Although it is difficult to measure, the difference in the health care system between rural and urban areas accounted for much of rural-urban disparities. Under the auspices of the New Co-operative Medical System (NCMS), the government instituted a new system of risk-pooling for China’s vast rural population. The NCMS includes three features that distinguish it from the Rural Co-operative Medical System: joint responsibility for financing; local responsibility for many aspects of programme design, implementation, and management; and voluntary participation.