Health Care during the Mao era

August 14, 2012

After the Chinese Communists (CCP) won the Civil war in 1949, health care improved in China. Prior to that, life expectancy for the average Chinese was thirty-five years. By Mao’s death in 1976, average life expectancy had increased by twenty years so the program worked.

In fact, the CCP was the first government in China’s history to set goals and plans to help its people living in poverty improve the quality of their lifestyles.  For example, soon after Mao Zedong’s healthcare speech in 1965, the concept of the barefoot doctor (with basic paramedical training) was developed. By 1968, the barefoot doctors program was a national policy.

The barefoot doctor program came to an end in 1981 with the end of the commune system of agricultural cooperatives. However, two-thirds of rural village doctors currently practicing in China were first trained as barefoot doctors

Under the barefot doctor program, there were three basic areas of medical care. Free substandard medical care was provided to the proletarian working class, meaning workers and peasants.

This program was the backbone of rural-health care in China, and anyone could become a barefoot doctor.

Mao told the people that if you wanted to be a doctor, you didn’t need to go to medical school. All you had to do was have the motivation to provide medical care to needy people and the government would support you and provide limited training.

The second class of medical care went to people like teachers, clerks and secretaries, ‘friends’ of the working class, the proletariat. The only difference was that the ‘friends’ had to pay to get medical treatment. It was possible to face financial ruin from one hospital stay.

The third class were considered enemies of the proletariat like former shop-owners, landlords and denounced intellectuals like liberal arts professors. These people were denied health care treatment altogether.

Then, between 1981 and 2003, the health care system in China was privatized, which meant people had to pay before treatment or no treatment. This changed in 2003, when the CCP launched a new cooperative medical system operated and funded by the government with copay of 10 Renminbi per year for each person covered by the program.

Discover China’s Urban Rural Divide


Lloyd Lofthouse is the award-winning author of The Concubine Saga. When you love a Chinese woman, you marry her family and culture too. This is the love story Sir Robert Hart did not want the world to discover.

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Note: This revised and edited post first appeared February 27, 2010