This article discusses challenges in the current U .S.healthcare system and their fundamental cau-ses.Such challenges include increasing health expenditure , deficiency and excess in health service utilization , worse health outcomes than other developed countries , and insufficient GP numbers .We suggest that mistakes in early healthcare legislation and an imperfect health management system are the primary causes for these problems .Implica-tions for China ’ s current ongoing healthcare reform are outlined .We draw on the experience in the U .S.and other developed countries but keep China ’ s unique features in mind .Factors that need to be considered in China are ensu-ring the right of healthcare for all , giving full play to the role of government and primary medical institutions , strengthening support for GPs , reforming payment modes , controlling the growth of health expenditure , strengthening legislation, and handling medical accidents and disputes reasonably .