Rein in Red Packets

This chapter identifies two major approaches that the Chinese government has employed to govern red packets, namely, the disciplinary approach and the market approach. The disciplinary approach relies predominantly on long-established institutions and inv

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Jingqing Yang

Informal Payments and Regulations in China’s Healthcare System

Jingqing Yang

Informal Payments and Regulations in China’s Healthcare System Red Packets and Institutional Reform

Jingqing Yang School of International Studies University of Technology Sydney Sydney, NSW Australia

ISBN 978-981-10-2109-1 ISBN 978-981-10-2110-7 (eBook) DOI 10.1007/978-981-10-2110-7 Library of Congress Control Number: 2016956911 © The Editor(s) (if applicable) and The Author(s) 2017 This book was advertised with a copyright holder in the name of the publisher in error, whereas the author holds the copyright. This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. Cover illustration: Cover design by Samantha Johnson Printed on acid-free paper This Palgrave Macmillan imprint is published by Springer Nature The registered company is Springer Nature Singapore Pte Ltd. The registered company address is: 152 Beach Road, #22-06/08 Gateway East, Singapore 189721, Singapore

To Suzhen, Bochan and Bozhi

CONTENTS

1

Introduction

2

Socialist Medicine and Theories of Informal Payments

29

3

Institutional Changes and the Power of Chinese Medical Professionals

67

4

1

Health Reform and the Rise of Informal Payments After 1978

133

5

Transactions of Red Packets in the Hospital

187

6

Rein in Red Packets

239

7

Conclusion

275

Index

281

vii

LIST OF FIGURES

Fig. 5.1 Fig. 5.2

Payment and responsibility structure in bureaucratic medicine Payment and responsibility structure in a red packet transaction

233 233

ix

LIST OF TABLES

Table 3.1 Table 3.2 Table 3.3 Table 3.4

Number of professional staff of the whole country Number of health organizations and beds of the whole country Healthcare operational budget in the pre-reform era Healthcare capital construction investment in the pre-reform era

107 107 108 108

xi

CHAPTER 1

Introduction

If the reform of any sector that has ever been claimed a failure by a Chinese central government agency, it was the healt