News Type
News
Date
Paragraphs

Author Michael Schuman writes an opinion piece informed by Scott Rozelle's publication Past Successes and Future Challenges in Rural China's Human Capital 

"Many investors and economists continue to believe China’s rise to global economic greatness is inevitable. Modern history, however, tells us that graduating from emerging- to a developed-economy status is hardly automatic. An overly intrusive state, dependence on debt, feeble gains in productivity and poor resource allocation are all reasons to fear China might struggle with the transition like so many nations before it...'China must significantly raise its level of human capital if it wishes to attain high-income status. In the end, China can only be as competitive as its people.'"

 

Read the full story here. 

Hero Image
ChineseHighSchool Rural Education Action Program
All News button
1
Authors
Noa Ronkin
News Type
Q&As
Date
Paragraphs

The U.S.-China relationship is in a dangerous downward spiral. The crisis in the relationship has spread virtually to every arena, from the intensifying trade war between the two largest economies to their escalating technology rivalry that is rippling into a U.S. government crackdown on foreign influence on research, and from security concerns over China’s growing military power in the Asia-Pacific region to mounting tensions over the antigovernment protests in Hong Kong and over longstanding frictions with respect to Taiwan.

Renowned Chinese politics expert David M. Lampton has been busy discussing these developing issues with academics and policymakers in China, Hong Kong, and Washington, D.C., and researching his book project about Chinese power and rail connectivity in Southeast Asia. In a conversation with APARC’s Associate Director of Communications and External Relations Noa Ronkin, the Oksenberg-Rohlen Fellow at the Freeman Spogli Institute and Shorenstein APARC analyzes the escalating U.S.-China conflict, one that will affect not only bilateral ties, but the regional and world systems beyond.

Q: What risks in the conflict are you most concerned about?

There are a number of problems on the agenda. Certainly trade is top of mind for people in Beijing and Washington. But I think the situation in Hong Kong has great potential to do tremendous harm to the U.S.-China relationship. The predicate is being laid for the possible use of force in Hong Kong. I don't think a decision has been made to do so, and I believe Beijing would prefer not to do so. However, remembering 1989 in Tiananmen, we shouldn't underestimate the willingness of China’s central government to use force to protect its power. You see the increasing spread of demonstrations within Hong Kong, which are very worrisome to the PRC government, and indicators are accumulating that to me signal a significant possibility that the Special Administrative Region and/or Beijing will use tough means to bring demonstrators under control. Such an outcome will, of course, feed into the policy and security anxieties in Washington, not to mention be a tragedy for Hong Kong itself. So, I think Hong Kong is a top concern.

Q: Can you expand on the politics and the context of the U.S.-China trade war?

We're in a situation in which each side thinks it can and will benefit by outwaiting the other. I think Beijing sees at least a significant possibility that Mr. Trump would not be reelected and fervently hopes that's the case. They're in no hurry, thinking that the U.S.-China trade dispute undermines Trump with his natural constituencies and makes his economic story harder to tell to the American people. Beijing believes that, by virtue of the United States’ being a democracy, China has a higher threshold for pain than we do, and so simply inflicting pain on key American constituencies and industries will turn up the political heat on the administration so that compromise would look increasingly attractive to Washington.

The Trump administration, on the other hand, looks at the high percentage of China's GDP that's involved in exports, particularly exports to the United States, which is over three percent. If you subtract the value added of all the components China imports in order to assemble these exports, then still approximately two percent of China's GDP is directly involved in trade with the United States, and the Trump administration believes that China has a lot to lose. The United States is not nearly as dependent on China's exports—that's one of our complaints, that we don't export enough. Therefore Mr. Trump sees Mr. Xi as facing many domestic problems and thinks he can outwait Mr. Xi.

We have then two leaders who are locked into the view that the other is going to blink first. I believe both sides benefit from an economic relationship, but both have the capacity to do without the other if they're forced to. And so I think the trade war can go on for a protracted period.

Q: The trade war, big as it is, is part of a more encompassing rivalry between China and the United States. How do you see this competition between the world’s two superpowers and its consequences?

