拉丁美洲医疗市场的未来：与Global Health Intelligence首席执行官Guillaume Corpart的对话

这是由AMI带来的Oraisontes播客，AMI是拉丁美洲领先的市场情报咨询公司。

This is the Oraisontes podcast brought to you by AMI, the leading market intelligence consultancy for Latin America.

AMI为在拉丁美洲拓展或巩固市场地位的企业提供定制化研究和战略建议。

AMI conducts bespoke research and provides strategic advice to companies both growing and defending their market position in Latin America.

我是您的主持人约翰·普赖斯。

I'm John Price, your host.

在本期及时的节目中，我们将通过拉丁美洲最资深的分析师之一——全球健康情报公司的吉勒姆·科帕特的视角，深入审视拉丁美洲的医疗行业。

For today's timely episode, we're going to take a close look at Latin America's health sector through the eyes of one of its most informed analysts, Guillaume Coppart of Global Health Intelligence.

在该地区的几乎所有市场中，医疗服务均由政府和私营部门共同提供。

In almost every market in the region, health care is a service provided by both the state and the private sector.

拉丁美洲的公共医疗部门以低效和普遍腐败而闻名。

Latin America's public health care sector is notoriously inefficient and often corrupt.

但新冠疫情迫使该行业重新思考，因为其受到了严格审查。

But COVID forced new thinking upon the sector as it was heavily scrutinized.

如今，拉丁美洲是全球老龄化速度最快的地区之一，慢性病的激增正给拉丁美洲各国政府的财政平衡带来日益沉重的压力。

Latin America today is one of the fastest aging populations in the world with an explosion of chronic diseases putting increasing strains upon the fiscal balances of Latin American governments going forward.

未来几年还需要更多的创新和效率。

Even more innovation and efficiency will be required in years ahead.

他们超过50%的医疗设备进口来自中国，而疫情前这一比例可能只有20%多一些。

Over 50% of their medical device imports come from China compared to probably by the high 20s before COVID.

因此，疫情成为推动供应链多元化、产品来源多元化的重大催化剂，而中国从中获得了巨大利益。

So COVID was a big detonator in terms of diversifying the supply chain, diversifying where products come from, and China has been able to capitalize on that greatly.

从更实际的角度来看，对于为美国医疗市场提供服务、技术或设备的供应商而言，该地区既带来可观的利润，也伴随着巨大的障碍和风险。

On a more practical level, for those servicing the American healthcare market as a supplier of services, technology or equipment, the region offers both healthy margins and enormous obstacles and risks.

例如，中国医疗设备如今已占巴西医疗行业进口总量的高达50%。

Chinese medical devices now take up as much as 50% of the volumes of imports in Brazil's healthcare sector, for example.

应对复杂的监管要求，为打算在该地区销售产品的公司带来了难以估量的成本。

Navigating regulatory complexities adds untold costs to companies set up to sell inside the region.

因此，为了帮助我们理解这个充满活力且迅速发展的市场的独特性，我非常高兴地邀请到全球健康情报公司董事总经理吉勒姆·科帕尔进行访谈。他长期隶属于美国市场情报公司，更重要的是，对我来说，他是一位挚友。

So to help us understand the idiosyncrasies of this dynamic and burgeoning market, I am so pleased to be interviewing Guillaume Copart, Managing Director of Global Health Intelligence, a longtime affiliate of America's Market Intelligence, and most importantly to me, a dear friend.

吉勒姆，很高兴见到你。

Guillaume, it's great to see you.

非常感谢你参与这次访谈。

Thank you so much for doing this.

我一直期待着这次对话。

Been looking forward to this conversation.

太棒了。

Awesome.

谢谢你邀请我，约翰。

Thank you for having me, John.

非常感激。

Appreciate it.

你知道吗，Guillaume，我认为对于医疗保健领域，对很多人来说——因为这次通话的大多数人并不一定来自医疗行业——但对我来说，医疗保健就像教育一样。

You know, Guillaume, I think for healthcare, for a lot of people, because most people on this call are not necessarily from the healthcare space, but healthcare to me is sort of like education.

它属于那种触及我们每个人的公共服务业，而且在经济上也有惊人的影响力。

It's one of those industries, one of those public services that touches us all as individuals, And it has surprising reach economically as well.

无论你从事什么行业，都很可能与医疗行业有某种交集。

It's quite likely that regardless of what business you are in, you probably have some sort of touchdown with the healthcare industry.

所以我认为，就像教育一样，人们对医疗保健以及各自国家医疗体系的现状往往持有非常强烈的意见。

So I think, and much like education, I think people have pretty strong opinions about health care and the state of their health care industry in their in their respective countries.

因此，我认为这应该会成为一个广受欢迎的话题。

So I think this should promise us to be a broadly popular topic.

你知道吗，吉勒姆，在我们深入探讨拉丁美洲医疗保健这一广泛而复杂的话题之前，你能和我们分享一下，是什么让你投身这个领域，以及你为何对研究它产生如此浓厚的兴趣吗？

You know, Guillaume, before we dive into a robust and multifaceted discussion about healthcare in Latin America, can you share with us a little bit about what led you to the sector and why you became so interested in studying it?

当然可以，没问题。

Sure, absolutely.

谢谢你，约翰。

Thanks, John.

我一直以来都被医疗保健行业所吸引，部分原因在于它的复杂性。

I've always kind of been drawn and attracted to the healthcare sector in general, partly because of its complexities.

当我们审视医疗保健行业时，我们明确识别出六个常被提及的利益相关方：患者、医生、服务提供方、支付方和政策制定者。

When we're looking at the healthcare sector, we've clearly identified about six stakeholders that we always refer to, the patient, the physicians, the providers, the payers, and the policymakers.

而这正是医疗保健行业的独特之处。

And that's very unique to health care.

没有其他行业像这样，对它的客户有着如此模糊的定义。

Like no other sector has you know, such a vague definition of its client.

对吧？

Right?

通常，客户是指实际购买或使用产品的人。

Usually, a client is someone who's actually buying the product or who's using it.

