Healthy adaptation: Political pressure, economic openness, and health care policies in post-Mao China

This dissertation project answers the puzzle of why authoritarian regimes provide public goods in the absence of adequate interest articulation and apparent political accountability. Though authoritarian systems are generally believed to be tight-fisted, the variations in social welfare systems within authoritarian regimes suggest that this predatory image is more variable than anticipated. I argue that changes in economic openness and political pressure drive political elites in authoritarian systems to respond with shifts in "survival strategy", a political paradigm that best ensures their monopoly on political power and consequently shapes the pattern of social welfare system.;Using the evolution of health care policies in post-Mao China as an example, I explain how different variations in economic openness and political pressure lead to temporal variations in health care policies by motivating the Chinese Communist Party to alter its survival strategy. The findings of this research suggest that in an economically open context, authoritarian regimes could also be responsive when domestic political pressure is high. Meanwhile, it also questions the anticipated causal link between economic development and democratization raised by modernization theory.