Social Equity in a Time of Change
Edited By Richard Greggory Johnson III
Chapter Three: Narrowing the Gap: Urban-Rural Inequalities in Healthcare Utilization in China
c h a p t e r t h r e e i n t r o d u c t i o n Reasons for Healthcare System Reforms According to Liu, Rao, Wu, and Gakidou (2008), the public’s complaints about it being “too expensive to see a doctor” and “too difficult to see a doctor” eventu- ally led to government action to reform China’s healthcare system (p. 1914). In April 2009 the Chinese government announced its comprehensive reform plan with the aim of establishing a universal healthcare system in which “safe, effective, convenient, and affordable basic health services” are available to all its citizens (Meng & Tang, 2010, para. 1). The following briefly describes how China made its transition from a health system in which preventive and basic healthcare services were affordable and accessible to almost all its citizens (i.e., The Mao Era Health System) to one in which even the most basic healthcare services were unafford- able for a lot of people, and poverty, or a return to poverty due to high medical expenses, became a widespread problem (i.e., 1980–2003 health system) (Yip & Hsiao, 2008). The Mao Era Health System It is well documented that during the Mao era (between the 1950s and 1980s) China built a healthcare system in which preventive and basic healthcare services Narrowing the Gap: Urban-Rural Inequalities in Healthcare Utilization in China junfang wang1 40 | junfang wang were affordable and accessible to almost all its citizens (Gao, Tang, Tolhurst, & Rao, 2001; Meng & Tang, 2010;...
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