HEALTH CARE SERVICES 129 Mass participation: 'Mobilizing the mass' is a central principle in the organization of current Chinese society and of the health care system. It is felt that great transformations can be made through mass participation and it is further felt that the individual will simultaneously be educated, himself transformed through active participation in society. Continuity with the past: Part of Mao's genius has been his ability to adapt socialist principles to China's needs and, even more important, to China's traditions. Much of what we now see in China has its roots firmly implanted in the past. This is true not only of the obvious—the continued and integrated use of traditional Chinese medicine - but in the continuation of selected traditional forms of community organization. The past is interwoven with the present but remoulded to lead to new goals. It is therefore extremely difficult to determine which of the methods of the Chinese are successfully transferable to other societies and which are so culture-bound that they are unique to China. PART OF A REVOLUTION It should be noted in conclusion that improvements in health care services are only one part, and probably not the most important, of the effort to change the health status of a people. Improvements in nutrition and in living conditions are, for example, almost certainly much more important than are services for therapeutic medical care.10 Furthermore, health care services are in every country an expression of the political structure and political struggles of the society. This fact is clearly recognized in China and criticism or advocacy of specific health care policies is closely linked to criticism or advocay of broader political, economic, and social policies and to the protection and expansion of revolutionary changes in the redistribution of wealth and power. In China, in short, health care is part of a revolution. In this respect China differs from most countries, technologically developed or developing, in which health care is often one of the methods used to attempt to delay a more fundamental redistribution of the resources of the society and thus, in some ways, acts as a barrier to better health for all of its people. Summing up, through a combination of improvements in nutrition, in living conditions, in sanitation, in preventive medicine, in health education, and in medical care (built on the base of a revolution which changed the control of resources and therefore the priorities of the society), the health of the Chinese people has improved markedly over the past twenty-seven years. This change has been one of the factors in the development of a vigorous, confident, productive population whose rapid further developmental progress seems assured 1 More complete descriptions of the changes in health status of China^s people and the development of its health services may be found in Joshua S Horn, Away with All Pests: An English Surgeon in People's China, Monthly Review Press, New York