PRC commentary

sanming healthcare reform 三明医改 sānmíng yīgǎi

A healthcare reform mode originating in 2012, when insurance funds in Fujian’s Sanming City province dealt with issues threatening localities nationwide such as

health insurance funds in deficit
state finances declining to cover the shortfall
the public hit by crippling medical costs
doctors paid low salaries

A leadership group coordinating the response was set up by Zhan Jifu 詹积富 then a Sanming vice mayor. It tackled pharmaceutical and medical supplies issues via

launching zero mark-up sales on medical supplies citywide
limiting pharmaceuticals within the ‘two-invoice system’
limiting purchase of a given pharmaceutical to a maximum of two receipts
centralised volume-based procurement
real-time monitoring of high-cost drugs with uncertain efficacy
controlling inflated prescriptions and trimming charges for major equipment tests

Medicine prices and healthcare costs fell citywide. Insurance fund deficits were curbed, with surpluses for years in a row. Service fees were raised, rewarding skills. Total salaries paid out in 2013 rose from C¥ 382 mn to 2.0 bn 2011–22.

State Council issued its ‘Key tasks for deepening healthcare system reform 2021’ in June 2021, urging ‘promoting Sanming reforms nationwide, speeding up coordinated reform of medical services, health insurance, and medicines’. With a growing elderly population straining healthcare insurance, State Council reiterated the need for Sanming-style reform on 6 June 2024.

institutional opening 制度型开放 zhìdù xíng kāifàng

Since its first mention at the 2018 Central Economic Work Conference, ‘institutional opening’ has risen as a trade and development priority for Beijing. Referring to ‘behind-the-border’ opening, addressing non-tariff barriers, and improving standards and policies beyond its WTO commitments, it is now frequently spotlighted in high-level conclaves such as Two Sessions and the Third Plenum.

Against shifts in geopolitics and emerging trade trends, ‘institutional opening’ is becoming integral to the process whereby Beijing is renegotiating and rewriting trade rules with the world. Much exploration and trial-and-error is in train. While advanced trade rules like CPTPP (Comprehensive and Progressive Agreement for Trans-Pacific Partnership) guide some reform efforts at home, Beijing is also championing norms-setting agendas of its own as a counterweight, not least via friendly bilateral initiatives and regional pacts such as BRI (Belt and Road Initiative) and RCEP (Regional Comprehensive Economic Partnership). Action is also underway to test new ‘institutional opening’ rules via the country’s many special zones, such as the FTZs (free trade zones).

nuclear development three-step strategy 核能发展 ‘三步走’ 战略 hénéng fāzhǎn sān bù zǒu zhànlǔe

Proposed in 1983, the Three-Step Strategy envisaged thermal neutron reactors, fast reactors and controlled nuclear fusion as core tech in the PRC nuclear strategy. Viewed as an alternate baseload power for coal, the buildout is speeding up as it aims to decarbonise and become a global nuclear powerhouse. The domestically developed Hualong One, a breakthrough for PRC industry, is now the go-to model for most new reactors. Fast (read: more efficient) reactors are meanwhile being built. A state-owned company has been set up to develop nuclear fusion, aiming to build an industrial prototype of an ‘artificial sun’ fusion reactor by 2035.

new three 新三样 xīn sānyàng

Fresh export drivers, the ‘new three’ (lithium batteries, solar PV cells and EVs) earned their buzz-term status in 2023. Green industries nurtured domestically for years, their exports totalled over C¥1 tn in 2023, up some 30 percent y-o-y and claiming the PRC’s dominant position globally. Already heading for 5 percent of export value, the ‘new three’ hold pole position in future export growth, set to overtake the ‘old three’–clothing, furniture and appliances. Their success burnishes Beijing’s green credentials.

'jiwa' parenting 鸡娃 jīwá

In Chinese slang, jiwa directly translates as 'chicken baby.' This colloquial term describes the trend of parents excessively urging their children to achieve academic and extracurricular excellence from very young. It indicates the undue pressure placed on children, including those not exceptionally talented, to attain significant accomplishments, reminiscent of 'hot-housing' or 'tiger parenting.' This reflects the high expectations and fierce competitiveness prevalent in modern Chinese educational culture.

'the Qian Xuesen question' 钱学森之问 Qián Xuésēn zhī wèn

‘Why do our schools fail to produce outstanding scientific and tech talent?’ That is ‘the Qian Xuesen question’. It was reportedly put to then-premier Wen Jiabao 温家宝 in 2005 by Qian Xuesen 钱学森. An engineer and rocket scientist, Qian was born in Shanghai in 1911, leaving in 1935 to study in the US. Graduating from MIT and CalTech, he returned to the now-Communist regime in 1955, pioneering applied mechanics. After retirement, he served as senior adviser to the National Defense Science and Technology Commission.

unveiling the list and assuming control 揭榜挂帅 Jiēbǎng guàshuài

‘Unveiling the list and assuming control’ is a scitech funding method to raise efficiency. A two-step selection protocol, it alludes to Chinese traditional knight-errantry, which featured

jiebang 揭榜, drawing up a public list of challenges
guashuai 挂帅, identifying a captain via open competition between champions

The point is to drive scitech via open competition, setting challenges and rewards. To take part, teams sign 'military oaths’, define milestones, and commit to prioritising the challenge. Under the motto ‘let whoever can, do’ (谁能干就让谁干), there are few formal limits. Projects are evaluated by ‘real end users’, and rewarded based on practical results (curbing the ‘entry’ focus, in favour of ‘output’).

Raised by Xi Jinping 习近平 in 2016 (and again in early 2020 in relation to COVID), the term’s inclusion in the 14th 5-year plan made it a Party buzz-phrase. Forty ‘National Key R&D Projects’ called for by MoST (Ministry of Science and Technology) in 2021 initiated a subcategory for such ‘open competitions’, awarding C¥2 bn, some 11 percent of the total amount.

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