 Good afternoon. This is Ray Tsuchiyama of Think Tech Asia. And we're here with another show focusing on a topic that is increasingly important in tourism. It's called medical tourism for people who go abroad, outside of their cities, to another place to get a medical or dental procedure and still have money left over for a vacation. That's very simple. And we're going to be focusing more on the potential for medical tourism from China to Hawaii. And right now, there's about 9 million annual visitors to Hawaii and how to grow that number with medical tourism. But it's not that simple. There are other places that have been doing that for a longer period, like in Bangkok, Singapore, or even in the United States, Mayo Clinic, Virginia Mason, in Seattle. How can Hawaii prepare for the surge for the potential of medical tourism? And here with us today from Beijing, we have Russell Liu, who will be introducing our guest, who will be joining us and really giving us insights into how can Hawaii become a player in international global medical tourism. Russell, where are you in Beijing right now? Well, good morning to all of our visitors out around the world and in Hawaii. I'm Russell Liu. I'm the co-host on today's show. And we are live in Beijing. We're outside the fourth ring road in Beijing. It's a very warm day. It's a 90-degree temperature. But today, we were fortunate to share with our audience our guest, Sunny John. Sunny is the CEO of NITRIPS, a US company, a point company. And we're going to talk about China's outbound medical tourism rapidly and otherwise. We're going to talk about how big is this China outbound medical tourism potential. We're going to talk about who is going outbound, what kind of medical treatment they saw, where are the Chinese going, and why are they going. And we're going to look at how big this market is. And is anybody doing anything about it in Hawaii? And Sunny John is going to give us a lot of insight today. So to my right is Mr. Sunny John. Hey, morning. My name is Sunny John. I'm the CEO of METRIPS. I'm happy to be here to share some of my thoughts on this market, because this is the market I'm working on for two years. And also, METRIPS is a Hawaiian-born company. I would love to do something for Hawaii to bring more traffic to Hawaii, especially in the medical end. So, Sunny, let's look at this industry that's China's outbound medical tourism now rapidly in their lives. And number show 2016, we had about half a million people who were in a Chinese medical travels on outbound. And globally, they spent $551 billion of which only 1.8% was spent in the US, which amounts to $10 billion. And the annual growth would be 31%. Can you tell us what by 2020, what's the forecast? Enough of this number. I actually have different numbers than this survey. But based on this number, based on my market conception, the spending to US would be much larger, because only one company that I know can bring like 1,000 patients to the top institutions like MD Anderson, Mayo Clinic, and Stanford do so long. So it should be larger. But this is not my point. My point is the market is large enough for Hawaii to be one of the participants in the market. And I also want to discuss more about how we can improve in terms of position in Hawaii as a favorite destination for medical tourism. So Sani, can you tell me, why did you form Medtrips? And tell us, what kind of service do you provide for medical tourism? OK, a little bit of background myself. I've been working for Bank of Hawaii's International Banking for several years before. And before that, I was a practicing dentist in China, in Beijing. So given my background of a medical background, my financial background, I find out during my stay in Hawaii, a lot of friends come to me to ask about the opinion on how to make appointment with the top hospitals in US and how they can find the top doctors in US. So I see that there is an increase in demands on the middle class of Chinese to seek opinions, not only second opinion, not medical opinions, from the top institutions in US. And then I'm thinking, I have another partner from a major medical insurance company, EUS. So we find out there is a unique opportunity for us to utilize insurance platform to provide a platform solution for the Chinese patient who seek overseas medical treatment. So basically, our products in the service, including we have hospital networks in US. It covers 90% of the hospital's nationwide, including the 50 states in the United States. We have about 75,000 pharmacies, colleges nationwide in the United States, including watering, CVS, and warm-up of those pharmaceutical stores. And also, we have a telemedicine setup for people who cannot go to US for their medical treatment. They can use the newly technologies to see doctors in China through a telemedicine platform to seek second opinions and to seek medical consultation services. So basically, this is our service. So let's show you what I'm saying about who your technical client is. It seems like it's a platform where you're working with insurance companies. Yes. And it seems like the kind of services will depend, perhaps, on the market segment. So I understand from a scale of 