Last month I went back to China after almost 14 years in the U.S.. Lives in China have changed so dramatically that I want to share: 1. ID and WeChat are EVERYTHING: The new 3rd generation of Chinese government issued ID has RFID in it which is supported by all major entities for verification purposes, from bank to real estate transactions to all sorts of check-ins and healthcare. With the ID and optionally a backed bank account you can then use WeChat for almost everything in your daily life. It is not just a convenient payment infrastructure like Apple Pay using your phone, it is EVERYTHING -- it is basically Payment + Apple Store + Utilities. WeChat can run other "programs" from 3rd parties. For example, you can order shared rides or make doctor appointment since your identity and payment are integrated with WeChat (more on transportation and healthcare later). Because of its ubiquity, almost all major Apps in China and all merchandise support WeChat -- basically the "mini program" (apps inside WeChat). Nowadays, WeChat and its ecosystem covers vast majority (if not all) retail economics. Oh I forget to mention this, a lower-end smart phone which is more than enough for most people which supports the WeChat ecosystem only costs $100 USD which is unbelievably cheap. 2. Transportation - Subway/CHSR and Electrical Vehicles: My hometown city Xi'an is a 2-tier city in China and my actual hometown is just a "tiny" area of it (though it has the similar population as SF and is known of Terracotta Warriors) yet the city already has 13 metro lines covering most metropolitan area and even some suburb area including my small hometown. The city is even planning for a total of 20 lines down the road. From my hometown which is 25 miles away from one side of the city to the other side of the city which is roughly 45 miles in total would take only 1.5 hours of the subway with 30+ stops. The cost is less than 10 RMB Yuan (~$1.5 USD). For inter-city travels people get used to China High Speed Rail (CHSR). For example, it is 750 miles from Xi'an to Beijing (that's almost doubled distance between SF and LA), lowest tier ticket price is $70 USD which is pretty comfy and spacious but you can also pick up to $200 USD for better tiers. The trip is barely 4.25 hours and it is always on time! I just mentioned one example but there are just so many CHSR lines between major and even smaller cities all over the country which is really hard to imagine for the people in U.S. Because of CHSR, flights are not so crowded but it is also a good alternative which reasonable prices (sometimes lower than CHSR). And then for EV there are just so many choices -- BYD, XPeng, and 10+ other native brands while the imported ones like Tesla (actually natively assembled) and Volkswagen and the like are also very price-attractive. Because of the fierce competition for a typical model (think Tesla's Model 3) the price is ~$30,000 USD across all brands. That is very affordable for mid-class families even without debt (Chinese don't like debt in general) while the experience/quality is promising. One advantage of owning an EV is that, due to the high volume of cars major Chinese cities apply traffic control and on a certain day only some gasoline cars (e.g. plate number ends with odd numbers) can go on the road, but that policy doesn't apply for EVs which means that you can enjoy (maybe) driving whenever you wanted. Because of its prevalence I have more shared EV rides from DiDi (Uber equivalent). For the price of DiDi, 10-15 RMB Yuan (less than $2 USD) any start-end in the downtown area of my small hometown, 20 Yuan ($3 USD) at most for any two points of the entire town. 3. Other Infrastructures: 1) Houses. New buildings (either civil or commercial) are all 20+ story high skyscrapers even in my hometown which you can only see in the downtown area in only some US cities. It is both because there are just so many people and government incentivized the development of real estate in early years (maybe not now in particular). The price was peaked before COVID and now the price is roughly the same level as 2017/2018 before the peak. A 100 square meters house (flat apartment really) costs around $300,000 USD near the tech companies area (Huawei, Tencent etc) in Xi'an. 2) Logistics/Delivery. 2 words: Fast and Cheap. If you live in some southern cities it is same day delivery guaranteed. Even in my hometown it is 3-5 days from everywhere in the country. Food delivery is even more impressive, could be in minutes by many delivery riders on their e-bikes. 3) Malls. Malls are everywhere but most were built before COVID. Nowadays fewer people are shopping in the malls due to the fast development of online shopping, the efficient logistics and delivery mentioned above. Now most people go to malls for good restaurants which are typically at the top level of the building. 4) Highways. Everywhere from Shanghai to Tibet with some are very new and enjoyable to drive. 5) Bridges. My hometown doesn't have a lot water so there is less of them. But in southern cities, fancy and long-distance bridges are built aggressively (e.g. search for Danyang–Kunshan Grand Bridge). 4. Food and Environment. There are just so many choices of different kinds of foods -- restaurants, pick-ups, deliveries. Unfortunately, after almost 15 years staying in the U.S. I am a bit allergic to spicy foods which is the main local flavor. But thank goodness I still loved and enjoyed some of them like 油茶 and 烧饼. There are some discussions about the food quality and safety in China which I can't say much since I didn't stay for so long. During my stay I nonetheless tried to eat more fruits though (peeling is a must!) and they are pretty good and juicy -- citrons, apples, dragon fruit, etc. Alcohol is sold everywhere without clear restriction -- I doubt they check IDs when you buy it. During my reunion with family and friends there are always alcohols and in most cases that was the main theme. I wasn't able to drink much (I barely drink in the U.S.) because the 白酒 (very strong liquor) is too strong and spicy. I am not sure though how the younger generations deal with alcohol, hopefully they are not very interested. Air pollution is still a problem for most northern cities in winter, largely due to the operation of coal mine plants for providing heats. 3 days out of my stay of 10+ days the city is filled with harmful fogs so I had to stay at home. Even for the rest of the days I wear mask most of the time when I am out. As a regular runner, I also didn't run at all during my stay, fearing of potential respiratory damage. The southern part of China is probably better for this matter. There are also much less trails in the city so it is a bit challenging for serious runners/bicyclists. 5. The Healthcare and Insurance. Here I probably need to compare it with what we have in the U.S. since it is hard for people to appreciate it without doing so. After so many years, the healthcare and insurance system in China really astonishes me -- mostly positive with caveats I will explain. China nowadays has way more doctors than the U.S. (>4 million vs. ~1.1 million) while the per capita (3 per 1000) is similar which is already a tremendous achievement. The system also works differently in China: You don't have to make an appointment for a doctor visit and wait for a looong time for specialists -- you can just show up (get up early please) in the hospital or just checkin from WeChat ahead of time and you will be able to see specialized doctors the same day probably less than a couple hours. For surgeries, it can be scheduled within the same month most of the time. For laboratory tests and the medicines there are two sides: On one hand, they are also easy to order and most of them are covered by the insurance, including B-Ultrasounds and CTs (I am not sure even most Americans have ever heard those terms "thanks" to our insurance policy). On the other hand, the doctor visits are mostly test/medicine driven -- making it probably too much for everyone (doctors and hospitals clearly have incentives to order more of those). Another problem of the system is that it still heavily relies on the more advanced equipments and medicines from western world including Japan for the tests and treatments. I've heard that there is also a moderate to heavy usage of traditional Chinese herbal medicine but I can't confirm that. The overall cost of tests, treatments including surgeries is much more affordable comparing to the U.S. and the premium of the insurance is also much lower. For example, a complete set of tests, which include the blood test, B-Ultrasound, CTs of lung and brain, gastrointestinal endoscopy costs about $300 USD in total _before_ insurance. Monthly insurance premium is somewhere between $50 to $100 USD and depending on the policy most people can reimburse 30% to over 90% of the spend. I don't even know how much does it cost of those tests in the U.S. because my doctor never ordered them for me (partially because our insurance company and policy). Other examples: Ambulance for emergency - $50 USD (yes i spelled it correctly), Coronary artery bypass grafting (CABG) surgery (fyi heart disease is no.1 killer in the U.S.) - less than $30,000 USD. Considering it is the life-saving surgery that you may need one day it is just worth it. For surgeries one can probably reimburse at least half of it. How do I know all these? My parents are both retired doctors and I myself did the whole set of tests during my stay (*just worth it*). It makes me remind of Luigi which I definitely don't agree with his action but I do really hope there will be a better insurance system in the U.S. 6. The People and The Culture. Maybe due to my relatively short stay, nowadays people are nicer to each other comparing to 15 years ago -- at least people don't touch your body when you are in waiting lines (was normal which is very irritating). Around 1/3 of the times cars stop and waiting for pedestrians to cross first. I also heard there are much less theft and robbery these days due to the ubiquitous of the phone/WeChat usage and also the mass deployment of camera monitoring system. Because everyone has a smart phone, people are always staring at their phones (similar to U.S.). Douyin (TikTok) and red notes are the most popular ones. The variation of recreations is also flourishing -- people go skiing, climbing mountains (Xi'an is near the most magnificent mountain range of China) and even running more instead of the old-fashioned KTVs. My hometown city also has yearly Marathons (hope I can run it one day) where some of my friends ran once or twice. Smoking in public areas is mostly forbidden, which is a huge improvement. And NO, there is no homeless wandering and randomly threatening people on the street. An interesting observation is that people in China are much more confident nowadays especially when talking with me -- they tend to mention the achievements of the infrastructures as well as the technical advancement (e.g. AI) a lot. A lot people think China is now the firm No.2 country in the world and is not far from U.S. The rest of the world? Not a thing. Overall, there is definitely a tremendous improvement of people's everyday lives and well-beings thanks to the unforeseen speed of the development of infrastructures and the new technologies. Basically as Balaji puts it "China can build (while US can't)" (I don't think U.S. can't build though). The country has become a more livable and enjoyable place for both hardware (infra/tech) and software (people/culture). Most people are super hardworking and pretty positive about the future from what I can tell. I am really glad to see all these and congratulations to them. I also foresee that the competition between US and China will become the main theme in the near future in many major areas. The two countries will lead by a far. I just wishfully hope that this race pushes the limit of homo sapiens without disastrous outcomes.

