Old and new Rural Co-operative Medical Scheme in China: the usefulness of a historical comparative perspective

Abstract

This work compares the health cooperatives fêted in Maoist China in the 1960s to the New Rural Medical Co-operative Scheme (NRCMS) that has been operating in China since 2002. Organizational and ideological similarities between the old and new co-operative medical schemes are described. By mapping continuities and discontinuities in the way the co-operative organizational model has been deployed under different contexts, we argue for the usefulness of blending historical method and organizational analysis as a means of understanding some of the challenges of contemporary Chinese social policies. Using this technique of historical comparison, this work concludes that the NRCMS, despite being different in orientation, is still affected by political influences, and organizational traits, evident within its former incarnation. This acknowledgement, we argue, has important implications for policy and practice today.

Keywords::

• China
• co-operative
• healthcare
• history
• New Rural Co-operative Medical Scheme
• organization

Acknowlegement

The work on original Mandarin Chinese documents was made possible by the support of Ms Xiaojiao WU, Zhejiang Chinese Medical University.

Notes

^1. Email: [email protected]

^2. Original Chinese: ‘至于如何解决广大农民的医疗卫生问题，那时共产党只有一个粗略的思路，既是走合作的道路’.

^3. ‘生产建设与和平生活就无从获得保障’, He Cheng, Deputy Minister of Health, quoted in Hu (2007, 51).

^4. Original Chinese: ‘要把过去两年放松了的爱国卫生运动重新发动起来，并且一定要于一九六0年，一九六一年，一九六二年这二年内做出显著的成绩’ quoted from Mao Z., Instructions for Public Health/关于卫生工作的指示’, 18 March 1960.

^5. WHO/E/5/418/11 SomnuekUnakul, Report on Rural Sanitation in China, February 1975, p. 3.

^6. WHO/AFR/MCH/66 3.9.75 V. Agbessi, ‘Organisation of Health Services in China’; Report on a Mission, 21 October 1974, p. 2.

^7. Original Chinese: ‘农村合作以来哦是人民公社社员依靠集体力量，在自愿互助的基础上建立起来的一种社会主义性质的医疗制度，是社员群众的集体福利事业’ (Article 1).

^8. Original Chinese: ‘尤其应优先挑选具有上述条件的贫下中农子女.’

^9. Original Chinese: ‘合作医疗站是集体福利事业单位，不用办成企业及副业，也不应要求他们上缴利润’ (Article 10).

^10. See also The Shanghai Porpaganda Poster Mueum and the website database curated by Marien van der Heijden: http://chineseposters.net/.

^11. Original Chinese: ‘举办合作医疗的形式要根据当地的实际情况和条件，经社员群众充分讨论决定’ (Article 10).

^12. Original Chinese: ‘赤脚医生的人数，应根据实际需要进行配备’ (Article 13).

^13. WHO/N52/180/2 CHN (2), File 1, WHO Study Missions to China, 1973–1978, ‘Medical Care in Rural Areas’, p. 2.

Additional information

Notes on contributors

Andrea Bernardi

Andrea Bernardi has been Senior Lecturer in Organizational Behaviour at Manchester Metropolitan University since 2012. Prior to that he was Assistant Professor at Nottingham University Business School (China) and Lecturer of Organization Studies at the University of Rome (Roma Tre). His main research interests have included the diversity of the co-operative firm, industrial relations, and occupational health and safety. He is currently working on Chinese co-operatives and on the historical perspective in Organization Studies.

Anna Greenwood

Anna Greenwood is Associate Professor of European Colonial History at the University of Nottingham Ningbo, China. Previously she was Lecturer in Medical History at the University of Exeter, England (2009–2010) and Lecturer in Imperial History at the University of Strathclyde, Scotland (2005–2009). She has published widely on the history of medicine in British imperial possessions, particularly on social and cultural aspects of colonial interchange. Her new empirical research focuses on Indian migration to colonial Africa, while her recent theoretical interests lie in the inter-disciplinary utilization of historical methods.