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Peace in the Shadow of Unrest: yinao and the State Response in China

Published online by Cambridge University Press:  28 October 2020

Xian Huang*
Affiliation:
Rutgers University, New Jersey. Email: xian.huang@rutgers.edu.

Abstract

Much research on contentious politics focuses on the origins and dynamics of contention or the impact of contention on policy change. Although some studies have delved into the state reactions to contention, relatively little is known about the outcome or effectiveness of state responses, especially in non-democratic settings. This paper attempts to fill this gap and to uncover the policy feedback effect in non-democratic settings by studying the Chinese state's repression of violent incidents targeted at healthcare personnel and facilities (yinao). I argue that without comprehensive healthcare reforms to tackle the root causes of yinao, state repression of yinao generates unintended adverse outcomes, causing the doctor–patient relationship to deteriorate. Using the difference-in-differences method with China Family Panel Studies data for 2014 and 2016, I find that the criminalization of yinao diminishes public trust in doctors and confidence in hospitals’ competence and instead increases public concerns about the healthcare system.

摘要

摘要

大部分已有的抗争政治研究集中在抗争行动的起源,发展经过和政策影响。尽管一些研究已经开始关注国家(或政府)对于抗争行为的回应,学界对于这些回应的认识,尤其是在一个非民主的政治环境里国家政府对抗争行为的回应是否真的有效,还十分有限。本文通过研究中国政府对于国内连续不断发生的医闹事件所作的政策回应(医闹入刑)来揭示非民主体制下的政策反馈效应。作者认为在没有实施全面的医疗体制改革的情况下,通过医闹入刑来解决医闹问题只会适得其反,导致医患关系进一步恶化。作者利用中国家庭动态研究2014和2016的面板数据和双差分的分析方法发现:医闹入刑导致公众对医生和医院能力的信任下降,也使得公众认为医疗体制问题更加严重。

