ABSTRACT
This chapter examines why the Shanghai municipal government, when implementing health insurance reform, was able to replace the free health care system with a new contributory health insurance system. It respectively examine four phases: the exploration phase; the experimental phase; the implementation phase and the extension phase of urban health insurance reform in Shanghai, reasons that enabled the Shanghai municipal government to implement urban health insurance reform and views of different stakeholders on changes and challenges brought about by the new health insurance reform. By examining health insurance reform in Shanghai, the centralized political system with the strong influence of the Chinese Communist Party (CCP) and the closed policy-making process placed the central government in an advantageous position to implement urban health insurance reform without any political opposition. The chapter conclude by examining urban health insurance in Shanghai using the theory of historical institutionalism.
