Social Protection under Authoritarianism: Health Politics and Policy in China

266 Pages·2020·14.309 MB·English

by  Xian Huang

Social Protection under Authoritarianism

Social Protection
under Authoritarianism
Health Politics and Policy in China
XIAN HUANG
1
3
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Library of Congress Cataloging-in-Publication Data
Names: Huang, Xian (Professor of political science), author.
Title: Social protection under authoritarianism : health politics and
policy in China / Xian Huang.
Description: New York, NY : Oxford University Press, 2020. |
Includes bibliographical references and index.
Identifiers: LCCN 2020007997 (print) | LCCN 2020007998 (ebook) |
ISBN 9780190073640 (hardback) | ISBN 9780190073671 (on-line) |
ISBN 9780190073657 (updf) | ISBN 9780190073664 (epub)
Subjects: LCSH: Welfare state—China. | China—Social policy. |
Medical policy—China. | Health insurance—China. |
Elite (Social sciences)—China. | Social stratification—China. |
Authoritarianism—China.
Classification: LCC HN733.5 .H844 2020 (print) | LCC HN733 .5 (ebook) |
DDC 306. 0951—dc23
LC record available at https://lccn.loc.gov/2020007997
LC ebook record available at https://lccn.loc.gov/2020007998
1 3 5 7 9 8 6 4 2
Printed by Integrated Books International, United States of America
For my parents, Baihui Huang and Xingwu Xie

Contents
Acknowledgments ix
List of Abbreviations xiii
1. Introduction 1
2. A Theory of Stratified Expansion of Social Welfare 27
3. Overview of China’s Social Health Insurance 57
4. The Center’s Distributive Strategy and Fund Allocation 86
5. Local Motivation and Distributive Choices 111
6. Understanding Subnational Variation in Chinese Social Health
Insurance 134
7. Who Gets What, When, and How from Chinese Social Health
Insurance Expansion? 160
8. Conclusion 190
Appendix A: Data Sources 203
Appendix B: List of Interviewees Cited in Chapters 205
Notes 207
References 227
Index 243

Acknowledgments
The journey for this book began in the summer of 2009 when I finished my first
year of PhD coursework at Columbia University and went back to China for two
months of exploratory fieldwork on labor, wages, and social welfare topics. As
I was interviewing managers and workers in Chinese enterprises, I became very
aware of the remarkable disparities in social welfare benefits among different
Chinese regions and social groups. I was so fascinated by this that I determined
to study the political causes and consequences of these social welfare disparities
and inequalities in China. Thus, the journey began.
The manuscript was initiated as my PhD dissertation. At that stage, I incurred
many debts to those who generously provided intellectual help, emotional
support, and friendship during the dissertation research and writing. First,
I would like to thank my dissertation committee members. My greatest intel-
lectual debt goes to Isabela Mares, my advisor at Columbia. Isabela has been a
role model for my academic career: she has the most passion and devotion to
academic research that I have ever seen and she sets a very high standard for
academic research. Isabela encouraged me to pursue this research and gener-
ously offered advice and guidance at every stage of its development. I am also
extremely grateful to Andrew Nathan, who provided critical help at every step
of my professional development. Nathan read through many drafts of my work
even though some of these were quite preliminary and rough. On each of these
drafts, Nathan gave me thoughtful and extensive comments, which I have saved
as treasures in my computer and I learn something new every time I read them
again. Finally, Vicky Murillo and Kimuli Kasara offered tremendous help during
my dissertation research and writing. Vicky was very generous with her time,
allowing me to discuss my ideas for dissertation chapters with her and always of-
fering helpful comments and suggestions. Kimuli was sharp in finding the weak-
ness of my arguments and reasoning; her insightful comments always improved
my work. I am lucky to have a group of wonderful professors, colleagues, and
friends who constantly provided encouragement and help during the ups and
downs of my graduate study at Columbia. I am deeply thankful to Ada Mui,
Ali Cirone, Benjamin Liebman, Boliang Zhu, Brett Meyer, Chao- Yo Cheng,
Elham Seyedsayamdost, Florence Larocque, Hanzhang Liu, Hiroaki Abe, Israel
Marques, Jerome Doyon, Kay Shimizu, Jack Snyder, Johanna Rickne, Kui-m in
Chang, Leanne Tyler, Li An, Pierce O’Reilly, Pablo Pinto, Pavithra Suryanarayan,