ABSTRACT
This chapter explores the continuum of commercialization in the context of neoliberal economic reforms in China since the late 1970s. The changes in the economy had far-reaching consequences for healthcare financing and provisioning in rural and urban areas in China. The shift from guarantee of universal, comprehensive, and equitable access to health services during the Maoist period was reversed with market socialism. With decollectivization, the rural population experienced the worst effects in terms of access to care. The system’s financial base was badly affected, and as a result, the structures of provisioning collapsed. The post-reform period in health was marked by commercialization of public hospitals with the introduction of ideas from New Public Management. During this period, a number of private hospitals were established by domestic and foreign capital, confined largely to urban areas and prosperous provinces. The consequence of commercialization of public hospitals has been growing inequity in access, variable quality of services, and an over-reliance on hospital-centered care at the expense of primary care. Thus, the crisis of commercialization and increasing privatization and corporatization is now visible in China.