1 to 10, the 10 being the most wealthy. Where does your client get in on the scale? You know, one thing is for sure. For overseas treatment, it's not only for super-rich. But the US market, because of the medical charges, is considered very high compared with China one. I think the middle class above, most of them, they have the capability, financial capability, to seek medical treatment options in Hawaii. And the typical EUS, I'm sorry, and the typical clientele of mine, my group, is middle class above. Maybe from 7, 8, all the way to 10. So you know, the middle class in China is in the major cities in Beijing, Guangzhou, Xinjiang. Those cities on the middle class, their spending power is huge. What's interesting is industry reports say that a lot of the outbound tourists from China, medical tourists, are super-wealthy that come to the US. Now, that was like 1.8% that in 2016 of all global Chinese jobs, 1.8% went to the US. And it seems that these were for very essential treatment, much more sophisticated cardiovascular cancer treatment. Yes, yes. Because the US has the top health care institution, has the world class top doctors, has world class research centers. We have the different clinical trials for the new jobs coming out. So based on this, a lot of cancer patients in China, they know the difference. I'm not saying the doctors here is not good enough. It's just for the new drugs. They don't have access to the new drugs. The new treatment matter. And right now, the pharmaceutical industry is involving so fast, so quickly. So the patients that's seeking the new medicines. That's really interesting talk, because I've been a lawyer in China for 14 years. And to get regulatory approval for drugs is very expensive, very time consuming. Yeah, you may not get approval. So it's very interesting, because now, if you work with insurance companies, you work with drug companies, latest drugs, you don't have to go offshore to China. You can still do the US. So that's an attractive point from many Chinese patients. We'll get access to medical drugs. So that's a sweet spot. But you will get a wider reach, not only for students, but also the men class. Yes. That's a very interesting point, because China has the largest cancer patients. I mean, annually, there are like 4 million newly detected cancer patients each year. And another scary number is the five-year survival rate in China for cancer patients is only 30%. And the same category in US is 66% of the survival rate. So that difference drive the people from China to US to seek a better option. That's a very good point for our audience. If you don't know China, a few years ago, they've had a ban on smoking in public places. The culture has changed after the Olympics, less and less people are smoking. But there's a large segment of population that have been exposed to smoking and cancer. So this is the group that are now seeking medical treatment. We can return to that huge topic of patients and treatments right after this break. We're in think tech Asia. We all play a role in keeping our community safe. Every day, we move in and out of each other's busy lives. It's easy to take for granted all the little moments that make up our every day. Some are good, others not so much. But that's life. It's when something doesn't seem quite right. That it's time to pay attention. Because only you know what's not supposed to be in your every day. So protect your every day. If you see something suspicious, say something to local authorities. We are back discussing this very interesting field of medical tourism. There is Russell Liu and Sunny Zhang back in Beijing, which will be really a foundation for further discussions. This is not a small topic, a very large topic. And one that will involve, of course, hospitals with people and, of course, tourism and the industry here in Hawaii. But first, we were discussing how to make people aware of such a topic called medical tourism exists for people in Hawaii. And how to make them consider this as part of their marketing, branding, and infrastructure. Go ahead, Russell. We're back here with Sunny Zhang, Brian Beijing. And we're going to talk about what we can do to wrap up medical tourism. Let's look at the numbers again. In 2016, Chinese medical travelers spent $6.3 billion in treatment, plus another $3.4 billion of related travel accommodation, making it a $10 billion business. Of this $10 billion, where are the Chinese currently going to spend dollars for treatment in the US? Why not Hawaii? And we're going to talk about how much of this can Hawaii realistically attract in this industry? Yeah, you know, for this $10 billion, I think what Hawaii doesn't have is the top health care institution. I mean, the top means, I know pre-sense shop are all top hospitals in Hawaii. But nationwide, we don't have a brand name like a Mayo Clinic. We don't have a brand name like a Massachusetts General Hospital, MD Anderson, UC, LA, and Central, those big names on market. So we cannot compete them from their back end. But I'm not saying we cannot compete totally because pre-sense has MD Anderson logos on their cancer centers. And also, I know job has a Seattle Cancer Care Alliance logos on