There is no such thing as free health care in China, a communist country

Andreea Brinza | 29 January 2020

As the Wuhan virus spreads, Chinese health care is under the microscope. On Jan. 22, the government declared that it would cover the costs of treatment for victims of the coronavirus. But that might not be enough by itself. In China, some 95 percent of the population has health care coverage, but the system looks more like a business than a platform to save lives.  Unlike in democratic socialist or most communist states, where health care is free for all citizens, in China the health care system is mostly private and always pricey. That underlying reality is behind much of the failings of the system.

During Mao Zedong’s communist era, health care, although defined only through basic services, was freely provided to everybody. That was the moment when “barefoot doctors” appeared. Even though they lacked medical studies, by undergoing apprenticeships and by practicing basic medicine, they aided farmers’ health, increasing life expectancy, contributing to the eradication of diseases such as smallpox and polio by promoting vaccination, and reducing the incidence of schistosomiasis—a disease caused by a worm living in swamps and rivers.

But once Deng Xiaoping came to power, China started its journey on the capitalist road, or, as China branded it, socialism with Chinese characteristics. This enabled an economic miracle in which hundreds of millions of people escaped poverty. Unfortunately, while profits boomed, access to health care suffered. Paradoxically, this didn’t stop the average health of Chinese getting better—reflected, among other things, in ever increasing height. Getting richer will do that, especially in a country that lacked food security until the 1980s, as will improved sanitation. But getting sick in China is still a nightmarish experience.

I first encountered the Chinese health care system during my first visit to China in 2016. Because of jet lag, I had problems sleeping, and I was looking for a doctor to give me a prescription for sleeping pills. Since my Chinese colleagues were aware of the impossible waiting times at Chinese doctors’ doors, they recommended that I go to a private Japanese clinic. While it was more available, it was also too expensive to go to for a simple prescription—which would cost around $350.

Modern China has a saying: kanbing nan, kanbing gui— difficult to see a doctor, expensive to see a doctor.



This article has been published by Andreea Brînză, Vice President of RISAP, in Foreign Policy. You can read the full article in Foreign Policy.

Photo Credits: The emergency entrance of a hospital in Beijing (Flickr/Michael Coghlan)


Andreea Brinza

Andreea Brinza is a researcher and the Vice President of RISAP. Her interests are related to the geopolitics, geostrategy and geoeconomics of the Asia-Pacific region and especially China. Her research focuses on the Belt and Road Initiative.

Related Posts