This comprehensive review of the progress in recasting China's provision of social welfare tackles a tough job. In addition to summarizing much theoretical literature on government benefit allocation, Tony Saich also surveys a wide array of other reform programs, including changes in the fiscal system, migration, the rural revamping of land tenure as well as alterations in rural fees and taxes, and trends in infrastructural investment, to name a few.
He supplies a huge wealth of statistical data on the coverage over time of the whole range of welfare policies. These include both social insurance (pensions, unemployment, maternity, work injury, and health care)—for each of which he presents material on early experiments and eventual policy initiatives—and one critical social assistance program, the means-tested Minimum Livelihood Security Scheme. He also includes a chapter on the government's handling of epidemics, namely SARS and HIV/AIDS. There is information on specific localities (provincial as well as urban) and comparisons with other Asian countries, as well as reams of such microdata as numbers of hospital beds in different areas and transformations in life expectancy and infant mortality over time. Citizen responses to his survey on satisfaction and grievances reveal that the chief areas of dissatisfaction concern employment and social welfare provision. On the whole, Saich does an admirable job; this volume (and its many tables) can be consulted as a mid-course resource on the topic for years to come.
The themes guiding the book will be familiar to scholars of Chinese politics and society—ongoing predominance of the state, given the leadership's largely unbroken lack of trust in the market and in autonomous civil society (but a continuing role for the family and kin networks); urban–rural dualism and regional unevenness, the foundation for inequity for decades, which have only been exacerbated by marketization; the burden on local finances that accompanied fiscal decentralization (as of 2005, basic levels paid 74 percent of total governmental spending on welfare); priority for the formal sector and for those with local registration, and the marginalization of the others. Saich skillfully demonstrates precisely how each of these impacts the welfare system and its delivery.
Pension reform and rural health receive the most attention. We learn, for instance, that health insurance is scarce just as medical costs have risen, and that government health care expenditures dropped from 79 percent of the total spent in 1980 to less than 48 percent by 2005. Saich does note, though, that the state budget for health increased by almost 90 percent between 2006 and 2007. The book also accents a set of social transformations since 1978—the breakdown of collective life in rural areas and the departure from them in the tens of millions; the aging of the population; the diversification of ownership in the cities, and the need to cope with the new urban poor and migrants produced by reforms. He explains how each of these trends sets up new pressures and challenges for what was once, in his view, a workable and, in comparative terms, relatively successful framework that adhered before 1978.
The book documents the many pitfalls that obstruct fundamental change, from the weak bureaucratic role of the government agencies in charge of these policies to an absence of accountability, transparency, and adequate training, in addition to misappropriation and reluctance to comply at the base, combined with shaky popular trust in the new systems. Still, Saich sees definite progress, as in the rise in China's Human Development Index from .527 in 1975 to .777 by 2005 on average (with great regional variation), a respectable, high to middle-level rate (pp. 45–46). And even if China's state welfare spending counts as low in international terms, it is comparable to that of other middle-income Asian countries, at 2 percent of gross domestic product.
Saich's bottom line is that the various urban and rural programs need to be integrated, with welfare distributed on the basis of national citizenship and need instead of status and residency. He also argues that the government should cede more control to market forces, and partner more effectively with civil society. For this reader, it was interesting to find support for a figure of around 30 million urban poor and an unemployment rate of about 12 percent, as of 2005 (p. 163), and that, though Hu Jintao and Wen Jiabao must be credited with carrying through on a number of welfare ventures, they were not their originators.
Despite the volume's many strengths, it suffers from disjointedness. There are frequent repeats of material, multiple returns to descriptions of the prereform era, paragraphs out of order, many paragraphs whose content strays from their topic sentences, and occasional missing footnotes. Sometimes there is confusion or insufficient clarity in citing others' findings (as on the urban dibao on pp. 177–78, where the figure for Beijing's poverty line for 2003 is presented as its minimum living standard allowance, and as if it were the national one).
There is also inconsistency in the extent to which Saich believes that expectations and a culture of dependency have been eradicated, and the degree to which SARS really constituted a “wake-up call,” when all is said and done. He might also be off base to insist on an underlying continuity in the concept of “self-reliance,” as this notion once applied to collectives, whereas it now refers to the individual. And, last, the idea that socialism still motivates the political elite's positions seems open to question.
