海外醫(yī)院和新興的醫(yī)療旅行公司，正在招引有錢的中國病人離開不堪重負(fù)的中國醫(yī)療系統(tǒng)?！都~約時(shí)報(bào)》2017.5.29

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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.

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北京——中國的醫(yī)療系統(tǒng)無法阻止癌癥侵蝕郭淑師的胃。在這名現(xiàn)年63歲的房地產(chǎn)開發(fā)商輾轉(zhuǎn)兩家醫(yī)院，經(jīng)受了手術(shù)、化療和放療之后，癌細(xì)胞卷土重來。

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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.

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他的女婿隨即在網(wǎng)上發(fā)現(xiàn)，一些公司愿意——以不菲的價(jià)格——幫助身患重病的中國患者去海外求醫(yī)。很快，郭淑師到了波士頓的丹娜-法伯癌癥研究院(Dana-Farber Cancer Institute)，得以使用一種在中國找不到的免疫治療方法方法新藥——吉舒達(dá)(Keytruda)。將近四個(gè)月后，也就是今年四月，他的腫瘤縮小了，體重也增加了。

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“When I arrived, I could feel how large the gap was,” said Mr. Guo of the difference in care.

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“來的時(shí)候，感覺差距是非常大，非常大，”郭淑師談及醫(yī)療方面的差異時(shí)說。

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The cost: about $220,000 — all paid out of pocket.

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花費(fèi)約為22萬美元——全要自掏腰包。

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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.

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中國已經(jīng)崛起為一個(gè)日益富裕的大國，將近14億中國人所依靠的卻是一個(gè)不堪重負(fù)、勉強(qiáng)維持的醫(yī)療體系，這讓其崛起黯然失色。但漸漸地，富人們找到了一條出路。

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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.

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西方醫(yī)院以及新涌現(xiàn)的一批掌握豐富資源的公司，正向一些中國富人伸出橄欖枝，他們需要接受國內(nèi)醫(yī)療機(jī)構(gòu)無法提供的治療，以保住性命。此種趨勢讓為了省錢而進(jìn)行醫(yī)療旅行——通常是做些并非危重的處理，比如看牙或整容——的看法發(fā)生了轉(zhuǎn)變。

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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.

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醫(yī)療問題只是中國巨大貧富差距的一個(gè)縮影。新一代富有的中國人可以到私立醫(yī)院或國外尋求幫助，其他人卻不得不忍受漫長的等候，而且無法得到應(yīng)有的治療。

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Chinese people took an estimated 500,000 outbound medical trips last year, a fivefold increase from a year earlier, according to Ctrip.com International. 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.

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根據(jù)攜程旅行網(wǎng)的數(shù)據(jù)，去年，中國人出國看病的總數(shù)為50萬人次左右。一些醫(yī)療旅行中介稱，其中大多數(shù)旅行都聚焦于整形手術(shù)和常規(guī)檢查，但出國求醫(yī)的危重病人數(shù)量正在增長。

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“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 ME, said in an email.

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“據(jù)我們所見，來自中國的患者是人數(shù)增長較快的群體之一，”美國權(quán)威M醫(yī)院(ME)高管健康保障項(xiàng)目和國際醫(yī)藥部門負(fù)責(zé)人斯蒂芬妮·L·海恩斯(Stephanie L. Hines)在電子郵件中表示。

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At Massachusetts General Hospital in Boston, employees help patients with travel and lodging. Mass General, ME and Boston Children’s Hospital provide interpreters.

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在波士頓的麻省總醫(yī)院(Massachusetts General Hospital)，有雇員為患者提供旅行和住宿方面的幫助。麻省總醫(yī)院、美國權(quán)威M醫(yī)院和波士頓兒童醫(yī)院(Boston Children’s Hospital)均提供翻譯。

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△患癌癥赴美求醫(yī)的中國公民郭淑師，在厚樸方舟波士頓的一套公寓內(nèi)，治療期間他一直住在那里。（托尼·盧對 紐約時(shí)報(bào)）

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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.

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北京的一家名為厚樸方舟的公司稱，它去年幫助過1000余名患者——它說這個(gè)數(shù)字比前一年多了一倍——郭淑師是其中之一。厚樸方舟會把病人送到美國或日本，病人一抵達(dá)這兩個(gè)國家，該公司的雇員便會在機(jī)場迎接，并將其送到一套租來的公寓里。病人去醫(yī)院時(shí)，厚樸方舟的一名翻譯會隨侍左右。

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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.