但在医疗行业，社会才是最终的客户。

But in the health care sector, the society is really the ultimate client.

而根据你实现目标的方式，你会与不同的利益相关者互动。

And depending on how you're reaching your goals, you're gonna interact with different stakeholders throughout.

因此，医疗行业令人着迷的地方就在于此，再加上它极其动态的特性。

So that's something that's absolutely fascinating with, with the health care sector on top of the fact that it's extremely dynamic.

是的。

Sure.

你和我认识很久了，我一直很惊讶，尽管你没有医学方面的学术背景，但医疗行业、你的客户和你的营销受众依然如此尊重你？

Now you and I have known each other for a long time, and I've always marveled at the respect that the health care industry, your clients, your marketing audience gives you in spite of the fact that you don't have an academic background in medicine?

因为你知道，医疗行业非常看重学术背景，常常对那些没有接受过专业医学教育的人持轻视态度。

Because as you know, the health industry can be pretty hung up on academic credentials and can be pretty dismissive to people who have not studied medicine professionally.

那么，你如何凭借商业背景而非医学专业训练，在这个行业中脱颖而出成为分析师的呢？

How did you manage to excel as an analyst of this industry with essentially a business background and not medical studies per se?

当然。

Sure.

而且我觉得你开头说得对，医疗保健关乎我们每一个人，对吧？

And I think you mentioned it correctly at the beginning, which is healthcare touches us all, right?

无论我们是婴儿、儿童还是老年人，医疗保健都贯穿我们的一生，就像教育一样。

Like whether we're infants or babies or seniors, healthcare goes throughout our lives, kind of like education.

我们必须牢记，终有一天我们都会成为患者，对吧？

And I think we have to keep in mind that at some point we are all patients, right?

无论是因为健康问题需要前往医疗机构就诊，还是在家进行预防性健康管理，对吧？

Whether we need to actually access a facility for direct health concern, or we're actually doing preventive health at home, right?

比如吃得更好、多运动，或者任何其他方式。

Like eating better or exercising or whatever it is.

所以我们都是患者。

So we're all patients.

因此，医疗保健伴随我们的一生。

So healthcare is with us through our entire lives.

此外，我认为当我们审视医疗体系时，总还有改进的空间。

In addition to that, I think when we look at healthcare systems, there's always room for improvement.

我从未遇到过一个人说，‘我国家的医疗体系太棒了。'

I haven't spoken to a single person in the world that says, hey, the healthcare system in my country is amazing.

它是世界上最好的，对吧？

It's the best one there is, right?

从来没人这么说过。

Like nobody ever says that.

没错。

That's right.

当然。

Absolutely.

存在

There's

在这方面总有改进的空间。

always room for improvement in that regard.

确实如此。

Absolutely.

这使得创办一家专注于这一领域的公司变得非常有趣。

Which makes it, you know, very interesting to kind of launch a business specializing in that space.

我记得，我们刚起步时，当时的客户CareFusion来找我们，说：‘吉勒姆，我们注意到巴西有大量的数据信息。’

And I remember, you know, when we first started off, you'll remember our client at the time CareFusion came to us and said, hey, you know, Guillaume, we see that there's a huge dataset of information in Brazil.

现在它叫De Jesus，某种程度上是可以获取的。

Today it's called De Jesus and it's, you know, somewhat accessible.

但当时，也就是十五年前，获取这些数据非常困难。

But at the time, like fifteen years ago, it was very difficult to access that data.

他们希望提取这些数据，以制定商业计划，了解医疗机构的情况以及在哪里可以推出新产品。

And they wanted to extract it to make their business plans to understand what's going on with institutions and where they could launch new products.

因此，我们是最早能够提取这些数据并将其转化为分析结果的公司之一。

And so, we were amongst the first to be able to extract that and turn it into an analysis.

结果，他们回来问：‘那我们能在墨西哥做同样的事吗？’

And, as a result, they came back and said, Hey, now can we do it in Mexico?

我们能在哥伦比亚做吗？

Can we do it in Colombia?

我们能在智利和其他国家做吗？

Can we do it in Chile and in other countries?

这真正成为了一个关键转折点，促使我们开发出当时医疗设备和医疗器材公司所缺乏的解决方案。

And that really became kind of like a pivotal moment to develop a solution or solutions that didn't exist at the time for medical device and medical equipment companies.

所以，是的。

So Yeah.

我清楚地记得，当你们公司Global Health Intelligence接手这项艰巨任务，试图通过整合各种公开数据，并通过呼叫中心等渠道进行电话调研来构建医院数据库时的情景。

I I remember clearly when your firm, Global Health Intelligence, took on this gargantuous task of trying to create a hospital database by drawing from different public data, as well as conducting your own telephone research through call centers, etcetera, to fill out that.

如果我没记错的话，这个过程花了大约两年时间才完成。

And if I recall, that was like a two year process to bill.

我知道你后来又增加了内容，但在此之前，你花了整整两年时间才做出一个可以推向市场的东西。

I know you've sort of added since then, but it was like two years before you had something you could kinda bring to market.

这需要极大的投入，坦白说，在拉丁美洲的研究公司中这种做法非常罕见，因为大多数时候，我们这个领域的公司只是在应对不断变化的市场，很少有人有决心、时间和远见去投资那些要几年后才能见效的项目。

And that takes an enormous commitment and is rare, frankly, amongst research firms in Latin America because most of the time, firms in our space are sort of reacting to what is a constantly changing market, and few have the conviction, the time, and the presence of mind to invest in something that's only gonna bear fruit a couple years down the road.

那么，是什么让你有勇气做出这样的投资呢？

So what what what gave you the confidence to make that investment?

你知道，这其实是

You know, so it's

你看到了什么别人没看到的东西吗？

What did you see that perhaps others didn't see?

对。

Right.

谢谢。

Thank you.

我认为部分原因在于这是一个空白领域。

I think it's, in part the fact that it's a white space.

对吧？

Right?

医疗设备，特别是在医疗保健领域，医疗设备和医疗器材市场并没有得到很好的整理或理解。

Medical devices, specifically within health care, the medical device and the medical equipment space is not very well cataloged or understood.

