Doctoral Dissertation Research in Political Science: Understanding Chinese "Welfare States": Rural Health Policy and the New Cooperative Medical System

University Of Wisconsin-Madison, Madison WI

Investigators

Abstract

Without the pressures of elections or independent civil society, what motivates the Chinese government to expand social welfare provision? Moreover, what accounts for local variation in implementation of social policy in China? Through an analysis of rural health delivery in China, this project will address the larger issue of welfare state performance in non-democratic developing countries, which comprise half of the world's people and nations. Despite the significance of this issue, the dominant research paradigms ignore or misrepresent authoritarian systems and instead focus on the impacts of democratic forces, such as civil society and electoral competition. Another gap in the current literature limits its utility for policy analysis in the quest for good governance. Much policy analysis of welfare regimes in developing countries is overly focused on policy adoption at the national level. In reality, all regime types have to grapple with the difficulties inherent to the geographic and regional diversity that produces the complex realities of local communities. Without understanding variation within a country, an analyst cannot fully grasp the causes driving policy successes and failures. This research begins to fill in these glaring lacunae. To this end, the dissertation will examine the adoption and variation in implementation of the New Cooperative Medical System (NCMS) in rural China. Building on the existing literature, this project will evaluate three broad categories of hypotheses: political and historical context, economic constraints, and social forces. The extant literature on the welfare state in developing countries examines the first two sets of hypotheses at the national level; this research will test whether these factors affect variation in implementation of the NCMS at the local level in China. As for the effect of social forces, the current literature typically emphasizes the role of democracy and democratization; this project will examine whether and how social forces affect the adoption and implementation of social policy in an authoritarian context. To test these theories empirically, the dissertation will rely on qualitative research, including archival research; semi-structured interviews with government officials, medical personnel, and villagers; and the analysis of an original survey of county-level Public Health officials in five provinces. In addition, this dissertation will have concrete broader impacts through the dissemination of an original survey and the presentation of results in China and other developing countries. First, the original survey will be archived for public use. Second, the co-investigator will collaborate with Chinese partners and present the results of her research in Chinese at Chinese universities. Third, the dissertation has policy implications for social policy in developing countries and will include a comparative chapter on social policy in other developing countries. Thus, the results will have implications for both academic debates and policymakers concerned with social welfare provision in China and beyond.