Modernization and health care in contemporary China.

This paper provides an analysis of the changes that have occurred in the Chinese health care system in the reform era, post-1978. The economic reforms have brought significant benefits to many Chinese people, but the benefits have not been distributed evenly throughout Chinese society. The paper evaluates some of the evidence indicating deterioration in both the quality and quantity of health care services in the reform era. There is some alarming evidence that rural women, especially those living in the country's poorest regions, have been experiencing lower levels of accessibility to health care, and increasing levels of both morbidity and mortality. It is also evident that during the reform era the gap between service levels in rural areas and the cities has widened, and that chronic poverty still exists in large parts of the countryside. It is important to stress that these inequalities were not created by the economic reforms--in fact they were first observed during the supposedly egalitarian era associated with Mao Zedong. The economic reforms and the widespread implementation of market socialism in Chinese society, have, in general, been associated with improved health status and greater access to health care. It is also apparent, however, that pre-existing inequalities have not been eradicated by the reforms, and, particularly along the lines of gender and geography, the evidence points to a widening of inequality.