The Quest for Legitimacy in a Transitional Economy: A Comparison of Private Hospitals in China and Vietnam

Abstract

The privatization of health services is an emerging trend in Asia. China and Vietnam are no exceptions, with their reforms to promote private hospitals gradually developed in early 1990s. As newcomers to the health-care system, private hospitals must achieve legitimacy in a state-dominated system in order to survive and develop. This paper describes the strategies of the quest to gain legitimacy from the state through “public-lization” and from the public through a campaign to associate private hospitals with professionalism, a caring environment, and customer orientation. It argues that, in a transitional economy, when the state is allocating power to other sectors but maintaining a central position, private hospitals must be careful to seek legitimacy from the state and, equally importantly, their customers. Improvements to the institutional environment to ensure better regulation are recommended, as well as professional self-scrutiny and consumer participation.

Keywords:

• Private hospital
• health policy
• legitimacy
• China
• Vietnam