Socio‐economic reforms in China’s rural health sector: Economic behaviour and incentives of village doctors

The post‐1978 micro‐economic reforms have dismantled China’s community‐funded rural health system, relying on paramedics called “barefoot doctors”. Examines the economic behaviour and incentives of village doctors (formerly “barefoot doctors”) as a response to a deregulated market and the private sector in the 1990s. The investigation of 519 village doctors showed that the occupation was male‐dominated. There was minimal labour mobility ‐ 86 per cent worked in the same village; 87 per cent were allocated land, but the majority spent 25 per cent or less of working hours on farming. Suggests that they should provide free patient services, and income should come from payment for medicine. In practice, monopolistic market situations enabled many to charge fees. To maximize income, 41 per cent of western medicine practitioners also sold Chinese medicinal herbs in competition with Chinese medicine practitioners. However, village doctors wanted more regulations on entry to the occupation and looked to government intervention to solve problems. Concludes with some policy implications drawing on the pursuit of private interests by village doctors.