From Chinese model to U.S. symptoms: the paradox of China's health system

This article explains the paradox of China's recent failure to secure significant improvements in the health of its people despite once being the envy of the developing world for its successful health policies and its huge sustained increases in both economic growth and expenditure on health care. The authors begin with an outline of the organization and financing of China's health services, then track the recent upward trend in health spending and examine its structural features in conjunction with those of spending in other, comparable countries. The main discussion consists of an evaluation of health service system performance in China during the reform era and an explanation of its health paradox. The key elements in this account are the waste of resources, the neglect of proven health interventions, and the lack of fairness in allocation of medical resources--all of which are underpinned by the neoliberal orientation of policy in the reform era. The authors conclude with some policy proposals centering on the restoration of social justice in the health system. The article draws on material previously unavailable in English.