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In the long-term, Tibet’s medical tradition has proven to be one of its most viable and enduring cultural institutions. Whereas Tibet’s military confrontations with China over the last century have led to the destruction of many Tibetan monasteries and to repression of Tibetan culture, the survival of the country’s medical culture has helped to preserve Tibet’s unique heritage. For the Tibetan people, traditional medicine has also served as an important form of treatment for the distress generated by ongoing social and political tensions. As a persecuted people whose feudal culture the Chinese have sought to extinguish, Tibetans have always struggled to preserve their history and culture. During the 1959 invasion of Tibet, religious institutions and monasteries were either destroyed or transformed into museums meant to exhibit the limitations of “feudal superstition.” Ironically, however, the Chinese embraced Tibetan medicine, which they found to be consistent with socialist ideology. The Chinese integrated Tibetan medicine into the family of traditional Chinese medicine, which has allowed it to survive over fifty years of Chinese cultural and political domination.

The People’s Republic now subjects Tibetan medicine to state control by incorporating it into its primary healthcare system. During the early post-Revolutionary period, the state began to actively sponsor Tibetan medicine, spreading its practice throughout China. In the 1970s, however, medical pluralism in China entered a new phase as the government attempted to “modernize” Tibetan medicine by introducing western biomedical ideas. This policy shift was consistent with the 1978 World Health Organization’s recommendation that governments integrate their national healthcare systems with traditional forms of care, though many anthropologists criticized the recommendation as implausible in modern, multicultural societies. To practitioners and patients of alternative medicine, the biomedical interpretation of sickness often makes little sense. Nevertheless, some progress in the direction of integration is evident. A large facility in Tibet dedicated to training new physicians in the practice of Tibetan medicine, known as Lhasa Mentsikhanglo, is now striving to accommodate the rise in chronic degenerative diseases by increasing emphasis on long-term care for elderly patients.

As China’s economy continues to move in a neo-liberal direction, the state has slashed its funding for health care, forcing many health services to be privatized. In Tibet, the regional Health Bureau has reduced healthcare funding to a quarter of its former level. As a result, many practitioners, such as those at the Lhasa Mentsikhanglo, have been forced to implement fee-for-service financing mechanisms. As the government loosens its regulation of private practice, it has given hospitals and clinics the freedom to manage their own resources and to make investments. This decentralization has ensured that financial incentives increasingly determine the accessibility and integrity of Chinese healthcare. As a case in point, take Tibet’s main medicine-making factory in Lhasa: in 1992 alone, the factory produced over 60,000 kilograms of four hundred different varieties of medicines, which it sold at high prices to Tibetan medical care centers and exported abroad. The economic limitations on the practice of Tibetan medicine are compounded by the fact that Tibet is one of China’s poorest regions. The increasing privatization of China’s health system is adversely affecting the accessibility and integrity of Tibetan medicine.