What has fundamentally happened here—even more important than the economic and cultural dimensions of the U.S.-China dispute—is a deterioration of the security dimension in the relationship. For the first three decades of engagement since the Nixon era, our security relationship with China was generally positive, based first on an anti-Soviet rationale, then counter-terrorism, and finally jointly tackling global issues such as climate change. Up through the Obama administration we had a security rationale for positive relations. Most countries and people prioritize their security, and hence as long as Americans and Chinese could feel the relationship had value for their security, they downplayed thorny issues such as human rights or economic frictions, even though they were unhappy with each other in those other domains.

But as China's military and economic capabilities have increased, so has its assertiveness abroad and its efforts to resolve longstanding disputes in its favor: in the South China Sea, in cross-Strait relations with Taiwan, against Japan, even against South Korea. From its more capable position today, China is pushing the perimeter of U.S. influence back away from the Chinese coast as far as possible, while the United States resists. And so we have a severe security competition that, in turn, has infected the economic relationship, because what makes a competitive military today is largely technological capability, which China is forging ahead with and using to develop new weapons systems. The United States thinks much of this capability is coming through the illicit acquisition of intellectual property and proprietary technology, and through university collaborations and exchanges. So the security competition is ramifying through the economic relationship and the cultural/educational relationship.

Q: If the competition between the two superpowers is here to stay, what steps, at home and abroad, are essential to achieve stable coexistence with China?

We have assumed that a huge, complex authoritarian society such as China has many disadvantages, which it does, but we're in danger of not realizing what it can achieve nonetheless. I'm worried about the competition with China because I don't think we are taking the right steps to put ourselves in the best possible competitive position, and I don’t mean just militarily.

If you consider the space race against the Soviet Union, there was a galvanizing vision of a serious competitor, yet there nonetheless was an abiding belief that we could prevail if we properly organized ourselves with discipline, commitment, and allocation of resources. We need the same sort of galvanizing spirit, not grounded in seeing China as an enemy, but in the realization that we Americans make up but four percent of the world's people and that if we're going to keep a strong position economically, intellectually, and socially, then we have to perform better than others, because we're just too small a percentage of the world's people. And I don't think anybody believes we're performing at our peak today.

Competition in general is a good thing. We surely recognize this in our own domestic lives, and free trade theories in international economics recognize that competition is an engine for positive forward motion. So I don't think we should be afraid of competing with China. Our society has been designed for competition from the ground up. And China has tremendous problems: demographic problems, educational quality problems, and debt problems. But what we must avoid is a destructive competition in which we're hurting our own ability to innovate by attempting to keep China from advancing. For instance, targeting foreign students in American research institutions and labs is a major problem.

Q: You have been studying China’s Belt and Road Initiative (BRI) and its implications across the Asia-Pacific. What are some of the takeaways from your research so far?

The Chinese learned a lesson from U.S. policy in the post-WWII era, namely, that you build your own greatness by integrating other countries into your economy and by building their strength. The Chinese are now looking at their underdeveloped periphery and think, "How can we build the new connectivity in the 21st century that will make China central to all countries along its enormous periphery and beyond?" BRI is therefore a big umbrella concept, based on the notion that you create economic growth through building infrastructure, and particularly transportation and communications, in an attempt to increase China's comprehensive national power and centrality in the emerging global system. It could be described as an “all roads lead to Rome concept.”

Some argue that BRI is a strategy, a master plan. And here's where I think we get it wrong. It isn't really a plan. China has created this umbrella policy concept, has said it will devote resources to it, but local provinces, state enterprises, private enterprises, foreign governments all are in effect lobbying Beijing to approve their pet projects that are shoved under this umbrella. So, you see a big vision painted by Beijing, but an extremely entrepreneurial system below Beijing is trying to grab as much of this money and opportunity, and build their locality into this vision. It's a combination of spontaneous combustion at the middle and lower levels and a grand general idea at the top.