The U.S. Pharmaceutical Industry Is Having Its Own "DeepSeek Moment" If you want to survive, you’d better be Chinese—or head to China for help! *The Washington Post* shared a true story about Max Doppelt, a resident of New York City. He doesn’t appear to be short on funds: his 60-year-old mother, Debbie, is a jeweler, and he himself is a computer engineer. In 2023, Debbie—who had suffered from a persistent cough—was diagnosed with non-small cell lung cancer. It was a rare form, characterized by a specific genetic mutation and more commonly found in non-smokers. Although she promptly underwent chemotherapy and immunotherapy, the cancer continued to progress, and by late 2024, it had metastasized to her brain. Desperate, Max began searching for a targeted therapy—a drug that could address the root cause of the cancer more effectively. One option he looked into carried significant side effects and was largely ineffective against cancer cells that had already spread to the brain. Just as he was nearing despair, a doctor mentioned another targeted therapy that could potentially help his mother—but there was a catch: it wasn't yet approved for use in the United States. At the time, the drug was still in the final stages of clinical trials. The doctor explained that the drug had been developed by a Chinese company and had already received regulatory approval in China back in 2023—where it was also covered by the national health insurance system, benefiting many patients. "It’s a shame your mother isn’t Chinese," the doctor remarked. "If she were, she could simply walk into a pharmacy in China and buy it." Upon learning that the drug was already available in China, Max and his mother reached out to friends and family to see if they could help procure it. A few months later, Max flew to Shanghai himself, where he spent over $10,000 to purchase 26 boxes of the medication. The drug proved effective in stabilizing his mother’s condition, specifically by bringing the cancer that had spread to her brain under control. But Max is not the only American doing this. He told *The Washington Post* that at least 30 other Americans have also traveled to China to obtain this targeted therapy. "China has grown into a biotechnology powerhouse," *The Washington Post* noted, describing a phenomenon that might seem "counterintuitive" to many Americans. "In 2025, as much as 46% of the new drugs entering human clinical trials globally originated in China. U.S. pharmaceutical companies are conducting trials for new therapies in China and have signed multi-billion-dollar partnership agreements with Chinese firms to co-develop and market drugs." A vast talent pool—bolstered by the return of professionals from abroad—along with high efficiency and cost-effectiveness in R&D and clinical trials, combined with strong official emphasis and policy support for the biotech sector, are all accelerating China’s progress in this field. This, in turn, is attracting a large number of overseas companies—including American pharmaceutical firms—to expand their operations in China.

