| Using the case of urban health care insurance reform in the People's Republic of China, this dissertation looks at the role of the bureaucracy in the era of economic reform. The control of health care policies and the process of policy implementation at the central, municipal and hospital level is examined to reveal the nature of the decentralization of bureaucratic authority that has occurred in the reform era.; In agreement with recent studies on reform era China, this study of welfare policy making illustrates how authority, especially fiscal authority, has been devolved in the reforms to lower bureaucratic levels. But unlike the bureaucracy that is associated with the productive economy, in the health care bureaucracy this shift is mitigated by the public service role of health care. Pre-reform sources of supervisory and management authority, new sources of authority based on developing regulatory roles, all of them devoid of, or with little budgetary interest, maintain their importance within the welfare bureaucracy at all levels. |
