Bill Hsiao, a respected Harvard China healthcare scholar, along with co-author Winnie Yip, also at Harvard, have in this most recent issue of Health Affairs describe the challenges China faces in healthcare reform very succinctly:

China is at a loss as to how to transform its new money into efficient and effective health care. To tackle the root cause of unaffordable health care—rapid cost inflation caused by an irrational and wasteful health care delivery system, the very same issue confronting the United States—China needs to decide how to reform its health care delivery and payment systems; otherwise, most of the new money is likely to be captured by providers as higher income and profits.

By injecting substantial government funding to provide basic health care universally, China has taken giant steps forward to address its problems of unaffordable access and medical impoverishment. But these initiatives are silent on how China intends to tackle a fundamental cause of its problems: rapid cost inflation and inefficiencies of the delivery system.

The decisions that China needs to make are complex, and there is no silver-bullet solution. In light of the potential scale and magnitude of their impacts, it would be advisable for China to take a step-by-step approach, guided by pilot experimentation and objective, evidence-based evaluation.

As I have argued before, the expansion of coverage without paying serious attention to the outcomes of that care, will be a very expensive and troubling experience for China.