China experienced both economic and epistemological transitions within the past few decades, greatly increasing demand for accessible and affordable health care. These shifts put significant pressure on the existing outdated, highly centralized bureaucratic system. Adjusting to growing demands, the government has pursued a new round of health reforms since the late 2000s; the main goals are to reform health care financing, essential drug policies, and public hospitals. Health care financing reform led to universal basic medical insurance, whereas the public hospital reform required more complex measures ranging from changes in regulatory, operational, and service delivery settings to personnel management. This article reviews these major policy changes and the literature-based evidence of the effects of reforms on cost, access, and quality of care. It then highlights the outlook for future reforms. We argue that a better understanding of the unintended consequences of reform policies and of how practitioners' and patients' interests can be better aligned is essential for reforms to succeed.

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State-owned enterprises (SOEs) retain a strong presence in many economies around the world. How do governments manage these firms given their dual economic and political nature? Many states use authority over executive appointments as a key means of governing SOEs. We analyze the nature of this “personnel power” by assessing patterns in SOE leaders’ political mobility in China, the country with the largest state-owned sector. Using logit and multinomial models on an original dataset of central SOE leaders’ attributes and company information from 2003 to 2017, we measure the effects of economic performance and political connectedness on leaders’ likelihood of staying in power. We find that leaders of well-performing firms and those with patronage ties to elites in charge of their evaluation are more likely to stay in office. These findings suggest that states can leverage personnel power in pursuit of economic and political stability when SOE management is highly politically integrated.

What impact does spending time horizon have on political budget cycles? While traditional political budget cycles increase visible spending with immediate gains before political turnover, I hypothesize that spending in categories with less-immediate gains categories increases when opportunity costs are lower. In this article, I build on existing literature on budget cycles in both democracies and non-democracies to disaggregate types of budget cycles: those with long-run versus short-run benefits. In China, after central-level reforms, welfare targets, with long-run gains, became visible to local leaders' constituents, the central leaders above them. Local leaders then had an incentive to provide welfare, but only when it was the least costly in terms of opportunity costs. Using fixed-effects models panel data from China's 333 municipalities for 1994-2012, I find welfare spending minimizes both relatively and absolutely around year three, and maximizes at the beginning and end of a politician's tenure, when opportunity costs and probability of political advancement are lowest. These cycles are the most dramatic in western provinces, where education is a particularly important tool for ideological spread. Health and Social Security spending also see expansion at the end of mayor's tenures, although the cycles are less pronounced than in education spending. This study expands the literature on political budget cycles by disaggregating government spending and considering the impact of timeliness on cycles.

Purpose To develop an EQ-5D-3L social value set based on Chinese rural population’s preferences using the time trade-off (TTO) method, and to compare the differences in preferences on health states between China urban and rural population. Methods Between Sep 2013 and Nov 2013, a total of 1201 participants were recruited from rural areas of five Chinese cities (Beijing, Chengdu, Guiyang, Nanjing, and Shenyang) using a quota sampling method. Each respondent valued 13 health states using the TTO, and a total of 97 EQ-5D-3L health states were directly valued for estimating the value set. Various models with different specifications were explored at both aggregate and individual levels. The final model was determined by a set of predefined selection criteria. Findings An ordinary least square model at the aggregate level included 10 dummy variables for specifying the level 2 and 3 for each dimension and an N3 term presenting any dimension on level 3 was selected as the final model. The final model provides a value set ranges from − 0.218 to 0.859. The predicted utility values were highly correlated with but consistently lower than that of the published Chinese EQ-5D-3L value set (for urban population). Conclusion The availability of the China rural value set provides a set of social preferences weights for researchers and policy decision-makers for use in China rural area.