Rural China Misses ‘Barefoot Doctors’
The rural health system started to collapse in the late 1970s and early 1980s as a result of China’s economic liberalization and the privatization of agriculture. Local medical facilities that had been financed collectively by the communes lost their source of income and had to close down. This in turn led to a collapse of primary healthcare and inoculation facilities and the result was that many diseases that had been eradicated re-emerged in the countryside.
Regarding hospitalization, the user-pays system introduced in the 1980s left many rural patients, practically all of whom had no health insurance, unable to pay for medical care, which led to a further decline in rural health standards.
While the authorities were not totally unaware of the collapse of the rural health system as a price to pay for de-collectivization, no systematic measures were taken to redress some of the downsides of economic reform. Indeed, in this field, like many others, the regime demonstrated its inability at implementing parallel policies rather than skipping from one priority to another. By the early 1990s, the government had not only done away with the constraints of collectivization, but had also, in the process, seen the collapse of the rural healthcare system. This was akin to throwing the baby out with the bath water.
The end result, according to the WHO, is that China is medically speaking two nations.