium cost $28,667.1 While this is almost twice the price, the journey takes more than 10 times as long and is nearly 30 times as far.2

In an emergency, the last thing you want is to be worried about where and how you’ll get the treatment you need. Our Evacuation and Repatriation service is here to help. It’s included in all our international healthcare plans and ensures you’ll be able to get the treatment you need if it isn’t available locally. We’ve helped people travel all around the world for important treatment and emergency care.

So, whether you need to be admitted as an inpatient in an emergency, or your appointed doctors don’t think your local medical facilities are able to provide the treatment you need, we’ll cover the costs of an emergency evacuation. We’ll also get you back to where you need to be afterwards, no matter where that is.

5. Why are costs so different?

These are just a few examples of how costs can differ between countries. And this isn’t necessarily reflective of the quality of care, or the qualifications of the surgeons involved.

There are many factors that can lead to cost discrepancies for healthcare services. The first one would be the nature of the overall healthcare system within a particular country. Some nations have universal healthcare, which often means social security payments and taxes contribute heavily to government healthcare spending. This usually results in free or subsidised healthcare costs for residents, and lower healthcare costs generally.

In the USA, on the other hand, there is no universal healthcare. There are also fewer regulations limiting the costs of certain treatments, so it’s a country where we often see higher prices.

Outside economic and environmental influences can also have a big impact on healthcare costs. Inflation, the cost of living and the strength of a nation’s economy can all play their part. In recent years, these outside influences have heavily contributed to the rising costs of healthcare across the globe.

6. Is the global cost of healthcare rising?

Throughout the world, healthcare costs have generally been rising steadily since the 1960s. There have been many contributing factors to this, from inflation and economic fluctuations to the world’s growing (and ageing) population. But over the last few years there’s been a paradigm shift in the cost of healthcare across the globe.

It’s important to remember that the word ‘healthcare’ covers a lot of different areas. It’s a very broad term that includes anything from a GP visit to a major operation. When it comes to costs, not all areas of healthcare will see the same rate of increase. And, while certain countries will be affected by rising costs more than others, on the whole we’re seeing an unprecedented rise in the price of healthcare throughout the world.

However, at AXA - Global Healthcare, we have a carefully selected and contracted medical network, which enables us to secure reasonable prices and accessible healthcare options for our members.

7. How are costs changing?

The amount healthcare costs change varies depending on where you are and what treatment or service you’re looking at.

In the UK, the average cost for a major operation like a hip replacement was $14,596.20 in 2020. Based on 2023 projections, this is set to increase to $18,351.32, which represents a price increase of more than 25%. Over the same timeframe, the UK’s average cost for an overnight hospital stay is also expected to increase from $1,030.32 to $1,295.40.

Elsewhere in Europe, Belgium’s 2020 average for a hip replacement was $10,131,48. This is projected to have increased by over 20% to $12,420.36 in 2023. And for something slightly more routine, like a hernia repair, the cost is expected to rise from $2,747.52 to $3,368.23.

While medical inflation is causing most projected healthcare costs to increase, there are some anomalies. In parts of the world where healthcare services have undergone reform or made improvements during or since the pandemic, we’ve actually seen healthcare costs go down. In Nigeria, for example, the average cost for a hip replacement was $24,742.78 in 2019 and $19,482.50 in 2022. That’s a reduction of around 21% and it’s expected to go down even further in 2023. And the cost for a hernia repair also went down by around 20%, from $4,289.55 to $3,377.60.

8. How did COVID-19 impact healthcare costs?

For much of 2020 and 2021, the global pandemic had a huge impact on healthcare costs across most parts of the world. Lockdown measures, as well as the need for social distancing, meant fewer people were able to access services, make appointments or schedule elective procedures.

As a result, healthcare spending dropped significantly. Once the world began to open up again, prices increased as providers looked to recoup their losses. There was also a backlog of patients needing treatment, which meant that demand outweighed supply and further affected costs.

COVID-19 also had a wider economic impact. Import and export became more expensive, which inflated the cost of medical equipment and medicine. And, because immigration stopped in most parts of the world, and was slow to pick back up, a lot of healthcare services found themselves under-staffed at a time when demand was at its highest.

9. 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. But there are other factors that continue to have an effect.

Inflation, for example, is the highest it’s been for decades in most economies.3 It’s being driven by rising fuel, energy and food prices, caused by a number of factors including both COVID and the war in the 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 we get older, we tend to experience more health concerns, and those concerns often require 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.

10. 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 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 level of cover, wherever you’re going and however long you expect to stay. Our international healthcare plans are designed to cover you for all kinds of eventualities, whether you’re on a short-term visit or moving overseas permanently. With long-term and short-term international healthcare options, we’re here to help protect you and your loved ones from significant or unexpected medical bills.

There’s also been a shift in the way we 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.

And while the pandemic made these platforms a necessity, their effectiveness and popularity mean they’re here to stay. They allow us to seek medical care for a fraction of the cost of seeing someone face-to-face, not to mention the added convenience of being able to speak to them from anywhere.

Our own Virtual Care from AXA service, from Teladoc Health, is included in all of our international healthcare plans. This means our members can seek medical guidance and certain support services for no additional cost.

_{The information in this article is correct at the time of publishing. All 2022 costs have been provided by contracted providers in the AXA Select medical network, and are correct as of December 2022. All 2023 costs are projections that have been calculated based on estimated medical inflation and medical insurers’ cost data from 2020. All prices are in US dollars and, where relevant, have been converted from local currency using www.xe.com.}

_{¹ Conversions from local currency to USD calculated in March 2023 (www.xe.com).}

_{² Figures calculated using www.airmilescalculator.com – based on flight times and distances from Jersey Airport to London Gatwick Airport (161 miles; estimated flight time 48 minutes), and from Beijing Capital International Airport to Brussels International Airport (4950 miles; estimated flight time 9 hours and 52 minutes).}

_{³ AXA Investment Managers research October 2022 - The unequal impact of inflation: How governments are responding.}

_{⁴ Based on world population data from Worldometer.}

_{⁵ Based on aggregated statistics from Data Commons.}

_{All dollar amounts are in US dollars. All figures represent an average cost per country, based on the available data for each treatment. Data was gathered in the local currency and converted to US dollars using www.xe.com. Currency rates correct as of December 2022.}