In the 1960s and 1970s China provided a good model for financing and delivering rural health services in developing countries. Since the implementation of economic reforms which began in the 1980s, however, health services in poor areas have been showing signs of declining, with fewer people able to pay for the services they need. This article examines major problems of access to basic health care faced by the poor, and proposes a strategy for improving health service delivery in the poor areas.