“Doctors in my country immediately told me to undergo joint replacement surgery. Since different diagnoses were being given, I heard that the ‘Kharaat’ Hospital in Hohhot, Inner Mongolia, was strong in this field, so after researching, I decided to go there for a check-up. After being examined there, it was decided that I would not need joint replacement but would instead undergo arthroscopic surgery. They said it would be a minor procedure, aimed only at removing the bone growth that had formed between the joints,” citizen Ch recounted.
The citizen recently traveled to Hohhot and said he spent a total of about 4 million MNT on transportation, interpreter and guide services, accommodation, examinations, and treatment. This amount included the cost of medication to be taken for 14 days. He added that he plans to travel to the city again soon to undergo the surgery.
Meanwhile, Citizen B shared on social media that he underwent a comprehensive health screening package at a private hospital in Hohhot, spending 899 CNY—approximately 458,000 MNT. He pointed out that the same tests in Mongolia, particularly at the “Nura” center, would cost more than twice as much, around 980,000 MNT. He noted that only Mongolians seek services at that hospital, and that between 8:00 a.m. and 1:00 p.m. hundreds of people were crowding the place. When he returned the next day to review his test results, the hospital was once again packed with Mongolians. Despite the overwhelming crowds, which were so dense that it was hard to tell where one person began and another ended, patients expressed great satisfaction with the doctors and nurses, who never became irritated or impatient and provided friendly service.
In addition, citizen S said, “Even though we pay several thousand MNT each month for health insurance in Mongolia, we cannot actually receive services. If you have an ultrasound this month, only next month do you become eligible for a gastroscopy. It feels as though they are saying, ‘If you lose time, that’s your problem.’ Or perhaps it is a policy aimed at supporting private hospitals. Many people have died while waiting in line for surgery.”
Another citizen said, “Getting tests done at hospitals in Inner Mongolia is completely hassle-free. The results come out while you are still going over the ultrasound findings. Test results that take 21 days here are determined within just 48 hours there. In Mongolia, I went from one public and private hospital to another trying to find out my diagnosis, losing time and money. In Hohhot, however, I learned my diagnosis within just four days.”
Examples like these from citizens who have turned to hospitals in Hohhot are countless. In Mongolia, more than 6,000 healthcare institutions are in operation. There are ample facilities at the province, soum, bag, and capital city levels, as well as large state and private specialized tertiary hospitals. Yet citizens continue to travel abroad, distrusting Mongolian doctors’ skills, communication, and attitudes, and lacking confidence in hospital equipment, testing, and diagnostics. In recent years in particular, Hohhot has been overwhelmed by the influx of Mongolians seeking medical care.
Magnet-like friendly medical services
From eight-year-old children to 80-year-old seniors, everyone needs access to healthcare services. In Mongolia, however, visiting a public hospital is widely known to be a formidable challenge. In a country with a small population but a high burden of illness, doctors are overwhelmed by heavy workloads, and medical equipment brought in through donations and aid frequently breaks down—facts no one denies.
To make matters worse, the introduction of so-called performance-based financing has pushed an already struggling healthcare sector to the brink. Today, the Health Insurance Fund Budget has been depleted, and early detection and screening programs have been completely suspended. Ordinary citizens are bearing the consequences. Not only that, private hospitals have also stopped providing discounted services covered by health insurance. Under such circumstances, it is hardly reasonable to blame people for seeking affordable, high-quality medical care elsewhere.
At many hospitals, even basic tests cannot be done because equipment is unavailable or reagents have run out. For people traveling from rural areas to Ulaanbaatar City, the situation is no better. After spending money and time to reach the capital, they are often faced with endless queues at public hospitals.
For instance, a citizen identified as E traveled from Khentii Province to Ulaanbaatar City to undergo an MRI scan of the head and neck. Unable to secure an appointment at the National Traumatology and Orthopedics Research Center within a reasonable timeframe, E turned to a private hospital instead. However, since that hospital’s funding had been suspended, it no longer offered discounted services for senior citizens. As a result, E paid 360,000 MNT for the MRI scan. By comparison, the same examination reportedly costs just over 100,000 MNT in Hohhot.
Hohhot, located about 1,200 kilometers from Ulaanbaatar City, is only a two-hour flight away. Although traveling abroad involves additional expenses, many Mongolians now prefer to receive prompt, friendly care from skilled doctors using modern equipment. As a result, Mongolian patients have become one of the main sources of income for hospitals in Hohhot.
