The new health reform started in 2009 has shown the determination of the Chinese government, especially the central government, to increase its responsibility in the health sector. The most obvious manifestation of this commitment would be to increase government health expenditure (GHE). But there is still a hot debate about whether the government should allocate more public finds to health or just deepen the marketization of the health sector. Moreover, commitments at the central and local levels are not the same: local government responsibility for GHE is high, and commitments by the central government to increase GHE have not translated into increases in local government GHE as much as proposed in the national health reform.

Our research seeks to answer two questions: What was the actual pattern of GHE? And why did China’s local governments respond as they did? We first discuss the necessity of public financing for health care, and then analyze how intergovernmental economic competition affects local governments’ behavior under “Chinese-style decentralization” (known as fiscal decentralization with political centralization). Empirically, we apply a dynamic panel data model to provincial panel data from 1991 to 2007 to identify the effect of GHE on health performance in each province over time, using infant mortality and some morbidity metrics as health performance variables. We also examine differences across regions, as well as before and after the Severe Acute Respiratory Syndrome (SARS) epidemic of 2003.

Our analysis provides evidence that Chinese-style decentralization negatively impacted GHE. The main findings are as follows:

1. Increasing GHE did improve health performance, and this improvement was mainly driven by the GHE through the health department directly, not through spending by other governmental departments that also impact health. However, pursuit of economic performance lowered local governments’ GHE, mainly by decreasing GHE through local health departments.
   
2. Compared with in the eastern and western regions, this health improvement was not significant in China’s middle regions, where the intergovernmental economic competition leads to much less GHE through health departments.
   
3. The outburst of SARS in 2003 further increased the positive effect from GHE through local health departments, while the effect from GHE through other departments was not equally significant.
   

All these results suggest that adjusting the structure of public health financing, reforming the fiscal system, and improving the performance evaluation system for local governments are critical for the success of China’s on-going health reform.

Lee Kong Chian was among the most influential Chinese entrepreneurs in the Asian diasporic landscape from the 1920s to 1960s. In 1903, as a young boy, he migrated from China to then-British Singapore. He went on to build a formidable plantation-based business empire. Known in his heyday as Southeast Asia’s “Rubber King” and “Pineapple King,” he left profound imprints on business, education, and philanthropy that can still be felt in the region today.

Lee Kong Chian lived through tumultuous times: the rise of Chinese nationalism, World War II, British decolonization, independent state formation, and the Cold War. Different impressions of him have been produced and projected at different times in different places: as “a leading capitalist and philanthropist in Nanyang,” “a representative patriot of the Chinese Diaspora,” and “a virtuous pioneer in the revised national history template.” After reviewing these images, Prof. Huang will move “beyond representation” to explore less well-known aspects of Lee’s life including the nature of his economic empire and the political sensitivity of his position at a time when the sun was setting over the British empire.

Huang Jianli is an associate professor in the Department History at the National University of Singapore and a research associate in the university’s East Asian Institute. His many publications include The Scripting of a National History: Singapore and Its Pasts (2008), Power and Identity in the Chinese World Order (co-edited, 2003) and Macro Perspectives and New Directions in the Studies of Chinese Overseas (co-edited, 2002). Recent journal articles include “Umbilical Ties: The Framing of Overseas Chinese as the Mother of Revolution” (2011), “Portable Histories in Mobile City Singapore: The (Lack)lustre of Admiral Zheng He” (2009), “Chinese Diasporic Culture and National Identity: The Taming of the Tiger Balm Gardens in Singapore” (2007), and “Entanglement of Business and Politics in the Chinese Diaspora: Interrogating the Wartime Patriotism of Aw Boon Haw” (2006). Further details including contact information are accessible at http://profile.nus.edu.sg/fass/hishjl.

The movement of people leaving and returning to China from the second half of the 19th century to the present is a vast and complex subject. Among scholars worldwide, none has contributed more to the study of these cycles of migration and settlement in Southeast Asian contexts than National University of Singapore Prof. Wang Gungwu. His extensive writings on the topic richly illustrate the conceptual difficulties involved. 

The very terms used to name the phenomenon are contested: “Greater China,” “Chinese Diaspora,” “Huaqiao,” and “Nanyang Chinese”? Are these migrants and settlers and their descendants “Overseas Chinese” or “Chinese Overseas”? Are they even “Chinese” at all?  Prof. Wang’s struggles with nomenclature will be used by Prof. Huang to discuss larger issues, including how language can bias thought and influence policy and how to navigate the troubled waters at the confluence of scholarship and policy.

