Yes, I think the business district of Shanghai or Western style hotels in Beijing are a world away from the conditions in 98% of China -- those are the 2 richest cities in China proper (not counting Hong Kong). While most (but not all) of the hotels we stayed in had Western style toilets, I can't remember actually seeing a Western style toilet outside of a hotel in my travels in China (like in restaurants, etc), although it has been 3 years and I could have forgotten. I did not visit Beijing or Shanghai, but more Chinese tourist cities like Guilin, Guangzhou, Dali, LiJiang, Kunming, Hainan island. I was more free to do this because my friend spoke both Mandarin and Cantonese fluently.
I am sure it depends a lot on where you travel in China. I learned so much about China (most of it negative) and it was a great experience. I don't think I met any Chinese person on the whole trip that spoke English, but my friend could interpret. My biggest fear before going was the food (not the cleanliness but the taste), but it turned out I loved almost everything.
At the end, when leaving China, we took an all night, bone jarring bus from Kunming to Sapa, Vietnam, probably the worst travel experience of my life. It was simply the worst travel conditions I have ever experienced even counting long bus rides in Myanmar
It was the real China, with mean looking army guys at various checkpoints checking everyone's passport or identity card, etc. They are all about control of the population.
Kramer