The Occasional Random Consideration - 5/1/19

Periodic thoughts that percolate forward while traveling about the world…

I’ve just returned from whirlwind visit to five cities in China – Xi’an, Zhuhai, Changsha, Beijing and Shenyang. Before I share some thought about health care in the context of the US-China relationship, I wanted to share a couple of observations: 

  1. The People – If you have the resources, you need to visit China. It is a wonderful country with even more wonderful people.  Unlike the uniformity of presentation and perspective that I originally experienced in 1978, there is massive diversity among the people. When you get them alone you learn about the very diverse thoughts they have which are creating an environment of intellectual diversity. It is evident by the adornment they wear which consists of multiple, bright colors (sometimes with matching hair color) and a variety of T-shirt statements that adorn their outerwear. I won’t repeat those T-shirt statements here. In fact, I’m not sure the Chinese actually know what their English statements on the front & back of their T-shirts are actually saying. Regardless – they are wonderful people. They are open. They are inquisitive.  They (the people) seem to love Americans…
  2. Air Pollution – Unfortunately, it seems that the presence of severe air pollution has become the new normal. Even with rain, the air did not clear in Xi’an.  It’s because of the reliance upon coal and wood-burning sources for heating and cooking.  There is a big national campaign to move toward less polluting resources but the latest report revealed that 337 cities in China had worse pollution this year than in 2018.  Not a good turn of events. When we think of global warming, we need to think international collaboration.
  3. Construction Everywhere – Oh, to be an architect in China at this time in history! The skyline of China in all of the major cities is adorned with high rises that challenge the traditional framework. While there are many, many (shall I say “many” again) high rises that are simple replications for housing – I mean row after row of 20 – 30 story buildings – the unique buildings are the ones that capture your attention.  There are a massive number of iconic buildings that are either under construction or already completed.  In fact, it is hard to take a picture of the skyline in any city without capturing at least a few construction cranes on the horizon.  They have become the national bird.
  4. Economic Development – The economy is clearly booming in China. In the US, we think of the Chinese taking over the manufacturing of all manner of goods.  And, in fact, they have done that in many instances because of their lower labor costs.  However, the “service” industry is the fastest growing component of the Chinese economy. Chinese manufacturing is moving from China to places with less costly production costs like Thailand, Bangladesh, Sri Lanka, major portions of Africa and other places in the world. So, the march of economic development continues its relentless pace.  It is a lesson for us, however.  We clearly need to redouble our efforts at investment in educating our work force for the next generation of economic development.  It will not be in repetitive manufacturing of widgets, vehicles or other similar products.  So, the question for the US is: what and how we deliver a work force prepared for the new economy.  From my perspective, too little debate and discussion has been held on this very important issue.
  5. The Cost of Living – We were told by our guides that the cost of housing in central Beijing is running about $15,000 a square meter. So, a 200 square meter apartment/condominium would run about $3M. It was clearly outside the range of our guides and the average Chinese resident.  The phenomenon is not just a central Beijing issue either.  So, inflationary concerns are top of mind for most Chinese.

Back in 1983, I applied for a Kellogg National Fellowship and was lucky enough to receive one of those coveted Fellowship experiences.  In my application, I noted that I wanted to study Chinese culture and language because I felt that “China will be the next great nation and the nation of the next century.” It’s becoming true.  I would encourage everyone to consider how we can embrace China rather than castigate it as a country.  There is much we can learn from one another.  The challenge for both sides will be in embracing a strategy of mutual respect, cooperation and collaboration. 

Finally, you might ask: Kevin, what’s this got to do with health care?  Everything!!  I believe we are moving toward a much smaller world where interaction, cooperation, collaboration, coopetition, co-learning are becoming the norm.  To survive in such a world means that rather than castigating countries and working to dismantle their efforts, we should be embracing those nations as learned relatives who over time become a part of us.  As the singular most diverse and accepting (even though it does not seem like it at times) country in the world, we have an opportunity to embrace such nations as partners in progress.  We need that because health care is going to continue absorbing more and more costs – despite our best efforts to control costs – due to the aging of our population. This is not just a US issue. It’s an EU issue.  It’s a China issue.  By working together; however, we can solve the problem.  The health care forum can actually serve as the petri dish for multi-national collaboration and development.  Economic development and sustenance is on the periphery of health care but, it’s central to health care.  Think about it…

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