NCPA - National Center for Policy Analysis


December 8, 2005

A crisis is growing in China's pay-as-you-go healthcare system, says the Wall Street Journal. Chinese patients must pay cash upfront or they receive no treatment -- even in emergencies. The strain of health care costs is so severe it is plunging growing numbers of people back into the poverty from which they so recently escaped.


  • Today, less than one-third of China's 1.3 billion people have health insurance; more than half of all health spending is out-of-pocket.
  • A Ministry of Health study in 1998 showed that 42 percent of people who checked out of hospitals discharged themselves, mainly because they ran out of money
  • In rural areas, 30 percent of children who die end their lives at home because their families cannot afford hospital care.

The World Health Organization ranked China fourth from the bottom of 191 countries in terms of the fairness of its medical coverage in a 2000 survey. This March, a Chinese cabinet think tank said that unless China overhauls its medical care, it will directly affect economic development, social stability and public support for reform.

The crisis in China's healthcare system is already showing signs of holding the country back. For example, healthcare costs are one of the main reasons Chinese save as much as 40 percent of their incomes, which is money not spent consuming more goods, as U.S. officials had been hoping amid concern about the big U.S. trade deficit with China.

President Hu Jintao has promised to overhaul the healthcare system. Until then, officials with the non-profit Society of Community Health Service say they are helping the government stitch together a network of publicly funded health centers.

Source: Andrew Browne, "Chinese Doctors Tell Patients to Pay Upfront, or No Treatment," Wall Street Journal, December 5, 2005.

For text:


Browse more articles on Health Issues