Unable to rely on China's broken health care system, the Ji family was desperate.

Doctors had taken 15-year-old Ji Xiaoyan off a ventilator and discharged her because her family could no longer pay her hospital bills. So an uncle cobbled together a makeshift ventilator from bicycle and washing machine parts, driven by a noisy electric motor. The contraption pumped air into the teenager's lungs through a washer hose plugged into an incision in her throat for more than a month, until the family got donations for treatment.

"I knew my child didn't want to leave this world. We had to save her no matter what," said Yang Yunhua, the girl's mother, a farmer in Henan province. "But we are only poor people."

Such horror stories prompted the government to launch a three-year, 850-billion-yuan ($124-billion) effort earlier this year to rebuild the crumbling health care system.

China once provided rudimentary but universal care to everyone. But as the country shifted from socialism to a market economy over the past 30 years, health care frayed. Medical costs soared faster than incomes, and treatment today depends on one's ability to pay. Nearly a third of the poor say that health is the most important cause of their poverty, according to the World Health Organization.

"People are paying too much out of pocket for their services for their health care. Many are becoming impoverished in the process," said John Langenbrunner, a World Bank health economist in Beijing. "The level of dissatisfaction, at the local level, is very high and the government is responding to this."

Affordable medical services also could help reduce China's dependence on exports by encouraging people to stop saving so much for potential medical costs _ and spend their earnings on consumer goods instead.

The government's goals include:

_ Improving health services, in part by building 2,000 county hospitals and 29,000 township hospitals and ensuring that each of the country's nearly 700,000 villages has a clinic.

_ Expanding state health insurance from 70 to 90 percent of the population, or an additional 200 million people _ equivalent to two-thirds of the U.S. population.

_ Reducing drug costs by controlling prices for medications deemed essential.

Longer term, the government is seeking ways to cut back on unnecessary treatment and drug prescriptions that are blamed for skyrocketing fees at public hospitals.

The challenges are daunting.