Towards a fair and accountable health policy making: assessment on the decision-making process of the Chinese healthcare reform

Abstract

In recent years, the Chinese healthcare system has generally performed its tasks well, but has been facing considerable challenges, such as rapidly ageing population and the increasing burden of non-communicable diseases which indicate that the Chinese healthcare system is at a crossroads that demands a reconsideration of its policies and decision-making process. This study focuses on how to build a fair decision-making process based on the conviction that procedural justice is of vital importance in achieving the legitimacy of any substantive outcome. We employ the four conditions of the 'accountability of reasonableness' framework as benchmarks to evaluate China's decision-making process from the year of 2006 to 2009 and explore the flaws and deficiencies of the current path-dependent healthcare system reform. Our study shows that China's healthcare system suffers from poor information disclosure, inadequate public participation, insufficient appeal processes, and multi-leadership. Given those imperfections, the paper provides several recommendations for improving China's healthcare decision-making process.