The Political Determinants of China's New Health Constitution

Abstract

The Basic Healthcare and Health Promotion Law 2019 became the new constitution of China’s health system in June 2020, giving legal effect to ambitious health reform programmes like Healthy China 2030. The concurrent outbreak of coronavirus disease 2019 must not distract us from appreciating the fact that this Law will comprehensively overhaul the health regulatory framework of the world’s most populous country during the coming decade, if not beyond. This article offers an original evaluation of the Law in its political context. The Law commendably promises to safeguard the right to health, assist citizens to live a ‘complete cycle of life’, and promote health using the resources of the public health system. However, it is also deeply politicised, guaranteeing extensive and penetrative political control in health campaigns, digitalised health data, the governance of health institutions, and the resolution of medical disputes. This can be explained by the consequential roles played by epidemics in China’s historical dynastic cycles, but even more so by powerful tendencies of centralisation on the part of the Leninist Party-state. The Law’s potential is thus subject to the overriding caveat that the Party-state’s existence and influence over law and public health must be secured.