After 1949, the Chinese Communist Party (CCP) took control of China, and the Ministry of Health effectively controlled China's health care system and policies.[7] Under the Chinese government, the country's officials, rather than local governments, largely determined access to health care. Rural areas saw the biggest need for healthcare reform, and the Rural Co-operative Medical Scheme (RCMS) was established as a three-tier system for rural healthcare access. The RCMS functioned on a pre-payment plan that consisted of individual income contribution, a village collective welfare Fund, and subsidies from higher government.[8]