因此，开发满足医疗设备和医疗器材公司需求的解决方案非常独特，且需要很长时间才能完成。

And so trying to develop solutions that meet the needs of medical device and medical equipment companies is really unique and does take time to develop.

我们之前提到的第一个数据集，HospiScope，花了两年时间才开发出来。

That first dataset that we're talking about HospiScope did take two years to develop.

之后我们又开发了其他数据集，有些花了三年时间，现在才刚刚准备发布。

Then we've developed others, and some have taken three years, and we're only about to launch them now.

要真正获取这些数据需要很长时间，部分原因是医疗设备非常复杂。

It takes a long time to actually get the data, in part because medical devices are very complex.

例如，起搏器就有成千上万种不同的型号，对吧？

There's thousands of versions of a pacemaker, for instance, right?

而拉丁美洲有17个国家，每个国家还有多个监管机构。

And then there's 17 countries in Latin America, multiple regulatory agencies.

理解起来非常复杂。

It's very complex to understand.

当然。

Sure.

我认为，支撑这一领域信心的一个重要因素是拉丁美洲的人口结构正在迅速变化。

I think one of the things that certainly underpins confidence in this sector is the fact that the demographics of Latin America are changing so rapidly.

我所说的是拉丁美洲的老龄化。

And what I'm talking about is the aging of Latin America.

拉丁美洲是全球老龄化最快的地区。

Latin America is the fastest aging region in the world.

在不到四十年的时间里，女性生育的孩子数量从五个下降到两个，这一转变速度比欧洲和美国都更快。

It's gone from five children per woman to two in barely under forty years, faster than Europe went through the same transition, United States went through the same transition.

因此，这意味着老年人口快速增长，而我们在这一阶段的医疗支出最多。

So that of course means a fast growing elderly population, which is when we spend most of our money on healthcare.

你觉得哪些国家受到这一人口趋势的影响最严重？

Which countries do you feel this demographic trend is is hardest hit and is is felt the most?

这显然是一股影响整个地区的趋势。

So this is clearly a trend that's impacting the entire region.

对吧？

Right?

如果我们回顾过去十年的数据，会发现0到25岁年龄段的人口减少了约10%，而工作年龄段（大约25到55或60岁）基本保持稳定，但60岁以上的人口在过去十年中增长了约50%。

And if we look at data from, you know, just going back the last decade, there's a contraction of age groups, you know, from zero to about 25 and about 10%, and then the, you know, the the working age, let's call it from about 25 to about 55, 60 remains relatively stable, but then above 60 has you know, that age group grew about 50% in the last decade.

因此，这是一股遍及整个地区的趋势，但如果我们只看老龄化人口数据，有几个国家尤为突出。

So that's that's a trend that's throughout the region, but there's a couple of countries that really stand out if we look at just the aging demographics.

如今拉丁美洲的平均年龄约为32岁，而智利的人口平均年龄比这高出五岁，约为37岁。

So the average age in Latin America is about 32 years old today, and the Chile, Chile's population is about five years older than that, about 37.

这听起来似乎只是五岁的差距，从地区中位年龄到一个国家的年龄，但这一差异对社会和老龄化人口产生了巨大影响，因为你要记住，这相当于把整个钟形曲线向右推移，随之带来的一切变化。

So it doesn't sound like much, just a five year difference from the median age to in one country versus the region, but it has a big impact in terms of society, in terms of aging population because you have to remember, it's like pulling that whole bell curve to the right and everything that goes with it.

因此，在各类产品和服务的需求上，包括医疗保健，也发生了巨大转变。

So, huge shift also in terms of the demand for all sorts of products and services, including health care.

对。

Right.

我知道，我的意思是，这个数据让我很惊讶，我不知道它是否可靠，但大约85%的人一生中在医疗上的花费都发生在生命的最后十八个月里。

And I understand I I mean, I was amazed by this statistic, and I don't know if it's a reliable one, but something like 85% of our lifelong spend on health care happens in the last eighteen months of our lives.

因此，如果这些老年人口的数量真的开始快速增长，这不仅会带来财政压力，还会引发其他社会变化，但会对这些国家造成巨大的财政负担，迫使它们的公共医疗系统不堪重负以应对这一挑战。

So if that population of those elderly people is really starting to accelerate, that's gonna have a fiscal burden as well as other societal changes, but it's gonna have a big fiscal burden on these countries as they and strain their public health care system to try to deal with that.

在这个地区，有没有哪些国家比其他国家更做好了应对这一财政挑战的准备？

Are there countries that are better prepared for that fiscal challenge versus others, in the region?

是的。

Yes.

当然。

Absolutely.

为了更好地说明问题，美国大约将其GDP的16%用于医疗保健，是全球最高的。

So just to put things in perspective, The United States spends about 16% of its GDP on health care, right, the most in the world.

大多数其他发达国家的医疗支出约占GDP的10%，比如日本、德国、法国、加拿大等国家。

Most other developed nations spend about 10%, whether that's, you know, Japan, Germany, France, Canada, and others.

大致就在10%左右。

It's right around 10%.

在拉丁美洲，实际上只有很少的国家医疗支出超过7%。

In Latin America, there are actually very few countries that spend above 7%.

所以差距非常大。

So big, big difference.

事实上，世界卫生组织建议将GDP的9%左右投入医疗保健。

In fact, the World Health Organization puts a target at around 9% of GDP should be invested in health care.

这是一个浮动目标。

That's a floating target.

对吧？

Right?

一般来说，拉丁美洲的人口比世界其他地区年轻得多。

And generally speaking, Latin American populations are much younger than the rest of the world.

他们还没有达到你提到的美国或日本十五、二十年前经历的那种人口年龄结构转变。

They're not quite at that, you know, a demographic age shift that you were talking about in, you know, The United States or Japan has experienced maybe fifteen, twenty years ago.

所以他们现在可以少投入一些，但迟早会面临压力。

So they can get away with investing a little less right now, but it's gonna catch up to them.

