How Has China Built the World's Largest Healthcare System?

Xi Jinping, President of the People's Republic of China, during a visit to Shiye Town in Jiangsu Province, eastern China, in December 2014, said: We must shift the focus of health services to the community level, allocate more medical resources to these areas, and expand equal access to basic public services in urban and rural areas.

He added that the purpose of this action is to provide public health services and basic medical care to people in a safe, efficient, accessible and affordable manner. This approach also aims to effectively address the problems and heavy costs that people face when accessing health care services in their places of residence.

Since the 18th National Congress of the Communist Party of China was held in late 2012, this party has made people's health its strategic priority and has made an important decision to implement the Healthy China Plan throughout the country.

The results of these measures can be clearly seen in the statistics. In 1949, at the same time as the founding of the People's Republic of China, the average life expectancy in this country was 35 years. According to data from the National Health Commission of China, this figure has increased to 79.25 years by 2025. The infant mortality rate has decreased to 3.8 cases per thousand live births and the maternal mortality rate has also reached 13.4 cases per 100,000 live births. Also, the death rate due to major chronic diseases in people under 70 years has decreased to 13.8%.

China has also built the largest primary health care delivery system in the world. According to the National Health Commission, more than 1.1 million hospitals and clinics operate in urban and rural areas of this country. Basic medical services are provided to 1.4 billion people and more than 90% of the population lives within 15 minutes of a medical center.

One of the prominent features of China's health care system is the emphasis on primary health care. According to the National Health Commission, in 2025, community clinics and hospitals handled 5.65 billion outpatient visits, which accounted for 53% of all outpatient visits nationwide.

Wang Hufeng, director of the Center for Health Care Reform and Development at Renmin University's School of Management and Public Policy, said the emphasis on primary care reflects Xi Jinping's strategic vision given the country's huge population and the disparity in the level of development of its different regions.

Technology alone is not enough and human power must also be developed along with it. It has dedicated more resources and trained staff to primary care across the country. According to the statistics of the National Health Commission, the number of primary care workers has increased by nearly 50% between 2016 and 2025.

In addition to bringing medical services and resources closer to where people live, China has also tried to make treatment costs affordable. According to the report of the National Health Care Security Administration, more than 1.3 billion people are covered by basic health insurance and the insurance coverage rate has stabilized at around 95%. Better coordination between health and treatment sectors, insurance and pharmaceutical policy has also helped to reduce the share of direct payment by patients from their own pockets to 27.1% of the total health costs.

According to the report of the National Health Commission, China's national list of essential drugs now includes 794 drugs, which make up 71% of the total volume of drugs consumed in the country's government hospitals and clinics.

Taken together, these measures show how the world's largest health care system works: health services are provided locally, medical expertise is made available through resource sharing, and costs are controlled by relying on broad insurance coverage and access to essential drugs.

This system has also received attention at the international level and the World Health Organization has placed China among the leading countries in the field of maternal and child health.