Quality of care between private and publicly funded facilities differs, and private clinics are more frequented in some rural areas due to better service and treatment. In fact, a study by Lim, et al. showed that in the rural Chinese provinces of Guangdong, Shanxi, and Sichuan, 33% of rural citizens in these provinces utilize private clinics as opposed to governmentally funded hospitals. The study showed that it was not so much the availability and access to health care for citizens, as it was the quality of the public health care people were receiving that drove them to opt for private clinics instead. The continued lack of health insurance, especially in the majority of rural provinces (where 90% of people in these rural provinces lack health insurance) demonstrates a continued gap in health equality. Many minority groups are still facing challenges in gaining equality in healthcare access. Due to the 1980s health reform, there has been a general increase in government health subsidies, but even still, individual spending on health has also increased. A disparity in inequality between urban and rural areas persists, since much of recent government reform is focused on urban areas. Despite efforts by the NRCMS to combat this inequality, it is still difficult to provide universal healthcare to rural areas. To add to this rural inequality, much of the elderly population lives in rural areas and face even more difficulties in accessing healthcare, and remains uninsured. Like minority groups, health policy makers are also faced with challenges. First, a system that keeps basic wages low, but allows doctors to make money from prescriptions and investigations, leads to perverse incentives and inefficiency at all levels. Second, as in many other countries, to develop systems of health insurance and community financing which will allow coverage for most people is a huge challenge when the population is aging and treatments are becoming more sophisticated and expensive. This is true especially in China, with the demographic transition model encouraging a larger aging population with the one-child policy. Several different models have been developed across the country to attempt to address the problems, such as more recent, local, community-based programs.