In the equation of economic growth—land, labor, capital—a healthy population is very crucial. China had achieved a high life expectancy even before the era of reforms. Why? This story provides rare insights into the vast healthcare system in rural China, that is, at and below the county level where over 80% of Chinese had lived. Through the eyes of its key protagonists—from “barefoot doctors” to “village doctors”— we get to see how the Chinese rural healthcare system evolved prior to and during the era of reforms, all within the so-called Health Trilemma (quality, access, and cost) that all countries have to face. Did leadership, public policy, or human intentionality make a difference? How did changing institutions impact on performance?