Type
Research Article
Copyright
Copyright © SOAS University of London, 2020

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References

Bo, Shiyu, Chen, Joy, Song, Yan and Zhou, Sen. 2020. “Media attention and choice of major: evidence from anti-doctor violence in China.Journal of Economic Behavior and Organization 170, 119.CrossRefGoogle Scholar
Cai, Yongshun. 2010. Collective Resistance in China: Why Popular Protests Succeed or Fail. Stanford, CA: Stanford University.Google Scholar
Campbell, Andrea Louise. 2011. “Policy feedbacks and the impact of policy designs on public opinion.Journal of Health Politics, Policy and Law 36(6), 961973.CrossRefGoogle ScholarPubMed
Campbell, Andrea Louise. 2012. “Policy makes mass politics.Annual Review of Political Science 15(1), 333351.CrossRefGoogle Scholar
Chai, Huiqun. 2012. “Yinan zizhi – xue'an pin fa: yisheng wei yiliao gaige zhihou maidan” (Difficult to treat themselves – there are frequent murders: doctors bear the brunt of the delayed healthcare reform). Nanfang zhoumo, 10 April, http://www.infzm.com/content/74368. Accessed 20 October 2018.Google Scholar
Chan, Cheris Shun-ching. 2018. “Mistrust of physicians in China: society, institution, and interaction as root causes.Developing World Bioethics 18(1), 1625.CrossRefGoogle ScholarPubMed
Chen, Patricia, and Gallagher, Mary. 2018. “Mobilization without movement: how the Chinese state ‘fixed’ labor insurgency.ILR Review 71(5), 124.CrossRefGoogle Scholar
Chen, Xi. 2012. Social Protest and Contentious Authoritarianism in China. New York: Cambridge University Press.Google Scholar
Duckett, Jane. 2011. The Chinese States Retreat from Health: Policy and the Politics of Retrenchment. Abingdon: Routledge.Google Scholar
He, Alex Jingwei. 2014. “The doctor–patient relationship, defensive medicine and overprescription in Chinese public hospitals: evidence from a cross-sectional survey in Shenzhen city.Social Science and Medicine 123, 6471.CrossRefGoogle ScholarPubMed
He, Alex Jingwei, and Qian, Jiwei. 2016. “Explaining medical disputes in Chinese public hospitals: the doctor–patient relationship and its implications for health policy reforms.Health Economics, Policy and Law 11, 359378.CrossRefGoogle ScholarPubMed
He, Xin. 2014. “Maintaining stability by law: protest-supported housing demolition litigation and social change in China.Law and Social Inquiry 39(4), 849873.CrossRefGoogle Scholar
Heurlin, Christopher. 2016. Responsive Authoritarianism in China. New York: Cambridge University Press.CrossRefGoogle Scholar
Hsieh, Chee-Ruey, and Tang, Chengxiang. 2019. “The multi-tiered medical education system and its influence on the health care market – China's Flexner Report.Human Resource Health 17(50), 113.Google ScholarPubMed
Hu, Tianlong. 2017. “Toward healing and restoration against medical disturbance (yinao) in China: reconsiderations and prospects of responsibility search and malpractice resolution.Frontiers of Law in China 12(4), 561583.Google Scholar
Huang, Haifeng, Boranbay-Akan, Serra and Huang, Ling. 2019. “Media, protest diffusion, and authoritarian resilience.Political Science Research and Methods 7(1), 2342.CrossRefGoogle Scholar
Huang, Yanzhong. 2013. Governing Health in Contemporary China. Abingdon: Routledge.Google Scholar
Jacobs, Lawrence R., and Mettler, Suzanne. 2011. “Public opinion, health policy, and American politics.Journal of Health Politics, Policy and Law 36(6), 911916.CrossRefGoogle ScholarPubMed
Kearney, Jordan. 2012. “Why China's 2010 medical malpractice reform fails to reform medical malpractice.Emory Interational Law Review 26, 1039–78.Google Scholar
Lee, Ching Kwan, and Zhang, Yonghong. 2013. “The power of instability: unraveling the microfoundations of bargained authoritarianism in China.American Journal of Sociology 118(6), 14751508.CrossRefGoogle Scholar
Li, Yao. 2019. “A zero-sum game? Repression and protest in China.Government and Opposition 54(2), 309335.CrossRefGoogle Scholar
Liebman, Benjamin L. 2013. “Malpractice mobs: medical dispute resolution in China.Columbia Law Review 113(1), 181264.Google Scholar
Liebman, Benjamin L. 2016. “Law in the shadow of violence: can law help to improve doctor–patient trust in China?Columbia Journal of Asian Law 113(30).Google Scholar
Lin, Nuannuan, and Hu, Weijun. 2018. “The evolving legal mechanism for medical malpractice dispute resolution in China.Columbia Journal of Asian Law 32(1), 3777.Google Scholar
Liu, Junqiang, Zhou, Hui, Liu, Lingrui and Wang, Chunxiao. 2020. “The weakness of the strong: examining the squeaky-wheel effect of hospital violence in China.Social Science and Medicine 245, 112717.CrossRefGoogle ScholarPubMed
Liu, Lu, and Li, Shanshan. 2018. “Wenling sha yi an 5 nian: Zhongguo de yi-huan guanxi you bian hao ma?” (Five years on from the Wenling murder: has the doctor–patient relationship in China improved?). Dingxiangyuan, 5 October, https://mp.weixin.qq.com/s/4cI0SsFxEI6Y6OKHQWvsPw. Accessed 29 October 2018.Google Scholar
, Xiaobo. 2014. “Social policy and regime legitimacy: the effects of education reform in China.American Political Science Review 108, 423437.CrossRefGoogle Scholar
