Before 1949 there was no formal health care system provided by the state due to the fact that it was all privatised. When General Mao took power, 95% of the population were under poverty line and the life expectancy was as low as 35 years old. The country was rife with infectious diseases such as polio and rabbis. Factors such as these motivated Mao to create an established health system, which comprised of a three tiered hierarchy. The 1st level consisted of barefoot doctors, whom had little health experience. 2nd level was township health centres, whereby the doctors had slightly more experience and lastly, the 3rd level included district hospitals and enterprise hospitals in the city. However, this was extremely flawed.
In urban areas government funded health support for those who worked in schools, factories, education and other public sector employment. Unemployment was very little so nearly everyone had some form of insurance. However, only 10% of the population lived in urban areas, meaning 90% of population, the majority, who lived in rural areas, received no government help. China was extremely poor and unconnected from the western world throughout this time. Western medicines cost a lot to import meaning this wasn’t the most feasible method. As a result of this they used a lot of natural and herbal medicines, some very effective. However, over time it became more apparent that western medicines were required.
In combination with Chinese medicines, the government tried to promote a social campaign of healthy eating, an active lifestyle and appropriate vaccinations when needed. By doing this they felt they could keep people healthy and fit without the intervention of doctors and health services. By 1975, life expectancy increased from 35 to 63 years and eradicated lots of diseases such as the previously mentioned polio and rabbis. In 1976 Mao died, which left the country feeling that the progress made in health services would be lost. However, this is when Deng Xioping took over. China then began its economic reform and opened up to the western World. Since then GDP has increased by 8-15% annually, showing the positive effects of Dengs era.
Only a third of practitioners have adequate training of a 4year degree in medicine, however this means 2/3 have college training or high school education. This statement demonstrates the huge demand for doctors; therefore they are resorted to calling those with college training “doctors”. This demand is also reflected in the amount of patients who queue hours on end, to be seen by a doctor. Quite often they can queue for days, as it is so important that they get seen. As expected, large amounts of tension have been created through this process whereby the public’s dissatisfaction has been displayed through violence. In 2008 the ministry of health reported 9,800 attacks on doctors in hospital resulting in 26 million dollars worth of damages. Conflicts over health care lead to a tense relationship between the patient and doctor as they become driven to desperation