Huang Jianli is an associate professor in the Department History at the National University of Singapore and a research associate in the university’s East Asian Institute. His many publications include The Scripting of a National History: Singapore and Its Pasts (2008), Power and Identity in the Chinese World Order (co-edited, 2003) and Macro Perspectives and New Directions in the Studies of Chinese Overseas (co-edited, 2002). Recent journal articles include “Umbilical Ties: The Framing of Overseas Chinese as the Mother of Revolution” (2011), “Portable Histories in Mobile City Singapore: The (Lack)lustre of Admiral Zheng He” (2009), “Chinese Diasporic Culture and National Identity: The Taming of the Tiger Balm Gardens in Singapore” (2007), and “Entanglement of Business and Politics in the Chinese Diaspora: Interrogating the Wartime Patriotism of Aw Boon Haw” (2006).

As the United States struggles to emerge from recession, India and China's continued robust growth is the subject of much interest and concern. Council on Foreign Relations (CFR) Senior Fellow Adam Segal will talk about his new book Advantage: How American Innovation Can Overcome the Asian Challenge, analyzing Asia's technological rise, questioning assumptions about the United States inevitable decline, and explaining how America can preserve and improve its position in the global economy by optimizing its strength of moving ideas from the lab to the marketplace.

In his book, Segal argues that the emergence of India and China does not mean the end of American economic and technological power. Instead, the United States should now leverage its many advantages.

Through his research, Segal concludes the United States has an advantage over Asia in the realm of the software of innovation. “In America, your ideas can make you rich. Intellectual property is protected, and individual scientists are able to exploit their breakthroughs for commercial gains,” he writes. “It is time to realize that software in its most expansive sense offers the most opportunities for the United States to ensure its competitive place in the world.” The challenge is “to recover a culture of innovation that was driven underground, overshadowed by sexy credit default swaps and easy spending.”

Speaker

Adam Segal is the Ira A. Lipman senior fellow for counterterrorism and national security studies at the Council on Foreign Relations (CFR). An expert on security issues, technology development, and Chinese domestic and foreign policy, Dr. Segal currently leads study groups on cybersecurity and cyber conflict as well as Asian innovation and technological entrepreneurship. His new book Advantage: How American Innovation Can Overcome the Asian Challenge (W.W. Norton, 2011) looks at the technological rise of Asia. Dr. Segal is a research associate of the National Asia Research Program and was the project director for a CFR-sponsored independent task force on Chinese military modernization.

Before coming to CFR, Dr. Segal was an arms control analyst for the China Project at the Union of Concerned Scientists. There, he wrote about missile defense, nuclear weapons, and Asian security issues. Dr. Segal has been a visiting scholar at the Massachusetts Institute of Technology’s Center for International Studies, Shanghai Academy of Social Sciences, and Tsinghua University in Beijing. He has taught at Vassar College and Columbia University. Dr. Segal is the author of Digital Dragon: High-Technology Enterprises in China (Cornell University Press, 2003), as well as several articles and book chapters on Chinese technology policy. His work has recently appeared in the International Herald Tribune, Financial Times, Washington Quarterly, Los Angeles Times, and Foreign Affairs. Dr. Segal currently writes for the CFR blog, “Asia Unbound".

Dr. Segal has a BA and PhD in government from Cornell University, and an MA in international relations from the Fletcher School of Law and Diplomacy, Tufts University. He reads and speaks Chinese.

Much has been written lately about the Chinese government's efforts to control and censor the Internet. Internet censorship is an important issue, but it is not the top priority of the country's 420 million Internet users. Their top priority? Connecting with other Chinese online. The Internet has opened access to information for ordinary Chinese citizens in ways that were unimaginable just a few years ago. Coming from a world where information was pre-filtered by editors at state-run media, China's Internet is freewheeling by comparison. Rather than kill social media, controls imposed by the government have created a vibrant and unique social media domestic ecosystem.

Speaker

Thomas Crampton, who oversees social media strategy in the Asia-Pacific region for the marketing and communications company Ogilvy and Mather, will speak about what social media means to China and Asia. A former foreign correspondent for the New York Times and the International Herald Tribune, he previously looked at the region in terms of political, economic, and social issues. In his current role, he has been a participant of change as social media is affecting Asia's economics, politics, and society.

Commentator

Daniel Sneider is the associate director for research at the Walter H. Shorenstein Asia-Pacific Research Center at Stanford University. Sneider was the former foreign affairs columnist of the San Jose Mercury News and had a long career as a foreign correspondent.

Media X is the partner of this seminar.

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