Yes but I think the lack of definitiveness is what makes history so compelling to me! There were potentials for something different, and we cannot erase them. I guess ultimately my stance on this is that I do not genuinely believe that the CCP introducing market forces into healthcare was necessary for good health outcomes (in fact, there is also a lot of literature on how access to certain technologies such as MRIs also does not wholly necessitate better health outcomes). Whole other sectors of the economy (defense, energy) were shielded from marketization due to national interests. Why couldn’t healthcare also have been shielded? Important to note that the UK may be a rich country but the NHS is breaking down because the Tory party doesn’t want to fund it. China has the will to fund lots of infrastructure projects for example. Money could be found for an expansion of public healthcare as well, but Whyte argues the issue is that China’s aging society plus the total lack of any welfare infrastructure means that the costs would be tremendous (along the lines of Japan, but without the benefit of Japan being an already wealthy society). That is a political economical deficiency that was caused, he argues, by the one child policy and also macroeconomic policy in the 80s and 90s that left poor provinces at the mercy of the market.

So while I agree that a one to one comparison of the healthcare systems of Maoist and post Mao China isn’t the most helpful, I also don’t share your optimism about the current model getting much better, simply because I do fundamentally believe that the sector could have been left decommodified to some degree or at least wholly state owned.