Transformation of Health Care in the People's Republic of China Meei-Shia Chen
26 The Great Reversal: Transformation of Health Care in the People's Republic of China Meei-shia Chen On October 1, 1949, Mao Zedong proclaimed the founding of the People's Republic of China (PRC) from the Gate of Heavenly Peace (Tienanmen) of its capital, Beijing. During the three decades after 1949, the PRC, under Mao's leadership, developed a central planning socialist system that emphasized public ownership and welfare, mass-based collectivism and egalitarianism, and de- emphasized the role of the market in the delivery of various services and products. But in 1978 Deng Xiaoping took over the leadership of China and set China onto a new course: the PRC has been undergoing dramatic market reform, privatizing formerly public systems, enterprises, and institutions, de- collectivizing rural communes, emphasizing individual responsibilities, and allowing an increase in social inequality (Hinton 1990; Leung 1994; Wong 1994; Weil 1996; MacFarquhar 1997; Meisner 1999). This political, economic, and social transformation was described as ``the great reversal'' by Hinton (Hinton 1990), the author of the classic, Fanshen: A Documentary of Revolution in a Chinese Village (Hinton 1966). During Mao's era, the PRC impressed the world by developing an innovative and successful health care system, with a great emphasis on preventive public health. This system included the development of the cooperative medical system; the use of barefoot doctors; the implementation of health programs through mass movements; the integration of traditional Chinese medicine and western medicine; and increased emphasis on the health of the rural population. How- ever, during the past two decades of market reform, the PRC transformed its health care system into a very different one.
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