In tandem with the country’s economic progress, the overall public health of the Chinese population improved significantly in the past decades. China now has a public healthcare system covering 90 percent of its citizens, and Chinese people are living longer with better access to more affordable and higher-quality health services. While the prevention of infectious diseases has been effective, the treatment of chronic diseases, and the care of the country’s aging population, continue to pose substantial challenges to the country’s healthcare system.
Re-engineering the medical care system
To provide all citizens with basic healthcare services while being financially protected, the Chinese government launched a reform to its health system in 2009. Major efforts were made in introducing cost-effective public health programs, establishing a universal health insurance scheme, and strengthening the infrastructures of the health service. These policies have reduced out-of-pocket (OOP) health payments with government subsidies, despite gaps in the quality of care, depending on socioeconomic status and region.
The epidemiological transition
China is going through a progressive shift in the health burden from infectious illnesses to chronic non-communicable diseases (NCDs). On one hand, apart from HIV/AIDS and tuberculosis, the mortality rates of most infectious diseases in China were reduced to levels below 0.05 per 100,000 population in 2021. On the other hand, unhealthy lifestyle, rising obesity, and the country’s rapidly aging population resulted in an ever-increasing upward trend in chronic diseases. Cancers, heart diseases, and cerebrovascular diseases were the leading underlying causes of death among of Chinese citizens. China is now facing a pressing demand for long-term healthcare for patients with NCDs, which would push the annual healthcare expenditure to over 1.5 trillion U.S. dollars by 2024.
The COVID-19 pandemic
Despite China’s initial achievements in containing the spread of the virus and a successful mass vaccination program, China's Zero-COVID policy eventually became unsustainable after three years of disruptions. The socio-economic impacts of the lockdowns and multiple lockdown-related accidents sparked protests in December 2022 in several cities. Subsequently, the Chinese authorities quickly lifted almost all COVID control measures, leading to waves of infections across the country. Given the different definitions of the cause of death in China, the extent of the pandemic's impact and the number of Chinese victims lost to COVID-19 remains unclear.
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