In 1949, before the People's Republic of China (PRC) was founded on October 1, the average life span in China was just 35 years. Today, it has risen to 77, more than doubling in 70 years.

The leap is not just a qualitative advancement in people's life expectancy, it is also a reflection of China's economic and social progress, the sustained peaceful environment at home that is so necessary for development, and most importantly, a transformation of China's medical services.

Getting medical treatment is a basic right. However, 70 years ago, many people failed to get timely treatment because of the shortage of medical facilities. In the first two decades after the founding of the PRC, war-torn China had next to no public health system. Pneumonia, malaria and other epidemics ravaged the land while parasitic diseases endangered the national health.

Given this dire state, the newly founded people's government took swift action to improve the public health system, introducing sanitation and building health centers and health education institutions at various levels. Apart from a general hygiene and disease control system, the Chinese Government also set up special treatment centers for tuberculosis and skin diseases. The public health services were free.

By 1960, China had basically eradicated the plague, endemics like Keshan disease, a heart problem caused by dietary deficiency, and schistosomiasis, a parasitic infection. Vaccination began for polio, Japanese encephalitis, diphtheria and other diseases. By the late 1970s, a comprehensive public health system had basically taken shape, improving national health indicators.

At that time, China followed a planned economy system, which was derided by the West. However, in retrospect, it was this system that made it possible for China to concentrate its very limited resources on building a nationwide public health system. At the International Conference on Public Healthcare in Almaty, Kazakhstan, in 1978, the World Health Organization hailed China's health development model as an example of primary healthcare.

However, there was still a big gap between urban and rural areas. In cities, people's medical expenses were all covered by the government's fiscal budget. In rural areas, residents' healthcare was funded by local collectives, depending on all farmers' incomes in each village. After China adopted the reform and opening-up policy, the collective economy began to break up, leading to the meltdown of the rural cooperative medical service. The public healthcare system began changing with the transformation from a planned economy into a market economy.

After a series of reforms in medical insurance and production and distribution of essential drugs, four major systems took form: a public health service system, a medical service system, a medical insurance system and a medicine supply system, covering both rural and urban residents.

As medical expenses had gone up with the scrapping of free medical services available under the planned economy system, making medical services affordable and ensuring adequate medical resources became one of the goals of China's healthcare system. The aim is to build up a primary healthcare system that offers safe, efficient, convenient and affordable services.

According to statistics from the National Health Commission, the primary healthcare system already covers both rural and urban areas. More than 1.3 billion people—accounting for 97 percent of the population—are now covered by a basic medical insurance system. China's basic medical care network, which covers the largest population in the world, has been established today.

There are more than 990,000 health care institutions, and the number of medical and health staff has reached 12.3 million. In 2018, China's hospitals and other healthcare institutions received 8.31 billion patient visits. The pharmaceutical sector is also growing rapidly. An essential drug supply chain as well as medical insurance and reimbursement system is in place. Primary healthcare is being more evenly distributed.

While the average life expectancy has gone up to 77, the infant mortality rate has declined to 6.1 per 1,000.

Nevertheless, public healthcare is a complex issue. Even as the health service has improved, accelerating industrialization, urbanization and an aging population have seen infectious and chronic diseases rise. There are higher public expectations on health and medical services.

Health resources, particularly, premium resources, are still in short or unevenly distributed in the country. China still has a long way to go in terms of the reform and development of its medical and healthcare sector, so that its population has access to better health and medical care services and lives a longer and healthier life.

Copyedited by Sudeshna Sarkar 

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