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The lack of significant improvement in people’s health status and other mounting health challenges in China raise a puzzling question about the country’s internal transition: why did the reform-induced dynamics produce an economic miracle, but fail to reproduce the success Mao had achieved in the health sector? This book examines the political and policy dynamics of health governance in post-Mao China. It explores the political-institutional roots of the public health and health care challenges and the evolution of the leaders’ policy response in contemporary China. It argues that reform-induced institutional dynamics, when interacting with Maoist health policy structure in an authoritarian setting, have not only contributed to the rising health challenges in contemporary China, but also shaped the patterns and outcomes of China’s health system transition. The study of China’s health governance will further our understanding of the evolving political system in China and the complexities of China’s rise. As the world economy and international security are increasingly vulnerable to major disease outbreaks in China, it also sheds critical light on China’s role in global health governance.
- Sales Rank: #4417763 in Books
- Brand: Brand: Routledge
- Published on: 2012-11-16
- Original language: English
- Number of items: 1
- Dimensions: 9.21" h x .50" w x 6.14" l, 1.05 pounds
- Binding: Hardcover
- 192 pages
- Used Book in Good Condition
Review
'Yanzhong Huang's book reflects a deep knowledge of Western theories as well as of Chinese political processes. On the basis of a decade of research, he traces the changes taking places in China in the politics of health policy as 'buck-passing' replaces 'bandwagoning'.' - Ezra F. Vogel, Harvard University, USA�and author of Deng Xiaoping and the Transformation of China
'Yanzhong Huang has written an important book. He asks―Why have Chinese public health indicators failed to match China's economic performance in the reform era? Indeed, why have they failed to match Mao's performance? The answer resides in the buck-passing, fragmented, unaccountable system that has developed. Public health improvement requires political change. I recommend this book highly.' ― David M. Lampton, Johns Hopkins SAIS, USA�and Author of The Politics of Medicine in China
'This is a meticulously researched book that has made a valuable contribution to our understanding of the crisis in China's healthcare sector. Yanzhong Huang's research is not only theoretically original, but also insightful in its analysis of the underlying causes of the poor delivery of social services in post-Mao China.' ― Minxin Pei,�Claremont McKenna College and author of China’s Trapped Transition: The Limits of Developmental Autocracy
'Ever since the SARS epidemic of 2003 lifted the curtain to reveal the extent of horrors and ineptitude in China’s system outsiders have puzzled over why health has remained an Achilles Heel of the transforming state. Yanzhong Huang is arguably the only expert able to solve this paradox, offering bold and startling insights. This is a must-read for anybody interested in global health, pandemic control, or the future of the Chinese state.' ― Laurie Garrett, Senior Fellow for Global Health, Council on Foreign Relations, USA�and author of Betrayal of Trust: The Collapse of Global Public Health
'Yanzhong Huang’s book is a welcome addition to the growing number of scholarly studies on the consequences and impact of post-Mao reforms – in this case, on developments in China’s health care sector...Huang’s book offers a critical evaluation of the factors contributing to the crises in the delivery of health care and the government’s attempts to deal with the challenges of rebuilding a viable health care system in the transition to a market economy.' - Ka-che Yip, University of Maryland Baltimore County, USA (China Information 2013)
About the Author
Yanzhong Huang is an Associate Professor at the John C. Whitehead School of Diplomacy and International Relations, Seton Hall University, and a Senior Fellow for Global Health at the Council on Foreign Relations. He is also the founding editor of Global Health Governance: The Scholarly Journal for the New Health Security Paradigm.
Most helpful customer reviews
1 of 1 people found the following review helpful.
Provides A Peek Deep Inside China -
By Loyd Eskildson
State engagement in health government governance is a relatively recent development in rapidly modernizing China - the government's first health-care moves post-Mao were to withdraw from the sector, acerbating problems of cost, access, and equality; average life expectancy rose by only five years between 1981 and 2009, compared to an increase of almost 33 years during the Mao era (1949-1980). To be fair, its initial improvements (35 to 67.9) came from a much lower base, yet other nations have improved more from a similar base in recent years.
Infant/maternal mortality has made considerable strides recently. Infant mortality in China decreased from 38 deaths/1,000 live births in 1990 to 16 in 2010, and the mortality rate for children under five dropped from 48 per 1,000 live births to 18. The maternal mortality ratio has also fallen, from 110 per 100,000 live births in 1990 to 38 in 2008.
Another substantial improvement - TB cases in 2010 China were estimated at 216 per 100,000, down 45% from 2000.
Chronic non-communicable diseases such as cancer and cardiovascular are the leading causes of death in China - with pollution contributing to at least the cancer death rates. Public opinion surveys in 2009 ranked health care and food and drug safety as among the nation's top three concerns. A major contributor was the introduction of market-oriented reform w/o adequate rule of law.
Industrial pollution is not the only instance of conflict between economic and health goals. China has one-third of the world's smokers and suffers about one million related deaths/year; its cardiovascular disease death exceeds that in the U.S.
Author Huang suggests separating public hospital ownership from management and ceasing the use of drug sales as the main revenue source for hospitals, similar to Taiwan. (Of every $100 spent on U.S. health care, $10-$12 goes for drugs, in China it is $40-$45.) He also suggests replacing fee-for-service with DRG and capitation to give those hospitals incentive to hold down costs and improve accountability. As for food and drug safety, Huang sees weak enforcement as the greatest problem, sometimes based on 'political consideration' (corruption), especially at the local level. This problem is acerbated by the absence of press freedom.
The 'good news' is the incoming president Xi Jinping has pledge to bring higher levels of health care to China's people - Beijing plans to triple its health care spending to $1 trillion by 2020.
Bottom-Line: China spent less than 5% of GDP on health care in 2005, vs. 16% in the U.S. and 10% in Canada. However, China's advantage in purchasing power parity leads author Huang and others to probably overstate the crisis in China's health-care as far as financial commitment is concerned; this is especially likely given that the author's estimates of government spending have been labeled as far too low (Tang, Baris). It also has initiated a program of encouraging Western hospitals to invest in China. A third major initiative - expanding health insurance to universal levels by 2020 (now reportedly at over 94%, though at low benefit levels that focus on in-patient care).
0 of 0 people found the following review helpful.
Five Stars
By L Hale
An excellent account of China's health care challenges by an expert in the field.
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