The People's Republic of China originally developed a unique health services system that embodies decentralization, continuity with traditional medicine, integration with the local political structure, and mass participation. In order to provide health services for over one billion people. China concentrated on training barefoot doctors, assistant doctors, midwives, and public health workers. Also, training programs attempted to integrate Chinese traditional medicine with Western medicine. However, economic reforms initiated during the 1980s currently are transforming the health care system. The rural cooperative medical service is being replaced by private hospitals and clinics and health insurance systems. In the future, China will have to balance increased specialization and technology with the delivery of health services to a largely rural population. This will be a difficult task for a nation in the process of economic reform.