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We estimate the evolution of healthcare demand under the influence of income growth and aging with two samples of patients surveyed in the same regions, but with an interval of 18 years (1989-2006). We focused on the specific role of prices and of distance to health care facilities. The data are from the CHNS database edited by the Carolina Population Center. We used a Mixed Multinomial Logit Model. It is found that healthcare price effects decreased over the period and became more heterogeneous. Aging impact overweighed income growth impact, resulting in increasing distance effect and patients’ preference to proximity of health care providers. However, to cope with urbanization, the Chinese policy consisted of privileging large hospitals. Our results suggest that this policy pushed a higher share of patients to choose self-care on one hand and, on the other hand, had during the 2000’s increased the burden of healthcare for poorer households.