By Clifton Leaf
November 20, 2017

The nations of the world now spend nearly $8 trillion on healthcare, according to a report in The Lancet. By 2040, say data scientists at three leading health research centers—Seattle’s Institute for Heath Metrics and Evaluation, the Harvard T.H. Chan School of Public Health, and the World Bank Group—that bill will more than double, to $18 trillion.

The sheer enormity of this expense will challenge citizens and governments in ways we can’t begin to predict. But one nation seems to be getting out in front of that challenge better than most—and that’s China.

I spent much of the weekend reviewing China-based startup companies that are competing in an innovation contest that Fortune is hosting at our inaugural Brainstorm Tech International conference in Guangzhou, China, next month. More than a fifth of them are focused on solving a problem, or meeting a substantial unmet need, in the healthcare realm. And the ingenuity of these companies is incredible.

I won’t reveal yet who my favorites are, but I will say that these young scientist-founders came up with very creative solutions for preventing infections in some common surgeries, tackling resistance in targeted antibody drugs, improving gene vectors for cell therapies, helping the vision-impaired “see” faces and better read their environments, imaging hard-to-see spots in the lungs and other organs, improving genetic risk analysis, and expediting the logistical operations of hospitals. These clever startups are developing new lasers, new materials, new diagnostics, and new strategies for efficiency and cost saving.

What’s also clear is that the time from concept to market is notably shorter in China than it is in much of the rest of the world—or at least it sure seems that way. Innovation is happening there in hyperspeed—and part of that, as Time Inc. International Editor Clay Chandler explains in the Dec. 1 issue of Fortune, is due to a big, concentrated push by the Chinese government to invest in developing home-grown tech industries, from robotics to A.I. (Please subscribe here, if you don’t already—and give a subscription to a loved one for the holidays!)

As Clay reports, the sudden revelation that America’s uncontested tech prowess, after generations of global leadership, may be under threat in the next couple of decades has raised alarm bells in some quarters of Washington. And judging from my introduction to Chinese innovators in the health sector—which, as I said, could be an $18 trillion market in just 20 or so years—that’s one area where the competition’s clearly heating up.

This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.

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