The Political And Social Sustainability Of China's Rural Health Service Provision

Domestic research on public service provision is mainly conducted via the technical perspective by focusing on its capability in improving cost-efficiency and customers'satisfaction. Nonetheless, research on whether certain provision mechanism is sustainable is remarkably scarce. Actually, the essence of public service provision is not just limited to cost-efficiency or effectiveness, but concerns on its sustainability should be given priority, especially in such a resources-constraint world. Many failures of previous public policy can be attributed to the poor sustainability of public service provision. Consequently, research on China's public service provision should be given much more attentions.Firstly, the author gives out a definition to the sustainability of public service provision and then narrows down the empirical research to China's health policy. The author finally chooses China's New Cooperative Medical Scheme to make study on this issue. The author identifies four categories factors that are affecting the NCMS's sustainability, which are economic factors, political factors, social factors and technical factors. This study is mainly focused on the political and social factors. In order to acquire empirical date, in mid-March, 2007, the author conducted a field study in Yushe County, Shanxi Province by employing research methods such as questionnaires, unstructured interview, literature study, and so on.In the research on political factors, the author makes analyses on China's mobilizing policy approach, macro-policy environment, county-level governments'political motivations, and governing structures, all of which are exerting critical influences on the NCMS's political sustainability. In the research on social factors, the author studies the social capital, peasants'trust, comprehension of NCMS that are crucial determinants of NCMS's social sustainability.Through normative and positive study, the author argues that NCMS has gained remarkable political support from the state government. And macro-policy environment has become more favorable. In this sense, the NCMS is politically sustainable. However, if county-level governments'political motivation could be strengthened, the governing framework could be improved, social capitals could be cultivated, NCMS could gain greater trust from peasants, and the peasants'comprehension of NCMS could be reinforced, its sustainability may stays poor.In the last section, the author advances several policy recommendations.