China is poised to introduce sweeping innovation and disruptive social change onto their national stage. As China’s leadership, economic power, and authority increase the country will be subject to increasing internal and external challenges. This study seeks to identify the significant internal social challenges China is most likely to confront along its path to global leadership. The purpose is to explore and discover the social challenges that are likely to face China and to predict the direction the country’s leadership will take over the next decade. The study approaches the problem by undertaking an initial 9-step process of investigating 6 environmental categories as influencers or drivers of change. This approach utilizes Schmieder and Mallette’s SPELIT Matrix Model; Saldana’s Themeing and Coding technique; and, Turoff’s Real-time Policy Delphi Method to identify these influential environmental categories and factors. The study then focuses on examining cultural ideologies, leadership, and organizational behavior as they converge to influence China’s social priorities. This study’s design and approach places emphasis on developing an extensive background and investigation into China’s historic, present, and future leadership ideologies as they are likely to drive the country’s social security and health care reforms. As a means of identifying critical themes and determining a valid focus, the study combines complex algorithmic analysis with a relevant Policy Delphi study to discover and confirm a set of valid policy reform predictions. This study assumes that China’s future challenges will be shaped by the country’s global growth, internal social environmental, transitioning ethnological, and intercultural ideologies as it shifts to a position of global superiority. This study’s findings and recommendations are significant in the context of assisting leaders, scholars, and analysts frame a subsequent narrative toward shaping policy decisions by addressing China’s present and future internal tensions due to a social security and health care crisis.