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Perspectives: A unique insight on China's healthcare sector
326 Plays11 hours ago
Jo Miyake, Head of Banking for Asia and the Middle East, Corporate and Institutional Banking, HSBC, sits down with Roberta Lipson. As Co-founder of United Family Healthcare, Vice Chair of New Frontier Health, Chair Emeritus of AmCham China and Director of the US-China Business Council, Roberta brings decades of on-the-ground experience. She provides an unparalleled look at the realities and opportunities in China’s business landscape and healthcare sector—including the “in-China-for-China” strategy, AI’s role in drug development, and recent regulatory shifts.
This episode was recorded on the sidelines of HSBC’s 12th Annual China Conference in Shenzhen on 1 September 2025.
Disclaimer: Views of external guest speakers do not represent those of HSBC
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Transcript
Introduction to Podcast Series
00:00:00
Speaker
Welcome to HSBC Global Viewpoint, the podcast series that brings together business leaders and industry experts to explore the latest global insights, trends, and opportunities.
00:00:12
Speaker
Make sure you're subscribed to stay up to date with new episodes. Thanks for listening, and now onto today's show.
Roberta Lipson's Background
00:00:21
Speaker
Welcome to HSBC's Perspectives podcast series. I'm Joe Miyake, Head of Banking for Asia and Middle East. And it's a real privilege to have with me today, Roberta Lipson. Welcome. Thank you so much.
00:00:32
Speaker
Of course, you've co-founded ah United Family Healthcare care Group. Prior to that, actually, you also led a business that was the top China medical equipment distributor. In 2019, United Family Healthcare Group merged with New Frontier Health.
00:00:47
Speaker
And now you are the vice chairwoman of that combined group. ah That's all very impressive. But of course, even more impressive is the fact that you were awarded the Great Wall Friendship Award, which to my understanding is the highest award ah Beijing can bestow upon a foreign expert. So really fantastic and really looking forward to getting into the conversation. Welcome.
00:01:08
Speaker
Thank you so much. It's my pleasure to be here with you. Now, ah over 45 years, you've obviously seen a lot. And actually, US-China relations have undulated a lot over that period of time. But before we get into that, ah perhaps a little bit about your background. um Let's go back to your origin story. So you started off, I believe, in New York, Massachusetts, um and ah really interested in what what what made you make this jump into China. I mean, I'm based in Hong Kong.
00:01:37
Speaker
And in Hong Kong, you often run into people who say, you know, I came to Hong Kong for two years, I've stayed for 10, 20. But 45 years a long time. And I think it probably even predates the definition of expat as we kind of use it today. So tell us a little bit about what what prompted you
Journey to China
00:01:52
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to do this. Right. So partly China is just interesting.
00:01:56
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But um the accident of my being in my formative years going to university in the early 70s, when ah the U.S. and China were starting to talk to each other again, China was beginning to wake up after the Cultural Revolution, talking about opening up.
00:02:12
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And so my early history class about um China ah was translated by the New York Times front page almost every day in those days with no wow Kissinger's visit and Nixon's visit. And it just continued to pique my interest.
00:02:28
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And I decided to make the investment in learning Chinese. And once you make that investment, you have to figure out something to do with it. right so And as China continued to open up, I found an opportunity um after my graduate studies to um get a job in Beijing.
00:02:45
Speaker
And it started out a sense of adventure, curiosity, but then seeing what was unfolding in China was just irresistible
Healthcare Leadership in China
00:02:55
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to me. and The opportunity of um filling some of China's development needs at that time was, I saw it as a huge business opportunity.
00:03:05
Speaker
And ah that caught my interest enough to make me want to stay and see where it would lead. It's fascinating. I've touched a little bit about on what you're what you've done in in the healthcare care space, but you've done a lot actually over that period of time and you've held multiple leadership roles, including ah you're now the chair of the American Chamber of Commerce in China.
00:03:25
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Emeritus. Emeritus. Emeritus. Yes. And I think the American Chamber Commerce has about 600, 700 members.
00:03:33
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and ah members And so it provides a very kind of broad perspective of what's happening in China. You're obviously very engaged with that community. for For the business community. Yes. yeah So um obviously this has been a time fraught with uncertainty and concern for the business community.