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近至1970年代，中國的醫(yī)療體系還提供著從搖籃到墳?zāi)沟尼t(yī)療支持。盡管該國實(shí)施了一個(gè)龐大的醫(yī)療改革計(jì)劃，但其公立醫(yī)院目前依然不堪重負(fù)，床位和醫(yī)生都太少，難以提供被很多西方人視為理所當(dāng)然的那種醫(yī)療服務(wù)?！读~刀》(The Lancet)在2015年按照聯(lián)合國相關(guān)標(biāo)準(zhǔn)開展的一項(xiàng)研究顯示，以居民健康狀況論，中國在188個(gè)國家里排名第92位，名次低于古巴和墨西哥。

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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.

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為了解決這一問題，中國政府正增加投入，并鼓勵(lì)私人投資者參與其中。據(jù)官方媒體報(bào)道，2015年，中國共有430萬人被確診罹患癌癥，也就是說，每天確診約1.2萬例，相比之下，2010年的數(shù)字是240萬人。根據(jù)中國國家癌癥中心的數(shù)據(jù)，中國癌癥病人的五年生存率約為30%，而美國的這一數(shù)字是70%左右。

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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.

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患者常常不得不到香港和澳門——即適用它們自己的法律的兩個(gè)中國地區(qū)——購買外國藥物，在內(nèi)地，那些藥物要等三至五年才能走完準(zhǔn)入程序。郭淑師正在使用的藥物吉舒達(dá)，直到去年才獲批在海南島的一個(gè)醫(yī)療旅游試點(diǎn)區(qū)使用。

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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.

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在中國一線城市的值得信賴的公立醫(yī)院里，午夜剛過就有人排隊(duì)。權(quán)威醫(yī)生的預(yù)約號在清晨之前便被會搶奪一空。有經(jīng)濟(jì)能力的人可以從黃牛處買預(yù)約號。北京當(dāng)局今年三月稱，將禁止公立醫(yī)院收取診療費(fèi)，試圖以此緩解公眾的不滿情緒。

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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.

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相比之下，郭淑師在丹娜-法伯癌癥研究院的體驗(yàn)“更為人性化”。郭淑師的醫(yī)生讓他充分表達(dá)想法。食物和飲料易于獲取。等候區(qū)設(shè)有長椅。

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“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.”

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“中國，我們較多是一個(gè)鐵椅子，”他在位于波士頓的公寓里參加視頻會議時(shí)說?！斑B喝個(gè)熱水都很不方便?！?/span>

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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.

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但患者可能無法長久享有這些好處?！拔覀兠媾R的大挑戰(zhàn)，就是在病人回到中國以后確保治療的連續(xù)性，”麻省總醫(yī)院特殊服務(wù)部(Specialized Services)負(fù)責(zé)人米斯蒂·海瑟薇(Misty Hathaway)說。

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△31歲的趙曉青，在南京的辦公室。她把她5歲的女兒帶到德國進(jìn)行質(zhì)子治療。?（紐約時(shí)報(bào)Patrick Wack）

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It has caused a lot of problems. Many patients go overseas, and indeed, for several months, it’s good。But when they return, if their treatment can’t keep up, then it’s useless.”

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所以就是導(dǎo)致很多問題，很多患者去海外了，確確實(shí)實(shí)在了一兩個(gè)月內(nèi)，兩三個(gè)月內(nèi)還算不錯(cuò)，但是回來了以后，其他的治療如果跟不上，一點(diǎn)用沒有。

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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.

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住在南京、現(xiàn)年31歲的橋梁設(shè)計(jì)師趙小晴，去年曾帶著患有腦瘤的五歲女兒菲菲，到德國的埃森大學(xué)醫(yī)院(Essen University Hospital)接受質(zhì)子治療。在上海，這種治療方法只面向14歲及以上的孩子。她花了大約14萬美元，超過一半都是從親戚那里借來的。

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Kefei’s tumor shrank. Ms. Zhao said she was willing to spend double what she had paid.

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菲菲的腫瘤縮小了。趙小晴說，即便讓她花費(fèi)多一倍的錢她也愿意。

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“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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“去過以后你就覺得其實(shí)中介沒有夸張，”她說。“它甚至說的還沒有我們體驗(yàn)的好。”

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原題：China’s Ill, and Wealthy, Look Abroad for Medical Treatment

作者：黃瑞黎(Sui-Lee Wee)

厚樸方舟2012年進(jìn)入海外醫(yī)療領(lǐng)域，總部位于北京，建立了由全球權(quán)威醫(yī)學(xué)專家組成的美日名醫(yī)集團(tuán)，初個(gè)擁有日本政府官方頒發(fā)的海外醫(yī)療資格的企業(yè)。如果您有海外就醫(yī)的需要，請撥打免費(fèi)熱線400-086-8008進(jìn)行咨詢！

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