their affiliate type of hospitals. But the patients, they're spending behaviors for Chinese. They want to see the best doctor. They want to go to the best hospital for the particular, like an essential treatment options. But in terms of Hawaii's unique type of advantage, we have to be realistic. We have to find out what Hawaii can offer. What's our competitive advantage, we can check more Chinese in. So for that, and we, as a company, match it, we're working with not only shop and pre-sense to develop what we call executive checkout program. So we're focusing on cancer screening services for the executives, for the rich, well-seeing Chinese population. So for Hawaii, definitely we're targeting those nine or 10, not seven or 18. They don't stand in Hawaii for medical reason, for the middle class. For people who choose Queens or Strat to do their medical, to do their executive checkout, has to be supervised. Because giving a cost of our hotel costs, logistic costs, and everything put together, the price tag is huge. So in that market, we also need to compete with a lot of popular destinations. Japan is one of them. The reason why Japan is so popular for executive checkout program, not only did they develop the program for so long, for now, it's more than 10 years in China. The other reason is their charge is considerably low. Comparing with US, the price tag is nominees 1 3rd to 1 half of Hawaii price. So and also decent-wise, it's easier to commute on a three-hour flight from Beijing to 1 half, three hours from Beijing. So those are the factors we have to take into consideration that we know Hawaii has a unique opportunity. Hawaii is not a place you can, those type of feeling cannot get other place else. So what the program is developing is like a seven or 10 days program. They spend one or two days in hospital for the executive checkout, for the screening and those services. And then the other day, they can play golf. They can play. They can go sex scene. So we have to combine this advantage how Hawaii can offer us and then put it together as a mature program to set out to the top reach. Top reach is in China. That's one segment, I think, Hawaii has the advantage. The second segment is senior care sections. I know some companies are thinking of a term share type of senior care services in Hawaii. So this is also the housing group. They can spend a quality time in Hawaii, but with the medical staff on board to help them to solve some issues they may have during their travel. So I think those are the market how I should focus more on rather than just compete have to have for those with those top hospitals in mainland because we don't have that kind of advantages compared to these good names. So this is very interesting observation. It seems like the essential care by the high wealth of competing with one end with male, competing with society to be treatment hospitals. And on the other hand, we're competing with the Asia destinations for electric treatment, which is South Korea and Japan. Logistic wise is cheaper and much more convenient. So you have to have a niche and I guess why it's magical having a name like that. So I'm just curious about your observation about these elder senior living times here because I know my previous form I've worked with a large insurance Chinese insurance company coming to the US and investing heavily into senior elder assisted living care like a system system like San Francisco. Could that work in Hawaii realistically? We lost you. Do we lose audio? Sorry for this intrusion here of what is of technology sometimes fail. I hope that we can get Russell and Sunny Zhang back on track on the tube here. But like Sunny and Russell were discussing, there is a huge potential market for medical tourism. But what is Hawaii's niche? Virginia Mason, Mayo Clinic, Stanford, Mass General all have very highly developed infrastructure in terms of say as Chinese speaking nurses, Chinese food, even DVDs and entertainment at the hospital. And so how can Hawaii leverage the vacation part of exciting natural vacation attractions so that it is part of a visit here to Hawaii and to have a great medical procedure or checkup. There are places in Bangkok, Bunarigrad, Raffles in Singapore. There are other hospitals very famous for attracting UK, EU, Middle Eastern visitors and they are there by thousands having great treatment and also that raises the quality of medical treatment in that city for local people. And I think that's another kind of promotion that you can say that what does medical tourism bring to a city and it helps local residents enjoy a higher level of medical treatment because the hospital transformed into a place for higher wealth individuals to come and pay for better doctors, better nurses, better equipment and better programs in many different areas of treatment. So Hawaii can look at that for the long term. How does healthcare be beneficial through medical tourism? So we're gonna go back to this area many times in the future where Russell and others contributing to how to formulate a strategy to develop a medical tourism infrastructure in Hawaii. This is Ray Tsuchiyama for Think Tech Asia. Hope you will join us in the future again.