Comparing the flaccid improvement of the ACA to the genuine and steady progress that China is bringing to their healthcare seems disingenuous. Health spending has quadrupled in about a decade, see here (most articles seemed to link back to this one); and the state makes sure not to let srug companies throw their cock around (for example as seen in that video widely shared on this site showing state negotiators all but forcing foreign pharma company reps to accept basically selling at cost). And frankly their responses to and attempts to contain COVID were incredible from a public health perspective.

That's just a few examples but they're signs of forward and continuing progress. It is not a sign of government inaction and abandoning people to the whims and ravages of private healthcare as seen in the US.

I dunno. At this point I am not ready to say I am more of an expert than the CPC about how to do comunism in China. I assume they had a reason related to material conditions. They don't have unlimited time and resources.