Health Care System Reform in Contemporary P.R.China: Public Agenda, Private Interests and Global Interactions

Contemporary China observers tend to agree over the positive role played by post-maoist market-oriented reforms in shaping a political system increasingly open to interactions between private interests and state authorities. Recent works exploring these interactions describe a context where “pursuit of economic expansion has led to the emergence of an interest-based social order” (Zheng 2002: 64) and a polity where “largest and most active interest groups are economically driven and have a great impact on . . . political and social affairs” (Yang 2007: 2). In the last thirty years, Chinese public health care system has experienced a pervasive restructuring process, whose trajectory has been defined by the State coherently with national development priorities. As reforms in the health sector deepens, private interests are emerging. Despite the deep influence of market-oriented reforms in the sector, however, scarce attention has been devoted in investigating policy inputs conveyed by economically driven interests—in particular those of medical providers and pharmaceutical producers—to the political power, either in the form of resistance to regulatory pressures or through the articulation of specific demands. This paper will attempt to investigate the processes which lead to the constitution of economically driven interests in post-Mao China’s health care sector, how they exerted their influence on the commitments taken by the Hu-Wen leadership towards a more “harmonious” pattern of socio-economic development and which avenues they might follow in articulating demands upon the political system. Finally, recent developments in health policies and the relevant debate involving major stakeholders will be introduced.