Impact of the Pandemic on Expat Businesses
00:03:51
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ah There was a big ah hiatus in China. ex export of expats, if you will, of ah a big um ah reduction in the number of expats in China and many businesses, because of the practical needs of the ah the pandemic, began to accelerate their localization.
00:04:16
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And what that caused, it was good in many ways for people's business to ah get closer to their market when they were in China for China. But it did tend to cause a bit of a hiatus between the Chinese management and the board back home.
00:04:32
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And so I think a lot of messages did not get across. And as the relationship continued to deteriorate through the first Trump administration administration and um has kept on that kind of downward slide until very recently,
00:04:47
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ah it's it caused a lot of concern um for for the the prospects of business in China. You can build up filled up a lot of bad stories it without having firsthand experience.
00:05:02
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So as the three years of the COVID pandemic passed and then another couple of years of really tense a relationship, ah many CEOs hadn't been to China in many years before.
00:05:16
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um They couldn't give firsthand reports to the board. And ah they kind of lost their link with the expats that used to rotate through China, who understood that both the headquarters business and the local business.
00:05:29
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And so it became very questionable. Should we continue here? Should we continue with the China plus one strategy and hedge our bets with some investment for our supply chain and other parts of China?
Post-Pandemic Business Opportunities in China
00:05:41
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um The Chinese economy hasn't rebounded as quickly as um some of the other economies. So there were concerns about, you know, where is this market going to go go without reminding themselves that, in fact, the 4% or 5% growth in China is as big as many other economies in the whole world. Yeah.
00:06:03
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things Things got a little bit unpredictable for U.S. business in China. It became politically unpopular in the United States to talk about China as an opportunity or China um potential investment opportunities.
00:06:18
Speaker
But this has started changing, and CEOs have started coming back. And, um for example, this year at the CDF, there were... ah 30, 40 US CEOs, um ah Fortune folks coming back to china And the CDF is the China Development Forum for yeah the Multinationals, right? it's quite a, what's it actually, a huge... It's a big, important meeting, yes. And pre-pandemic, I think every Fortune 100 CEO would try to come if China meant anything to their business, which in most cases, it means a lot to their business.
00:06:56
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And so they've started coming back. And what I'm hearing people say, they hit the ground and they say... oh my gosh, the the economy doesn't look so bad from the ground. And um in fact, my counterparts are willing to talk to me and the government is willing to talk to me. We don't see u s companies leaving China
U.S. Companies' Continued Investment in China
00:07:15
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so much. There are some, but very, very few.
00:07:18
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And many, many, many of our members are continuing to expand their investments. I think that's a really interesting point because you you you mentioned it, and we were fortunate to have you on a panel earlier, ah because there is a perception of course, people are retreating from China. But actually what you're seeing is ah companies remaining and investing further.
00:07:39
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and We also discussed um the you know the Chinese consumer market and how that's accelerated. It was actually a striking distance of being the same size of the US in 2019, just before COVID.
00:07:50
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It's a bit smaller now, but the fact that ah it's that close means you know businesses have to participate. its There's no real option. And so you're actually seeing that through membership. Oh, very definitely. yeah I mean, i think there are for U.S. companies to be in.
00:08:07
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Well, first of all, what's a U.S. company? Multinational is a multinational. Right. And no matter where they're registered or their headquarters are, investors are all over the world and business, for the most part, is all over the world.
00:08:19
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So there there are basically two kinds of companies that are investing in China. One is because that's where their most efficient supply chain is, and um they're manufacturing in China for export either to the U.S. or for the rest of the world or for both countries.
00:08:35
Speaker
And then there's the companies that are in China for China. For example, my company, um we're providing health care services and to to the Chinese market. And the consumer market is huge. And when you look at the aging population, of course, for health care, it's even huger and the potential is huge.
00:08:54
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But um so the companies that are there for supply chain reasons are perhaps looking at de-risking a bit by doing a China plus one strategy, finding somewhere else in the world that they can supplement um and balance their China supply chain.
00:09:10
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ah And the ones that are in China for China really have no choice but to be there because as you say, the consumer market is just too great a potential.
Growth in China's Healthcare Sector
00:09:19
Speaker
Yeah. I'd like to um bring it to the healthcare space, which we're beginning to touch on. And you said there's still a ah big opportunity. Yes.