Right now what we're seeing is the implementation of numerous projects—some are unmitigated fiascos, some are successful to a limited degree, and some are likely to become quite successful. There will be a sorting out process. In fact, Beijing, for its own welfare, is already starting to constrain the system and apply more economic analysis to differentiate between good and bad projects. But because BRI is so entrepreneurial and so many people at the bottom are trying to grab a piece of this policy, it's very difficult for Beijing to get its arms around all that's going on.

I think that one of the policy implications of BRI is that we—the United States, the West, American allies—must realize that BRI isn't necessarily a bad idea. This is how development occurs: big infrastructure projects create urbanization, pathways for production chains, and so forth. And if we were to sit back and say, "This is destined to fail," or "The Chinese are biting off more than they can chew," or essentially decide that we have a "no” policy, then we will essentially abandon what I believe is largely a sound concept. The U.S. government is, I think, beginning to understand that it has to respond with something, not nothing. The United States needs to use its creativity, capital, and capacity to get others to cooperate and be more active in showing our private sector where it can get involved.

We're in a transition stage. I think that one of the big problems right now is that it's hard to induce our allies to cooperate when we’re badgering them about defense expenditures and so forth. We need a remake of our foreign policy process before we'll be able to consistently pursue a vision for development. On some projects we might even choose to cooperate with the Chinese. In fact, we're already cooperating through the World Bank, the Asian Development Bank, and even indirectly through the Asian Infrastructure Investment Bank, which has gotten almost all U.S. allies involved with it. So we shouldn't absolutely oppose China on all fronts, but evaluate the alternatives and tradeoffs in each particular case.

Q: Your current book project focuses on China’s development of high-speed rail between southern China and Singapore. What have you found in researching this project?

My core interest has always been Chinese politics, and particularly what I call the "implementation problem." That is, the realization that what Beijing says isn't necessarily implemented faithfully down the hierarchy in localities, despite the assumption that, because China is authoritarian, there ought to be a high correlation between what the top says and what the bottom actually does. The idea to build connectivity between China and the seven continental Southeast Asian nations south of it makes for a fascinating implementation case study. The underlying question for my book is: “Does China have the capacity to pull off such a gigantic initiative?”

In the case of this particular railway connectivity vision linking China and seven Southeast Asian neighbors, the idea was not Chinese, but rather, a vision of Southeast Asians themselves. In the past, China didn't have the technology, capital, or frankly the inclination to build somebody else's rail system. Around 2012, however, China decided to step out and build infrastructure beyond its borders, and essentially adopted the Southeast Asian idea of rail connectivity. What interests me is the implementation question: if it's difficult to get things done within China itself, how do you create an interconnected system that transits seven more countries, from Thailand, Malaysia, and Singapore, through Myanmar, Laos, Vietnam, and Cambodia? It's a fantastically complicated project, with financing, environmental, and displaced population problems, among many others.

The results so far are mixed, but you would be surprised at the progress that China has made. I believe that within a few years, certainly before 2030, there will be a high-speed and conventional-speed rail system that connects south China to at least Bangkok and another link that connects Singapore to Kuala Lumpur, with the major uncertainty being the stretch from Kuala Lumpur to Bangkok. It’s less clear whether it will also eventually go through Myanmar and Vietnam. But the Chinese are well on the way to finishing the Laos railroad and began construction on some railroad in Thailand, so I think that probably by 2025 you'll see a railroad to Bangkok, which would be a major change in the economic geography of the region. What bothers me is seeing the United States mired in our own preoccupation with ourselves and not reacting in a way that is most productive for our future given what China is doing and how other countries are moving forward.