在拉丁美洲，智利是唯一一个在医疗保健上投入其GDP约9%至10%的国家，其准备程度远超其他国家。

The one country that's much better positioned than any other in Latin America is Chile, investing right around nine to 10% of its GDP on health care.

这既包括发展医疗设备、基础设施和机构，也包括提高民众获得医疗服务的可及性。

And that's that's both in terms of developing equipment, in terms of developing infrastructure, institutions, as well as, you know, increasing access to care for populations.

在其他国家，你和我都是加拿大人，加拿大几乎拥有完全公共的医疗体系。

Now in other countries, you and I are both Canadian and Canada has an almost exclusively public healthcare system.

所以我们从小接触并受到各种面向消费者的广告影响，这些广告教导人们如何保持健康、避免某些食物、确保进行特定活动。

So we grew up with and exposed to all kinds of advertisements directed at consumers to basically how to stay healthy, how to avoid certain foods, make sure you do certain activities.

这一切都是因为医疗保健给政府带来了巨大开支，因此他们试图通过引导消费者行为来控制成本。

And that was a direct result of the fact that health care costs the government a lot of money, and so they're trying to shape consumer behavior to keep those costs down.

那么，拉丁美洲今天是否也在出现类似的宣传信息呢？

Is that are we seeing that kind of messaging happening in Latin America today?

确实有一些这样的情况在发生。

So there there is a little bit of that happening.

比如，我们看到一些国家开始在高糖或高盐含量的产品上贴上标签。

You know, we've seen several countries put labels on products that have high sugar content or high salt content, for instance.

这种情况确实有一点发生，但我们还没有看到它对整体人口健康或消费者习惯产生直接的结果或影响。

That is happening a little bit, but we haven't seen a direct result or direct impact on population health in general or on consumer habits in general.

所以这更多是一种信息性的举措，但在看到对人口健康产生实际效果或影响方面，我还没有发现任何指向这一点的证据。

So it's more like an informative aspect, but in terms of seeing a result or an impact on population health, I I haven't seen anything pointing to that.

好的。

Okay.

在财政挑战方面，拉丁美洲几乎每个国家都拥有公共和私人医疗保健的混合体系。

And along the lines of this fiscal challenge, almost every country in Latin America has a mixture of public and private health care.

嗯。

Mhmm.

各个国家的公共医疗体系的健全程度差异很大。

The level of robustness of the public system varies quite a bit by country.

因此，这两种体系并存。

So these two systems live side by side.

考虑到这些财政限制，以及随着医疗支出增加而带来的更大财政负担，你认为未来十年该地区这种混合模式将如何变化？

Given those fiscal constraints and given what will be even bigger fiscal burdens on as health care spend goes up, How do you see that mix changing over the next ten years in the region?

所以我觉得，目前拉丁美洲的政府确实面临很大的财政压力。

So I I feel that there's definitely a lot of fiscal constraints on the part of governments right now in Latin America.

虽然医疗保健就像教育一样，是一个非常本土化和国家性的领域，但我们也必须认识到，医疗设备和器械的很多产品都来自国外。

And while health care is a very domestic and a national element, right, kind of like education is, we also have to recognize that when it comes to medical devices, medical equipment, a lot of them come from outside.

因此，当这些产品来自欧洲或美国时，它们的成本通常是美元计价的。

So, when they're coming from Europe or from The United States, typically their production is dollarized in terms of costs.

我们现在看到的是一种非常独特的情况：大量中国产品，不仅仅是亚洲产品，而是特指中国产品，正在进入拉丁美洲。

What we're seeing right now is really kind of unique is seeing a lot of Chinese products, not just Asian, but specifically Chinese products coming into Latin America.

按数量计算。

By number of units.

例如，巴西、哥伦比亚和智利目前超过50%的医疗设备进口来自中国。

For instance, Brazil Brazil, Colombia, and Chile currently have over 50% of their medical device imports come from China.

相比之下，新冠疫情前这一比例可能在20%多一点。

Right, compared to probably by the high 20s before COVID.

因此，新冠疫情成为了一个重要的催化剂，推动了供应链的多元化和产品来源的多样化，而中国已经充分利用了这一机会。

So COVID was a big detonator in terms of diversifying the supply chain, diversifying where products come from, and China has been able to capitalize on that greatly.

好的。

Okay.

我之前没意识到，是的，这确实是一个新动向。

I didn't realize that, yeah, that that is a new development.

我的意思是，我知道他们在电子商务领域已经取得了巨大进展。

That's I mean, I know that they've made huge inroads in ecommerce in general.

出于好奇，这些产品是通过传统分销渠道进入市场，还是也越来越多地采用直接面向消费者的模式？

Just out of curiosity, is that are those products going through traditional distribution channels, or is there also more and more direct to consumer kind of stuff?

不是。

No.

它们通常通过直销渠道或经由进口商进入传统渠道，进口商再将产品分销给各类机构，比如诊所、药房或医院。

They are going through typically direct channels or traditional channels through an importer that then looks to distribute their products to institutions, whether clinics, pharmacies, or hospitals.

然而，这些渠道大多尚未整合，也不如现有主流厂商的渠道完善。

However, most of these channels are not consolidated or not as well established as for the incumbent players.

因此，你经常会看到某种产品只销售了六个月或一年，然后分销商就更换或退出了，你甚至找不到替换零件。

So what you'll see is oftentimes a product appear being carried for six months or a year, then the distributor shifts or moves, You can't find a replacement part for it.

你知道，这些正是目前许多来自其他地区的新兴企业正在解决的问题。

You know, those are kind of the kinks that are being worked out right now with a lot of these, new players from from from other other regions.

对。

Right.

你还要认识到，并非所有亚洲、中国或市场上的新进入者都是低成本的小公司。

You also have to recognize that not all, you know, Asian or Chinese or new players in the market are necessarily small players at low cost.

这个市场中有一些非常先进的企业。

There are some very sophisticated players in this market.

微创医疗就是其中之一。

MicroPort is one of them, for instance.

迈瑞医疗是另一个例子。

Mindray is another.

联影医疗也是其中之一。

United is another.

