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.

two unwaverings 两个毫不动摇 liǎnggè háobù dòngyáo

The political idiom ‘liǎnggè háo bù dòngyáo’ means to insist on (literally, ‘unswervingly uphold’)

bolstering and growing the state-owned economy
encouraging and supporting private firms

First introduced in the 18th Party Congress report (2012), the two unshakable principles seek to convince the private (i.e. non-state) economy that its existence and prosperity were assured under the incoming Xi administration. Leaders and Party-aligned scholars regularly reiterate it to ease doubts felt by entrepreneurs, given the state’s recurrent market intervention and crackdowns.

In the cartoon, the big rocket, labelled ‘PRC economy’ and attended by red-suited Party officials, is supported by booster rockets labelled ‘State economy’. It is welcoming the addition of a ‘private economy’ booster, carried by civilian ‘people’. This is parsed as a case in point of ‘unswervingly upholding the Party and its socialist path’.

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.

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