Hero Image
Traders and financial professionals work ahead of the closing bell on the floor of the New York Stock Exchange (NYSE) on August 1, 2019 in New York City.
Traders and financial professionals work ahead of the closing bell on the floor of the New York Stock Exchange (NYSE) on August 1, 2019 in New York City. Following large gains earlier in the day, U.S. markets dropped sharply after an afternoon tweet by U.S. President Donald Trump announcing his plans to impose a 10 percent tariff on an additional $300 billion worth of Chinese imports. His announcement said the new tariffs will take effect on September 1.
Drew Angerer/ Getty Images
All News button
1
News Type
News
Date
Paragraphs

James Green, former Minister Counselor for Trade Affairs at the U.S. Embassy in Beijing, gave a talk titled “U.S.-China Diplomacy: 40 Years of What’s Worked and What has Not” before a Stanford China Program audience on May 6. Green is currently Senior Research Fellow at Georgetown University and is the creator of the new U.S.-China Dialogue Podcast, which features in-depth interviews with approximately two dozen former U.S. ambassadors, cabinet-level secretaries and other senior officials who were at the forefront of U.S.-China negotiations.

He recounts salient takeaways from these conversations regarding pivotal moments in U.S.-China relations, including normalization of relations, anti-Soviet cooperation in the 1980s, Tiananmen Square crackdown in 1989, Taiwan Strait crisis of 1995-1996, WTO accession in 2001, Belgrade bombing and EP-3 incident in 1999 and 2001, respectively; global financial crisis of 2008, the Beijing Olympics and the current U.S.-China trade tensions.  Among his many motivations for beginning this podcast series include his desire to question the notion circulating among U.S. foreign policy experts today that U.S. policy of engagement towards China had somehow failed. To Green, who has been active in U.S.-China relations since the mid-1990’s, U.S. policy had never been about transforming China from a one-Party, authoritarian system into a liberal democracy. In order to more accurately pinpoint what U.S. goals have been, Green stated, he undertook the project and interviewed those who had played key roles during pivotal moments in U.S.-China bilateral relations.

His interviewees have included, among others, such luminaries as Ambassador J. Stapleton Roy, who in 1978 participated in secret negotiations that led to the establishment of U.S.-P.R.C. diplomatic relations; John Negroponte, first director of national intelligence and deputy secretary of state in the late 2000s during China’s rise; and Ambassador Michael Froman, former U.S. Trade Representative under President Obama. His talk at the Stanford China Program includes key lessons he has derived from these interviews even as we enter into one of the most volatile times in U.S.-China bilateral relations.

The recording and transcript are available below.  

Hero Image
green photo
James Green, Senior Research Fellow at Georgetown University, speaks at the Asia-Pacific Research Center's China Program on May 6th, 2019.
All News button
1
News Type
News
Date
Paragraphs

David M. Lampton gave a talk titled “Chinese Power and Rail Connectivity in Southeast Asia” before the Stanford China Program audience on February 6th. He addressed three issues in particular: the scope of his research project, conducted in partnership with two co-authors based in Singapore and Malaysia; the long genesis of this railroad construction idea from Southeast Asia to China; and, third, the overarching question of whether China can effectively implement the gargantuan feat – technologically, financially, and politically. The high-and conventional-speed rail project will span seven Southeast Asian countries, plus China, Lampton highlighted.  This project is not only geographically forbidding, but the political terrain, and its socio-economic variety, is an even greater challenge.  Lampton’s talk comprised part of Stanford China Program’s 2019 Colloquia Series, “A New Cold War?: Sharp Power, Strategic Competition, and the Future of U.S.-China Relations.”

Lampton began by clarifying that the vision of rail connectivity through Southeast Asia into China is not the brainchild of either China’s leadership or Xi Jinping. This idea has a long history, he stated, beginning with the British and the French in the 19th century when they were occupying Burma and Indochina, respectively; and even during World War II when Japan further entertained building railroads from the Korean Peninsula to Singapore to advance their military ambitions. In contemporary times, ASEAN had articulated a plan in 1995 to develop a rail line from Singapore to Kunming city, P.R.C. In 2010, ASEAN again put forth a master connectivity plan for 2025 where railroad development comprised a prominent part. Only in the aftermath of these many plans and proposals did Xi Jinping, in 2013, officially announce China’s Belt and Road Initiative (BRI), an infrastructure initiative with a scope far greater than simply Southeast Asia. The idea of infrastructural connectivity in the region, in other words, has a long history that predates China entering the picture as a major actor. Only recently has China amassed the technological capacity and financial wherewithal to realize this enormous project, with economic, diplomatic, and strategic military implications.

