Authoritarian regime legitimacy and health care provision: survey evidence from contemporary China

Duckett, J. and Munro, N. (2022) Authoritarian regime legitimacy and health care provision: survey evidence from contemporary China. Journal of Health Politics, Policy and Law, 47(3), pp. 375-409. (doi: 10.1215/03616878-9626894) (PMID:34847220)

Abstract

Context: Over the last two decades a growing body of research has shown authoritarian regimes trying to increase their legitimacy by providing public goods. But there has so far been very little research on whether or not these regimes are successful. Methods: This article analyzes data from a 2012–2013 nationally representative survey in China to examine whether health care provision bolsters the communist regime’s legitimacy. Using multivariate ordinal logistic regression, we test whether having public health insurance and being satisfied with the health care system are associated with separate measures of the People’s Republic of China’s regime legitimacy: support for “our form of government” (which we call “system support”) and political trust. Findings: Having public health insurance is positively associated with trust in the Chinese central government. Health care system satisfaction is positively associated with system support and trust in local government. Conclusions: Health care provision may bolster the legitimacy of authoritarian regimes, with the clearest evidence showing that concrete benefits may translate into trust in the central government. Further research is needed to understand the relationship between trends in provision and legitimacy over time and in other types of authoritarian regime.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Munro, Dr Neil and Duckett, Professor Jane
• Authors: Duckett, J., and Munro, N.
• College/School: College of Social Sciences > School of Social and Political Sciences > Politics
• Journal Name: Journal of Health Politics, Policy and Law
• Publisher: Duke University Press
• ISSN: 0361-6878
• ISSN (Online): 1527-1927
• Published Online: 29 November 2021
• Copyright Holders: Copyright © 2021 Duke University Press
• First Published: First published in Journal of Health Politics, Policy and Law 47(3): 375-409
• Publisher Policy: Reproduced in accordance with the publisher copyright policy

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
190489		Performance evaluations, trust and utilization of health care in China: understanding relationships between attitudes and health-related behaviour	Jane Duckett	Economic and Social Research Council (ESRC)	ES/J011487/1	S&PS - Politics