Why hasn’t China’s high-profile health reform (2003–2012) delivered? An analysis of its neoliberal roots

Abstract

In March 2013, China’s so-called fourth generation of leadership stepped down. Upon taking office a decade ago, they launched a series of high-profile health reform programmes, which have often been touted as a prime example of their commitment to prioritizing social welfare. However, throughout their period in power the reform remained remarkably unsuccessful at delivering as promised. This paper explains the failure. Unlike most of the existing literature which hinges upon issues within the health sector, this paper places the country’s political economy at the centre of the analysis. In particular, it highlights the role of neoliberalism. It argues that rather than improving the population’s health, the primary purposes of the health reform were to, first, accommodate socio-political unrest that was caused by neoliberal policies implemented prior to the early 2000s, and, second, facilitate further neoliberal economic restructuring. Moreover, anti-welfare neoliberal tenets, which run counter to improving health outcomes, were deeply imbedded in the formulation of health reform policies.