China’s Healthcare Cost Burden Approaches U.S. Levels, IMF Report Finds

Children and adults receive vaccinations at the Jiangbei Community Health Service Center on September 15, 2026, in Huizhou, Guangdong province, China.

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BEIJING — According to a new International Monetary Fund publication titled “Toward a New Economic Growth Model for China,” high health‑care expenses are a major driver of saving behavior among Chinese households. The analysis highlights that rural households allocate a larger share of disposable income to health care than almost any other major economy, rivaling the United States.

In rural China, 8.7 % of disposable income is spent on health care—second only to the U.S., where the share reaches roughly 9.9 % among the world’s 20 largest economies. Urban China ranks third, with 5.4 % of disposable income devoted to health services, slightly above Canada.

The burden is especially acute when income levels are considered. The average per‑capita disposable income in the United States was $68,289 at the end of last year, more than ten times the $6,400 equivalent of China’s 43,377 yuan. Rural households, which only officially emerged from extreme poverty in 2020, face an even steeper disparity.

Official data from Wind Information show that urban disposable income exceeds rural income more than twofold, with city residents earning 56,502 yuan versus 24,456 yuan in the countryside.

The IMF researchers argue that targeted increases in government health and social‑security spending in rural areas could materially lower rural savings rates. They note that China’s overall social spending remains low relative to international peers, and expanding it would help boost consumption.

“China’s social spending is low compared with international peers, and increasing that spending would lift consumption,” said Yizhi Xu, an economist in the north‑Asia division of the IMF’s Asia and Pacific Department, and Fan Zhang, the IMF’s deputy resident representative in Beijing. Their analysis recorded a savings rate of about 14 % for rural migrants working in cities, compared with roughly 6 % for urban hukou holders who enjoy broader welfare benefits.

“Declining house prices in recent years continue to weigh on consumption and contribute to elevated household savings,” Xu and Zhang added.

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