When the Chinese state wants something done it tells all districts what they want to achieve, officials in districts determine their own course of action and the central government makes the money available

Interesting, that's exactly how Brazil's universal health system works. Every single building has a lot of autonomy (one little health unit will determine what goal they want to achieve within the community, then get the resources), and the biggest problems arise from where they don't (commissioned chairs get us health secretaries that don't have any experience in health, for example, so the federal money leaks into their pockets and the rest is badly distributed - in my city, it's some random lawyer). I've asked many professionals during classes and literally every single one of them confirmed me that the health system would be 1000 times better if the professionals could decide the funding between themselves