这些公司都是在顶级舞台上竞争，直接与世界顶尖企业抗衡。

And these play in the big leagues, you compete head on with the world's best companies.

奥里赞特斯领导力论坛由美洲市场情报公司主办，该公司是该地区领先的咨询与顾问公司，三十多年来一直为在拉丁美洲和加勒比地区运营的企业提供服务。

The Orizantes Leadership Forum is brought to you by America's Market Intelligence, the region's leading consultancy and advisory firm, serving companies operating in Latin America and Caribbean markets for over three decades.

AMI在美洲各大市场拥有庞大的顾问网络，从独家渠道收集关键市场情报，由我们的行业实践负责人转化为富有洞察力的分析，帮助我们的客户——拉丁美洲最大的一些投资者——做出关键的商业决策。

AMI's vast network of consultants located in every major market in The Americas gather vital market intelligence from privileged sources that our industry practice leaders turn into insightful analysis to help our clients, some of the largest investors in Latin America, make vital business decisions.

在您决定投资、推出产品、选择合作伙伴、进入市场或收购企业之前，请确保您的决定是基于充分信息的。

Before you decide to invest, launch a product, choose a partner, enter a market, or acquire a business, make sure your decision is an informed one.

请访问americasmi.com了解更多信息。

Find us at americasmi.com.

网址是americasmi.com。

That's americasmi.com.

现在回到《Ole Son Test》播客。

And now back to the Ole Son Test podcast.

我们之前讨论过人口老龄化这一问题。

Now one of the things we've talked about demographics in the aging population.

另一个问题，作为一名在该地区生活或旅行超过三十年的人——我想说是二十五年吧——我认为这样说并不失礼：我注意到，至少在中上层阶级中——而我通常接触的正是这类人群，无论是在飞机上、机场、酒店还是商务会议等场合——他们的肥胖问题正日益严重。

Another issue, you know, as somebody who's lived in the either lived in the region or traveled the region for over thirty years yourself, I think, quarter century, I don't think it's impolite to say that I've seen, at least amongst the sort of middle and upper classes who tend to be where I interact, whether it's on a plane, at an airport, at a hotel, in business meetings, etcetera, are increasingly obese.

有统计数据能证明这一点吗？

Is that is there statistical proof of that?

这只是我的观察吗？

Is that just my observation?

你对此有什么看法？

What what's your sense there?

你知道吗，约翰，随着岁月流逝，你一直保持着非常健康的体态。

You know, John, you managed to remain extremely fit as the years pass on.

这简直令人难以置信。

It's unbelievable.

但我觉得你的观察是正确的，而且有数据支持。

But I think your observation is correct, and it it is backed up.

根据世界卫生组织的数据，拉丁美洲是全球超重人口比例最高的地区，超过百分之六十二。

According to the World Health Organization, Latin America has the highest prevalence of overweight people in the world, surpassing sixty two percent.

哇。

Wow.

对吧？

Right?

好的。

Okay.

因此，这种情况下的疾病负担非常沉重，可能是最肥胖的国家。

So it's it's huge burden of burden of disease in this case, and probably the most obese countries.

所以我们必须区分超重和肥胖。

So we have to distinguish between being overweight and being obese.

拉丁美洲超重人口的比例为百分之六十二。

The prevalence of overweight population is sixty two percent in Latin America.

显然，肥胖问题在智利、墨西哥和阿根廷最为严重，成年人口中超过百分之三十五。

Then there's obviously the obesity element, which is highest in, Chile, Mexico, Argentina at over thirty five percent of the adult population.

哇。

Wow.

因此，超重和肥胖人群的数量非常庞大，具体取决于国家。

So it's a huge amount of overweight and also obese people, depending on the country.

肥胖对慢性病水平造成了什么影响？哪些慢性病因此显著增加？

And what has that obesity done to chronic disease levels, and which chronic diseases have sort of grown as a result of that?

确实如此。

Absolutely.

从糖尿病、某些类型癌症的激增，到整个地区这些疾病的大幅上升。

So everything from the expansion of diabetes, of certain types of cancers, growing dramatically throughout the region.

我们当然可以查看一些具体的增长率，但在我看来，仅从肥胖角度而言，有两件事令人震惊。

We can certainly look some growth rates within that, but what I think is just astonishing, just from an obesity standpoint, are two things.

第一，拉丁美洲整体的肥胖率仍在以每年超过百分之三的速度增长，对吧？

One, obesity is growing at over three percent a year still in Latin America, right, region wide.

这简直难以置信。

I mean, it's just unbelievable.

我认为更令人担忧的是，这不仅仅是成年人的肥胖问题，还包括儿童肥胖问题。

And I think more worrisome still, it's not just the adult obesity part of it, but it's also the child obesity part of it.

目前，拉丁美洲五到十九岁的儿童中，超过三分之一超重。

So right now, over one third of children between five and 19 are overweight in Latin America.

所以我们需要问自己一个问题：在这种情况下，我们正在为孩子们创造一个怎样的健康未来？

So we wanna ask ourselves the question, what kind of health future are we giving our kids in this case?

我们在向孩子们传递什么样的信息？抛开外表和社会因素不谈。

What kind of messaging are we giving our children in terms forget about the aesthetics of it, forget about the social elements of it.

如果他们从小就已经超重，这对他们未来的健康意味着什么？

It's just what does this mean for their health moving forward if they're already starting, from an overweight stage at that young of an age.

是的。

Yeah.

作为经常往返于该地区的人，我非常喜欢步行，只要有机会，我都会步行去开会。

It's you know, as someone who travels the region frequently, and I'm a I'm an avid walker, so if given the opportunity, I'll walk to my meetings.

但坦率地说，在一些城市，步行路线非常不舒适，因为交通拥堵、污染严重，或者不安全。

But frankly, in some cities, either the walking routes are just very unpleasant because it's congested traffic, heavy pollution, or unsafe.

这不仅对我这个外国人如此，对任何在黄昏或晚上步行的人来说都是如此，我认为人们步行少的一个主要原因就是安全问题。

And not just for me as a foreigner, but for anybody walking at dusk or in the evening, I think one of the reasons people don't walk as much is safety.

