ABSTRACT

This chapter focuses on how health and social policies have evolved since 1949. It then looks at the main actors in the policy process and the main influences on policy making. Since the early 2000s, the Party-state has reasserted its responsibility for providing universal basic social goods and safety nets, and has concentrated health and social policy initiatives on the long-neglected countryside. Into the 21st century, health and social policy became as important as economic policy for China's top leaders. China's health and social policy are shaped predominantly by a combination of top leaders and elite debates. Leaders set the general policy orientation or 'line' based on their own experiences, preferences and perceptions of China's problems. The chapter shows that China's top leaders and central government ministries to be the key actors, but argues that policies are influenced by elite debates and public opinion as well as by institutional arrangements such as a decentralized fiscal system.