The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care by T. R. Reid:
When I was traveling the world looking for lessons Americans could benefit from, several economists suggested I look at China as an example of what not to do. “Just to make your American readers feel better,” advised Ikegami Naoki, the health care expert at Keio University’s hospital in Tokyo, “you ought to tell them about China.It has all the problems of American health care but none of the benefits.” “To many in the United States,” wrote Harvard professor William Hsiao, “China’s portrait of pockets of medical affluence in the midst of declining financial access and exploding costs and inefficiency will sound depressingly familiar.” What galls these experts is that China, virtually alone among nations, has gone backward in terms of health care. Mao’s Cooperative Medical System was Spartan but universal and essentially free--a poor man’s version of Britain’s Beveridge Model. It produced impressive results: From 1952 to 1982, life expectancy in China increased from thirty-five to sixty-eight years, and many contagious diseases were controlled. In the early 1980s, though, this government-run system essentially shut down, and China reverted to the Out-of-Pocket Model for most of its 1.3 billion people. The results are clear. Infant and child mortality rates actually increased in China during the first decade of the twenty-first century; life expectancy is unchanged since the ‘80s; some infectious diseases are causing epidemics not seen in decades.