A "barefoot doctor" listens to the heartbeat of a fetus. These community health workers dramatically improved maternal health in China during the 20th century. World Health Organization/U.S. National Library of Medicine hide caption

A "barefoot doctor" listens to the heartbeat of a fetus. These community health workers dramatically improved maternal health in China during the 20th century.

Over the past six decades, China has been experimenting with radically different forms of health care systems.

As the country struggles to figure out the best way to get health care to 1.3 billion people, the rest of the world can learn from its past successes and failures, researchers wrote Wednesday in The New England Journal of Medicine.

Back in 1949, health care was free to everyone in China. The communist state operated all clinics and hospitals, and it employed all doctors, nurses and health workers.

Then in 1984, the government started implementing free-market reforms. People lost their free medical care. And by 1999, only 7 percent of those living in rural regions had health insurance.

Hospitals began to act like for-profit companies. Doctors and nurses were often rewarded for increasing hospital profits. So they started acting like entrepreneurs.

To patients, it seemed like everyone was just out to make a buck or a yuan. And the public became increasingly angry and distrustful of doctors.

In 2008, the government began to abandon a system based largely on free-market principles and made a commitment to providing affordable health care for all by 2020. About 95 percent of the population had health insurance in 2012.

A community worker teaches fishermen about staying healthy. World Health Organization/U.S. National Library of Medicine hide caption

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What China Can Teach The World About Successful Health Care