Five Biggest Myths I See About China’s Healthcare

Here’s what everyone keeps getting wrong - and why it really matters.

🩺 This is a Vital Signs post: the first in a series of essential explainers from China Health Pulse, where I lay out the key structures and systems shaping health in China.

China holds a fifth of the world’s population. It is now a major global force in biotech, digital health and pharmaceuticals. Yet I see the same misconceptions about China’s healthcare surface again and again.

Some were once true. Some never were. The rest are artefacts of media narratives or political biases that have somehow hardened into conventional “wisdom”. But the biggest reason? Most people discussing China’s healthcare have never actually used it.

These mistakes matter. Flawed assumptions lead to bad policies, failed investments, and ultimately, worse outcomes for patients. Whether you’re a patient, doctor, policymaker, or industry leader, getting China wrong on health has real consequences well beyond its borders.

That’s where China Health Pulse comes in. I created this newsletter to cut through the noise, explore the big questions and bring clarity to one of the world’s most complex and fast-changing health systems - and how it is impacting all of our futures.

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A Familiar Conversation

A few days ago, at a policy event in London, a journalist leaned in after hearing I work on health and China.

"China’s health system is a mess, right?" they said, glass in hand, eyes expectant.

I paused. It was a familiar line I’d often heard before.

"What makes you say that?"

They barely blinked. "Well, hospitals are overcrowded. Services are patchy. Doctors are overworked. And patients mostly pay out-of-pocket…"

It wasn’t entirely wrong. But it wasn’t right, either.

China’s fragmented health system can be deeply unequal, but also extraordinarily efficient. The real question isn’t whether the system is good or bad. It’s: who gets care, how fast, and at what cost?

Healthcare in China is being transformed by technology, private capital, and a shifting social contract between doctors and patients.

Last month, when I was in China, I went for a hospital check-up. I booked a specialist appointment through my WeChat mobile app. A few taps on my phone and an online payment of 25 RMB (roughly £3) later, I had a slot within the hour.

Blood tests? Done immediately after the clinic.

MRI scan? Booked and completed few hours later that day.

Results? All images, numbers and reports available on my app on the same evening.

I turned to the journalist, "I’d been trying to get this appointment in London for months. I’m a UK doctor myself, but I ended up using China’s health system! It was faster, cheaper and easier. Pretty incredible, right?"

There was a pause, and we both laughed.

Cutting through the noise

I wasn’t surprised by the journalist’s reaction. I hear versions of this conversation all the time.

But the more I work in this space, the more I realise: most people discussing it have never actually interacted with it.

As a doctor and health consultant who has worked across government and industry, I translate clinical realities into strategy and regulatory jargon into insights. Born in China and raised in the UK, I’ve seen both sides - and the blind spots in between.

I’ve listened to executives dismiss China as a low-cost drug manufacturer while its biotech sector races ahead. I’ve watched policymakers generalise about the country’s public health system, even as private hospitals and self-pay models redefine patient care. These costly health mistakes impact lives well beyond China’s borders.

So for this first post, I’m setting the record straight.

Here are the five biggest myths about China’s healthcare system - debunked.

Let’s get into it.

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MYTH: “China’s health system is monolithic and government controlled.”

REALITY: Wrong. China’s healthcare system is not a top-down machine. it is a hybrid network of state control and market forces, with huge variation at the local level.

I often come across the assumption that China’s health system functions like its politics: a single, state-run entity. In reality, it’s less like the UK’s NHS or Canada’s single-payer model, and more a patchwork. Public hospitals, private clinics, employer-based insurance, and out-of-pocket payments are all tangled together in a system that shifts dramatically depending on where you live and what job you have.

Yes, national policies set broad goals, and China is working toward universal health coverage through initiatives like Healthy China 2030 (detail to come in future posts), but the private sector remains a major player, sustained by service fees and drug sales.

