by CHEN Yang, HUANG Hua

Foreign patients seeking treatment in China have drawn attention at Shanghai's 'two sessions', as those at the meetings moved to reassure the public that international medical services would not crowd out access to basic healthcare.

Shanghai's 'two sessions' refer to the annual meetings of the city's legislature and political advisory body, where policy priorities for the year ahead are set.

The issue has gained traction as China eases entry rules. The country expanded transit visa-free access at the end of 2024, lowering barriers for short stays by overseas visitors. Lower medical costs and faster treatment timelines have helped draw more foreign patients, amplifying online discussion about seeking medical care in China.

Shanghai has been exploring international medical services for nearly a decade. The effort dates to the 2016 "Healthy China 2030" blueprint and was later incorporated into the city's Healthy Shanghai Action Plan. Pilot programs were launched in private hospitals in 2020 and extended to municipal public hospitals in 2023. The city has also said it will proceed cautiously with policies allowing wholly foreign-owned hospitals.

Some pilot institutions have reported rising demand. The Shanghai Children's Medical Center said it treated nearly 900 foreign patients in 2025, while Huashan Hospital reported a 25 per cent year-on-year increase in international outpatient visits in the first 11 months of the year.

Despite the uptick, those at the meetings said fears that overseas patients could strain local access to care are overstated. XU Meidong, a member of the Shanghai Committee of the Chinese People's Political Consultative Conference (CPPCC) and vice president of Tongji University-affiliated East Hospital, said the overall scale remains limited.

The number of foreign patients and patients from Hong Kong, Macao and Taiwan admitted to hospitals across Shanghai reached about 4,100 in the first half of 2024, up by roughly a quarter from a year earlier, but still accounting for only a small share of the city’s total hospital admissions.

XU and WU Shaoyou, a member of the CPPCC and chairman of Shanghai ChingHo Medical, said international medical services are intended to operate alongside, rather than replace, public healthcare. In public hospitals, international and premium wards are typically built around newly added beds, space and dedicated teams, rather than reallocating resources from general wards. These services are mainly funded through self-pay or commercial insurance, rather than China's basic medical insurance system.

While Shanghai has a dense concentration of top-tier hospitals, they said the main constraints are regulatory and operational rather than medical. Differences in licensing rules, quality standards, data protection and privacy requirements complicate cross-border referrals, joint operations and telemedicine. Cross-border payment and settlement processes also remain cumbersome, they said.

Service-related gaps also persist. Medical care requires more than basic language skills, particularly when explaining complex conditions, risks and follow-up care, Xu said. Wu added that hospital processes are still largely designed for local patients, with limited provision for case managers, cross-border follow-up and remote monitoring.

Looking ahead, they said Shanghai should take a city-wide approach, with clear rules and standards in place before scaling up international medical services. Wu pointed to Singapore's model, where healthcare, visas, aviation and insurance are coordinated across government agencies to create a predictable environment for overseas patients.

Xu said destinations such as Singapore and Thailand have relied heavily on international accreditation, including certification by the Joint Commission International, which serves as a quality benchmark for patients and insurers. Shanghai has begun moving in that direction by issuing a local standard for international medical services.

For now, the sector should expand gradually, with clear boundaries between international provision and basic care, as the city tests demand and builds trust among overseas patients.