Sam Radwan, founder of Enhance International, has worked on health developments inside China for two decades. He shares his insights and raises some difficult questions. Over 80 year olds continue to be highly vulnerable; only 66% have been vaccinated. China’s 400 million rural poor live with starkly different medial support realities, and we have little visibility into what they are experiencing. An increasing number of Chinese will be traveling abroad to seek medical care, as medical literacy rises. Hong Kong is gearing up as a medical center. Can we imagine a radical decoupling in the health sector, between China and the United States? The deterioration of the US-China relationship is pushing in that direction and will have consequences for reform of the health care sector in China. We need to watch the Chinese government’s drive to restore economic growth. His hope: “cooler heads will prevail” as we realize we need one another in health.