Individuals in China are shouldering a growing portion of medical expenses as the government share of healthcare funding declines, according to new national data reported by Caixin Global.
The findings, based on the National Health Commission’s 2024 Statistical Communiqué on the Development of China’s Health Undertakings, indicate that rising out-of-pocket spending is reshaping the country’s medical system. Caixin Global notes that this shift coincides with increasing dominance of large urban hospitals, leaving smaller providers struggling to survive.
The report highlights growing inequality in hospital capacity and access. A small number of major hospitals in major cities continue to attract most patients, government support, and experienced medical staff, creating what experts describe as a “vacuum effect.” Smaller hospitals in rural and township areas are reportedly experiencing falling patient numbers, financial strain, and difficulty retaining staff.
Despite consolidation and concentration of resources, top hospitals are also beginning to feel pressure. Caixin Global reports slowing growth in revenue and patient volume at leading medical institutions, driven by demographic change, cost-control policies, and tighter public budgets.
Structural challenges — including limited insurance coverage for outpatient care, underfunded primary care networks, and a strong public preference for elite hospitals — continue to reinforce these trends, according to the report.
Experts cited in the article warn that rising personal spending and weakening local healthcare infrastructure could create long-term risks as China faces a rapidly ageing population and rising chronic disease rates. While policymakers have announced plans to improve primary care capacity, strengthen referral systems, and expand insurance reimbursements, progress remains uneven.
The data reflects a system undergoing significant stress, with shrinking state support and increasing patient financial responsibility raising concerns over long-term equity, access, and sustainability.
Research Associate at StratNewsGlobal, A keen observer of #China and Foreign Affairs. Writer, Weibo Trends, Analyst.
Twitter: @resham_sng