Next he described the key role that Beijing’s industrial policy has played in the rapid development of China’s high-speed rail. From a nonexistent industry in 2001, China has built a sector that is now an international powerhouse in high-speed rail technology. As of 2014, China boasted four trunk lines, North and South; and four trunk lines, East and West, crisscrossing the P.R.C. China’s industrial policy has clearly delivered striking results (as well as some setbacks) not only with respect to high-speed rail but also in other industries.  In light of this, Lampton opined that China is not likely to yield to U.S. demands for major structural reforms in onoing trade talks with China. 

Lampton described the progress in high-speed and conventional-speed rail construction with partners in Southeast Asia (ASEAN) that the Chinese have made, with Laos and Thailand furthest along in implementation. Nonetheless, Beijing also has met with significant resistance due to the complicated political situation in various regions. Lampton described, for example, the drawn-out financial negotiations between Singapore and Malaysia with respect to the rail line connecting Singapore to Kuala Lumpur; and the jockeying among various heads of Malaysia’s federation of local states. The election of Mr. Mahathir in 2018 also put an at least temporary halt to the construction and planning of two rail projects for many reasons, including the corruption of the preceding regime of Najib in Kuala Lumpur. Although Lampton expressed overall confidence that the rail lines will get built to Kuala Lumpur and Bangkok, for example, in the not-too-distant future, the political complexities of the region and China’s ability to successfully navigate them are still open questions.

He also described the competing world views regarding infrastructure construction and economic development. There are powerful constituents in China – now backed by Xi Jinping himself – who believe that infrastructure development drives growth: i.e., “if you want to get rich, build a road.” By contrast, the U.S. and entities such as the World Bank are more cautious, seeing all the negative social and environment extenalities such massive projects create. They also want to see greater assurances of projected returns from these infrastructure projects before devoting resources. Having said this, both multilateral financial and development institutions, and the United States Government, are gradually adopting a more supportive posture on large infrastructure projects, in part not wishing to abandon the commercial and strategic battlegrounds of the future to the PRC.

Lastly, Lampton debunked the notion that the BRI is a unified, top-down “plan.” Rather, he described it as Beijing’s “umbrella policy” that “creates a predisposition [among Chinese entities] to build infrastructure.” It incentivizes “entrepreneurial SOEs, provinces, localities, overseas Chinese . . . to push their pet projects . . . onto . . . the national largesse.” This being the case, Lampton described the BRI as a dynamic, chaotic and, sometimes, even a rapacious process for the transit countries. Yunnan Province, for example, started a rail line even before the central government had approved it; and Guangdong Province began developing its own special economic zone and port construction in Malacca all without central approval. As Lampton stated, the “BRI isn’t just about Xi Jinping and Beijing . . . . [I]t’s about local initative, and how Beijing can or cannot control or . . . under what circumstances, it chooses to control [its local actors].”

The recording and transcript are available below.  

Hero Image
lampton photo 2
David M. Lampton, Oksenberg-Rohlen Fellow and Research Scholar at APARC, speaks at Stanford's China Program on February 6th, 2019.
All News button
1
News Type
News
Date
Paragraphs

“Win support from the people,” Yuhua Wang, Assistant Professor of Government at Harvard University, repeated the words from one of Xi Jinping’s speeches that was given to justify China’s massive anti-corruption campaign. The exact scope and motivations for President Xi Jinping’s anti-corruption campaign is, as yet, unknowable, Wang stated; but clearly, a major public aim of CCP Chairman Xi Jinping was to build regime support by cracking down on bad actors in the government.

Prof. Yuhua Wang gave a talk titled “Why Xi Jinping’s Anti-Corruption Campaign has Undermined Chinese Citizens’ Regime Support?” at the Stanford China Program on November 12th, 2018, based on a national-level survey analysis that he had conducted with his co-author, Prof. Bruce Dickson at George Washington University. Rather than focusing on Xi’s motivations for undertaking his crackdown, however, Wang and Dickson tried to measure the impact of Xi’s anti-corruption campaign on public perception of the central government and the Chinese Communist Party (CCP). Did the campaign, in other words, shore up public support for China’s central government and Party, as Xi hoped it would – or did it, in fact, undermine regime support?

