China saw major health improvements from the 1950s-1970s through programs like the Rural Cooperative Medical System, which established universal healthcare access and helped increase life expectancy. However, economic reforms from the late 1970s decentralized the healthcare system and reduced government support, leading to rising costs, rural-urban disparities, and coverage declines affecting millions of Chinese. Current challenges include inadequate funding, lack of insurance coverage for many, and uneven quality and resources between urban and rural areas.

1. Health Care In China MHC 720 Health Care Systems

11. Chinese Government's Share of National Health Care Spending, as % of Total Health Care Expenditures.

12. Current Crisis http://www.bbc.co.uk/worldservice/specials/1543_ruling_china/index.shtml

30. Guiyang city, Guizhou province: A woman extracts a client's tooth at her stand offering dentistry services on a pedestrian overpass in Guizhou's capital. Dental health is not a high priority to many low-income Chinese people, who are not covered by medical insurance http://www.guardian.co.uk/news/gallery/2007/jul/10/internationalnews?picture=330175082 Care for the Uninsured

31. Prescription Drug Sales http://www.guardian.co.uk/news/gallery/2007/jul/10/internationalnews?picture=330166411 Barefoot Doctor Hua Wanxiang recently shut his clinic and opened a shop selling groceries alongside medicines The sale of medication now accounts for half of hospital incomes, which has led to suspicions of over prescribing http://www.guardian.co.uk/news/gallery/2007/jul/10/internationalnews?picture=330166435

35. Comparison With United States http://www.who.int/countries/chn/en/ $41,950 $6,600 Gross national income per capita 298,213,000 1,323,350,000 Total population Per capita total expenditure on health at international dollar rate Total expenditure on health as percentage of gross domestic product $6096.2 $276.7 15.4% 4.7% U.S. CHINA

36. Socialist Collectivist Privatized Decentralized

37. The Future

39. Questions

40. Sources Blumenthal, David, M.C., M.P.O. and William Hsiao, Ph.D. (2005, September 15) The New England Journal of Medicine.Privatization and Its Discontents – The Evolving Chinese Health Care System. http://content.nejm.org/cgi/content/full/353/11/1165 The Economist. Where are the patients? (2004August 19) http://www.economist.com/research/ backgrounders/displaystory.cfm?story_id=3104423 Hesketh, Therese. & Zhu, Wei Xing. Effect of Restricted Freedom On Health in China. BMJ Publishing Group Ltd. (2004 December 18) http://www.bmj.com/cgi/content/full/329/7480/1427 Liu, Yuanli (2004) Development of the Rural Health Insurance System in China. Health Policy and Planning. http://www.heapol.oxfordjournals.org/cgi/reprint/19/3/159.pdf