Covering approximately 9.6 million square kilometers with a population of 1.35 billion, China is the world's second-largest country by land and the largest country by population. Knowing this, healthcare must be one of the most important issues in China. As China becomes more populated, there is becoming a greater need for health care professionals, quality health care facilities, technological improvements, and most importantly a proper amount of funding to support a successful health care system. However, recently, China has been struggling in regards to health care. There has been a widening gap in health status between urban and rural residents, correlated with increasing gaps in income and health care utilization. There have also been drastic changes in health care financing, including a dramatic reduction of insurance cover for the rural population.
In 1949, the Chinese government took complete control ...view middle of the document...
The RCMS functioned on a pre-payment plan that consisted of individual income contribution, a village Collective Welfare Fund, and subsidies from higher government” (p.1349). The first tier consisted of barefoot doctors that were trained in basic hygiene and traditional Chinese medicine. This system of barefoot doctors was the easiest form of healthcare access, especially in rural areas. Township health centers were the second tier of the RCMS, consisting of small, outpatient clinics that primarily hired medical professionals that were subsidized by the Chinese government. According to an article, “Changing Health in China: Re-evaluating the Epidemiological Transition Model”, Ian Cook and Trevor Dummer proclaim (2003) “RCMS has significantly improved life expectancy and simultaneously decreased the prevalence of certain diseases. Life expectancy has almost doubled (from 35 to 69 years), infant mortality has been slashed from 250 deaths to 40 deaths for every 1000 live births” (p.329). The success in healthcare during this time is a reflection of the Chinese government as a whole and also local, community efforts to increase good health.
However, by the 1980s the Chinese healthcare system went completely downhill. Most importantly, government funding for healthcare decreased significantly from 32% to 15%. Since the government felt the healthcare system was performing well, it decided to put money towards the agriculture reform. As a result, more pressure is being put on localized provinces and their money toward healthcare in their specific region. This does not bode well for poor rural communities, but does bode well for wealthy communities where money is certainly not an issue. Now, all of a sudden an inequality in health care has become clearly evident and the minority groups are being left without any insurance.
Cook, Ian G., and Dummer, Trevor J.B. (2004). Changing health in China: re-evaluating the
epidemiological transition model. Health Policy, 3, 329-343.
Liu, Yuanli, Hsiao, William C., and Eggleston, Karen. (1999). Equity in health and health care:
the Chinese experience. Social Science & Medicine, 10, 1349-1356.