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Bureaucratic Interests And Institutions In The Making Of China’s Social Policy

PAQ, Vol. 27 No. 2, (2003)

Explanations of China’s post-Mao social policy have concentrated on
the political, social, fiscal, and economic goals of the state and its
governing elite. In a study of urban health insurance policy, this article
argues that bureaucratic interests and institutions within the Chinese
state are also influenced. This article first shows how bureaucratic
interests within the central government have influenced the adoption of
a new national social health insurance framework. It then shows how
that framework has been modified following local implementation
experiences that have allowed other bureaucratic and non-bureaucratic
interests to be expressed. This examination of both central and local
interests helps explain the adoption of a basic social health insurance
system that provides for only the urban working population, subsidizes
civil servants, and is administered locally. The article also shows the
policy process in this sector to have been particularly protracted and
incremental and argues that further incremental policy changes are

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