China’s failures are similar. It has no universal health-care system. It wasn’t until 1998 that the government even began to provide subsidized health insurance for urban residents through the Urban Employees’ Basic Medical Insurance system. Rural residents got their own program in 2003. Those programs were complemented in 2007 with the Urban Residents’ Basic Medical Insurance program, which covers the unemployed, students, and retirees. Overall, government spending on health care has more than doubled in recent years, from $156 billion in 2006 to $357 billion in 2011. That doesn’t mean that the government has been providing adequate health care, though. In state-run hospitals, there is an increasing shortage of general practitioners for primary health care. There is often a long waiting period for medical attention, and rural residents often lack access to the same medical technology, beds, and equipment as urbanites.
China’s education policies are somewhat more promising, however. In 2012, the government finally reached its goal of spending four percent of GDP on public education. In 2013, moreover, the central government waived school enrollment fees for poor children, and federal grants continue to help poor children obtain scholarships to good schools. Nevertheless, major challenges remain. There is still an urban-rural divide in access to quality public schools. And families are often forced to spend out of pocket for private education, which has increased inequality in access to education.