What makes China compelling? Sure, it’s a huge and largely untapped market. But what I’ve always found most compelling about China is its potential to leapfrog the status quo and create something new, to unwittingly break paradigms if for no other reason than not knowing how it approaches a problem isn’t the conventional way to solve the problem. As just two examples, look at China’s telecommunications and electrical distribution and control infrastructures. Both have their flaws (the latter in particular as any factory owner in Shenzhen will be happy to tell you), but each illustrates how China can take the way something is currently done and spin it on its head.
Telecomm is a great example of this: China never bothered to build the hardline infrastructure which America and Europe both have. Rather, China made massive investments in its mobile infrastructure, a difference between our two countries’ respective technology capabilities that Tom Friedman recently poked fun at. Let me suggest that one other example where China is going to break old (and create new) paradigms is in healthcare. Specifically, in the role, home healthcare could play addressing China’s expansive problems with healthcare access and inequality to what little services do exist.
Lua’s recent blog post on the JP Morgan “Hands-On China” report covering China’s investment in healthcare has left my mind churning. The numbers from the report are staggering: 29,000 township hospitals, upgrades to another 5,000. Even if these investments happen as planned, and even if they are managed successfully (keeping in mind China’s track record of building versus managing new infrastructure needs to be kept on two distinctly different tracks), the question remains whether all this new capacity will actually help? Or, to say it another way, if China chooses to simply replicate the model for healthcare delivery that has worked in western developed economies, is it missing the transformative opportunity to dismantle the hospital–centric model for delivering healthcare?
Let me be more specific: one of the most powerful trends in American healthcare is the de–emphasis on the role of the hospital as the centralized location for patient treatment and the emphasis on decentralized home healthcare. The CDC’s most recent report on the topic showed that in 2007 1.5 million people were treated at home in the United States with an average treatment period of 315 days. An Ohio State study on the question pegs a much higher number, suggesting that over 12 million people in the United States will be under some sort of home healthcare in a given year.
Several trends have facilitated the expansion of home healthcare in the American market: financial rationalization has created visibility on the enormous savings made possible by getting patients out of the hospital back into their home, technology has empowered home delivery of nursing and – in particularly advanced organizations – doctor care, and business model changes (doctors going from being independent businesses to employees) has enabled centralized healthcare providers to disrupt the model of delivery for healthcare even in the entrenched and traditionally hierarchical American market.
If this has worked in the United States, then let me suggest it might work even more so in China. Again, even if China builds the before–mentioned 29,000 township hospitals, guess what; it still won’t be enough. Massive inequalities in terms of access to hospital care will still exist. The more interesting question is whether China can embrace (or get out of the way of entrepreneurs who can facilitate) entirely new models of healthcare delivery. The technologies and service models that would best facilitate these new models would be those that could be most easily adopted in China.
