US-China Negotiations: Trade, Healthcare, and Policy

Introduction: US-China Negotiation in Multiple Arenas

The entire world by now knows and acknowledges China as an awakening giant and an emerging global economic superpower (Abbott, 2005). Its 1.3 billion people confront serious health problems and an aging population. Their most progressive and responsive minds must address these challenges. US-China negotiations have taken place across a range of sectors — from biotechnology and cancer treatment to healthcare informatics and international trade policy. Each of these arenas reveals both the potential and the pitfalls of bilateral engagement between the two nations. The following sections examine specific cases that illustrate how optimistic assumptions have often given way to unexpected complications, enforcement failures, and structural weaknesses in US strategy.

Cancer Treatment Negotiations and Biotechnology Partnerships

HST Global, Inc., through a contracted partner, began negotiations with the Chinese government to introduce a new treatment and solution for late-stage cancer (Business Wire, 2008). The company claimed that the treatment was the globally recognized medical alternative of choice. Its partner, EBITDA Capital LLC of Newport Beach, California, was to work together with the Chinese government through Congressman Sarpalius. The Congressman stated that every community in China has a cancer center, and that cancer treatment is one of the commitments of the Chinese government. He was tasked by the government and authorized private investors to negotiate cancer treatment arrangements (Business Wire, 2008).

HST Global, Inc. is a development-stage biotechnology company devoted to cancer treatment (Business Wire, 2008). It in-licenses drug companies that conduct initial testing of products for cancer treatment, and then develops these products for commercial use. In the pursuit of these endeavors, the company invokes the provisions of the Private Securities Litigation Reform Act of 1995. It cautioned readers about possible risks and uncertainties in the course of research and development and clinical trials conducted by others (Business Wire, 2008).

Healthcare Informatics in China: An American Perspective

A team of 23 US informaticians arrived in China to consult with the progressive sector on the need for and benefits of healthcare information technology (Abbott, 2005). These health care professionals included nurses, physicians, informatics and computer scientists, academicians, practitioners, and consultants from the field of informatics. The representation was part of the International People to People program, designed to foster international understanding through educational, cultural, and humanitarian activities. Many of the health professionals were received in Beijing and consulted with the China Medical Informatics Association — the Chinese equivalent of the American Medical Informatics Association. The Chinese counterpart took the American health professionals to universities, hospitals, major sites, schools, and villages (Abbott, 2005).

The delegates considered the state of informatics in China to be where the US was more than two decades prior (Abbott, 2005). The Chinese perceived the concept of informatics primarily as signal and image processing, rather than in its current form used routinely in patient care settings. The delegates found only a few more advanced "showcase" settings, such as at the Peking Union Medical College in Beijing. They observed that nursing in China was still in a growing stage. A Johns Hopkins School of Nursing had only recently introduced the first PhD program for nurses in China in the spring of 2005. There were as yet only a few nurses with advanced degrees, which prevented China from competing with nurses who had advanced training in nursing informatics in more technologically developed countries.

The use of information technology in healthcare in China was quite rare at the time. Healthcare was dominated by physicians and computer scientists still engaged in computationally complex tasks such as image processing. However, a rapid increase in awareness of the importance of health information was observed in China's healthcare sector. The middle class had been growing, and reliance on the government for healthcare was decreasing. There was also a rising tide toward capitalism — the "Chinese" kind — along with the growing influence of Western medicine and the 2003 threat of Severe Acute Respiratory Syndrome (SARS). These influences drew increasing attention and interest in informatics and bio-surveillance in China (Abbott, 2005).