Products are never refurbished in the U.S. from what I can tell.
They always get done in China.
No pun intended, but that's not an Apple to Apple comparison. Okay, Pun intended. Most Apple products are refurbished in California, and every one I, and apparently every one many others have gotten have shipped from California (and someone said Pennsylvania?). So perhaps it's an industry standard to refurb at the factory (China), but Apple is not an industry standard company, they are an industry leading / standard setting company.
Apple really doesn't outsource alot. Usually, once the product arrives on US shores after initial manufacturing, it stays there in every sense of the phrase. You don't contact call centers in India that handle issues for a dozen companies, you contact a specially trained individual who is picking up the phone at a nearby mall, most likely. If you call AppleCare, I don't know that it's not outsourced, but they are certainly trained, and have more of an "american" accent. In addition, most work is done here in the states, and refurbs usually come from here in the states.
I remember an HP computer I bought, first AND last, that had problem after problem. Initially, it was the keyboard. It was scary how quick the tech knew that was the issue, apparently it is common. It was a PS/2 keyboard, and they shorted alot, and it was preventing it from POSTing, so I swapped it for another, and forgot about it, until 6 MONTHS later it arrived in the mail from China. That wasn't the only issue, after a month it wouldn't turn on, bad PSU. Took two months to get it back. After I got it back, had it for another month and it wouldn't POST again. Swapped in some different RAM and it booted (but this one had 512MB of RAM and all I had was a 64GB stick, besides, why spend money on something under warranty?) I called and complained and complained and complained about the two months and they finally agreed to let me ship it to a US address. Still took a month to get it back. After that, by the grace of God, we had a bad lightning storm that took it out. Homeowners insurance took care of that computer much better than HP ever could have, by giving me the funds towards replacing it with a Mac