Marilynn M Rosenthal - Health Care In The Peoples Republic Of China: Moving Toward Modernization

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Health Care in the People's Republic of China

About the Book and Author

The Chinese health care system is deeply rooted in a traditional, agricultural way of life, but since the late 1970s it has been increasingly influenced by the dynamics of a modernizing society. Dr. Rosenthal, using data collected through interviews, small-scale surveys, and the Chinese press, examines how Chinese medicine is being transformed. She describes how barefoot doctors are involved in a slow professionalization process, how traditional health care methods are being selectively integrated with western medicine, how the traditional pharmacopoeia is becoming patent medicine, and how recent market policy has introduced the practice of private medicine into the public system. Despite these advances, though, rural-urban disparities in the quality of health care are growing. Because modernization has emphasized the expansion of already advanced health facilities, rural health care, except for selected projects, is rapidly falling behind.

Marilynn M. Rosenthal is associate professor and medical sociologist in the Behavioral Sciences Department and director of the Program in Health and Society at the University of Michigan-Dearborn.

Health Care in the People's Republic of China

Moving Toward Modernization

Marilynn M. Rosenthal

First published 1987 by Westview Press, Inc.

Published 2018 by Routledge
52 Vanderbilt Avenue, New York, NY 10017
2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN

Routledge is an imprint of the Taylor & Francis Group, an informa business

Copyright 1987 Taylor & Francis

All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

Notice:
Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

Library of Congress Cataloging-in-Publication Data
Rosenthal, Marilynn M.
Health care in the People's Republic of China.
(Westview special studies on China)
Includes index.
1. Medical careChina. 2. Medicine, ChineseChina. I. Title. II. Series. (DNLM: 1. Delivery of Health CaretrendsChina. WA 395 R815h)
RA395.C53R67 1987 362.1'0951 86-32501
ISBN 13: 978-0-367-01603-6 (hbk)

Dedicated to J.J., Addy, Al (1904-1986), Josh, Helen, Sue,
Bob, Gary, Chris, Ellen, Richard, Harriet, Irv, Leslie, Marty,
Andy, Pam, Elliot, Jackie, Jill, Sandy, Dan and Gregorythe
familyfilled with fun, warmth and caring

Contents

, with Jay Greiner

, with Paul Pongor

1. ii
2. iii

Guide

Tables

Figures

Striking changes are taking place in the health care system of the People's Republic of China, particularly in relation to its characteristics during and immediately after the Cultural Revolution.

This book captures the early phase of those changes, in the period of time shortly after the current modernization policies were announced and as they began to be implemented. The first five chapters of this book will provide the reader with the background necessary to understand what is taking place today. The sixth chapter, however, includes current material and brings the reader up-to-date.

are based primarily on material gathered in 1979 and 1981 during study courses on health care in the People's Republic of China. They describe and discuss the historical development of health policy and the health system, beginning with the Chinese Communist revolutionary success in 1949, and bring the reader to the early stages of the modernization process. In the late 1980s, the changes are accelerating; in the early 1980s, the health care system was just starting to respond and those early responses are reflected in the first five chapters of this book.

Hence, the book begins with a discussion of the slowly emerging efforts to professionalize the Barefoot Doctors and the new conceptualization of how they ought to change.. Not only is the program partially carried out in the health care sector, but its success is pivotal to the success of modernization in general.

These chapters of the book lead the reader through the foundations of the most recent changes to the final chapter, , which offers a summary overview of what is taking place today. In fact, the reader may want to begin with the last chapter and then return to the first five for a decade-long perspective that provides backdrop for current development.

One of the keys to the changes occurring throughout Chinese society as a whole is the Responsibility System which emphasizes individual and family enterprise and has stimulated the development of a private market sector. Collective and commune activities have subsided or even disappeared in many rural areas. This has had important implications for the health care system. These range from encouragement and creation of private medical practice to a disruption of the rural cooperative medical funds. It has also stimulated greater concern for quality of medical care and a desire for more and better medical technology as well as higher standards for existing practitioners and practices. Discussion of these can be found in .

China is a large and complex country and the modernization process will be a long and arduous one. It will take place neither evenly nor smoothly. Indeed, in many areas of the country, particularly poorer ones, the health care system will remain essentially as we saw it in 1979 and 1981. So while the most dramatic changes will continue to be noted and discussed, this book provides a picture of the diversity in the health care system. A diversity which will remain as the People's Republic of China moves slowly towards modernization.

Marilynn M. Rosenthal

It was Peter M. New (1932-1986) who first encouraged me to analyze the voluminous material that had been gathered during my 1979 study course to the People's Republic of China. His interest, encouragement and enthusiasm sustained that effort for some period of time beginning with his invitation to organize a panel presentation of our material at the 1980 annual conference of the Society for Applied Anthropology, Peter also reviewed several of the articles in this book in their earlier drafts. His expertise was made available with considerable generosity, and his untimely death was a great loss to his family, friends, colleagues and the discipline to which he contributed.

A number of other people have been particularly helpful over the years these essays have been in the making. Charles Tilly helped me think through the first article that was written, "Political Process and the Integration of Traditional and Western Medicine." Marty Whyte seemed to direct me towards a new source of information at just the right moment on several occasions, and he also provided the hospitality of a desk at the Center for Research on Social Organizations at The University of Michigan where much of the writing for this book was undertaken. Sheila Hillier in London, in endless, extended and animated conversations over many summers, shared her tremendous knowledge of the Chinese health care system. David M. Lampton and Arthur Kleinman offered encouragement via letter that was most helpful. To all these colleagues, many, many thanks. I take full responsibility, however, for any perversions of their ideas and suggestions and, of course, for all the conclusions of this book.

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