Despite the improving quality of treatment options available domestically, more and more wealthy Chinese are opting for medical tourism to treat serious illnesses, signaling an increasingly apparent health crisis in the country.

Perhaps the most dramatic recent example has been the tragic case of the Chinese Nobel Laureate, Liu Xiaobo. The civil rights activist was imprisoned since 2008 but was released on medical parole in June 2017 due to his terminal case of liver cancer. To treat this illness, the Chinese government eventually allowed Liu access to Western doctors, although he later passed.

Many wealthy Chinese are opting to pay large sums out of pocket to travel and gain access to high-quality care. According to Ctrip, in 2016 500,000 Chinese went abroad to receive care as opposed to seeking or continuing care in China.

Ctrip even has an option on its website to book medical travel. Many of these travelers are seeking plastic surgery in South Korea or other Asian destinations; however many others are seeking life-saving, cutting-edge treatments.

The reasons for this are multifaceted. Part of the issue rests with the low quality of many domestic hospitals. The situation for many patients is extremely dire. The five-year survival rate for cancer in the US is 70 percent, but in China it is only 30 percent. For high quality medications, many Chinese simply fly to Hong Kong or Macau.

Still another severe crisis is the lack of technique approval. The wheels of regulatory bodies in China often move slowly. This means that many experimental techniques for cancer and other serious illness are still not available in even the best hospitals.

One potential solution is a $3 billion development project in Hainan, sometimes called “China’s Hawaii” that will bring in cutting-edge treatments from abroad and make them domestically available for China’s wealthy.

Generally speaking, the solution for avoiding poor care by those with enough means is to travel abroad. Many sick Chinese citizens travel to Hong Kong or Macau to buy higher quality pharmaceuticals. However, for more serious diseases, long-term, high-quality treatment is a necessity.

The New York Times reported that some American hospitals were upping their efforts to accommodate Chinese medical tourists with lodging or interpreting services. Many Chinese companies also charge fees to help connect wealthy patients with hospitals in the US to the care they desperately need.

Of course, this trend is not limited to China’s wealthy. The continuing health crisis in China affects China’s poor the hardest. Violence against doctors and medical staff is relatively commonplace because of disenfranchised seekers of treatment, often coming from away to seek treatment unavailable in rural locales, only to face a kafkaesque bureaucratic run-around that can last days or weeks and end up more costly than expected.

It’s because of such resentment that Chinese hospitals often have armed guards, and there have been high profile assaults and even murder cases. The situation has often been described as a breakdown in the doctor-patient relationship.

For poor Chinese citizens, travel to Australia, the United States, or Britain is simply out of the question. However, many residents of third and fourth-tier cities, many of which lack the kind of hospital infrastructure and medical expertise considered standard in developed countries, are traveling to India to seek treatment for diseases like cancer and liver disease. This has led to new medical tourism agencies for helping Chinese citizens travel to India for cheaper, higher-quality care.

This illustrates that there is a market for facilitating easy and high quality treatment. Countries in the region could certainly attract more medical tourism through Chinese language outreach and facilitating life abroad for an extended period of time. However, it also illustrates how serious the health crisis in China is becoming and in the long-term such options will not help the majority of Chinese unable to pay such high costs out of pocket.

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