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Institutional Changes and the Power of Chinese Medical Professionals

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Informal Payments and Regulations in China's Healthcare System

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Abstract

This chapter first demonstrates that in the Republic era the Chinese medical profession enjoyed significant professional autonomy and organizational power in their relationships with the state and could control its work and economic terms. During the pre-reform era between 1949 and 1978, the profession quickly lost its autonomy and organizational power and was nationalized and bureaucratized. Bureaucratic medicine, which featured impersonalism toward patients, permeated the healthcare system, despite the Party-state’s efforts to promote universal particularism and demand doctors to treat patients as families. The bureaucratic power of the doctor was further strengthened by shortage of quality services corollary to economical expansion of healthcare. To cope with bureaucracy and shortage, patients had to resort to particularism characteristic of the acquaintance society. Backdoor medicine became endemic.

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Yang, z. (2017). Institutional Changes and the Power of Chinese Medical Professionals. In: Informal Payments and Regulations in China's Healthcare System. Palgrave Macmillan, Singapore. https://doi.org/10.1007/978-981-10-2110-7_3

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