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Over the past fifty years, the health status of the people in China has improved dramatically. The medical system in China, the Cooperative Medical System (CMS), has provided health care to the rural population by means of 'barefoot doctors,' who provide both preventive and curative care. Patients who are seriously ill are referred to communal health centers and, if need be, are then sent to county hospitals, which serve from 200,000 to 600,000 people. However, over the past 10 years, the CMS has been in a decline, both financially and politically. The number of rural Chinese who were covered by the system has declined from 85 percent in 1975, to 40 percent in 1985. There are several possible reasons for the decline including: the lack of money after economic change in China in 1980; the control of the preventable diseases; or political changes. To understand the reasons for the decline, surveys were conducted among the villagers, the barefoot doctors, and the local administrators in three counties, Fengxian, Shanggoa, and Loaan. The three counties ranged in economic status from poor to good. The people and the doctors were found to be satisfied with the health care system. Overall, the CMS was found to be in a good financial state and its use did not decline to the same extent in all areas. In Fengxian, which is a relatively affluent county, the CMS is still prevalent. In areas where the services of the CMS have declined, the health of individuals, as measured by infant mortality, immunization coverage, and the incidence of infectious diseases, has diminished. Villagers now spend more on health care, while less money is available to train the doctors. Therefore, the decline of the CMS is not due to poor medical care, financial problems, lack of accessibility, inadequate facilities, nor to dissatisfactions with the system. It appears that the reason for the decline is because local community leaders thought it was no longer backed by the central government. Local administrators may not want to pay for preventive services unless they are backed by the government. National commitment and community involvement are both necessary for the health care system to be effective. (Consumer Summary produced by Reliance Medical Information, Inc.), Introduction Since 1949, when the People's Republic of China was founded, indices of health in that country have improved dramatically; for example, from 1950 to 1982, the infant mortality rate [...]

Universal coverage of health services is required to ensure social equity and justice, particularly for China, which is a developing country with an enormous population. Since the 1980s, the Chinese [...]

Competing Interests: Competing interests: We have read and understood BMJ’s policy on declaration of interests and have no interests to declare.

Objective: To evaluate the hyperlipidemia prevention programs and policies in different countries and highlight the need of reforming the hyperlipidemia prevention policies in China to lower the growing cardiovascular disease (CVD) risk., Research Design and Methods: PubMed, Google Scholar and Cochrane were searched for global hyperlipidemia prevention policies. Government-funded policies pertaining to lipid management were considered for this review. Only those studies that evaluated the success of prevention policies on the basis of: (i) achievement of hyperlipidemia targets; (ii) improvement in Cardiovascular (CV) risk reduction; and (iii) outcomes with reduction in hyperlipidemia after implementation of the policy, were included., Results: Several global policies and programs aimed to improve CV health by highlighting lipid profile management. Implementation of the global and national policies led to improvement in cholesterol related outcomes such as availability of diagnostic measures, awareness of the risk factors, decrease in cholesterol levels, achieving healthy lifestyle to prevent CVD and improvement in availability of hypolipidemic medications, etc. Statins have been covered under reimbursement policies in many countries to improve usage and thereby preventing incidence of stroke and CVD. We observed a need for introducing new programs in China as the ongoing hyperlipidemia management policies are inadequate. The World Bank Report 2016 recommended that prevention policies in China be modeled on the US Million Hearts program., Conclusions: New hyperlipidemia prevention policies must set a time-bound target, and need to be patient and clinician centric in terms of applications, and revised periodically for long-term benefits.