Chinese visitors may revive focus on medical tourism

Accelerating numbers of Chinese visitors to the islands represent a refreshed and unprecedented opportunity for health tourism. Several years ago, on contract with the Hawaii Tourism Authority, Global Advisory Services, a consulting firm I head, worked with the health care and hospitality industries and developed a business plan: "Healing in Paradise: A Strategy for Cultivating Health and Wellness Tourism in Hawaii." The consensus was that success depends on gaining an intimate understanding of the unique intentions of our visitors. Chinese visitors will come to party, to relax and to enjoy the sun and surf. They will also seek health care, housing and education for their children.

Previous attempts at formal medical tourism on Oahu were unsuccessful. They focused on modern medicine and executive wellness, targeting visitors from Japan. Hawaii is too expensive to compete with Thailand, Malaysia and India for discounted modern services such as dental implants, plastic surgery or elective joint replacements. Hawaii also has difficulty competing with world-renowned brands on the mainland such as Mayo Clinic or Cleveland Clinic for rare or complicated conditions.

Unique conditions at home: The upswing of Chinese visitors, however, has a different landscape. In China pollution of the air, water and food is untenable, the economic environment uncertain, the rule of law still questionable and the social milieu burdensome, while the educational system struggles to foster the creative spirit instead of rote learning. In addition, the quality of health care is perceived by the mainland Chinese as unreliable. There are mounting concerns regarding the quality of medical education, the small amount of time spent during clinic visits and trustworthiness of pharmaceuticals manufactured in China. Chinese also worry that they might not have access to the most advanced, innovative medical technology.

In contrast, Hawaii offers a pristine, attractive environment, excellent weather, a welcoming, multicultural society, myriad educational opportunities and quality health care.

In 2014 three carriers will offer 11 nonstop flights between China and Hawaii: China Eastern, which flies from Shanghai, will now offer three flights per week, while Air China and Hawaiian Airlines each plans to offer three flights per week from Beijing. As such, airlift directly from China is expected to rise to more than 120,000 seats in 2014, a 181 percent increase over 2013, according to the Hawaii Tourism Authority. Additional indirect arrivals are projected to bring the number of Chinese visitors to approximately 150,000, with a spending goal of $358 million, a 39 percent increase over 2012.

In 2014 more Asian investors will come to search for a broad range of opportunities in Hawaii. The desire to reside in a secure, sustainable, socially dynamic yet comfortable haven is of universal value. They will seek luxury homes, modern health care and quality schools for their children.

Luxury homes: Our new visitors have high standards for luxury housing where they will be able benefit from a long and enjoyable retirement. Intelligent design and sophisticated home automation with the flexibility to accommodate a multigenerational family will be of distinct interest. Safety is also essential not only for children, but also for those who wish to age in place. Intelligent design and cutting-edge technology will be used to empower both.

Health care: Chinese visitors to Hawaii will seek to balance their stressful and toxic lifestyle at home. They will come to relax, but many will want to detox from environmental poisons, check on their hormone levels and figure out why they can’t sleep and manage their pain. "Whether or not it’s empirically true, the U.S. brand of medicine is still perceived as being the most advanced health system," according to a McKinsey & Co. report.

Education: A major challenge in modern education, especially in Asia, is that students spend long hours in school followed by afternoon and weekend "cram" programs. The result may be top grades and high marks on standardized exams, but when candidates are interviewed for university, they all give the same predictable answers to questions. Many parents will seek institutions that foster creativity and cooperation in schools that nourish the entire developing being. Learning English, exposure to American culture and "guan-xi" (developing connections) are also at a premium.

Green cards: They will also need green cards. The current crossroads is reminiscent of the run-up to the handover of Hong Kong in 1997 when the pre-emptive emigration of Hong Kong residents to Canada alone brought with it $4.2 billion of investment. The EB-5 Immigrant Investor Visa Program offered by the United States is a vehicle for foreign investors to secure green cards. More Hawaii companies will want to become an instrument for this coveted opportunity.

From the time of the first Hawaiians, each wave of visitors came to forge their own relationship to the islands. The mainland Chinese who fly to Hawaii in 2014 will come for tourism. They will also look to make business investments, improve their health, buy homes and secure the future for their children.

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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.