Traditional Medicine in China Today: Implications for Indigenous Health Systems in a Modern World

In the United States, traditional Chinese medicine (TCM) is recognized by the National Institutes of Health as an effective complementary and alternative medicine modality, widely used by consumers and growing as a profession.1–3 Ironically, while TCM is expanding in the United States, it may be contracting in China as a result of dramatic health care reforms and changing cultural values. There is, however, little information in Western literature explicitly delineating the impacts of these forces on TCM. The purpose of this inquiry was to interview a sample of select respondents, particularly individuals from a major Chinese college of traditional medicine, regarding their perceptions of the field. The results provided insight into the survival and assimilation of indigenous health systems in a modern world. In the late 1970s, Deng Xiao Ping introduced elements of the market economy into China. During the 1990s, significant health care reforms were also initiated. These reforms placed a new emphasis on profitability, economic autonomy for health facilities, and decentralization of public health services and contributed to the demise of the rural cooperative medical system.4–6 These reforms also produced fundamental changes in health care financing, including replacing free universal health care with fee-for-service and private insurance strategies.4,7 This has contributed to increased medical care costs, higher out-of-pocket expenses, growing inequity in access, a reduction of prevention programs in poor areas, and pricing policies that encourage overprescribing drugs and high-tech services.4,7,8–10 As a significant percentage of all health care delivered in China is in the form of traditional treatments,11 such reforms will invariably affect this ancient healing system as well.