中国富人出国求医，顺便接受患者教育 | 双语
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.
北京——中国的医疗系统无法阻止癌症侵蚀郭先生的胃。在这名现年63岁的房地产开发商辗转两家医院，经受了手术、化疗和放疗之后，癌细胞卷土重来。
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.
他的女婿随即在网上发现，一些公司愿意——以不菲的价格——帮助身患重病的中国患者去海外求医。很快，郭先生到了波士顿的丹娜法伯癌症研究院(Dana-Farber Cancer Institute)，得以使用一种在中国找不到的免疫疗法新药——吉舒达(Keytruda)。将近四个月后，也就是今年四月，他的肿瘤缩小了，体重也增加了。
“When I arrived, I could feel how large the gap was,” said Mr. Guo of the difference in care.
“来的时候，感觉差距是非常大，非常大，”郭先生谈及医疗方面的差异时说。
The cost: about $220,000 — all paid out of pocket.
花费约为22万美元——全要自掏腰包。
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.
中国已经崛起为一个日益富裕的大国，将近14亿中国人所依靠的却是一个不堪重负、勉强维持的医疗体系，这让其崛起黯然失色。但渐渐地，富人们找到了一条出路。
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.
西方医院以及新涌现的一批掌握丰富资源的公司，正向一些中国富人伸出橄榄枝，他们需要接受国内医疗机构无法提供的治疗，以保住性命。此种趋势让为了省钱而进行医疗旅行——通常是做些并非危重的处理，比如看牙或整容——的看法发生了转变。
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.
医疗问题只是中国巨大贫富差距的一个缩影。新一代富有的中国人可以到私立医院或国外寻求帮助，其他人却不得不忍受漫长的等候，而且无法得到应有的治疗。
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.
根据业务范围涵盖医疗旅行预订的中国旅游预订公司携程旅行网的数据，去年，中国人出国看病的总数为50万人次左右。一些医疗旅行中介称，其中大多数旅行都聚焦于整形手术和常规检查，但出国求医的危重病人数量正在增长。
“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.
“据我们所见，来自中国的患者是人数增长最快的群体之一，”梅奥诊所(Mayo Clinic)高管健康保障项目和国际医药部门负责人斯蒂芬妮·L·海恩斯(Stephanie L. Hines)在电子邮件中表示。
At Massachusetts General Hospital in Boston, employees help patients with travel and lodging. Mass General, Mayo Clinic and Boston Children’s Hospital provide interpreters.
在波士顿的麻省总医院(Massachusetts General Hospital)，有雇员为患者提供旅行和住宿方面的帮助。麻省总医院、梅奥诊所和波士顿儿童医院(Boston Children’s Hospital)均提供翻译。
患癌症赴美求医的中国公民郭树石（音），在波士顿的一套公寓内，治疗期间他一直住在那里。Tony Luong for The New York Times
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.
北京的一家名为厚朴方舟的公司称，它去年帮助过1000余名患者——它说这个数字比前一年多了一倍——郭先生是其中之一。厚朴方舟会把病人送到美国或日本，病人一抵达这两个国家，该公司的雇员便会在机场迎接，并将其送到一套租来的公寓里。病人去医院时，厚朴方舟的一名翻译会随侍左右。
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.
近至1970年代，中国的医疗体系还提供着从摇篮到坟墓的医疗支持。尽管该国实施了一个庞大的医疗改革计划，但其公立医院目前依然不堪重负，床位和医生都太少，难以提供被很多西方人视为理所当然的那种医疗服务。《柳叶刀》(The Lancet)在2015年按照联合国相关标准开展的一项研究显示，以居民健康状况论，中国在188个国家里排名第92位，名次低于古巴和墨西哥。
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.
为了解决这一问题，中国政府正增加投入，并鼓励私人投资者参与其中。据官方媒体报道，2015年，中国共有430万人被确诊罹患癌症，也就是说，每天确诊约1.2万例，相比之下，2010年的数字是240万人。根据中国国家癌症中心的数据，中国癌症病人的五年存活率约为30%，而美国的这一数字是70%左右。
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.
