Why Americans Are Flying to China for Surgery (And Saving a Fortune)
In this episode, Jon sits down with Adam Cunningham, founder of SylkHealth, to explore the growing trend of Americans traveling abroad for medical care, specifically to China. Adam shares the personal story that led him into this space, including a close friend who was priced out of treatment in the U.S., and explains how massive cost differences are pushing patients to look outside the country for care.
The conversation breaks down the economics behind medical tourism, highlighting shocking price gaps like MRIs costing thousands in the U.S. versus under a thousand total including travel in China, and major procedures such as heart bypasses and cancer treatments being significantly cheaper abroad. Adam argues that quality concerns are largely outdated, emphasizing that many Chinese hospitals offer advanced technology, highly experienced doctors, and strict regulatory standards.
They also discuss the logistics and emotional barriers, including travel, language, aftercare, and trust. Adam explains how SylkHealth simplifies the process by connecting patients directly with hospitals, removing middlemen and hidden costs. Ultimately, the episode challenges listeners to rethink assumptions about global healthcare and consider whether leaving the country might be the most practical path to getting life-saving treatment.
Host
Adam Cunningham, thank you so much for being on the podcast.
Sylk Health — Adam Cunningham
And thank you very much for having me on, John. It's a pleasure to be here.
Host
Yeah, absolutely. We haven't covered this topic of kind of taking your medical necessities, procedures outside of the country and traveling. You run a website called Silk Health and that's S Y L K health.com and it's a consultancy for people looking to do medical procedures in China specifically. and the assumption I have is to obviously save costs. Tell me a little bit about, you know,
Sylk Health — Adam Cunningham
Yeah.
Host
how you got into this, why China and what your role is in this space.
Sylk Health — Adam Cunningham
Well, it's a bit of a long story, a personal story, but I'll give you the Sparks Notes version of it. I was a very sick child. I still do get sick. I had asthma starting at about four years old in and out of hospital. And I thought, hey, when I grow up, I want to help people. So I went to medical school, got sick, couldn't practice. And now here I am. But the personal story that brought me directly to...
to international healthcare travel specifically when it comes to China is a mixture of things. I have my own personal worldview when it comes to how we understand and appreciate Chinese goods and services. But more importantly, I've got a friend in the US, she lives in Maine. She was a women's advocate working for an advocacy, I think about a year and a half ago, lost her job due to the Doge budget cuts.
In the process of losing a job, she started developing very, very, very severe rheumatoid arthritis. Her insurance company gave her the run around as if it's their profession to give her the run around. And by the time she actually did start getting treatment, her insurance had expired because she'd lost her job. And as a result of that, her only other job was bartending. And it got to the point where
she physically couldn't bartend. She actually couldn't like hold a bottle or hold a glass or anything like that. It was that bad. And at that point I thought, well, hey, I know quite a few doctors in China. know for quite a few facilities in China. Why can't you go there and get treatment? And so that really got me down the rabbit hole of, hey, why aren't Westerners going to China for treatment? You need to go to all these medical tourism websites and their information on China is sparse.
Host
Sure.
Sylk Health — Adam Cunningham
and you go to search about medical treatment in China. And frankly, the information is sparse by comparison to other countries such as South Korea, for instance, which is incredibly popular when it comes to things such as cosmetic surgeries and stuff like that, or even by comparison to Mexico that a lot of American patients go to. And...
Host
And why you, why do you think that is? Let me, let me stop you. Why is it so sparse for China? I mean, I can understand why it is compared to Mexico because it's a shorter flight. English is it's Latin based. So the language crossover probably isn't as hard. The currency issue isn't as big, in terms of getting payments to and from, but South Korea seems like it would be just as difficult.
Sylk Health — Adam Cunningham
Of course.
Host
to kind of travel to and at least from my understanding. So to someone with novice ears, why is China so much more kind of cloaked in confusion?
Sylk Health — Adam Cunningham
Well, I have my own personal opinions on that, but my personal opinions have shaped the business that I'm running now and the ability for me to help people. And I think it really comes down to several things. One has been the historical perception of Chinese quality in particular over the past, 30 or 40 years. And I think a good analogy to that, a direct analogy to that would be how Japanese quality has been.
shaped and understood over the years. I remember, for instance, my father would say as a child, Japanese goods, were regarded as junk when he was a kid. After the war, they were just producing cheap metal and things like that. now, anytime you want to buy a kitchen knife, for instance, it's Japanese or nothing. When you want to buy a motorbike, for instance, for most of the time, it's Japanese or nothing. When you want to buy a car, Toyota is considered the pinnacle of reliability. And so,
That switch from mass production to quality takes time and so do all the understandings of what a country produces. They also take time to change. And the same thing occurs with China. Yes, China certainly did produce mass goods before and mass services and things like that, but by the same measure that they do produce things in quantity, they also do produce things in quality.
