The Dynamics of Guanxi in Hospital Care in China

Abstract

When 'quality medical care' is in short supply and public hospitals are undergoing corporatization, patients are mobilizing their guanxi (social relationships) to obtain preferential treatment and better care. Intermediaries play a critical role in connecting service seekers to service providers. As there are many seekers but only limited number of providers, many seekers rely on indirect intermediaries for help. Based on ongoing ethnographic research in Guangzhou and Beijing, this talk will focus on these intermediaries' motives for helping those whom they do not know. They vary from sympathies to obligations and favor exchanges. Tie strength is found to be an important variable that affects intermediaries' willingness to help, as well as the seekers' chance of obtaining preferential treatment. The study illustrates how relational work is performed and constantly negotiated among different groups of actors. It also demonstrates how indirect reciprocity in multiple levels of intermediations is realized through the intermediaries.