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Unlike developed countries, which are 'being rich while being old' and 'being rich before getting old', China was in a state of 'being rich before getting old' when it first entered an aging society. With the arrival of an aging society in 2026, even with the current economic development trends, it is difficult for China to reach the level of 'richness', that is, the population aging process is ahead of the economic development process, which makes the risks and challenges facing China more severe. It is estimated that by 2050, the proportion of GDP spent on pensions, medical care, care, welfare and facilities in China's GDP will increase from 7.33% to 26.24%, an increase of 18.91 percentage points. Faced with such a severe aging challenge, China urgently needs to develop a path to actively respond to aging with Chinese characteristics, and provide experience for countries that have also stepped into the ranks of “before getting rich”. The 'Healthy China Strategy' is one of the important national strategies emphasized in the report of the 19th National Congress of the Communist Party of China, which aims to provide the people with a full range of full-cycle health services. This marks a major shift in China's top decision-makers' understanding of the issue of aging: without 'healthy aging,' there can be no truly 'healthy China.' However, in the face of basic national conditions such as a large population, a weak foundation, few resources, and inadequate development, healthy aging in China still needs to break through a series of bottlenecks and obstacles. The welfare state is not the only reference for China, let alone a model that should be copied. In this regard, the article will put forward a number of targeted policy recommendations.

The challenges of aging in China: is healthy ageing a key for medium-long term sustainability of care?