Advancing primary care to promote equitable health: implications for China

Reforming healthcare is a key challenge for almost every country worldwide because there are aspects of each nation's healthcare delivery system that can be improved upon. The fundamental goal of healthcare reform is to promote the equity of health systems; equity includes the following five aspects: (1) broad access to care, (2) expansive coverage, (3) affordable costs for consumers and providers, (4) positive health outcomes, and (5) few disparities [1]. Although it is impossible to eliminate all disparities in healthcare, existing gaps can be narrowed through reform efforts. Healthcare reform priorities are generally very different from country to country. For example, the primary reform goals for developed nations most likely focus on seeking equitable access to care, a high level of public satisfaction, and high quality of care while controlling costs. Meanwhile, countries with emerging economies may focus on delivering high-quality care at costs that are affordable for growing middle class populations. In contrast, a top priority in the healthcare agendas of developing countries would be to provide access to basic healthcare for as much of the population as possible within the constraints of limited funding.The continuum of international health systems can be differentiated by the role of the government versus the market. For example, the health systems of developed nations, such as the United Kingdom and Switzerland, are predominantly government run--health institutions are mainly held and operated by the government. In contrast, administration and oversight of the health system in the United States (U.S.) is fundamentally rooted in the concepts of a market economy, although the government has provided health insurance coverage for the poor and the elderly since 1965. Japan and Germany are two examples of countries that fall between the two modes mentioned above--the government plays an important role to varying degrees.China is the most populous country in t