Challenging the economic reform paradigm: policy and politics in the early 1980s collapse of the rural cooperative medical system

Over the last two decades an economic reform paradigm has dominated social security and health research: economic reform policies have defined its parameters, established its premises, generated its questions and even furnished its answers. This paradigm has been particularly influential in accounts of the early 1980s collapse of China’s rural cooperative medical system (CMS), which is depicted almost exclusively as the outcome of the post-Mao economic policies that decollectivized agriculture. This paper draws primarily on government documents and newspaper reports from the late 1970s and early 1980s to argue that CMS collapse is better explained by a change in health policy. It shows that this policy change was in turn shaped both by post-Mao elite politics and by CMS institutions dating back to the late 1960s. The paper concludes by discussing how an explanation of CMS collapse that is centred on health policy and politics reveals the limitations of the economic reform paradigm and contributes to a fuller understanding of the post-Mao period

State self-earned income and welfare provision in China

Local governments in China in the 1990s relied increasingly on self-earned income, but little is known about the impact of this on the provision of public goods, especially in wealthy urban areas. This paper shows how departments charged with providing welfare and social services to the poor have been supplementing budgetary expenditures with other, self-earned, finance. Based on research in the city of Tianjin, it argues that although self-earned income can increase spending on welfare and social services, increasing reliance on such income, and variation in departmental capacities to generate it, exacerbate already inequitable welfare provision even within this wealthy city. It also creates conflicts of interest and problems for local government spending controls

Bureaucratic institutions and interests in the making of China's social policy

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 likely

A study of the opinions of fifty elderly persons regarding their health needs

Thesis (M.S.)--Boston Universit

An adaptive appearance-based map for long-term topological localization of mobile robots

This work considers a mobile service robot which uses an appearance-based representation of its workplace as a map, where the current view and the map are used to estimate the current position in the environment. Due to the nature of real-world environments such as houses and offices, where the appearance keeps changing, the internal representation may become out of date after some time. To solve this problem the robot needs to be able to adapt its internal representation continually to the changes in the environment. This paper presents a method for creating an adaptive map for long-term appearance-based localization of a mobile robot using long-term and short-term memory concepts, with omni-directional vision as the external sensor

Explaining public satisfaction with health care systems: findings from a nationwide survey in China

Objective: To identify factors and covariates associated with health care system satisfaction in China. Context: Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health care utilization, media use and perceptions of services may affect health care system satisfaction, but the relationships between these factors are poorly understood. New data from China offers the opportunity to test theories about the sources of health care system satisfaction. Design: Stratified nationwide survey sample analysed using multilevel logistic regression. Setting and participants: 3,680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Main outcome measure: Satisfaction with the way the health care system in China is run. Results: We find only weak associations between satisfaction and socio-demographic characteristics, income and self-reported health. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. Conclusions: To improve satisfaction, Chinese policy makers – and their counterparts in countries with similar health care system characteristics – should improve insurance coverage and the quality of health services, and tackle unethical medical practices