Bhutan Medical Insurance
The Kingdom of Bhutan is a small landlocked country situated in South Asia, east of the Himalayas, and bordered by India and China. With a long history of influence from India, Hinduism, Buddhism, British colonial powers, and Nepal, Bhutan is a place rich with history and a wide range of ethnicities, religions, and cultures. Bhutan covers an area of approximately 47,000 sq. km., with diverse and beautiful landscapes. While the south is covered by subtropical forests and plains, the north is much more mountainous with some peaks exceeding 7,000m, which makes it a popular destinations for trekkers. Not only has Bhutan been ranked as the happiest country in Asia by Business Week magazine in 2006, it also enjoyed one of the highest gross national incomes (GNI) in South Asia in 2008. However, despite these promising statistics, 52.9% of Bhutan’s population still remains below the poverty line.
Since the 1960’s, the council of ministries, prime Minster, and king have worked cooperatively to form the development strategies of the country, which is laid out in the 10 Five-Year Plans. Bhutan is currently on its 10th Five-Year Plan. In terms of healthcare, the 8th Five-Year Plan focused more on decentralization, seeking to expand health coverage to more of its citizens. This was a success because by 2002, Bhutan had achieved its desired level of coverage with 90% of the population having access to health care. In the 9th Five-Year Plan, focus was then shifted to improving quality of care. Currently, the 10th Five-Year Plan (2008 – 2013) is being implemented and focuses on continuing to improve health care, particularly in increasing the health care personnel to population ratio, improving life expectancy, and decreasing the number of hours that its citizens will have to walk to a health care facility down to 3 hours for 90% of its population.
The Royal Government of Bhutan, which developed the concept of the Gross National Happiness as a measurement of the quality of life and social progress of a country, highly prioritizes its social sector. This is evident in the current Five-Year plan, which allocates 22% of its national budget to the social sector, with 8.5% going to the health sector. In addition, Bhutan has also established a national health trust fund, which aims to reach $24 million USD. The Bhutanese government has also pledged to match all donations to this trust fund, one-to-one. Sixty percent of Bhutan’s health care services are currently funded by foreign aid, which makes its stability unpredictable. The Bhutan Health Trust Fund will help fund its health services in the event that foreign aid may decrease or become unavailable. Bhutan’s economy is continuously growing and improving and is expected to stabilize within 15-20 years. Hopefully, by then, Bhutan’s health sector can become independent of foreign aid.
Bhutan’s health care system is administered nationally. Strategies and policies are developed by the prime minister and the council of ministries, but actual implementation of these policies is headed by the Ministry of Health, with the Department of Public Health undertaking most of these responsibilities. These responsibilities are then passed onto the different administrative heads of each region. The country is divided into four different dzongdey (administrative zones), which are subdivided into twenty dzongkhags (districts). Larger dzongkhags are further divided into dungkhags (sub-districts). Bhutan’s health services are organized in a four-tiered network, which is made up of the National Referral Hospital, regional referral hospitals, district hospitals, basic health units, and outreach clinics at the local level. The health service units on the lower levels depend mainly on local authorities and administrators for their support, who in turn, report to the health department at the national level.
There is currently no privatization of any physicians or clinics. Bhutan’s National Referral Hospital, 4 regional hospitals, 28 district hospitals, 160 basic health units, 447 outreach clinics, and over 1000 village health workers serve all of its citizens and tourists free of charge under the national health care system. The best health facility in Bhutan is the JigmeDorjiWangchuk National Referral Hospital in the capital, Thimphu. Here, patients can receive free basic medical treatment, as well as, advanced services such as surgical and emergency treatment. There are general practitioners, several specialists, and operating rooms. Recently, the hospital has even acquired CT and MRI diagnosis equipment and made improvements to its laboratory services as well. The hospital also includes a medical library with many up-to-date textbooks. However, treatment for more complicated illnesses and procedures such as cancer and neurosurgery are not available. Patients will have to be transported to better medical facilities in India and Thailand if they wish to receive treatment. Outside of the major urban areas, it is difficult to find medical care beyond basic health services. One of Bhutan’s biggest challenges in improving its health care system is the severe shortage of health personnel. Currently, in urban areas there are 5.1 physicians and 11.5 nurses for every 10,000 people. The averages for rural areas are even more dismal with 0.2 physicians and 2.4 nurses for every 10,000 people.
Traditional medicine also has a large presence in the Bhutan health care system. The government funds the Institute of Traditional Medical Services (ITMS), which has set up a network of 1 indigenous hospital, training center, pharmaceutical and research laboratory, and 17 indigenous dispensaries, which are attached to district hospitals. Often, both allopathic and traditional health services operate in the same hospital, and there are even inter-referrals of patients between the two systems. All traditional medicines are produced in Thimphu and distributed to the other regions. As is with allopathic health services, traditional health care is also free of charge.
Expatriates and tourists traveling to Bhutan are strongly advised to take out an international private health insurance policy beforehand. Aside from health facilities being few and far between outside the capital, the facilities and standards of healthcare are significantly below that of Western Europe and North America. Poor road conditions are one of the biggest dangers that beset tourists and citizens alike. The mountainous terrain and lack of maintenance make landslides, steep drop-offs, blind curves, and falling rocks not uncommon on Bhutan roads. Tourists are required by the government to organize their trips through recognized tour companies and travel in groups. All visitors are urged to consider a plan that will cover evacuation costs in the event of a serious illness or injury. Expenses for emergency evacuations exceeding $100,000USD without insurance coverage are not unusual.
Visitors to Bhutan should make sure that all their vaccinations are up-to-date. Recommended vaccinations include adult diphtheria, tetanus, hepatitis A and B, polio, typhoid, varicella, Japanese B encephalitis, meningitis, rabies, and tuberculosis. Vaccination for yellow fever is required for entry into the country if arriving from a yellow fever infected country in Africa or the Americas. Other possible health risks include Acute Mountain Sickness, also known as altitude sickness. Always ascend slowly when trekking, avoid grueling activities in the first 24 hours, and alcohol consumption at high altitudes.
Be sure to always bring adequate supplies of your own medication when traveling. Medicine and supplies easily accessible in your home country may not be available in Bhutan. Diarrhea is the most common ailment of tourists in this part of the world. Most cases are mild and can be treated with rest and adequate fluids.
Pacific Prime can assist you with any health insurance needs in Bhutan. We offer professional advice at no cost to you. No matter what your budget is or what your requirements are, our professional consultants can help find a policy that fits you or your group. Our policies can cover wide range of services including dental, maternity, specialist consultation, transportation, inpatient services, and many more. Please contact us today for a free consultation.