💡 Why this matters:

For policy analysis & IR specialists: Beijing does not dictate all. Local governments control key decisions like funding, hospital management, and policy implementation. Misjudging this decentralisation leads to bad policy recommendations and ineffective foreign engagement.

For global health engagement & technical research: International programmes often default to partnerships with national authorities and so miss provincial health departments and private providers. These are the real players who control implementation in budgets and policy enforcement.

For pharma, biotech & healthtech industry: You must understand how both local regulatory authorities and hospital funding models shape access. I tell my clients: China is not one market. It’s many. After approval from national regulators is only step one, drug pricing, procurement, and reimbursement all plays out at the provincial level. Hospitals, too, operate with financial independence, making decisions based on profitability, not just government mandates.

If China’s healthcare system isn’t fully state-controlled, then what about its innovation? Many assume it’s just copying the West - but that couldn’t be further from the truth.

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MYTH: “China is just a generics manufacturer. It’s not a real innovator.”.

REALITY: that story is out of date. China is no longer playing catch-up. It’s leading.

For years, China was known for mass-producing generics and reverse-engineering Western copycats. But today, its health innovation sector is moving at an incredible speed. It is now a global leader in cell therapy, biologics, and precision medicine, propelled by an enormous patient base generating real-world data, an accelerated regulatory environment and government-driven R&D incentives.

There are over 3,000 internet hospitals in China, and telemedicine platforms like Ping An Good Doctor have over 420 million registered patient users. Digital health technologies including AI-assisted diagnostics, robotics and even augmented and virtual reality tools are increasingly utilised in health services and medical education. Chinese firms are filing record numbers of global patents and racing ahead in mRNA vaccines, CAR-T cancer therapies, and precision medicine.

💡 Why this matters:

For policy & IR: China is not just a manufacturing hub. It is now setting new regulatory standards in biotech, AI-driven healthcare, and digital medicine, with the potential to significantly influence global frameworks.

For global health & research: China is emerging as a vaccine and biotech powerhouse, filling gaps in affordable and innovative therapies. Low- and middle-income countries are turning to China over Western alternatives.International organisations focused on drug affordability, vaccine security, and global health equity need to engage because China has the potential to transform global access to care.

For industry: Chinese firms are developing drugs faster and cheaper than their Western counterparts are gaining ground in global markets. Those still dismissing China as a low-cost producer are missing an industry that is outpacing them in both speed and cost-efficiency.

With China now leading in biotech and digital health, it might seem like an easy market to enter. But size alone doesn’t guarantee access.

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MYTH: “China’s huge population equals a huge market.”

REALITY: The market is big, but access is not that simple.

With 1.4 billion people and a fast-growing middle class, China looks like an incredible market for drugs and medical devices. But opportunity alone is not enough. Even when the market potential is enormous, tight regulations and complex local policies create significant obstacles.

• Domestic companies tend to get priority in funding, partnerships, and procurement, making it extremely tough for foreign firms to compete.

• China’s Volume-Based Procurement (VBP) slashes drug prices so aggressively that foreign firms must accept deep cuts or risk being shut out of public hospital contracts.

• Even after national approval, securing hospital buy-in at the provincial level requires navigating separate pricing negotiations and procurement processes.

💡 Why this matters:

For policy & IR: China’s aggressive cost-cutting health policies are influencing global drug pricing models. VBP has driven drug prices down so aggressively that governments in Latin America, Africa, and Southeast Asia are considering similar models. Understanding how these policies develop will be key for predicting shifts in global health financing and access, particularly the emerging markets.

For global health & research: Data-sharing restrictions and research barriers complicate technical partnerships. Differences by province often create additional barriers – you cannot copy and paste across regions, and the additional time, effort and resource needs to be integrated into early planning.

For industry: Getting regulatory approval is just step one, and progress really depends on regional pricing differences, procurement rules, and hospital decision-making structures at the provincial level.

There’s another major misconception for those trying to break into the market: that China’s vast troves of health data are easy to tap into.