But the difference is that you're not going to notice unless you look. The only time you're going to look is when something breaks. And when it comes to Chinese healthcare quality, healthcare is something that regardless of whether you're in the US or India or Australia or wherever it might be, healthcare is something that is always going to have a premium quality placed on it. Whether it is by people who undergo treatment, whether it is by the government, it doesn't matter.
quality is going to be demanded. And when it comes to China, the regulations when it comes to governing quality are actually quite strict, more strict than many other countries as a matter of fact. And when you see the facilities in China, in particular the high-end facilities, which are still cheaper than mid or low-end facilities in the US, you can see that not only is the equipment that they're using very high-end and very capable, the doctors there are incredibly well-trained and
Sylk Health — Adam Cunningham
I don't mean to put any shade, so to speak, on China, but the simple quantity of people in China has the direct result of the doctors who do practice there, the medical staff who practice there, are incredibly well-experienced. The sheer volume of patients that they see is significantly higher than what many doctors and medical professionals see in the West. And as a result, they see more patients, they see more symptoms, and they're better able to treat it, in my opinion, at least.
Host
And when did you start visiting or getting connected to China as an individual yourself? How did you kind of get exposed to this world?
Sylk Health — Adam Cunningham
Well, a few things. I've got a bit of an odd geopolitical understanding. I don't necessarily see China as the bad guy. I don't see Chinese people as the bad guy. To be very frankly, I eat Chinese food. I love Chinese food. I love going to Chinese restaurants. These people can't be half bad after all. And so I apply the same thinking to medicine and to surgery and to all the treatments that they have. That's really how I got to the conclusion is what
What have these people ever done to me? And so I got in contact with various hospitals and various doctors in China and they were all quite happy. In fact, very happy to see Western patients. And one of the biggest things that came as a surprise to me is simply the misunderstanding of Western healthcare prices. Quite a few times, like I've had senior people at
top hospitals in say Beijing for instance and say why would an American want to come to our hospital? It's it'd be too expensive to fly here and Even to me it's been a surprise that many many large hospitals healthcare networks in China just simply Don't necessarily understand it in an executive level Health care is very unaffordable for the vast majority of Americans and soon-to-be Australians and certainly inaccessible in times of
timeframe for many people in the United Kingdom for instance and slowly spreading to Europe as the pressure on our healthcare systems increases.
Host
So did you spend time in China or has this all been done? I mean, it sounds like you, when you look at the facilities, some of the language you use, actually, were you a tourist first and then you kind of fell in love with the idea of the medical thing or was this, did this kind of come up medical first?
Sylk Health — Adam Cunningham
Well, it really came up as medical first and as a result, I then visited China and I've been to a few hospitals and clinics and realized, hey, this isn't so bad. Hey, these cities aren't so bad after all. Honestly, I do not speak a lick of Chinese whatsoever, or lick of Mandarin for that matter. But I had really no issue navigating the country, no issue getting around or anything like that. pardon?
Host
I said, that's amazing. mean, when you think of it, if you were able to, without speaking any Mandarin and being a kind of a consummate tourist of China, of China to get around and navigate, I actually think that bodes well for people.
who are looking to go to China for a medical procedure, because it's not like you're a native of Beijing saying it's not that difficult and not having that perspective. You're like, no, I was able to, I don't speak any Mandarin, I can't read any of the signs that are in Mandarin and I'm still able to get around.
Sylk Health — Adam Cunningham
No.
Sylk Health — Adam Cunningham
No, it certainly would be easier, you know, having someone who does speak the language there with you. But the mindset that I approach to say medical tourism is that, you know, when you're down on your luck, when you've got some issue that you need to get solved, things might be tedious, they might be a little bit more painful, so to speak. But if I can get treated in say China for $5,000, where it might be $26,000, $30,000 in the US.
Yeah, I'll figure out how to speak a little bit of Mandarin. Yeah, I'll download a translator app on my phone. I'll figure it out when the price difference is that massive. And so, yeah, there are going to be challenges. There's going to be difficulties. I won't pretend that that's not the case. But what I will say is that for people who do need treatment, people who do need help, it's a no-brainer.
