Towards universal health coverage: lessons from 10 years of healthcare reform in China

Tao, Wenjuan; Zeng, Zhi; Dang, Haixia; Lu, Bingqing; Chuong, Linh; Yue, Dahai; Wen, Jin; Zhao, Rui; Li, Weimin; Kominski, Gerald F

The People's Republic of China (PRC) covers approximately 9.6 million km 2 , and is now the most populous country in the world with 1.42 billion people. 14 The urban population accounts for 58.0% of the total population. 15 PRC was founded on 1 October 1949. At the time, China had one of the world's poorest healthcare delivery systems due to an economy weakened by war. 16 Today, China is an upper middle-income country whose gross domestic product has grown substantially at an average annual rate of 9.5% over the past 40 years, and has lifted more than 850 million people out of poverty. 17 With the rapid economic growth, China has made great efforts to achieve UHC. For example, China has devoted increased public funding to health-the largest increase among Brazil, Russia, India, China and South Africa countries. 18 China has almost achieved all of the Millennium Development Goals (MDG) by 2015, making a major contribution to the achievement of the MDGs globally, and is now moving towards SDGs to achieve UHC by 2030. 19 Table 1 illustrates a summary of key socioeconomic and health indicators in the country from 1990 to 2017, as well as the comparable data in the other Emerging 7 (E7) countries (India, Brazil, Mexico, Russia, Indonesia and Turkey) in 2017. China has experienced remarkable improvements in economic conditions, human development and health outcomes, such as life expectancy and mortality. Compared with other E7 countries, China is at a relatively good level in both its economy and population health.