Professor Wang first offered some background on how this anti-corruption campaign got started around 2012-2013, shortly after Xi Jinping became Chairman of the CCP. A staggering 261 vice-ministerial officials and 350,000 officials had been investigated to date; and, even those at the highest levels of China’s leadership – former Politburo and Politburo Standing Committee members, for instance –were not immune from scrutiny. And, equally unprecedented, media coverage of these corruption cases – from Bo Xilai to Zhou Yongkang and Xu Caihou – were extensive, exposing their lavish lifestyles and illicit dalliances on social and traditional media. Wang speculated that such lurid publicity most likely shocked the public, potentially turning citizens against even the central government, which consistently enjoys significantly higher levels of public trust than local governments in China. He decided, therefore, to explore with his co-author what the effects of such exposés might be on public perception of the central regime.

Replicating the same questionnaire and sampling design, Wang and his co-author took a national random sample in two waves – one before the anti-corruption campaign in 2010 and a second one during the campaign in 2014. They interviewed approximately 4,000 people across 25 provinces in China in order to measure potential shifts in people’s attitudes towards the regime over those four years. The findings were, indeed, illuminating:

First, Wang stated, increasing frequency of corruption investigations in a locality was correlated with a greater drop in popular regime support (defined as trust in central government or support for the CCP) in that locality. Higher volume of corruption investigations in a locality was also negatively correlated with people’s perception that government officials were generally honest and clean. The corrosive effects of the campaign, furthermore, proved strongest on those who had initially believed in the integrity of government officials; but for those who were already cynical about official corruption, the campaign had a smaller effect. Lastly, higher the survey respondent’s use of social media like WeChat, stronger the negative effects on his/her support for the regime. The authors also took into account how the chilling effects of the campaign may be negatively impacting local economies and how that slowing economy may actually be the primary cause behind decreasing public regime support. To account for this potentially confounding effect, Wang looked for evidence as to whether the campaign had contributed to a slowdown in China’s economy by 2014. Perhaps because 2014 was still early on in the campaign, he stated that they found no evidence of slower GDP growth rate, growth rate per capita GDP, etc., in the regions where they had undertaken their surveys.

Overall, Wang’s research calls into question whether Xi Jinping’s anti-corruption campaign is, in fact, advancing one of his main goals– i.e., to increase people’s faith in the central regime – or whether it is actually proving counterproductive to his aim. In fact, Wang’s research seems to indicate that the more Chinese citizens are exposed to evidence of government corruption, the more the central regime appears to suffer a loss in credibility. Wang was careful to point out, however, that they were barred, due to political sensitivity, from asking any questions regarding respondents’ attitudes towards Xi Jinping himself. Thus, it is still an open question whether popular support for Xi Jinping himself is increasing even though public trust in the regime might be decreasing.

The recording and transcript are available below.  

Hero Image
wang
Yuhua Wang, Assistant Professor of Government at Harvard University, speaks at the Asia-Pacific Research Center's China Program on November 12th, 2018.
All News button
1
0
CDDRL Postdoctoral Scholar, 2019-20
carothers_headshot.jpeg

I am a scholar of comparative politics and currently a postdoctoral fellow at the University of Pennsylvania’s Center for the Study of Contemporary China. My research is on authoritarianism and corruption control with a regional focus on East Asia—especially China, the Koreas, and Taiwan. My first book, Corruption Control in Authoritarian Regimes: Lessons from East Asia (Cambridge University Press, 2022), is about why some autocrats are motivated to curb corruption, why their efforts succeed or fail, and what the political consequences of such efforts are. I received my Ph.D. in Government from Harvard University in 2019.

