The mainland failed to reach its 20-year goal of universal health care by 2000, even though gross domestic product doubled over this period, according to a leading economist. 'Lack of health-care service is a serious problem in vast areas of the country,' Hu Angang of Tsinghua University said in a paper published this month. 'There is a huge gap of primary health-care levels among different areas, and between urban and rural regions.' The report has appeared in the magazine China Reform and online. The quality of health care was widely discussed during the Sars outbreak amid fears that the virus would spread from Beijing and Guangdong to rural areas with less advanced hospitals. About 100 million people, mainly in poverty stricken and rural areas, do not receive basic health-care treatment, and 30 million people do no receive prompt treatment, Professor Hu wrote. He found that 100 million rural residents lacked access to clean drinking water, and 20 per cent of rural counties had no clinic, no clean drinking water and no hygienic toilets. About 8 per cent of children, mostly from villages, do not receive vaccines. He also cited the 2000 annual World Health Organisation report, which ranked China's health system 144 out of 191 countries. Professor Hu's report said the country's allocation of health-care resources was unfair and unbalanced. China ranks in the bottom 10 among WHO members when it comes to the portion of GDP it spends on health care. He suggested more spending in poor areas. 'This 'one country, two systems' of health care that is the medical treatment urban people enjoy cannot be beneficial to rural farmers and should be eliminated as soon as possible,' he said.