Tide Turning: China’s Health Care Policy in Transition


  • Baogang Guo


Health Care Expenditure, Public Welfare


This article systematically reviews the historical process of China’s healthcare system reform, and provides his prospective on the future reform direction. The author examined the unintended consequences of China’s market-oriented healthcare reform since the collapse of the socialized health system in 1979, including the sharply decreasing health insurance coverage, diminishing public health prevention services, increasing healthcare costs and worsening inequalities, resulted from the reduction in public health expenditures. In response to the collapse of universal health system, a new Urban Basic Medical Care Insurance System for Staff and Workers (UBMCI-SW) was started in 1993 for urban employees; the New Rural Cooperative Medical System (NCMS) was reestablished in October 2002 for the rural residents; and various forms of medical care insurance schemes were established starting in 2007 to provide coverage for the elderly, children and migrant farmer labors. China has achieved a significant success in restoring its universal healthcare system in one decade, in spite of the limited health services and scope of illness coverage. Witnessing the currently heated debate over whether the future reform direction should focus on marketization or public welfare, Dr. Guo believes that the reform-minded China’s new government will increase public expenditure and focus more on the welfare function of healthcare system.


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