Mettler, Suzanne. 2002. “Bringing the state back in to civic engagement: policy feedback effects of the G.I. Bill for World War II veterans.American Political Science Review 96(2), 351365.CrossRefGoogle Scholar
Minter, Adam. 2019. “Violent crimes in China's hospitals make many citizens happy.” Bloomberg, 29 March, https://www.bloomberg.com/opinion/articles/2012-03-29/violent-crimes-in-china-s-hospitals-spread-happiness. Accessed 30 September 2018.Google Scholar
Munro, Neil, and Duckett, Jane. 2015. “Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.Health Expectations 19(3), 654666.CrossRefGoogle ScholarPubMed
National Health and Family Planning Commission. 2014; 2015. China Health and Family Planning Yearbook. Beijing: National Health and Planning Commission.Google Scholar
O'Brien, Kevin J., and Li, Lianjiang. 2006. Rightful Resistance in Rural China. New York: Cambridge University Press.CrossRefGoogle Scholar
Ong, Lynette H. 2018. “‘Thugs-for-hire’: subcontracting of state coercion and state capacity in China.Perspective on Politics 16(3), 680695.CrossRefGoogle Scholar
Pan, Yu, Yang, Xiu Hong, He, Jiang Ping, Gu, Yan Hong, Zhan, Xiao Li, Gu, Hui Fang, Qiao, Qing Yan et al. 2015. “To be or not to be a doctor, that is the question: a review of serious incidents of violence against doctors in China from 2003–2013.Journal of Public Health 23(2), 111116.CrossRefGoogle Scholar
Qian, Jiwei, and Blomqvist, Ake. 2014. Health Policy Reform in China: A Comparative Perspective. Singapore: World Scientific Publishing.CrossRefGoogle Scholar
Reynolds, Lucy, and McKee, Martin. 2011. “Serve the people or close the sale? Profit-driven overuse of injections and infusions in China's market-based healthcare system.International Journal of Health Planning and Management 26, 449470.CrossRefGoogle ScholarPubMed
Shirk, Susan. 2010. “Introduction.” In Shirk, Susan (ed.), Changing Media, Changing China. New York: Oxford University Press, 137.Google Scholar
Tam, Waikeung. 2012. “Health care reform and patients’ trust in physicians in urban Beijing.The China Quarterly 211, 827843.CrossRefGoogle Scholar
Tang, Min, and Huhe, Narisong. 2014. “Alternative framing: the effect of the internet on political support in authoritarian China.International Political Science Review 35(5), 559576.CrossRefGoogle Scholar
Tian, Jia, and Du, Li. 2017. “Microblogging violent attacks on medical staff in China: a case study of the Longmen County People's Hospital incident.BMC Health Services Research 17(1), 363.CrossRefGoogle ScholarPubMed
Tong, Yao. 2017. “Narrative as an Aid for the Doctor–Patient Relationship in China.” MA diss., Massachusetts Institute of Technology.Google Scholar
Tu, Jiong. 2014. “Yinao: protest and violence in China's medical sector.Berkeley Journal of Sociology, 11 December, http://berkeleyjournal.org/2014/12/yinao-protest-and-violence-in-chinas-medical-sector/.Google Scholar
Tucker, Joseph D., Cheng, Yu, Wong, Bonnie, Gong, Ni, Nie, Jing-Bao, Zhu, Wei, McLaughlin, Megan M. et al. 2015. “Patient–physician mistrust and violence against physicians in Guangdong province, China: a qualitative study.BMJ open 5(10), e008221.CrossRefGoogle ScholarPubMed
Uzun, Ozge. 2003. “Perceptions and experiences of nurses in Turkey about verbal abuse in clinical settings.Journal of Nursing Scholarship 35(1), 8185.CrossRefGoogle ScholarPubMed
Wang, Yuhua. 2019. “The political legacy of violence during China's Cultural Revolution.British Journal of Political Science. doi:10.1017/S0007123419000255.Google Scholar
Wells, John, and Bowers, Len. 2002. “How prevalent is violence towards nurses working in general hospitals in the UK?Journal of Advanced Nursing 39(3), 230240.CrossRefGoogle ScholarPubMed
Wu, Siying, Zhu, Wei, Li, Huangyuan, Lin, Shaowei, Chai, Wenli and Wang, Xiaorong. 2012. “Workplace violence and influencing factors among medical professionals in China.American Journal of Industrial Medicine 55(11), 1000–08.CrossRefGoogle ScholarPubMed
Xu, Xin, and Lu, Rongrong. 2008. “Baoli yu bu xinren – zhuanxing Zhongguo de yiliao baoli yanjiu: 2000–2006(Violence and distrust: study of medical violence in transitional China 2000–2006). Fazhi yu shehui fazhan 79(1), 82101.Google Scholar
Yan, Yunxiang. 2018. “The ethics and politics of patient–physician mistrust in contemporary China.Developing World Bioethics 18(1), 715.CrossRefGoogle ScholarPubMed
Yuan, Yuan. 2016. “The crowded waiting room: citizens call for quality medical services.” Beijing Review, 24 March, http://www.bjreview.com/Nation/201603/t20160322_800052800.html. Accessed 22 March 2019.Google Scholar
Zhang, Jing, and Cai, Yongshun. 2018. “Medical disputes and mediation in China: government and responsibility shifting.China Information 33(3), 350371.CrossRefGoogle Scholar
Zhang, Liuyi, Stone, Teresa E. and Zhang, Jingping. 2017. “Understanding the rise of yinao in China: a commentary on the little known phenomenon of healthcare violence.Nursing and Health Sciences 19(2), 183–87.CrossRefGoogle ScholarPubMed
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