另一个原因当然是汽车的泛滥以及人们逐渐远离步行。

And the other of course is just the proliferation of automobiles and the moving away from walking.

但没有改变的是这种高热量、富含卡路里的饮食，这种饮食原本是为需要大量体力活动的人设计的，无论是以碳水化合物为基础的饮食还是以蛋白质为基础的饮食。

But then what has not changed is this highly delicious caloric rich diet, which is really designed for people to be very productive with physical activity, whether it's mice based diets or protein based diets.

所以饮食没有变，但人们的生活方式却变得更加久坐不动。

And so the diet hasn't changed, but they're much more sedentary lifestyles.

我认为这确实是美国肥胖问题的根源，我猜想在拉丁美洲的情况也差不多。

And I think that's certainly the root of obesity in The United States, and I imagine it's not that different in Latin America.

没错，确实如此，而且这对糖尿病、心血管健康、高血压、脑血管疾病和癌症的影响巨大。

No, absolutely, and again, huge impact in terms of diabetes, cardiovascular health, hypertension, cerebrovascular and cancers.

如果我们看一下一些统计数据，墨西哥的糖尿病病例在2000年至2020年间增长了两倍半。

And if we just look at some of the statistics, the number of cases of diabetes grew by two and a half fold in Mexico between 2020 between 2000 and 2020.

想象一下。

Imagine that.

二十年内，病例数量增长了两倍半。

Two and a half fold the number of cases in twenty years.

而在同一时期，心血管疾病的数量也翻了一番。

And, the number of cardiovascular illnesses grew twofold during the same period.

这对医疗系统来说确实是一个沉重的负担。

It's just like that it's a real burden for the healthcare system.

没错。

Right.

因此，人口老龄化、慢性病增多，医疗成本大幅上升。

So aging population, more chronic disease, big cost increases.

这些患者需要最高水平的护理、最精密的诊断设备，成本非常高。

These are people that require the highest level of care, the most sophisticated diagnostic machinery, big costs.

那么，您在该地区看到哪些技术进步，或者说是颠覆性的医疗模式，被采纳来降低医疗成本呢？

So what technological advances or perhaps disruptive, I include in that sort of disruptive healthcare models have you seen adopted in the region ostensibly to bring costs down?

当然。

Certainly.

我必须说，我们看到的最大创新实际上来自私营部门，他们致力于提供私营解决方案，以实现更快的医疗服务获取。

So I have to say that the biggest innovation that we've seen is, really comes from the private sector, and looking to offer private sector solutions so faster access to care.

这确实是关键。

That's really the key.

以更低的成本实现更快的医疗服务。

It's faster access to care at a lower cost.

试图覆盖那些负担得起医疗但无法承受如今价格水平的人群。

So trying to get to the population that can afford care, but not necessarily at today's, you know, price range.

因此，努力进入这个略低一些的社会经济群体。

And so trying to get into that slightly lower socioeconomic segment.

规模才是这里最终的目标。

Scale is really the ultimate goal here.

我们看到医疗机构，无论是医院还是诊所，都专注于某一种治疗方式并实现规模化。

So we've seen healthcare institutions, whether hospitals or clinics, really focusing and zeroing in on one type of treatment and scaling it.

从通常每天接诊10名患者增加到每天接诊30或40名患者，通过集中采购等方式降低成本。

So not going from typically seeing 10 patients a day to seeing maybe 30 patients a day or 40 patients a day, lowering costs through GPOs essentially, amongst others.

因此，这正是目前在整个地区实际应用的创新。

So that's really the innovation that we've seen currently in place throughout the region.

而我们未来可能看到的，是人工智能推动的系统效率提升。

Now what we can expect is possibly also some efficiencies through the system being driven by AI.

目前，我认为我们处于一个有趣的位置：技术已经存在，但在人工智能方面的应用尚未真正出现。

Right now, I feel we're in an interesting position where the technology exists, but the applications haven't come about yet in terms of AI.

所以我们现在谈论人工智能，但方式非常孤立。

So we're talking about AI, but very in a very isolated manner.

比如在CT扫描仪、MRI设备或其他诊断工具上。

So on a CT scanner, on an MRI, or others in terms of the diagnostics.

但我们现在能将其规模化吗？

But now can we scale that?

我们能否让整个行业真正从中受益，提升效率？

Can we make it so that the sector as a whole can really benefit from it in terms of efficiencies?

我认为我们还达不到那个阶段。

And I don't think we're there just yet.

我毫不怀疑它终将实现，但可能需要四到五年才能达到。

I have no doubt it will come, but it's probably gonna take about four or five years to get there.

是的。

Yeah.

不。

No.

我同意。

I I agree.

我想，你知道，实际上你几天前在危地马拉做过一场关于人工智能的演讲，当你看到它在写邮件或摄影这样简单的领域中的应用时，就会意识到它的潜力，包括在诊断领域。

I think, you know, actually, you have a talk on, artificial intelligence in Guatemala a couple days ago, and it is pretty dramatic when you consider when you see it applied in a simplistic area like writing emails or or photography, and you realize its potential and including in the diagnostics field.

对吧？

Right?

所以，找到加快并降低诊断成本的方法，而如今的诊断依赖于非常训练有素且昂贵的医疗人员。

So finding ways to speed up and bring down the cost of diagnostics, which today rely upon very well trained, very expensive medical personnel.

但就像你说的，我们知道它具备这种能力，但目前还没有一个被广泛推广、能让人明确指出‘是的’的成熟应用。

But like you said, that's you know, we know that it has that capability, but there's not an active application out there that's widely marketed that that people can point to and say, yeah.

它已经在颠覆某些事物了。

It's already disrupting things.

我们之前稍微谈到了监管问题。

We talked a little bit about regulations.

我记得过去与某些快餐连锁企业政府关系负责人交谈时，他们提到糖摄入、脂肪摄入和标签规定对他们的业务构成持续威胁。

I remember in past conversations I've had with heads of government relations for certain fast food restaurant chain mentioning the constant the constant threat to their business born by regulations around sugar consumption, around fat consumption, around labeling.