患者常常不得不到香港和澳门——即适用它们自己的法律的两个中国地区——购买外国药物，在内地，那些药物要等三至五年才能走完准入程序。郭先生正在使用的药物吉舒达，直到去年才获批在海南岛的一个医疗旅游试点区使用。
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.
在中国一线城市的顶级公立医院里，午夜刚过就有人排队。顶尖医生的预约号在清晨之前便被会抢夺一空。有经济能力的人可以从黄牛处买预约号。北京当局今年三月称，将禁止公立医院收取诊疗费，试图以此缓解公众的不满情绪。
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.
相比之下，郭先生在丹娜法伯癌症研究院的体验“更为人性化”。郭先生的医生让他充分表达想法。食物和饮料易于获取。等候区设有长椅。
“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.”
“中国，我们最多是一个铁椅子，”他在位于波士顿的公寓里参加视频会议时说。“连喝个热水都很不方便。”
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.
但患者可能无法长久享有这些好处。“我们面临的最大挑战，就是在病人回到中国以后确保治疗的连续性，”麻省总医院特殊服务部(Specialized Services)负责人米斯蒂·海瑟薇(Misty Hathaway)说。
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.
另一家医疗中介——瑞弗健康管理（上海）有限公司的创始人周继昭(Oscar Zhou)说，他已经开始推动自己的公司转型，致力于帮助客户在香港和澳门搜罗药物，并找寻可以在国内治病的医生。
31岁的桥梁设计师赵笑晴（音）在其位于南京的办公室里。她曾把五岁的女儿带到德国，让其接受质子治疗。Patrick Wack for The New York Times
“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.”
“所以就是导致很多问题，很多患者去海外了，确确实实在了一两个月内，两三个月内还算不错，但是回来了以后，其他的治疗如果跟不上，一点用没有。”周继昭说道。他还表示，从纯医疗旅游的角度看，有些企业的前景颇为有限。
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.
其他一些人则更为乐观。北京盛诺一家医院管理有限公司的创始人蔡强说，其客户数量已经从2011年的区区两人增至去年的约1000人。盛诺一家拿到了硅谷风投公司红杉资本(Sequoia Capital)的投资，但具体金额不详。
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.
蔡强被普遍视作中国医疗旅游领域的先驱，正设法缩小他的中国客户和美国医院之间的文化鸿沟。
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.
他回忆了一名中国患者在一家美国医院就医时，未经通报便走进医生的办公室问问题之后，医院电召他开“紧急会议”的情形。那位医生当时正为别的病人看病。
“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.”
“所以中国没有隐私的概念，”蔡强说。他还表示，自那以后盛诺一家就设立了一个“患者教育”部，告诉患者在海外的医院里该做什么、不该做什么。“实际上不是患者的问题，是我们的问题。”
Mr. Cai said he started the company after being moved by the friendliness of Australia’s doctors and nurses when his daughter was born.
蔡强说，他在女儿出生之际因澳大利亚医护人员的热情友好而受到触动，随后便创办了这家公司。
“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?”
“每年那么多中国人去买进口的车，进口的时装，进口的化妆品，”蔡强说。“所以我就在想，为什么中国的客户，当他有了病的时候，当他有了重病的时候，他不可以考虑到国外去看病呢？”
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.
住在南京、现年31岁的桥梁设计师赵小晴，去年曾带着患有脑瘤的五岁女儿菲菲，到德国的埃森大学医院(Essen University Hospital)接受质子治疗。在上海，这种疗法只面向14岁及以上的孩子。她花了大约14万美元，超过一半都是从亲戚那里借来的。
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.
菲菲的肿瘤缩小了。赵小晴是在瑞弗健康的安排下赴德的，对其服务很满意，她说花费即便再多一倍她也愿意。
“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.”
“去过以后你就觉得其实中介没有夸张，”她说。“它甚至说的还没有我们体验的好。”
作者：黄瑞黎(Sui-Lee Wee)
黄瑞黎(Sui-Lee Wee)是《纽约时报》驻京记者。
Zhang Tiantian对本文有研究贡献。
翻译：纽约时报中文网
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