Host
have you ever done the math to figure out, you know, the minimum cost of a procedure or the minimum savings that actually makes it financially viable? I'm just, I know I'm putting you on the spot, but you know, let's say you're coming from either LA or New York in terms of, you know, factoring in the cost of the flight and everything, you're not going to go there to get some simple stitches, obviously. So what is the kind of cost savings and differentials that make it make sense?
Sylk Health — Adam Cunningham
No, no, no.
Sylk Health — Adam Cunningham
I'll take you up on that simple stitching as a matter of fact. The way I've experienced it thus far, and I've had to learn a lot about the American healthcare system beyond just everything's bloody expensive. What I have learned is that, yes, quite often hospitals are exceptionally, absurdly expensive when it comes to their prices. I've heard of patients that I've spoken to, that colleagues have spoken to.
Host
Okay.
Sylk Health — Adam Cunningham
being charged five, six, $7,000 for MRIs at hospital. Absolutely ridiculous numbers. And then I've come into contact with other clinics, like non-hospital practices, who are doing the same MRIs for $600, $500, and so on and so forth. But I'll take MRIs as an example. I think that's kind of close to a few stitches. And I think it's been shown a bit on social media recently. For the price of an MRI in China,
I could get a flight from say LA to Beijing anywhere between 800 to 1200 dollars and get a 70 dollar MRI at almost any hospital except the very high-end private hospitals and then fly back all for less than a thousand dollars most of the time and to compare that against hospital prices it's a no-brainer when you're paying five or six thousand dollars or being charged
five or $60,000 by a hospital. So it's not always necessarily the best choice, but in a lot of cases, is certainly a very reasonable choice. say there's things such as heart bypasses, that's a common one. Heart bypass in the US, our lowest estimates are about $45,000. That estimate is not true. It's closer to
all the way up to $85,000, $90,000 most of the time. But that's our lowest estimate we'll go by. We have published direct information from our healthcare providers in China showing heart bypasses for anywhere between 15 to $20,000 all the way up to about $30,000. And once you call up and find out, you can generally get a quite accurate price. But the point is that
Host
Mm-hmm.
Sylk Health — Adam Cunningham
even the upper end of Chinese healthcare is still cheaper than the very lowest estimate you can possibly get in the US. And that's not lacking any quality or anything of that nature. And I think that's the hump, the issue, the hurdle that many people need to get past is this understanding that, it's Chinese junk or something like that.
The hospitals that we partner with in China are not just good. They're on the same tier as many elite hospitals in the US when it comes to the equipment they have, when it comes to the doctors and healthcare staff that they have, when it comes to the research they publish by any and every metric. They are quite often on par and also quite often ahead of their Western competitors, you might say.
Host
Sure. And what do you find are you mentioned heart bypass being common? Are there other quite frequent, quite common requests for specific procedures? What are the most common ones that you're seeing?
Sylk Health — Adam Cunningham
Orthopedics. It's almost always orthopedics and it's almost always cancer treatment. The big ones are orthopedics, cancer treatment. One of the huge search terms is CAR T treatment. As a matter of fact, I'll give you a story there. We recently got our search engine optimization running properly on our website. And in our first day, we generated about, I think, 11,000 impressions just for CAR T treatment.
And to go from zero to 11,000 a day, it's quite impressive. And the clicks that we generated, we got about 800 clicks for CAR T treatment just in a single day. And it's only been going up ever since. And the point being is that people really do need solutions, in particular for cancer. And just the price difference is quite often the issue. CAR T treatment in the US, CAR T cancer treatment in the US.
is quite often $400,000 $500,000 and it goes above that. And in China we're looking closer to about $50,000 to $75,000. It can go a little bit higher than that.
Host
What is CAR T treatment?
Sylk Health — Adam Cunningham
CAR T treatment, it's probably the most advanced means by which cancer can be treated these days. There's been plenty of other approaches to it previously, but CAR T treatment is effectively the most, not the most aggressive, but it's certainly the most effective form of cancer treatment that's currently on the market. And there are some adjuvants, sorry.
Not algebra, that's what I'm saying. There are some other treatments that go alongside it. I know many hospitals in China are engaging things such as stem cell treatment in addition to CAR T treatment. But CAR T is currently the gold standard.
Host
Well, I mean, when you start introducing stem cells where there's regulation and it's not even available in America, that also makes it somewhat appealing. What about, tell me about aftercare. So let's say you have some of these procedures and you actually have to stay hospitalized for a while or in kind of a therapy kind of post-op. What are the costs of staying in China? Like, are they also kind of conveniently affordable?
Sylk Health — Adam Cunningham
Mm.