My writing has been published or is forthcoming in numerous academic and policy journals, including Perspectives on Politics, Government and Opposition, the Journal of Democracy, Politics and Society, the Journal of Contemporary China, the Journal of East Asian Studies, Foreign Affairs, Foreign Policy, the China Leadership Monitor, and The National Interest.

Before academia, I lived and traveled in East Asia for several years, learning Chinese and Korean along the way. I worked for The Wall Street Journal Asia in Hong Kong, taught English in Xinjiang, and studied Korean in Seoul. I received my B.A. (summa cum laude), also from Harvard, in Social Studies and East Asian Studies.

Authors
Noa Ronkin
News Type
Commentary
Date
Paragraphs

A group of more than 100 leading American Asia specialists, former U.S. officials and military officers, and foreign policy experts has signed an open letter calling on President Trump and Congress to develop a U.S. approach to China that is focused on creating enduring coalitions with other countries in support of economic and security objectives rather than on efforts to contain China’s engagement with the world.

The signatories include five FSI scholars: Shorenstein APARC Fellow Thomas Fingar, Oksenberg-Rohlen Fellow David M. Lampton, FSI Senior Fellow and APARC’s China Program Director Jean C. Oi, CISAC Senior Fellow Scott D. Sagan, and FSI Senior Fellow Andrew G. Walder.

In the letter, published in the Washington Post, the signatories express their concern about the growing deterioration in U.S.-China relations and outline several elements of what they describe as a more effective U.S. policy toward China.

China’s troubling behavior in recent years, the signatories write, presents serious challenges that require a firm U.S. response. The best American strategy “is to work with our allies and partners to create a more open and prosperous world in which China is offered the opportunity to participate.”

China’s engagement in the international system is essential to the system’s survival, argue the signatories, and “efforts to isolate China will simply weaken those Chinese intent on developing a more humane and tolerant society.”

Read the full letter in the Washington Post.


The views expressed by the signatories to the open letter are their own and are not opinion or information of Stanford University or of FSI.

 

Hero Image
Journalists watch a live broadcast of China's President Xi Jinping speaking during the first session of the G20 summit on June 28, 2019 in Osaka, Japan.
Journalists watch a live broadcast of China's President Xi Jinping speaking during the first session of the G20 summit on June 28, 2019 in Osaka, Japan. President Trump and Xi met at the G20 for the first time in seven months to discuss deteriorating ties between the world's two largest economies.
Tomohiro Ohsumi/Getty Images
All News button
1
Authors
Noa Ronkin
News Type
News
Date
Paragraphs

Asia Health Policy Program Director Karen Eggleston and colleagues examine China’s progress in enhancing financial protection under its social health insurance to achieve universal health coverage.

In 2009, China launched comprehensive health system reforms to address challenges such as increasing rates of non-communicable diseases and population aging, problems with health financing and healthcare delivery, and overall growing health expectations of its people. Promoting universal health coverage by building a social health insurance system was a central pillar of the reforms.

After a decade of system reforms, has the Chinese government made good on its commitment to bolster universal health coverage? In a new article published in a BMJ collection, a team of four co-authors including Karen Eggleston, APARC’s deputy director and director of the Asia Health Policy Program, evaluates China’s progress towards enhancing financial protection of social health insurance and identifies the main gaps that need to be filled to achieve universal health coverage. Their article is part of a special BMJ collection with Peking University that marks the tenth anniversary of China’s health system reforms by analyzing their accomplishments and challenges ahead.

The 2009 reforms aimed to cover the entire Chinese population with one of three (since 2012 one of two) basic social health schemes. To provide added financial protection to patients with critical illnesses, catastrophic medical insurance was initially launched in 2012 and implemented nationally in 2015. Eggleston and her co-authors determine that the expansion of health insurance has had several major successes. First, it improved access to and use of healthcare. In 2011, China achieved near-universal health insurance coverage, with more than 95% of the Chinese population covered by health insurance. Moreover, the annual inpatient hospital admission rate increased from 3.6% in 2003 to 17.6% in 2017, and admission rates for outpatient services were much higher than the global average.

