Social Appeal And Government Responsiveness

"Sending medical to the grassroots"(songyixiajiceng)as a means for the government to respond to the society shows significant differences in its effectiveness with the change of time and place.This dissertation aims to explore the factors affecting the effectiveness of government response through the study of the causes of these differences,which is expected to,on the one hand,theoretically supplement the existing researches about government response,and on the other hand,contribute to improving the government responsiveness.This dissertation focuses on the impact of different response objects on the effectiveness of response.A comparative study of the "sending medical to the grassroots" practice in the three cities of Jiaxing,Yuyao and Hangzhou in Zhejiang Province during the period of Republic of China,Mao Zedong and post-year of 2013 shows that "needs" and "demands" as two objects of response will have different impact on the effectiveness of government responsiveness by influencing the achievement of sub-goals of response and their coordination with the main goals,and shaping different types of government-society relations.The health conditions and health management practices during the Republic of China demonstrated the initial attempt to manage health issues in the process of China's transformation to a modern state,which set the background of the "sending medical to the grassroots".After the period of the Republic of China,the emergence of "sending medical to the grassroots" and the changes brought out by it reflected that it is necessary for the government to respond to the society.For the "sending medical to the grassroots" in Mao Zedong's era,on the one hand,due to the high concentration of state power in the central government and the government' s expectation of building a strong industrialized country with speed and convenience,the object of government response is strictly limited to the survival needs;on the other hand,the particular economic and social background at that time,mainly the shortage of medical and health resources as well as the low level of economy and the imperfect transportation facilities,guaranteed the government a good condition for guiding people's needs by policies.Therefore,the "sending medical to the grassroots" turned to be effective in term of improving the accessibility of health service and coordinating it with the main goal——maintaining national security.However,because of limiting the object on the survival needs,the government-society relationship has been gradually shaped to the relation between a survival-oriented government and a mass society.Since the reform and opening up,with the change in the mode of governance,local governments have been conferred greater freedom so that the "sending the medical to the grassroots" of the three cities in Zhejiang Province showed different patterns.During this period,due to the lack of both the collecting mechanism and the processing mechanism of public opinion,Jiaxing City responded to the mixture of people's needs and demands instead of distinguishing them in the process of“sending medical to the grassroots" so that the object of response evolved into only demands at last.It has turned the government-society relations into a relationship between a pacifying government and a private society.At the same time,although the government has improved the accessibility of health services to some extent in this process,the coordination between the sub-goal and the main goal has not been achieved.In Yuyao,since it has established an administrative absorption mechanism enabling the collecting and the processing public opinion before "sending medical to the grassroots",it can identify and respond to people's developmental needs in the sending process which not only improved the accessibility of health services and its coordination with the main goal but also potentially created certain condition for the formation of a more benign government-society relations.However,due to the constraints of local conditions,Yuyao City failed to guide the "demand," which to some extent impaired the effect of "sending medical to the grassroots" and reduced the government-social relationship in this city to a quasi-service-oriented government and civil society.For Hangzhou's "sending medical to the grassroots"(mainly refer to sending health education to the grassroots),the identification mechanism of its response object is similar to the one in Mao Zedong era which is also elite-oriented so that the object of response naturally falls into the survival need.Therefore,although Hangzhou can improve the accessibility of health services through this practice,it faced difficulty in coordinating it with the main goal of alleviating the tension between the increase in health care costs and the shortage of human capital or quality due to the decline of people's health.At the same time,the government-society relationship has gradually evolved into a relation between a survival-oriented government and a mass society.It can be seen that government response is not necessarily the end of social problems,to the contrary,itself may also generate new social problems.The object of government response has a decisive impact on the effectiveness of the response and can have different effects.Whether the government can identify and respond to"needs" is the key to determine whether the government response is effective,because when the government defines the object as "need",it can at least achieve the sub-goal and its coordination with the main goal of government response.Among them,the response to the "developmental needs" will affect the adaptability of the results of government response,because the institutional arrangements formed in this process and the civic culture thus cultivated can better adapt to the trend of social diversification in the future.The ability to successfully guide "demand" will determine the strength of the government response because when the government's limited financial resources are used to meet unlimited demand,it is difficult for the government to coordinate the sub-goals and main goals of its actions.At the same time,the relationship between a pacifying government and a private society formed in this process cannot be conducive to the long-term development of the entire country.