是的。

Mhmm.

拉丁美洲人正在觉醒。

And, you know, Latin Americans are waking up.

人们对饮食和不良习惯的意识正在逐渐提高。

There is a consciousness level, growing around eating and around the bad habits that have been formed.

有许多名人和其他拥有活跃社交媒体渠道的人在讨论这些问题。

And there's plenty of celebrities and other people with outspoken social media channels to talk about these issues.

你认为这会对行业产生什么影响？

How does this impact the industry, do you think?

这种意识的提升，是否正促使人们更主动地关注自身健康，或更积极地进行定期体检？

Like, is this, is that raising of consciousness, is that leading to people perhaps being more proactive about looking after themselves or more proactive about getting regular checkups?

拉丁美洲消费者在健康问题上的行为是否已经发生了变化？

Is there a has there been a change in Latin America's consumer behavior around health and how they deal with that?

当然。

Sure.

我们必须记住，在医疗方面，最好且最经济的措施是预防性健康。

And we have to keep in mind that the best and least expensive actions in terms of healthcare are preventive health.

我们希望尽可能长时间地保持健康，以延缓这种负担和投入，并持续投资于健康和改善问题。

We wanna be healthy as long as possible to delay that burden, that investment and continue to invest in health and correcting issues.

所以这些都是其中的一部分。

So that's all part of it.

无论我们看到名人参与其中并关注健康，还是城市组织像步行马拉松、五公里健走或积极运动等活动。

Whether we see celebrities taking part in that and being health conscious, or even cities organizing things like the Walkathons or the Walk five ks or the active movements and so on.

因此，确实有很多围绕这一主题的行动和活动，提升了社会意识。

So definitely there's a lot of movement and activity around that, raising social awareness.

再说一遍，我认为今天的社会意识确实存在，比你我都在该地区生活时的十年前或二十年前要强烈得多。

Again, I I don't I think the social awareness is definitely present today, much more so than it was ten years ago or twenty years ago when, you and I both lived in the region.

但就对日常生活和大规模产生影响而言，我认为仍然存在需要弥合的差距。

But in terms of having an impact on the day to day and on a massive scale, I think there's still kind of like that gap that needs to be closed.

因为在圣保罗或墨西哥城这样的城市，人们可以接触到各种各样的食物，比如水果、蔬菜，甚至可以去本地市场买鱼等，即使他们远离海洋；这与住在离这些城市两小时车程外乡村的人截然不同。

Because the consciousness in a city like Sao Paulo or Mexico City where you have people can get access to all sorts of foods, right, fruits and vegetables, and, they can go to a local market for fish, etcetera, even when they're far removed from the oceans is very different than someone that's living, you know, in a campo that's two hours drive away from from those cities.

而对于那些更关心日常生计、为基本生存发愁的人来说，参加五公里健走活动来保持活跃，并不一定能引起同样的共鸣。

And for them, for those people who, you know, are worried more about their day to day, about their day to day subsistence, then, you know, having a five k walk to remain active doesn't necessarily resonate the same way.

对，没错。

Right, right.

我们换个话题，过去十年，可能十五年里，零售药房市场结构最显著的变化之一就是整合。

Switching gears for a second, one of the most dramatic changes in terms of market structure over the last ten, probably fifteen years has been the consolidation of the pharmacy, the retail pharmacy market.

我认为智利可能是这方面最典型的例子。

I think Chile might be the most dramatic example of that.

你非常熟悉的一个市场，你一直记录并建立独特数据库的是医院的数量，包括公立和私立医院。

One of the markets that you're very familiar with that you've been documenting and create a unique database for is the number of hospitals, both public and private.

即使以美国标准来看，甚至与其他国家相比，拉丁美洲在医院和诊所方面仍然相当分散。

By certainly US standards, but even by other country standards, Latin America is still fairly fragmented when it comes to hospital and clinics.

它们的平均规模比世界其他地区要小。

Their average size being smaller than other parts of the world.

我们会看到医院和诊所的整合吗？这种整合合理吗？

Are we going to see a consolidation of the hospital and clinic environment, would that would that make sense to happen?

可能推动这种整合的原因是什么？

What what might drive that?

约翰，我已经等待这一天发生大约十五年了。

John, I've been waiting for this to happen for about fifteen years.

好的。

Okay.

是的，我先给你一些数据，暂时以墨西哥为例。

Yeah, just to give you some statistics and I'll pick on Mexico for a second.

墨西哥大约有3500家医院，其中三分之二是私营的。

There's approximately 3,500 hospitals in Mexico and two thirds are in the private sector.

明白吗？

Okay?

但这些医院仅占墨西哥总病床数的约20%。

But these hospitals account for only about 20% of the beds in Mexico.

所以三分之二的医院只提供了20%的病床。

So two thirds of the hospitals account for just 20% of the beds.

这意味着私立医院比公立医院小得多。

And that means that the private sector hospitals are much smaller than their, public sector counterparts.

归根结底就是这个问题。

That's really what it comes down to.

在区域层面，你知道，你提到了医疗机构的规模。

On a regional level, you know, you touched upon size of institutions.

拉丁美洲的平均医院大约有50张病床，而美国或欧洲则约为160张。

The average hospital in Latin America has about 50 beds compared to around a 160 in The United States or in Europe.

也就是三分之一的规模。

So about a third of the size.

这意味着它们所接诊的病例数和患者数量远不及世界其他地区的医疗机构。

That means that they just simply don't see the number of cases, the number of patients that, other institutions do in other parts of the world.

对吧？

Right?

这意味着他们很难建立专业中心。

And that means that they it's much harder for them to develop centers of expertise.

可扩展的空间更小。

There's less to scale.

对吧？

Right?

是的。

Yeah.

因此，我认为这一直是制约该领域潜在并购活动的一个因素，总体而言，就是医疗机构缺乏可扩展性。

And so and I think that's been one of the elements that's kind of put the brakes on potential acquisition, potential more m and a in this sector has been the lack of scalability of institutions, generally speaking.

