Whereas the NRCMS implementation represented
China’s efforts to rebuild rural health insurance system,
there were no similar efforts in urban areas in the three
years after the SARS outbreak, resulting in dissatisfaction
among urban residents as they had difficulty paying medical
bills, or had to go without care [6]. Summarizing the
wide-spread discontent, a report by a high profile think
tank that is affiliated with the State Council, China’s Cabinet,
concluded that the health care reform before 2005
“was basically not successful” [19]. The report raised the
political stake to a higher level because of its immediate
popularity, and more importantly, its high profile authors,
who rarely publicly criticize government policies. Therefore,
it sparked a national debate about health care reform
in 2005.