IT WAS A SIGHT TO REMEMBER -- 600 Chinese physicians, government health officials and academic leaders were gathered in the conference center of the Massachusetts Institute of Technology in Cambridge, Mass. With them were more than 100 representatives of the Harvard Medical School, Massachusetts General Hospital and other academic medical centers across the United States.

The meeting of Chinese health care leaders and their counterparts in the United States was the culmination of a yearlong planning effort by representatives of both countries. The conference, "Health Care East and West, Moving Into the 21st Century," was designed to "improve understanding of each other's health systems, enhance health care in both countries, and encourage cooperative ventures."

For five fast-paced days, Chinese and American speakers emphasized the remarkable contrasts between the two countries. The nature and magnitude of China's health problems and the government programs that address them are vastly different from those of this country.

China is on the crest of impressive improvements in living standards. During the last 50 years, the average life expectancy of Chinese men and and women has increased by a remarkable 30 years -- from 41 in 1950 to 71 in 1997. Yet, disease patterns in China are still unusual by American standards.

China's minister of health, Dr. Zhang Wenkang, told the conference that cancer of the liver, a relatively uncommon condition in the United States, is the leading cause of death in China. "In fact," he said, "though China has 22 percent of the world's population, 45 percent of worldwide deaths from cancer of the liver occur in mainland China."

Xu Wenqing, director of China's National Health Education Institute, described several of his government's public health education programs. For example, the "Farmers Health Education Project" is aimed at improving the health literacy of an astounding 900 million rural Chinese.

Since it cannot possibly treat the diseases of its over 1 billion people, China is focusing on national health promotion projects aimed at factory workers and their families, school students, parents and staff, disease prevention projects, and risk-factor surveillance systems.

Disease prevention is an important priority in China, as evidenced by its annual commitment of 4 percent of its health care expenditures. The United States spends less than 1 percent of its health care dollars on disease prevention.

Similarly, medical education in China is poles apart from that in the United States. Two significantly different medical education systems are required to prepare medical practitioners for China's two very different health care systems. People living in China's major cities have access to an urban health care system that provides modern medicine and conducts highly advanced research in quite sophisticated hospitals.

Presently, 177 medical schools prepare physicians for modern medical practice. The length of training, however, is quite varied. The majority of medical schools teach at the undergraduate level. These students can receive a bachelor's or masters' degree in medicine. There are also doctoral degree programs more comparable to ours.

Those living in China's vast rural areas often are cared for by practitioners of China's ancient traditional medicine. Traditional Chinese medicine remains a mainstream health care service that shares a parallel political and ideological role with Western medicine. The numbers reflect its importance.

China has more than 2,600 traditional medicine hospitals with 264,000 beds, 500 clinics and over half a million traditional medicine workers. Over 90 percent of modern hospitals have departments of traditional medicine, with a total of 72,000 beds. Practiced for centuries, traditional Chinese medicine is still the basis for the current rural health care system and an important adjunct to its modern medical care.

Clearly, the reliance on herbal remedies, acupuncture, massage, manipulation, dietary interventions, meditation and relaxation techniques, and exercise arts such as chi gong and tai chi, gives China an economical way to provide health care to millions of its people with practitioners of limited professional education.

The East-West Health Care Conference went off without a hitch. The 600 Chinese physicians and government officials returned to their homeland filled with new and in-depth information about both the accomplishments and shortcomings of American health care. The Americans gained a new appreciation for China's health care challenges and, particularly, the important role played by traditional Chinese medicine.

As China prepares to welcome the world to Beijing for the 2008 Olympic Games, the Chinese Medical Association will be working with Harvard Medical International, the worldwide arm of Harvard Medical School, to improve health care, medical education and medical research for the benefit of people throughout the world.

HARRY A. SULTZ, DDS, MPH, is a professor and dean emeritus at the University at Buffalo and co-author of the Aspen publication, "Health Care USA, Understanding Its Organization and Delivery." He spoke at the East-West Health Care Conference.

　　From Healthy.net