“Social Protection under Authoritarianism: Health Politics and Policy in China”. by Dr Xian Huang, Rutgers University

Published: 28 January 2021

“Social Protection under Authoritarianism: Health Politics and Policy in China”. by Dr Xian Huang, Rutgers University

4pm–5.30pm Wednesday 17 February 2021

Zoom Registration Required at: https://uofglasgow.zoom.us/meeting/register/tJEpduqsrzMtHdzXxhknJLUa0IyqawYiyjOS 


Why would an authoritarian regime expand social welfare provision in the absence of democratization? Yet China, the world's largest and most powerful authoritarian state, has expanded its social health insurance system at an unprecedented rate, increasing enrollment from 20 percent of its population in 2000 to 95 percent in 2012. Significantly, people who were uninsured, such as peasants and the urban poor, are now covered, but their insurance is less comprehensive than that of China's elite. With the wellbeing of 1.4 billion people and the stability of the regime at stake, social health insurance is now a major political issue for Chinese leadership and ordinary citizens. 

In this talk, Xian Huang analyzes the transformation of China's social health insurance in the first decade of the 21st century, addressing its expansion and how it is distributed. Drawing from government documents, field interviews, survey data, and government statistics, she reveals that Chinese leaders have a strategy of "stratified expansion," perpetuating a particularly privileged program for the elites while developing an essentially modest health provision for the masses. She contends that this strategy effectively balances between elites and masses to maximize the regime's prospects of stability.

In China's multilevel governance, both centralized and decentralized structures are involved in the distribution of social health insurance. When local leaders implement the stratified expansion of social health insurance, they respond to varied local conditions. As a result, China's health insurance policies differ dramatically across subnational regions as well as socioeconomic groups. Providing an in-depth look into China's health insurance system, this book sheds light not only on Chinese politics, but also on how social benefits function in authoritarian regimes and decentralized multilevel governance settings.

Speaker bio

Dr. Xian Huang is an Assistant Professor in the Department of Political Science at Rutgers University. Her research interests include (1) political causes and consequences of social inequality, stratification, and (im)mobility; (2) redistribution, social welfare, and health policies; and (3) public opinion and preferences in the autocratic setting. Dr. Huang’s research has appeared in Governance, Social Science Research, Studies in Comparative International Development, Social Science Quarterly, The China Quarterly, among others.

Dr. Xian Huang received BA degrees in Political Science and Economics and a MA degree in Political Science from Peking University. She received a PhD in Political Science from Columbia University. Before joining Rutgers, she was a postdoctoral fellow in the Center for the Study of Contemporary China at the University of Pennsylvania. Dr. Huang is an affiliated faculty member in the Center for Chinese Studies at Rutgers University and an associate in the China Center for Social Policy at Columbia University.


The Scottish Centre for China Research Seminar Programme gratefully acknowledges the financial support of the MacFie Bequest. 

First published: 28 January 2021

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