Sylk Health — Adam Cunningham
Yeah, to put very simply, with all the costs that are involved in US medicine, and about 34 % of your hospital cost in the US is going to be in administrative fees. So it doesn't even go to treating, it just goes to paperwork. But the cost in the US is so absurd that for many different procedures, say you're doing
say you're doing like a five or six or seven day stay at a hospital in Beijing, for instance, you can easily afford to stay at some of the best hotels there, paying $1,000 a night. And it's still going to work out at maybe a third or half the price of American treatment. But for longer things such as cancer treatments, ongoing cancer treatments, such as any blood treatments, for instance, where you might be staying for a month or two months at a time, or maybe returning and things like that, the costs will rack up. I won't pretend they...
they don't. However, they're still going to be relatively reasonable, and still significantly cheaper than the equivalents in the US. So for instance, there are many hotels, places in Beijing, which is by far one the most expensive cities in China. And I'm not talking like going out to some slum in the middle of nowhere, but you quite often can get affordable housing for a month or two at a time for about $80 to $120 a night.
It's not great, but it's still cheaper than your alternatives.
Host
Well, where I live in Los Angeles, can't get an Airbnb for anywhere close to that. So it still sounds like a steal. And what's your role? So what does Silk Health do?
Sylk Health — Adam Cunningham
You
Sylk Health — Adam Cunningham
Right, so like with all things, I like to give a bit of context to it. A lot of other medical tourism sites, what they do is they obfuscate the ability to get in contact with medical providers. And while I am running a business inherently, my goal is effectively to help people. And the way I do that is by getting rid of all the friction. So the way our website works is,
you find a procedure that you'd like to have done or multiple procedures that you'd to have done. So you search for that on our website or you go through our catalog, you select it. You then see all of the different healthcare providers that we're partnered with in China who provide it. And all of them generally have their prices or their price range for a procedure listed on it. And then you can select them and then move on to a consultation. And they all generally speaking,
have a consultation time that they have posted. And so you can just simply take one of those consultation times, book it, and you'll be done in about three, four, five minutes at most. And then from there, sorry.
Host
When you say book a consultation, are you booking it with the hospital or with you or one of your staff?
Sylk Health — Adam Cunningham
No, so we hand off the entire process immediately to the hospital. We don't want to provide you services that you then have to pay for. That just racks up the bill. So as far as we're concerned, we hand the patient or the potential patient a patient ID, we hand the hospital a patient ID, and then that's it. We're done. And that way,
Host
So they don't actually interact with you other than your website.
Sylk Health — Adam Cunningham
No, no, we're acting purely as a marketplace, so to speak, like eBay or Amazon or whatever. We're just simply there to get the word out, so to speak.
Host
Got it.
Host
That's great. there's no, you know, kind of playing this phone tag with you and then this delayed relay like you get with other medical tourism sites where you have to kind of rely on the one person who secretly knows which doctor and which facility. So the transparency is kind of right up front because the price is the price. You're talking directly to the hospital. There's no surprises.
Sylk Health — Adam Cunningham
Exactly.
Sylk Health — Adam Cunningham
Exactly. And that's the one thing that both in my experience, working in hospitals and seeing other people who are sick and being sick myself is that the price is always obfuscated. It's always hidden. It's always a long and arduous and tedious process. And I understand that, you know, as a patient, have to do due diligence. You have to look around, you have to evaluate your options. And as a service, that's partly what we're here for is so you can evaluate your options. You can see what's out there.
But the perfect world, as far as I'm concerned, is the use our website and you're able to get a consultation in a matter of minutes. You're able to schedule it. It might be this week. It might be next week. And then you're able to hopefully book a flight to China the week after and receive treatment. No needless tedium and back and forth and all kinds of nonsense. It's all about how quickly can you get treated? How quickly can you get back to living your life?
Host
And I see on your, on your website, on your homepage, when I visited it, you have actual prices right on the homepage, everything from hip replacements to IVF to CAR T therapy, the dental with 50 to 90 % savings. So you're, you know, you're kind of consistent with what you're telling me here. It's like, it's right there and black and white or green and white, guess in your case. And, and, and it's, and there's no kind of beating around the butch. Now, are there costs to the patient and how does that work?
Sylk Health — Adam Cunningham
Yeah.
Yeah.
Sylk Health — Adam Cunningham
costs of the patient as far as our service goes, the cost is free. We're paid by the hospitals, but as far as everything goes, it's an entirely free service. We're not here to fleece the patient for a bunch of money. And that's the issue that I see with other medical tourism sites. And that's the issue I'm trying to avoid is we don't want to fleece people. We're not going to add on needless packages. as a matter of fact, we're trying to do some deals right now with Air China to try and reduce.
transport costs and things like that. for us, as far as we're concerned, it's all about bringing the price down. So no, we don't do that.
