Document Type


Publication Date

Spring 2011


The state of health and healthcare in rural China has been an area of growing concern for the Chinese government and international observers for the last twenty years. A pattern of regression, marked by shockingly low health service utilization rates and staggeringly low health indicators across the board compared to urban neighbors, has thrown the backward farmlands of Central and Western China into the spotlight. The story of how health conditions in rural China arrived at its current state involves characters from the Chinese Revolution, the liberalization and privatization era of post-Mao China, and the ranks of contemporary providers, insurers, and government officials. A close look at the current system and its problems lead to the uncontestable conclusion that reform is needed. Fortunately, this fact has been recognized by the central Chinese government, which, bolstered by full coffers—the prize of unprecedented economic growth—and galvanized into action by the discontent of its citizens, has begun a significant attempt at healthcare reform in the past ten years. The following paper examines these efforts, with both a look back at the circumstances necessitating them and a prospective look ahead at potential obstacles, both institutional and political, to their successful implementation.