Accessing the Inaccessible

Accessing the Inaccessible

Healthcare and Internet access are becoming increasingly intertwined in China.

by Sydney Gehrking, MHA ’17, EMI Fellow

The countryside zipped by at lightning speed as I watched from the comfort of my seat on the bullet train. My 2016 China Trek cohorts and I had set off from the glitzy skyscrapers of Shanghai, the “economic showpiece” of the People’s Republic of China (PRC), and were barreling towards the more classical – though nonetheless breathtaking – spires of Hangzhou, the antique capital of China’s eastern Zhejiang Province, and with it the headquarters of the e-commerce titan Alibaba. Too excited at the prospect of our tour to sleep, but too jet-lagged to string together a coherent sentence, I let my eyes wander over the passing scenery. The rate at which the high-rises and smoothly-paved thoroughfares of China’s largest “direct-controlled municipality” gave way to thatched roofs and dirt paths was astonishing. The dichotomy between the city we had just left and the province through which we were transiting was stark.

Since its “Reform and Opening Up” in the late 1970s, the People’s Republic of China has experienced rapid economic growth, placing it behind only the United States in rankings of Gross Domestic Product (GDP). As of late, the Chinese economy has begun to exhibit signs of a broad transition from a primarily industrial to a more service-oriented economy. In 2015, the service sector accounted for 50.5%[1] of the country’s GDP – a record level for what has been enduringly viewed as the “factory of the world”. Healthcare expenditures alone constituted approximately 5.6%[2] of the national GDP in 2013, a percentage that is projected to reach double-digits in the not-too-distant future.

This expansion in the healthcare sector presents an opportunity for growing investment by firms seeking to expand their market share in health services – an opportunity that is, of course, not without its challenges. China’s population is currently estimated at around 1.3 billion people, of which 46%[3] reside in rural, mountainous, or otherwise remote areas. It has become increasingly challenging for the roughly 600 million residents of these rural locales to gain access to even the rudiments of modern healthcare, such as prescription drugs, medical devices, and well-trained physicians. These challenges have sparked a great deal of interest in a number of quite innovative methods of healthcare provision, including digital health and telemedicine, which would allow individuals to obtain quality medical services, regardless of their geographic location. Such approaches to healthcare delivery, however, hinge entirely on Internet access.

This led me to wonder about Alibaba’s strategies for expanding its e-commerce and mobile platforms to areas where Internet and cellular network access are particularly weak, if not altogether nonexistent. If successfully implemented, these strategies have the potential to have a profoundly positive impact upon the quality of life in rural China, especially in the context of healthcare delivery.

Alibaba is not without allies in this pursuit. It and other e-commerce firms, such as, have been working hand-in-hand with the Chinese government to overhaul and expand Internet access in rural areas. Alibaba has marketed heavily to working-class residents who travel to and from villages and smaller urban areas for work, residents who are then hopefully enticed to return home and inform their family members about Internet access and online commerce. In this effort, “Alibaba has pulled out the stops to get its e-commerce platforms in front of villagers, setting up free Internet-equipped computers and working with local officials to train potential buyers and sellers. It now has a presence in 12,000 villages across the country.”[4] Alibaba has labored intensely in marketing to China’s younger demographic as well, and recently reached an agreement with the Chinese Communist Youth League to “train 1 million teenagers to take e-commerce to rural areas.”[5]

Participating in the 2016 China Trek was an eye-opening experience, and afforded me an especial degree of insight into the workings of the Chinese state and society from a commercial perspective. Healthcare and Internet access are becoming increasingly intertwined, and with e-commerce becoming more prevalent in regions of the People’s Republic that have more dirt roads and fewer skyscrapers, we can be justified in growing ever more optimistic about the quality of care accessible in these areas.