所以我们看到这种情况最明显的国家，肯定是巴西。

So the countries where we see this most, definitely Brazil.

明白吗？

Okay?

在更多国家，整合和 Providers 与支付方、医疗（抱歉，是保险公司）之间的垂直整合更为普遍，而在墨西哥这样的国家，私立医院平均只有15张床位。

A lot more consolidation, a lot more vertical integration between providers and payers and healthcare, excuse me, insurance companies, and not so much in countries like Mexico where the average private hospital has just 15 beds.

所以当我们谈论墨西哥的高科技、高复杂度医疗机构时，实际上只是指整个医疗体系中寥寥无几的几家机构。

So when we're talking about high-tech, high sophisticated institutions in Mexico, we're really talking about just a handful of institutions within the greater healthcare landscape.

对。

Right.

如果这些诊所和医院的物理结构没有整合，那么所有权是否在整合呢？

Now if the actual physical structure of these clinics and hospitals are not consolidating, is the ownership consolidating?

比如，你有没有看到多个诊所、多家医院形成统一的所有权集团？

Like do you see ownership groups of multiple clinics, multiple hospitals forming?

所以，我认为未来我们会看到更多这样的趋势。

So again, I think we're gonna see more of that in the future.

而目前，这种情况仅限于一些独立收购了一两家设施的特定集团。

And right now it's really limited to certain groups that have purchased independently one or two facilities here and there.

我们也看到一些集团在某些特定医疗领域扩张，拥有了五到六家医院。

We've also seen a few groups kind of expand in very specific areas of care and have like five, six hospitals.

但总体来看，墨西哥有大约3500家医院，其中三分之二是私立医院，也就是大约2000家，这些集团仍然只是沧海一粟。

But in the grand scheme of things, you know, of the 30 3,500 hospitals that are in Mexico and the two thirds being, being private, so that's, you know, about 2,000 hospitals, it's still just a drop in the bucket.

我们总是谈论同样的几个集团，也就是那五到十个拥有七家、十家甚至三十家机构的集团，但就这些了。

Like, we're always talking about the same groups, the same five to 10 groups that have, you know, seven, ten, to 30 institutions, but that's it.

是的。

Right.

有大量的小型私立医疗机构。

There's a lot of small private health care facilities.

而那些拥有多个医疗设施的大型集团，是纯粹由墨西哥本土拥有，还是也出现了跨境收购的情况？

And and and those larger groups, these these ownership groups that own multiple properties, are they strictly Mexican owned, domestic owned, or are we seeing cross border acquisition as well?

比如克里斯塔集团，他们在整个拉丁美洲都拥有医院，对吧？

So there's the Christa's group that owns hospitals throughout Latin America, right?

显然在美国，同时也在墨西哥一直延伸到智利，他们据说在五到六个国家都有业务。

Obviously in The United States, but as well in Mexico all the way down to Chile, and they're present I think in like five or six countries.

这是目前少数几个存在的区域性集团之一。

That's one of the few, I would say, regional groups that currently exist.

巴西也有一些国际参与者，但大多数拥有多个医院和机构的医疗集团都是国内企业。

There's a few international players in Brazil as well, but most other healthcare groups that own multiple hospitals and institutions are national players.

Horizontes领导力论坛由美洲市场情报公司提供。

The Horizontes Leadership Forum is brought to you by America's Market Intelligence.

每年，美洲市场情报公司的资深业务负责人，在我们的播客主持人约翰·普赖斯的带领下，都会受邀参加超过50场会议、研讨会和私人商业洽谈，就美洲地区当前最紧迫的商业趋势与挑战提供见解、预测和观点。

Each year, AMI's most senior practice leaders, led by our podcast host, John Price, are invited by over 50 conference, seminar, and private business meeting organizers to provide their insights, predictions, and opinions concerning the most pressing business trends and challenges of the day in The Americas.

如需了解如何通过美洲市场情报公司领导团队的演讲提升您下一次区域规划会议或大会的质量，请访问americasmi.com。

To learn more about how your next Regional Planning meeting or conference can be enhanced by a presentation from AMI's leadership team, visit us at americasmi.com.

网址是americasmi.com。

That's americasmi.com.

现在，我们回到Horizontes播客。

And now back to the Horizontes podcast.

你之前提到过，你们专注于医院市场，GHI为此开发的数据库，特别有助于你们为医疗器械和设备供应商、耗材供应商提供服务，这些供应商大多将产品出口到拉丁美洲。

Now you alluded to earlier on, your focus on this hospital market, the database GHI has developed around that hospital market, that really lends itself to you providing services, especially to device and equipment providers, consumables providers, many of whom ship their products, export their products into Latin America.

虽然有些国家有相当规模的本地生产，但总体而言，这仍然是一个以进口为主的市场。

There's obviously some big local production in a few countries, but by and large, this is very much a import market.

对于那些正试图确定如何在拉丁美洲起步，或如何在一个中国产品已占据重要地位的市场中竞争的供应商，你们会给出什么建议？

What's your advice that you give to providers who are trying to figure out, say, where to start in Latin America or how to compete in a market where, as you pointed out, Chinese product has really gained a foothold.

您的客户从中吸取了哪些经验教训？

What what are some of the lessons that you've seen learned by your clients?

当然。

Sure.

我觉得，关于这个话题，我们完全可以花一整天，或者至少好好吃顿饭来深入聊聊。

And I I think there's you know, we could have a whole conversation about this over the course of a day or at least one good meal.

但毫无疑问，第一步是要了解当前的市场格局。

But, there's definitely you know, the first step, I would say, is to to understand the current market landscape.

对吧？

Right?

比如，真正的市场机会有多大？

Like, how big is the opportunity really?

因为拉美市场的生态系统与大多数公司在欧洲、美国、日本或澳大利亚所熟悉的环境截然不同。

Because it's just so different in terms of ecosystem to what most companies know in Europe or in The United States or in Japan or Australia.

那么，从潜在客户机构的数量来看，我们具体在讨论多大的机会呢？

So what what are we talking about in terms of opportunity in terms of number of institutions that are potential clients?