00:09:28
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um I mean, you've seen this over four decades, so you've seen the trajectory. I think the latest numbers were that the the Chinese healthcare sector is about 1.5 trillion of value. Comparatively, the US is 4.5. So it goes to this sense of what the upside opportunity that still remains in China is.
00:09:45
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But we've also seen decisions by the Chinese government to allow wholly foreign-owned hospitals, which I think is a big move, in and in nine of the major cities.
00:09:57
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And if you actually look at the nine cities that have been selected, it represents about 45% of overall foreign investments into China. So that seems like a very substantive decision.
00:10:07
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How do you see that playing out? And is that what you think will really capitalize on the opportunity you see in the healthcare care space in China? So it used to be that foreign investment in hospitals required a 30% local equity partnership.
00:10:22
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um Obviously, there were ways around that with VIEs, or um there was, in fact, a period about 10 years ago when it was possible also to do wholly owned foreign-invested hospitals in certain cities.
00:10:35
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So I think it it's it was more of a symbolic decision um that just signaled the fact that, yes, China is open for business and China has been looking for various ways to signal that message.
00:10:51
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And so saying, yes, it's one more industry off of the negative list, um I think that's very, very important. But will it open a floodgate for foreign investment in health care services?
00:11:04
Speaker
I'm not sure about that. Because... Healthcare care is extremely complex industry. It is anywhere in the world. And um obviously, it's very, very controlled by um government regulations, not only national regulations, but local regulations.
00:11:23
Speaker
So jumping into that business in China is a big decision and maybe even a risky decision for newcomers. um I have to say our own company, we've i've been building this business for almost 30 years now.
00:11:39
Speaker
And so we have a deep understanding about the regulatory environment and about the consumer needs and the cultural needs. So I'm not sure that's going to actually open a floodgate of investment.
00:11:51
Speaker
But that having been said, the health care market it provides an opportunity for all kinds of industries, for example, pharmaceutical, medical devices, pharmaceutical development, CROs, insurance.
00:12:05
Speaker
And um the fact that China is aging as quickly as it is means that headroom for growth um is going to happen for sure, because we all know as we age, our needs for health care become greater and greater.
00:12:22
Speaker
And the consumer's ability to make their own decision is to um pay out of pocket for services ah that the government might not be able to apply is getting um better and
Innovative Drug Exchange Between U.S. and China
00:12:33
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better. More and more people are choosing to pay for their own health care.
00:12:37
Speaker
So that gives an opportunity not only for various segments of the health care services industry, but also for innovative drugs that might not be covered by the social system or high-end medical devices and ah that might not be covered by the social system. And then a little bit about China and the U.S. I mean, these days, you know, tariff is probably the best used word in these types of discussions. It's a difficult, ah unpredictable environment.
00:13:08
Speaker
What i was really intrigued by was as as we take that conversation into the health space, you mentioned on stage actually that when you looked at the, i guess, the exposure ah to the U.S. markets of ah imports in the healthcare care space, uh, and analyze whether it was exclusively importable from the US or whether you had other choices, that there were other choices. So do you mind just elaborating Because I think it kind of shows a malleability to the choices that are available as China's, you know, healthcare care space kind of grows. Yeah, I think ah an interesting thing to keep perspective um on what the impact of tariffs actually um can be is that only 2% of the Chinese economy um is accounted for by exports to the U.S.,
00:13:56
Speaker
So what are tariffs going to mean there? In terms of um importing from the U.S., we took a ah look at our um pharmaceutical purchases, consumable purchases, and capital equipment purchases, and found that perhaps not even 10% of what what we use in our in our operations are exclusively available from the U.S.,
00:14:22
Speaker
So I think that China has a lot of leverage um leveraged there. There's things that are substitutable. But the other thing that I think U.S. has to keep in mind is that China is increasingly involved in um innovative drugs, new ah pharmaceuticals that ah might be ah unique product.
00:14:45
Speaker
cure to certain kinds of cancers. And I think that U.S. patients and U.S. consumers would like to have the availability of those drugs coming from China, as Chinese consumers deserve to have access to those drugs coming from the U.S. So I'm hoping that both sides will wake up to the fact that health care isn't a place to have a trade warrant.