Second, the expansion of health insurance coverage reduced the share of out-of-pocket heath expenses in total health expenditure, thus raising the level of financial protection. Third, catastrophic medical insurance was also effective in supplementing the basic social health insurance schemes and provided extra financial protection to a range of vulnerable groups. By 2017, more than a billion people in China were covered by such insurance.

However, much remains to be done. Out-of-pocket health expenditures remain fairly high and are one of the main reasons for catastrophic health expenses and low financial protection in China, which disproportionately affect deprived populations. Catastrophic medical insurance currently does not target underprivileged people, while medical aid is relatively small in scale and covers only a minority of patients with catastrophic health expenses.

Eggleston and her colleagues conclude that the Chinese government should focus on underprivileged populations within the current insurance system and enhance their financial protection as an important element of targeted poverty alleviation. Such targeting, the researchers emphasize, requires a clear and integrated policy encompassing the basic social health insurance schemes, catastrophic medical insurance, medical aid, and improved healthcare efficiency.

 

Hero Image
A doctor checks a young girl in a countryside clinic at Shihao Township on October 13, 2007 in Qijiang County of Chongqing Municipality, China.
A doctor checks a young girl in a countryside clinic at Shihao Township in Qijiang County of Chongqing Municipality, China.
China Photos/ Getty Images
All News button
1
Authors
Noa Ronkin
News Type
News
Date
Paragraphs

Forty years after the establishment of diplomatic relations between the United States and China, the two superpowers are competing and contesting every arena, from trade to AI research and from space exploration to maritime rights. Instead of what Americans referred to as engagement and Chinese called reform and opening, many experts and analysts now characterize the relations between the two countries as dangerously brittle. Some see a new kind of Cold War in the making. Such assertions, however, argues Shorenstein APARC Fellow Thomas Fingar, “both ignore history and impute a level of fragility that has not existed for many years.”

Fingar reflects on the U.S.-China bilateral relationship in a new article, “Forty years of formal—but not yet normal—relations,” published in the China International Strategy Review. He claims that the relationship is resilient and not destined for conflict, albeit it is beset by a host of aspirational, perceptual, and structural differences.

A political scientist and China specialist who served over two decades in senior government positions, Fingar urges readers to remember that assertions of fragility of the U.S.-China relationship undervalue the strength, scope, and significance of interdependence, shared interests, and constituencies in both countries. These, he says, have a substantial stake in the maintenance of at least minimally cooperative relations.

U.S.-China relations are indeed highly asymmetrical: Chinese citizens and organizations have far greater access to the United States than Americans do to China, notes Fingar. He also recognizes that the troubles that have soured the relationship are more intricate and often more sensitive than those of the past. Decades ago, most of the issues that arose were handled at the governmental level. But now “the number and variety of players with stakes in the relationship and disputes with counterpart actors are much greater.” Furthermore, explains Fingar, the U.S. business community is expressing a stronger voice for government action to change Chinese behavior and is not as consistent an advocate of stability in U.S. policy toward China as it used to be. “This is an extremely important development,” he says, “because it reverses a key dynamic in the U.S.-China relationship.”

Ultimately, however, the two countries and our institutions and people are linked by myriad ties that bring mutual benefits as well as the constraints of interdependence. “I remain confident that we will continue to be able to manage the relationship,” concludes Fingar. He expresses disappointment, though, that normalization of U.S.-China relations remains a work in progress and cautions that merely managing the relationship to prevent it from deteriorating is an unsatisfactory goal that should be unacceptable to both sides. Not only does such a low bar limit what each counterpart can achieve, but it also inhibits the kind of cooperation required to address transnational challenges like climate change, infectious disease, and proliferation of dangerous technologies.

 

Hero Image
A display for facial recognition and artificial intelligence is seen on monitors at Huawei's Bantian campus on April 26, 2019 in Shenzhen, China.
A display for facial recognition and artificial intelligence is seen on monitors at Huawei's Bantian campus in Shenzhen, China. The U.S. government battle with the Chinese telecom giant represents multiple concerns about China's technological prowess.
Kevin Frayer/ Getty Images
All News button
1
Subscribe to China