Unaffordable healthcare amid phenomenal growth: the case of healthcare protection in reform China

This article provides an up-to-date assessment of China's reformed urban healthcare system. It illustrates that, in the Chinese case, economic growth does not automatically bring equitable healthcare protection; policy and system designs are also important. The article finds that the reformed urban healthcare system is financially sustainable, but that individual citizens contribute the largest share of healthcare costs, whilst the state is reducing its financial commitment. It also reports the views of two principal stakeholder groups. The survey findings indicate the endorsement of an old ethos for a strong state in healthcare protection. But a substantial minority view is also unveiled, which supports access to healthcare on the basis of insurance contributions. In sum, affordability remains a critical issue for the Chinese despite the fact that they have a new healthcare system and a strong economy.