The objective is to identify the fundamental difference between health care reform in US and China. Embracing and incentivizing prevention, the Patient Protection and Affordable Care Act signed by President Obama stipulates that restaurant chain with more than 20 locations has to virtually display exactly how many calories and nutrients in each food and the employers should provide insurance coverage without cost sharing requirements for evidence-based effective preventive services, including tobacco cessation. In sharp contrast, while China ambitiously promised to provide “safe, effective, convenient and affordable” health care services to all citizens, it also refused to stipulate sufficient warning sign on cigarette packages and ban smoking entirely in offices and indoor public places. The sustainability of China’s health care is critically dependent on a wider alignment of deep-rooted culture and political grandstanding rather than massive funding increases and facility construction. The deadly effects of smoking cigarette remain a remote understanding to the majority of Chinese. Per capita annual alcohol consumption for youth rose to 4.45 liters in 2001 from 0.75 liters in 1970. China is experiencing an epidemic of obesity unprecedentedly and the prevalence of diabetes is approaching 10% among men and women. Tobacco consumption, substance abuse and obesity are the major contributors to skyscraping health expenditure. If China fails to respond to these threats, they will become an economic and welfare time bomb, and China’s health care system, no matter how well funded or equipped, will soon itself be on life support. The government’s addiction to revenues from tobacco and alcohol is seen as the major reason of lack of political will and poor regulatory adherence to foster healthy culture. The year 2011 marks a turning point for global chronic diseases control. Earlier this year was the first time ever that the World Economic Forum put non-communicable diseases on its agenda. In September of this year, the UN General Assembly will hold the first ever UN high-level meeting on chronic diseases. This is an unprecedented opportunity to increase the visibility of devastating damage caused by unhealthy lifestyle, redesign the fundamentally-defected health reform, and avoid band-aid solutions in the future. Specific collaborative opportunities or interests: Best practices of success and deeper lessons from system failure of US health care system.