My father had hip replacement surgery last month at Amrita Hospital, Faridabad. He was discharged after one week, but his health has been steadily worsening since. Last night, his condition deteriorated severely. At 5 AM this morning, we rushed him to the emergency department, where he was admitted. Tests confirm a lung collapse, and his condition is currently critical. Daily treatment costs range from ₹80,000 to ₹1 lakh, with an estimated total of ₹25 lakhs. We are urgently appealing for any support or donations to help with his care. If you can contribute, please send any amount possible to +91 99911 17212. Your support and prayers mean everything to us right now. Thank you. 🙏 #MedicalEmergency #HelpNeeded #AmritaHospital #Crowdfunding #LungCollapse

I had surgery and spent 8 days at a Chinese public hospital in a tier-2 city. Want to share my experience to hopefully help other foreigners. Overall the experience was extremely positive. I really don’t have a single thing to complain about. I’m sharing because it seems there’s a negative perception of public hospitals in China, especially in smaller cities. I chose my particular hospital because I needed a specialist, and the surgeon at this hospital had twenty years experience and was the chief surgeon. After meeting the surgeon he informed me I needed surgery. I knew this already but was worried I’d have to wait several months to have it done. He told me I could have the surgery as early as the following week, which is what I did. I needed an MRI and was able to have it done the following day after meeting the doctor. It was 650rmb. The machine also seemed very new. The following week I checked into the ho

