Cambridge, UK: Cambridge University Press, 2022. xiv, 228 pp. US$100.00, cloth. ISBN 9781316512470.
Local Politics and Social Policy in China: Let Some Get Healthy First, by Kerry Ratigan, is an important contribution to the literature on welfare politics and central-local relations in China. Ratigan proposes a policy-style theoretical framework, and employs both quantitative and qualitative methods to explain the dynamics of social policy making and implementation at the provincial level during the Hu-Wen era.
Chapter 1 provides an overview of the book. Chapter 2 reviews the evolution of the Chinese health system since the early 1980s. Chapter 3 addresses the framework for provincial-level social policy making. The policy style of local states is characterized by policy priority, local state resources, institutional approaches (e.g., delegation to lower-level governments, transparency, etc.) and patterns of policy making (i.e., bottom-up or top-down). Pragmatist provinces invest more in human capital (i.e., education and sometimes health) and also have more discretion in policy innovation. These provinces are economically wealthy with a more homogenous population, compared to other provinces. In sharp contrast, the paternalist provinces focus more on targeted and ad hoc social policies (e.g., poverty alleviation). These provinces are economically poorer with larger ethnic minority populations. The rest are named as “mixed” provinces which combine pragmatist and paternalist features to varying degrees.
Chapter 4 analyzes the characteristic features of pragmatist provinces. These provinces are more likely to delegate the authority of policy implementation to localities (e.g., Jiangsu Province). Chapter 5 discusses case studies such as Yunan, Gansu, and Hunan to illustrate the policy style in paternalist provinces. In these provinces, policy making is more likely to be top-down. Chapter 6 engages with the case of Hubei Province to show the pattern of policy making in a “mixed” province. In these provinces, local officials sometimes innovate in policy making; in other cases, policies are implemented in a top-down manner. Chapter 7 concludes the book and discusses the implications of subnational variations in policy making.
The book’s contribution to China studies and welfare politics literature is two-fold. Theoretically, it provides a unique framework for policy style to show how the variations between local welfare states are very broad. The author developed a set of policy-style indexes to characterize the features of three clusters of provinces. By discussing a wide array of welfare policy areas, including health, education, poverty alleviation, pension, and housing, Ratigan also explores the determinants of these variations at the provincial level. Methodologically, this well-researched book combines qualitative and quantitative methods. The theoretical framework and arguments are convincing, largely due to the rigorous research design in constructing indexes, applying mixed methods, collecting first-hand interview material as well as engaging in a robust sampling process.
Acknowledging these achievements, I raise three issues worth discussing for future research. First, it is worth asking whether the policy styles can be endogenously determined given the dynamics of central-local relations. In particular, the role of the central government in the policy-style framework could be further discussed. As suggested by Ratigan, the central government may use personnel management and fiscal transfer to configure local policy-making (see also the research of Yumin Sheng). Following this rationale, under certain circumstances, the central government might be able to change the policy styles of the provincial governments by leveraging fiscal transfers. A pragmatic province might be converted to a paternalistic province if the transfers are earmarked and the size of the transfer is substantial.
Second, one could also extend the analysis to consider another dimension, as policy styles to solve problems can be either proactive or reactive. A reactive style refers to a passive and responsive government. By contrast, proactive policy styles, as described by Kenneth Dyson, imply the capacity to “acquire information and knowledge” (“West Germany: The Search for a Rationalist Consensus,” in Policy Styles in Western Europe, ed. J. J. Richardson, Allen and Unwin, 1982). In general, with the engagement of civil society, citizens’ demands regarding social policy provisions could be anticipated by policy makers, and policy styles therefore might be proactive. Ratigan touches on this proactive dimension in chapter 4 by discussing NGOs in pragmatist provinces (e.g., Jiangsu). It would be very useful to push further in this direction to characterize the conditions for the emergence of proactive policy styles at the provincial level.
Third, another possible extension is whether the policy-style framework could be applied to administrative levels below the provincial, in particular in paternalist and “mixed” provinces. In this book, Ratigan defines policy styles at the provincial level, and within-province variations in policy making are largely confined to those pragmatic provinces. However, within-province variations of policy styles could be significant in paternalist provinces, as the variations in local economic conditions are large. For example, my own research shows that during the Hu-Wen era, within-province economic inequalities were the driving force of county-level inequality across all national-level poverty-stricken counties (in terms of GDP per capita). In contrast, between-province economic inequalities across poverty-stricken counties were stable during the Hu-Wen era. Note that many of these poverty-stricken counties are located in paternalist or “mixed” provinces. It would be very interesting, therefore, to explore whether these variations in local conditions could induce different policy styles within a province.
National University of Singapore, Singapore