Host
Okay. Well, what haven't we covered? mean, I thought this was pretty extensive and kind of a short order here. What, what am I not thinking to ask you that a lot of times comes up along the way?
Sylk Health — Adam Cunningham
I think you've asked probably the heavy questions. The most important one is quality. It's really understanding what quality is. And it's something that's simply changing with the times. It's an old understanding of what Chinese services and products are, is that the old understanding of their garbage, their cheap, their junk, blah, blah, blah, blah, blah. And the reality is, is that's completely shifted. That's completely changed. And frankly, you're going to be getting superior treatment in most cases.
in Chinese hospitals. Of course, I should probably say that given that I'm advertising Chinese hospitals, but it is my true and honest belief that yes, you are going to be getting better treatment most of the time in Chinese hospitals. Certainly the ones that we partner with. And I from my perspective, I honestly want to I want to not necessarily push this, but I want to give people options. I want to give people so many options that
US healthcare either has to kick me off an elevator, kick me out a window, or they have to change. Because in my honest opinion, eventually I'd like to go out of business. I know that sounds like a bit of a bold statement to make, but eventually I'd like to go out of business. And the way I'd like to do that is by putting so much pressure on the American healthcare system, by putting so much pressure on the British healthcare system, and by putting so much pressure on the Australian healthcare system.
that they have to take notice, they have to listen, and they have to realize we can't keep getting away with this. We can't keep getting away with 18, 20, 30 month wait times in the UK. We can't keep getting away with healthcare prices in the US that are charged either three to 30 times more than their Medicare standard price. I want to put so much pressure on these companies that they have to take listen, they have to listen, they have to take notice, and they have to change.
Host
Talk to me a little bit about culture. So, you know, what is the actual experience of the personalities and the care in the hospitals? Are there cultural differences other than the obvious language barrier that you have to kind of figure out to navigate around?
Sylk Health — Adam Cunningham
There are certainly cultural differences when it comes to perhaps the understanding of your needs. And that's something that can be easily communicated either personally or by a translator or whatever it might be. But perhaps one of the biggest things and what many people don't necessarily realize is many, if not most hospitals, especially private hospitals in China offer traditional Chinese medicine in addition to
their standard practice, their standard surgical or medical practice or whatever it might be. And it's not necessarily seen as something that is just there as like some tourist attraction or something like that, but it is seen as a real addition to standard treatment. And for many people, I believe there's bit of a consciousness shift when it comes to people, say of my generation, your generation.
when it comes to understanding that there's not just...
that medicine, that surgery, that health is not necessarily just like the standard Western treatments, but it's more holistic, you might say, but there's more to it. There's more things that need to be taken into consideration. And I would say that's one of the big, big things that stands out both to me as a, as a business owner and operator, but also as a patient as well is that there are other facets to your treatment. There are other facets to your health. And I think they're well taken care of in China.
Host
And do they have any kind of bias against Americans that you've heard? You know, I know a lot of people are like, I'm going to be the annoying American and they're not going to treat me well because they have a bias against me. Or do you find that once you get into the hospital system, that's not the case?
Sylk Health — Adam Cunningham
Absolutely not. As a matter of fact, there's a woman I speak quite frequently with from United Family Health. That's one of the largest medical groups in that we are partnering with. And she's, I'm not mistaken, from Bolivia, speaks great English and she sees plenty of American patients. She's actually the International Patient Coordinator.
or one of the international patient coordinators, and they see plenty of Americans. And when I gave them the news, essentially, that we'd like to bring American patients to them, they were absolutely overjoyed and absolutely over the moon just to see more and more patients coming from abroad. And it's not so much as a revenue question, it's more of a, wow, people are recognizing our hospitals, our services for what they are, for the quality that they bring, for the different angle that they can provide.
And so in my experience, no. Chinese people are incredibly welcoming of foreigners. I certainly have never felt like I'm, well, certainly you feel like you're a stranger, but I've never felt unwelcomed by Chinese people. I've always felt very welcomed and always very happy for me to be there and to do business with them. And certainly as a patient, the people that I've spoken to, I haven't had a single one that's complained yet.
Host
Good to hear. Well, if you want to take a look at the website again, it's silkhealth.com. That's S-Y-L-K health.com. Adam Cunningham, thank you so much for being on the podcast.
Sylk Health — Adam Cunningham
It's been a pleasure. Thank you very much, John.
