The second unique feature of China’s health care history was its use of mass campaigns. For example, to combat syphilis, which was endemic in much of China when the Communists came to power, the government first closed all brothels, outlawed prostitution, and retrained former prostitutes for other work. They then trained thousands of physician extenders to identify persons likely to have syphilis by asking 10 simple questions, such as whether the person had ever had a genital sore. By so doing, the government made manageable the task of finding—in a population of more than 500 million people—the small percentage of people who needed to be treated for syphilis. The government also mandated testing for persons applying for marriage licenses, newly drafted soldiers, and en- tire populations in areas where syphilis was especially common. These measures were in no way democratic, but they dramatically reduced the prevalence of syphilis in China.
Purchasing Care By the 1980s, China’s economy was changing from a largely socialized and centrally controlled system toward a more decentralized, econom- ically heterogeneous model. These changes would be mirrored in the country’s health care system.
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