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The Chinese population achieved good health and longevity under the Chinese Communist Party''s authoritarian rule. After the opening up of China''s economy in 1978, GDP (gross domestic product) increased, but the health sector declined instead of keeping pace with economic growth. Privatisation of the health sector led to variances in the availability of healthcare facilities. The social welfare system was unsatisfactory, and people did not trust the government enough to participate in voluntarily financed ''Co-operative Medical Systems'' (CMS). In the absence of centrally planned financing, appropriate government control and accountability, public healthcare facilities have been mismanaged. The case provides an opportunity to discuss the appropriate degree of government finance, and control, in the provision of basic healthcare and the need for a satisfactory social welfare system, which people can trust. It also illustrates the problem facing the communist government, which has left the health of its 1.2 billion people to market forces, and the lack of international concern about the situation until SARS was ''exported'' to other countries. The case raises the question as to whether GDP growth is appropriate as a sole measure of a country''s progress.