Governing Health in Contemporary China examines how post-Mao institutional and political dynamics shape the patterns and outcomes of China's healthcare system and explores the public health and healthcare challenges, as well as the policy responses, in contemporary China. The author's research question might be a question that many are asking: ‘Why have the reform-induced dynamics produced an economic miracle but failed to reproduce the success that Mao had achieved in the health sector?’ (p. 4).

The main themes of the book include an outline of the political process in China, health and healthcare during Mao's era, and health issues post-Mao (problems and regulatory issues, as well as health reform policies) and the concluding remarks.

The book provides a detailed review of Chinese health policies under Mao's leadership (1949–76), when the People's Republic was emerging and facing countless challenges. From eliminating ‘four pests’ for environmental health to the invention of ‘barefoot doctors’ for rural healthcare delivery, as well as the completion of a multi-tiered healthcare network including community and workplace clinics (chapter 2), China increased its population's life expectancy by nearly thirty years in less than three decades (Eggleston and Fuchs, Reference Eggleston and Fuchs2012).

The book then discusses the various reform attempts in the realm of health in post-Mao decades, and analyses the complexity of the government structure through discussing public health crises, such as Severe Acute Respiratory Syndrome (SARS) and Influenza A Virus subtype H1N1 outbreaks, and food safety scandals, such as the dairy products’ quality issue. The author proclaims the urgent nature of the issues and the current political culture's shortcomings in addressing them.

I enjoyed reading the book, although I found it hard to follow or agree on some viewpoints. For example, the author attributes China's unsuccessful health system reforms to its non-democratic political system (p. 140). In reality, it is a common knowledge that the world's foremost democracy, the US, does not have much success in this particular sphere. Also, the author states: ‘With continuous government restrictions on religious freedom, the pursuit of material interests is seldom constrained by morality’ (p. 117). Since there is no reference indicated, I do not know whether it is true that the Chinese government has restrictions on religious practice. I do wonder: is there a linear causal relationship between religion and morality? I guess a political science background and the US Council on Foreign Relations’ post may influence the author's point of departure.

As an enthusiast in healthcare policy studies, I found this book very useful for research or gaining knowledge about China – it has a great amount of literature and information, thanks to the author's devotion.

While reading the book, I spotted some shortcomings in content and material presentation (as a non-political-scientist).

Contentwise: first, some important factual material in health governance is missing: i.e., healthcare insurance/coverage. Second, some claims/statements are without analytical foundation (or do not arrive with plain logic); i.e., reporting on the occurrence of doctor–patient conflicts in China is followed with the statement: ‘The message is clear: advancement in socioeconomic rights relies on the advancement of political and civil rights’ (p. 141). It sounds odd, and the message is unclear. Third, some realities presented could be misleading: i.e., (1) ‘in the 1990s, GIS and LIS covered about 230 million people, or 19.6 percent of the population, yet this segment of population consumed 42.5 percent of the annual total medical spending’ (p. 63). It sounds outrageous. But, what the GIS (government insurance schemes) and LIS (labour insurance schemes) covered was simply the urban population, who had better/easier access to healthcare than the rural population (so they spent more). Personally, I think a sentence on the rural–urban divide in healthcare access should show a clearer picture. Instead, the author thinks that ‘this group’ utilised medical care often unnecessarily, and names ‘this group’ as wasteful users of the healthcare system as if it is a privileged interest group. Recent reform did take away the GIS and LIS coverage, and many of them can no longer afford healthcare (Dong, Reference Dong2003). The perceived ‘moral hazard’ (p. 63) was a perfect excuse for the government to remove ordinary citizens’ rights to free or minor cost healthcare access. The author discusses the less affordable healthcare as a concern (p. 66), which would flow well if there was less or no prior attack on the LIS and GIS insurers. (2) Table 3.2 ‘Cost of medical care in comprehensive hospitals, 1998–2008’ (data in the table: 1980–2005) shows the rapid increase of outpatient and inpatient medical costs. The author states ‘During the 1980–2003 period, total health expenditure increased at an annual rate of 18 percent.’ It sounds alarming, but the truth of the matter is that before the recent reforms hospitals were government financed. Their ‘medical care cost did not include medical care professionals’ wage, equipment and other hospital functional costs. They only recorded minor costs, such as prescription drugs. Once the government withdrew its financial backing to the hospitals, the hospitals’ cost calculation formula changed accordingly. Healthcare expenditure will continue to rise with the increased costs of salaries, equipment, drugs, etc. – welcome to capitalism, or the market economy! And, lastly, the book uses materials from Chinese non-official and non-academic websites, which may be challenged for their appropriateness for such a work.

In material presentation, I would: (1) eliminate or reduce the blunt/bold statements that are interruptive to the flow of the factor presentation; (2) add an explanation to ‘The political logic of China's health system transition’ (Figure 1.5, p. 22) as to what the solid and dashed lines mean; (3) add meanings next to Chinese terms in Pinyin format; (4) use ‘healthcare’ when appropriate instead of ‘health’; and (5) correct the year indications on some figures and table titles – they differ from the actual data years (i.e., p. 2, figure 1.1; p. 65, tables 3.2, 3.3).

China has undergone a series of healthcare reforms in recent decades. However, the level of healthcare coverage is still unsatisfactory, and healthcare access inequality remains severe. Indeed, why cannot a much wealthier China than in Mao's time provide better care to its citizens? Well, maybe because the (economic) reform-induced government was growth oriented, and therefore could not produce any miracle beyond the economy.