China’s Ill, and Wealthy, Look Abroad for Medical Treatment
Hospitals and a new generation of medical tourism companies are luring well-heeled Chinese patients away from an overburdened health care system.
BEIJING — China’s medical system could not stop the cancer eating at Guo Shushi’s stomach. It roared back even after Mr. Guo, a 63-year-old real estate developer, endured surgery, chemotherapy and radiation at two hospitals.
Then his son-in-law discovered online that — for a price — companies were willing to help critically ill Chinese people seek treatment abroad. Soon Mr. Guo was at the Dana-Farber Cancer Institute in Boston, receiving a new immunotherapy drug, Keytruda, which is not available in China. In April, nearly four months later, his tumor has shrunk and his weight has gone up.
“When I arrived, I could feel how large the gap was, ” said Mr. Guo of the difference in care.
The cost: about $220,000 — all paid out of pocket.
China’s nearly 1.4 billion people depend on a strained and struggling health care system that belies the country’s rise as an increasingly wealthy global power. But more and more, the rich are finding a way out.
Western hospitals and a new group of well-connected companies are reaching for well-heeled Chinese patients who need lifesaving treatments unavailable at home. The trend is a twist on the perception of medical tourism as a way to save money, often on noncritical procedures like dental work and face-lifts. For these customers, getting out of China is a matter of life or death.
Medical care is just one manifestation of China’s wide wealth disparity. A new generation of affluent Chinese can seek help at private hospitals or go abroad, even as the rest endure long waits and find their treatment falling short.
Chinese people took an estimated 500,000 outbound medical trips last year, a fivefold increase from a year earlier, according to Ctrip.com International, a Chinese travel booking company, which offers medical travel on its website. While the bulk of that is focused on plastic surgery and routine examinations, medical travel agencies say the number of critically ill Chinese patients leaving the country for medical treatment is growing.
“China is among the countries where we have seen the greatest growth in recent years, ” Dr. Stephanie L. Hines, the chairwoman of executive health and international medicine at the Mayo Clinic, said in an email.
At Massachusetts General Hospital in Boston, employees help patients with travel and lodging. Mass General, Mayo Clinic and Boston Children’s Hospital provide interpreters.
Mr. Guo is one of more than 1,000 patients that one company based in Beijing, Hope Noah Health Company, says it helped last year — a number it says was double that of the year before. Upon arriving in the United States or Japan, the two countries to which Hope Noah sends people, patients are greeted at the airports by Hope Noah employees and whisked off to a rented apartment. When they head to the hospital, a Hope Noah translator is by their side.
As recently as the 1970s, China’s health care system provided cradle-to-grave medical support. But despite a huge health care reform plan, its public hospitals are overburdened, with too few beds and doctors to deliver the kind of care that many in the West take for granted. A 2015 study by The Lancet based on United Nations criteria found that China ranked 92 out of 188 countries, after Cuba and Mexico.
The government has increased spending and encouraged private investors to address the problem. A total of about 4.3 million cancer cases were diagnosed in China in 2015, or almost 12,000 cases a day, compared with 2.4 million in 2010, according to the state-run news media. The five-year survival rate of Chinese cancer patients is around 30 percent, compared with about 70 percent in the United States, according to China’s National Cancer Prevention and Research Center.
Patients often have to travel to Hong Kong and Macau — regions of China governed by their own laws — to buy foreign drugs, which on the mainland face an approval process that takes three to five years. The drug that Mr. Guo is using, Keytruda, was approved for use only last year in a medical tourism pilot zone in the southern Chinese island of Hainan.
In top public hospitals in the top-tier Chinese cities, lines begin forming just after midnight. Appointments for the best doctors are snapped up before dawn. For those who can afford it, tickets can be bought from scalpers hawking appointment numbers. In March, the authorities in Beijing said that they would bar public hospitals from imposing consultation fees on patients, in a bid to reduce public discontent.
By contrast, Mr. Guo said his experience at Dana-Farber was “more humane.” Mr. Guo’s doctor let him speak. There was easy access to food and beverages. The waiting area had a couch.
“In China, the most that we can get is a metal chair, ” he said, speaking by videoconference from his apartment in Boston. “Even having a cup of hot water is inconvenient.”
But the benefits can be fleeting. “The biggest challenge that we’ ve had is ensuring continuity of care when the patient returns back home to China, ” said Misty Hathaway, who leads Mass General’s Center for Specialized Services.
Oscar Zhou, who founded Ryavo Health Management of Shanghai, another medical travel agency, said he had started to shift his business into one that helped clients look for drugs in Hong Kong and Macau as well as doctors who could treat the problem domestically.
“It has caused a lot of problems. Many patients go overseas, and indeed, for several months, it’s good, ” Mr. Zhou said, adding that he thought the outlook for businesses from a pure medical travel standpoint was limited. “But when they return, if their treatment can’ t keep up, then it’s useless.”
Others are more bullish. Cai Qiang — the founder of Beijing Saint Lucia Hospital Management Consulting Company, in which the Silicon Valley venture capital firm Sequoia Capital has invested an undisclosed amount — says his number of clients has increased to about 1,000 last year, from just two in 2011.
Mr. Cai, who is widely considered the pioneer of medical travel in China, is trying to narrow the cultural gap between his Chinese clients and American hospitals.
He recalled how an American hospital called him in for an “emergency meeting” after a Chinese patient walked unannounced into a doctor’s office with a question. The doctor was in the middle of treating someone else.
“In China, we have no concept of privacy, ” Mr. Cai said, adding that his company had since set up a “patient education” department on the “dos” and “don’ ts” in hospitals abroad. “It wasn’ t the patient’s fault. It was ours.”
Mr. Cai said he started the company after being moved by the friendliness of Australia’s doctors and nurses when his daughter was born.
“Every year, there are so many Chinese people who buy imported cars, clothes, cosmetics, ” Mr. Cai said. “They go abroad to travel and send their children to study abroad. Why can’ t a Chinese person consider going overseas to see a doctor if they are seriously ill?”
Last November, Zhao Xiaoqing, 31, a bridge designer in the Chinese city of Nanjing, took her 5-year-old daughter, Kefei, to the Essen University Hospital in Germany to get proton therapy treatment for her child’s brain tumor. The treatment is available in Shanghai only for children 14 and above. She spent about $140,000, more than half of that borrowed from relatives.
Kefei’s tumor shrank. Ms. Zhao, who went to Germany with Ryavo Healthcare, is a satisfied customer, saying she was willing to spend double what she had paid.
“After going abroad, you can see that the middlemen are not exaggerating, ” she said. “In fact, what they’ ve told us pales in comparison to what we’ ve experienced.”
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