00:15:07
Speaker
that we we We learned from the pandemic that diseases know no borders, especially communicable diseases, yeah um but also cultural trends that we learned from each other bring lifestyle
AI's Impact on Healthcare Innovation
00:15:20
Speaker
diseases. The whole world is aging, and we need everybody's participation in finding cures to the diseases of aging, which include cancer, hypertension, cardiovascular disease,
00:15:33
Speaker
And to close either of our populations off from the the the contributions of the other side would be the wrong thing to do. If it's not exclusive to the U.S., where are the areas around the world where you can turn to to for this thing? as as you know, the listeners try and kind of play through what will the impact be if it doesn't?
00:15:52
Speaker
Yes. Well, so much now is available locally from China that a lot of substitution can be had domestically. There's also good options coming from the EU and ah European manufacturers.
00:16:10
Speaker
And ah even the US manufacturers, for example, of high-end medical equipment are manufacturing products in China and in the EU. And um Chinese innovation is really catching up in many areas, especially in biotech.
00:16:25
Speaker
So we talk about technology and healthcare, we have to be able to talk about AI. There's a huge amount happening in this space. And I was really interested hear recently a statistic that 40% of the world's large language models are developed in China. As you think about AI healthcare, care like what what are you seeing in that space?
00:16:42
Speaker
know What are some of your predictions? well the after use If you dare to predict it. The opportunity in healthcare care is huge, but the opportunity, i I think across all sectors is huge. And I can't compare it to what's happening in the U.S. because I'm not in the U.S. But what I do see in China is an immense amount of enthusiasm for incorporating the resources of these open models um to individual businesses.
00:17:09
Speaker
And in our own business, and we we see it just transformational at such a huge speed. It used to take a doctor maybe a half hour to review ah patient's total history and all of their records and the the trends of their lab tests. and um And now we have the AI, just give them a one-page summary, even back 25, 30 years for for any patient, and then look across published literature about input that the doctor should be thinking about before seeing the patient.
00:17:41
Speaker
And it's it's just transformational. It's ah transformational in terms of efficiency, but also giving um the doctor immediate access to What are the options for this patient, and especially in complex diseases?
00:17:58
Speaker
Of course, we don't just rely on that AI output, but um using that output and then putting together a multidisciplinary review team to review it so the most complex issues will have the options that come from the whole world.
00:18:14
Speaker
So the option that pops out might be there's ah there's a clinical so trial going on in Mayo Clinic that might be useful for that patient. And we have actually an international medical services division that can put that patient together with our multidisciplinary team to the research team, for example, at Mayo Clinic. We have a special relationship with them as well.
00:18:40
Speaker
And it can bring amazing ah solutions for people that maybe had to poke around themselves, the whole world for months before maybe coming up with that solution for them.
00:18:54
Speaker
From a patient's perspective, um it's it's brilliant new opportunities. From our doctor's perspective, it's not only educational opportunity,
00:19:05
Speaker
every time they see a patient, but also um an efficiency opportunity, an efficiency opportunity for our organization. ah So it's it's just so exciting. And then looking at how AI is being used now in drug development and drug drug research, it's just accelerated the whole process tremendously.
00:19:26
Speaker
And the fact that Chinese companies have embraced this opportunity So, so much. I mean, a weekend doesn't go by when there's not a course of um AI application going on in people.
00:19:39
Speaker
People in China, I'm not sure if this is the case in the U.S. now or not, but everybody I know in China spends every weekend going to conferences, studying, learning new things, taking ah ah an advanced degree. And um with the rapidity communication,
00:19:57
Speaker
technology development and change, to be able to keep up with this and to access it and to make use of it means you need to be developing yourself.
00:20:08
Speaker
And I see this spirit among Chinese people. um And
Future Opportunities in China's Market
00:20:12
Speaker
it's just so impressive and gives me so much optimism about the future. Yeah, it goes back to the potential kind of exponential scale, because I think what China does well is it operationalize a lot of these capabilities, people embrace it, as you say.
00:20:27
Speaker
and of course, off the back of that is all the application that all of us really benefit from. I think it's been fascinating to talk to you. We've talked about the China opportunity, ah the excitement of everything happening within China.
00:20:40
Speaker
and all the possibilities that brings. So thank you very much for spending the time with us. It's been a great time. And I look forward to next conversation. yeah Thank you. too Thank you for joining us at HSBC Global Viewpoint. We hope you enjoyed the discussion.
00:20:53
Speaker
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