Soon after the barefoot doctor system came to an end, in the years between 1977 and 1989, village doctors began charging patients for their services. Because of the new economic incentives, they began to shift their focus to treatment of chronic conditions rather than preventative care. By 1984, village RCMS coverage had dropped from 90% to 4.8%. Without the public-service oriented work of barefoot doctors, "health-care crises of peasants substantially increased after the system broke down in the 1980s." With health care privatization, the central government played an increasingly smaller role in the national healthcare. Most importantly, the central government began contributing less funds to healthcare, placing the responsibility on local governments. These individual, local governments had to collect funds through taxation, which led to imbalances between areas with wealthy and poor citizens.