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MYTH: “China’s health data is a goldmine.”

REALITY: Think again. China’s health data is heavily protected, and foreign access is tightly controlled.

I often meet foreign investors and researchers who are eager to tap into China’s vast health datasets. Surely 1.4 billion people, digitized hospitals, and a massive disease burden are ideal for clinical trials, AI-driven research, and drug discovery?

That used to be true. Fifteen to twenty years ago, foreign firms could access hospital records, genetic datasets, and clinical trial data with relative ease. Not anymore.

Data security laws like the Personal Information Protection Law (PIPL) and Data Security Law (DSL) now impose some of the world’s strictest controls on health data. Meanwhile, global restrictions are also tightening. The US Biosecure Act and similar foreign policies are blocking collaboration with China on genomics, AI-driven healthcare, and other “sensitive” research areas. Scientific partnerships are becoming harder on both sides, even when global health challenges demand cooperation.

💡 Why this matters:

For policy & IR: China’s strict health data approach is influencing global trends. Governments worried about AI security and digital sovereignty are watching closely, and some may follow China’s lead in restricting cross-border flows of health data. This risks complicating international collaborations.

For global health & research: You cannot work with Chinese datasets the same way you do in other countries. Partnerships depend on deep integration with China’s research ecosystem and workaround adaptations including indicator-based research models rather than raw data access.

For industry: China’s data environment is not a barrier, but a reality to work within. Companies that secure strong local research partnerships, align with China’s data storage rules, and engage regulators early will still be able to thread the needle and find opportunities – and even longer-term market stability.

Strict data controls make collaborations challenging, but rural healthcare presents another surprise. Many assume wrongly that poor infrastructure means poor access to care.

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MYTH: “Rural healthcare in China is severely underdeveloped.”

REALITY: Disparities persist, but China’s rural healthcare is transforming fast - with lessons for other countries.

China’s 120 million rural seniors over the age of 60 need better healthcare. Rather than relying on expensive hospital expansion, China is leapfrogging brick-and-mortar expansion and scaling skillsets by focusing on AI-driven diagnostics, telemedicine, and new insurance models. Rural healthcare might still lag behind major cities, but technology is rapidly closing the gap:

• AI-powered imaging tools help rural doctors diagnose diseases faster.

• Remote healthcare platforms connect patients with top-tier specialists.

• Free medical school tuition programmes incentivise young doctors to work in rural areas.

• Insurance reforms reduce out-of-pocket costs for rural residents.

💡 Why this matters:

For policy & IR: Rural health doesn’t always require costly hospital expansion. China’s rural strategies could be a model for other resource-constrained countries in leveraging technology and innovative service delivery models – and not just in healthcare.

For global health & research: The challenge for global health teams is to collaborate within a rapidly evolving system that may not align with traditional Western-led public health initiatives.

For industry: China’s rural market is now a fast-growing healthcare sector. Pilots in AI-driven diagnostics, decentralised clinical trials, and digital health innovations have the potential to shape the next generation of health solutions for emerging markets worldwide.

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Final thoughts: Unknown unknowns

China’s healthcare system defies easy narratives. Misconceptions reveal a lot about the assumptions that individual bring to the table, based on experiences and biases.

From inequalities to innovation, and from market opportunities to data barriers, behind every myth lies a much bigger story - this newsletter is just getting started!

I’ll be covering the real shifts happening with China’s health - the policies and market trends reshaping care, the overlooked players driving change, and the global impact of what comes next.

What do you want to know next? What aspects of China’s health interest (or puzzle) you most? Which areas of this post shall I dive deeper? Please leave a comment or send a message.

I’d love to hear from you.

🩺 This is a Vital Signs post: the first in a series of essential explainers from China Health Pulse, where I lay out the key structures and systems shaping health in China.

Coming up soon: my curated shortlist of the best reads and listens out there right now on China and health.