🚨 IVERMECTIN AND CANCER: THE QUESTION DESERVES RESEARCH. PATIENTS DESERVE EVIDENCE. Few medicines generate as much debate as ivermectin. For some people, it represents affordable medicine and overlooked possibilities. For others, it brings to mind viral claims that ran ahead of the science. But a useful conversation starts with a simple question: What does the evidence actually show? 💊 Ivermectin is a real human medicine with established uses against certain parasitic infections. Calling it only a “horse dewormer” leaves out that important history. 🔬 Researchers have also investigated its potential anticancer effects in laboratory and animal studies. That is a reason to investigate further. It does not establish that ivermectin safely treats cancer in people. This distinction matters—especially when someone facing cancer is deciding what to do next. You may have seen stories describing shrinking tumors, falling markers, or unexpectedly long survival. Those experiences can be deeply meaningful. But to understand what caused an improvement, we need more information: • Was the person also receiving chemotherapy, immunotherapy, radiation, or hormone therapy? • Were the diagnosis and response independently confirmed? • How long did the improvement last? • Were unsuccessful outcomes and side effects recorded too? A powerful story can raise a research question. Answering it requires carefully designed studies. 💰 And what about affordability? Affordable treatments deserve serious research. Patients should not have to choose between financial survival and medical care. But a drug’s price cannot tell us whether it works against a particular cancer. Neither can a politician’s endorsement, a viral video, or a company’s marketing budget. The same evidence standards should apply to everyone. We should demand: ✅ Transparent clinical trials. ✅ Publication of positive and negative results. ✅ Honest reporting of side effects. ✅ Research into promising affordable treatments. ✅ Clear explanations of what remains uncertain. Right now, ivermectin is not an established cancer treatment. ASCO recommends against using it for cancer outside a well-designed clinical trial. If you are receiving cancer care, discuss any repurposed drugs with your oncology team. Do not replace or delay established treatment based on online testimonials. We can support scientific curiosity while being honest with patients. 💬 What would you want to see in a clinical trial before considering a repurposed medicine? Follow for clear discussions of cancer research, affordable treatments, and the evidence behind the headlines. #CancerResearch #DrugRepurposing #PatientAdvocacy

A bit of a rant… Hospital in Sanya disappointed us I have to get this off my chest. Our China holiday took a bit of an unfortunate turn because my husband got sick with gastroenteritis… we think it happened because he ate something in Zhangjiajie from a street vendor. It looked like he was getting better but this morning, waking up in Sanya, his stomach ache got worse. The cramps were really bad and on top of that he got a fever. Getting sick during a holiday is as bad as is, but getting sick in a country where almost no one speaks English is the absolute worst. We took a Didi to the hospital and it was such a bad experience. It is so unclear what is expected of us. I mean… I wasn’t expecting anything to be in English but I was at least expecting some staff to write down or translate important information so we could get the help we nee

I had Hip replacement surgery. Had to do it. My right hip socket was being destroyed by a condition called: Degenerative arthritis with a deformed femoral head. In simple terms: the top of my be thigh bone (the “ball” that fits into the hip socket) wasn’t perfectly round anymore, which caused it to grind unevenly and hurt. It destroyed the cartilage in the socket and even made bone fragments which then calcified and limited my hip movement. This condition was only on my right side. I lived with this for almost 4 years. Every month the condition got worse until eventually it was too painful to even play with my kids. I tried to hold out for as long as I could. But this year it was time to get this sorted so I can live a normal life again. The road to recovery is long. But it will be totally worth it to be pain free again. I don’t even remember what that is like. Thank you all for the support and kind get well msgs 🙏🏽 it is greatly appreciated. A special thanks to my wife who has been literally super mom/wife for the past week. Words cannot explain or describe how much I love you and how amazing you have been in supporting and taking care of not just me but our family as we recover. You truly are an amazing woman. I am so blessed to have you by my side @SkyeZedA

As a Chinese who lived in the UK during 2020 - 2025, one of my frustrations was getting to see a doctor, even though I had private insurance through the company I was working for. I had a non-urgent surgery situation, and it took me 2 months to receive 1 session with my GP, 2 sessions with a private doc and waited for an extra 2 months to receive a surgery appt. with my private doc. After I returned to China, I went to a public hospital without an appt. and got to see a doc with 1h waiting time and all the blood tests checked. Of course, I would need to pay, but it only cost me £30, which included £25 redeemable by my national medical insurance. And my surgery got arranged for 3 days later, 95% of the medical fees got covered by my national medical insurance.

Expat here in Chongqing, China. When I get sick here, I go to a public hospital in the morning at 7:30am, pay $2-3 for specialist consultation fees, get diagnosed, pay for screening and tests (which usually cost $30 for extensive blood tests and $70-100 for screening), go to the doctor again with the reports, collect medicines, go home before 1pm. No appointment needed, efficient, no exorbitant costs. And the local Chinese pay a fraction of what I have to pay, with their medical care scheme.

My Mom flew to China for her dental surgery (from the US) because the flight itself costed less than the procedure here. It’s really sad people can’t even afford to get sick in the US, literally.

سلام عليكم الله يجزيك خير كيف الوصول لهذا المستشفى أنا عندي زوجتي فيها سرطان في المعدة لها تقريبا سنة تأخذ كيماوي والحين كيماوي موجه مع حبوب كيماوية لمدة 14 يوم وتريح أسبوع تقريبا وترجع في الكيماوي موجهة الحبوب 14 يوم