When contacted, the founder of a company officially registered in Hohhot that provides guide and intermediary services said that their Mongolian clients never seem to stop coming. “We receive a large number of people every year,” he noted. Because people unfamiliar with the area and unable to speak the language are at high risk of fraud and scams, he established an official medical guide service. The fee for a medical guide-interpreter is 250 CNY for half a day and 450 CNY for a full day, covering services for one person; additional fees apply for accompanying two or three patients. This, he explained, is the average rate. He also emphasized that guides with medical knowledge are crucial when seeking healthcare services.
That said, many Mongolians manage without guides, navigating on their own and even using the internet and artificial intelligence to interpret their test results. Communication is also easier at international hospitals in Hohhot, where a considerable number of Inner Mongolian doctors work.
Explaining why Mongolians are flocking to Hohhot in such large numbers, the company’s founder said, “All the latest medical equipment is being manufactured in China. Every public hospital here is equipped with it. How many hospitals in Mongolia truly have state-of-the-art equipment? As for doctors’ skills, comparison is difficult. It may sound harsh, but it is the truth that Mongolia’s medical sector is lagging decades behind those of other countries.”
Is everything better outside our country?
More than a decade ago, a hospital specifically catering to Mongolian patients was opened in Hohhot. It was established to treat certain illnesses that could not be managed in Mongolia at the time. Yet today, people are traveling to the Inner Mongolia Autonomous Region even for something as basic as blood and urine tests. Of course, there are also patients with serious conditions—those whose diagnoses remain unclear, who have spent years moving from one hospital to another in exhaustion, and who arrive as a last resort, clinging to hope. Still, guides and patients there alike say that the majority go not because treatment is impossible in Mongolia, but to verify diagnoses, tests, surgeries, and treatments already done at home—to weigh truth against doubt.
This trend may not so much reflect a loss of trust in Mongolian doctors themselves, but rather frustration with systemic dysfunction, bureaucracy, dependence on external support, outdated and worn-out equipment, and the prohibitively high cost of medical services. Mongolia has been striving to reduce the number of diseases and conditions that cannot be treated domestically by sending doctors and specialists abroad for training, strengthening their capacity, and successfully introducing and localizing certain types of surgeries at home. The aim is to keep the massive flow of money spent on healthcare within the country instead of letting it drain abroad.
Yet on the other hand, ordinary citizens who faithfully pay their health insurance contributions continue to suffer, unable to receive necessary care in a timely manner. As a result, the outflow of patients seeking treatment overseas has become impossible to stop.
According to the General Authority for Border Protection, from 2024 through the first 10 months of the following year, 13,008 citizens traveled abroad either out of necessity or by personal choice to receive medical treatment. Most of them went to South Korea, China, and Turkey. However, there is no clear data on the total number of Mongolian citizens treated abroad or the expenses incurred. This is because border-crossing data categorize travelers by purpose; official, private, tourist, employment, study, permanent residence, or other; and there is no specific category for those traveling “for medical treatment or diagnosis”. Neither the Ministry of Health nor other relevant institutions maintain official statistics on overseas medical patients.
In 2020, however, the Ministry of Health, the Bank of Mongolia, and the Health Development Center jointly conducted a sample survey on the expenses of Mongolian citizens receiving medical treatment abroad. At the outset, the study noted that the tourism sector is rapidly expanding worldwide, largely driven by the growth of medical tourism.
According to the survey, in 2018, 53 percent of Mongolians who sought treatment abroad went to South Korea, 36 percent to China, six percent to Thailand, one percent to India, and the remaining three percent to other countries. In 2019, 47 percent went to China, 43 percent to South Korea, five percent to Thailand, and one percent to India. The 406 citizens who participated in the study spent 11.7 million USD on overseas medical treatment between 2018 and 2020. Of this amount, 185 people spent 5 million USD in 2018, while 195 people spent 5.8 million USD in 2019. In 2020, 26 people spent 882,000 USD, according to the survey.
When citizens are forced to seek treatment abroad due to diseases or conditions that cannot be treated in Mongolia, financial support is provided, and relevant figures are available at the Ministry of Health. The more critical issue, however, is that people are increasingly choosing to travel abroad for medical services even when it is not strictly necessary.
A particularly large number of patients are leaving the country due to cancer. Meanwhile, Mongolia has been talking for years about building additional cancer hospitals, with little to show for it. Do the sector’s leaders and those in power truly have the will and the solutions to revive the healthcare system? If these distortions are not addressed urgently, there is a real risk that citizens will continue to flee abroad, leaving behind nothing but empty shells of hospitals bearing the name of healthcare institutions.
