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Masterpost on the People's Republic of China

Introduction
The People's Republic of China is the largest nation on Earth, and one of only four officially Marxist-Leninist states in the world today (alongside Vietnam, Laos, and Cuba). Over the last few years it has emerged as the world's leading economic power, and as a result has been subjected to near-constant demonization from Western media and propaganda outlets. In order to gain a proper understanding of the PRC, and to distinguish legitimate points of criticism (of which there are many) from Sinophobic slanders, it is necessary to go over the history, economy, and development of the country. As always, all sources are cited at the end.
Pre-Communist China
Before going over the revolutionary and post-revolutionary periods in China, it is necessary to understand what the country was like before the People's Republic was declared in 1949. According to a study in the Journal of Global Health, China at this time was "one of the most impoverished nations on Earth." To quote:
After a century of domination by Europeans, the fall of the Qing Empire was followed by partial Japanese occupation and a 38-year civil war. The vast majority of the population were engaged in subsistence agriculture, and a survey on the causes of death conducted in 1929-31 revealed that more than half of all deaths were caused by infectious diseases.
In a book on China and India, Nobel-winning economist Amartya Sen (Harvard University) notes that pre-communist China suffered from "high levels of mortality, undernutrition, and illiteracy." According to a study from the London School of Economics:
Western visitors to China in the 1920s and 1930s paint a picture where land scarcity is the predominant cause of high levels of hunger and poverty. Famines were widespread and severe and periods of hunger were a fact of life for many Chinese peasants. Ownership of land was highly unequal. The best estimates from this period suggest that, taken together, landlords (who were rich enough to avoid doing agricultural labor) and rich peasants (who did agricultural labor but also relied heavily on tenants and hire labor) typically owned upward of half the land though their share in the population typically did not exceed 10 percent. Poor peasants and agricultural laborers who owned little or no land formed the majority of the population.
Educational standards in Kuomintang China were horrible. According to a study in the journal Population Studies, in 1949 "more than 80 per cent of China's population was illiterate. Enrollment rates in primary and middle schools were abysmal: 20 and 6 per cent, respectively." In addition, women's rights were highly curtailed and patriarchal norms were widespread; according to a study in the journal Modern China, this trend continued as Kuomintang rule took root in Taiwan. All-in-all, KMT China can be safely said to have been one of the poorest societies in the world, plagued by starvation, patriarchy, and feudal oppression.
The Maoist Period (1949-1976)
After the PRC's founding was declared in 1949 (an event captured on film, for those who are interested), the Communists quickly set to work implementing their new agenda. According to the aforementioned study in the Journal of Global Health:
The Communists were quick to make good on promises of land-reform and establishment of a national “people’s” government. In 1950 a Marriage Law was enacted, providing equal rights for women, and the first National Health Congress established a focus on rural health, disease prevention through campaigns, and collaboration between western and traditional Chinese medicine.
According to the aforementioned study from the London School of Economics, the land reforms "led to the destruction of feudal power relationships in agriculture," leading to "universal and egalitarian access to land within localities." The reforms also led to a dramatic reduction in poverty and hunger. To quote:
Mao's legacy of universal and egalitarian access to land represents a key means of avoiding hunger. This helps us to understand how China has managed to escape the high levels of hunger which typify low income countries.
Health outcomes improved dramatically after the Communists took power. To quote from the Journal of Global Health:
China’s progress on communicable disease control (CDC) in the 30 years after establishment of the People’s Republic in 1949 is widely regarded as remarkable. Life expectancy soared by around 30 years, infant mortality plummeted and smallpox, sexually transmitted diseases and many other infections were either eliminated or decreased massively in incidence, largely as a result of CDC.
The aforementioned study in Population Studies, confirms these findings, noting that "China's growth in life expectancy between 1950 and 1980 ranks as among the most rapid sustained increases in documented global history." Another study, this one from the journal Health Services Evaluation, makes similar observations:
The health of China’s population improved dramatically during the first 30 years of the People’s Republic, established in 1949. By the mid-1970s, China was already undergoing the epidemiologic transition, years ahead of other nations of similar economic status, and by 1980, life expectancy (67 years) exceeded that of most similarly low-income nations by 7 years.
According to the Journal of Global Health, these improvements "can be attributed to population mobilization, mass campaigns and a focus on sanitation, hygiene, clean water and clean delivery," as well as "clinical care and continuing public health programs to the masses through community-funded medical schemes and the establishment of community-based health workers."
Education also improved dramatically in the Maoist era. According to the aforementioned study in Population Studies:
China made large strides in primary and secondary education under Mao. [...] During the 1950s, capital investments in primary and secondary school infrastructure increased tenfold, and dramatic increases in attendance followed. Primary school enrolment rates rose to 80 per cent by 1958 and to 97 per cent by 1975, and secondary school rates increased to 46 per cent by 1977.
Amartya Sen makes similar observations, noting that literacy was greatly expanded under Mao:
China's breakthrough in the field of elementary education had already taken place before the process of economic reform was initiated at the end of the seventies. Census data indicate, for instance, that literacy rates in 1982 for the 15-19 age group were already as high as 96 percent for males and 85 percent for females.
These achievements of the Maoist era made possible China's later economic miracle. Amartya Sen states that "the accomplishments relating to education, healthcare, land reforms, and social change in the pre-reform [Maoist] period made significantly positive contributions to the achievements of the post-reform period. This is so not only in terms of their role in sustained high life expectancy and related achievements, but also in providing firm support for economic expansion based on market reforms." In his aforementioned book on the topic, Sen summarizes the achievements of the Maoist period thusly:
Because of its radical commitment to the elimination of poverty and to improving living conditions - a commitment in which Maoist as well as Marxist ideas and ideals played an important part - China did achieve many things… [including] The elimination of widespread hunger, illiteracy, and ill health… [a] remarkable reduction in chronic undernourishment… a dramatic reduction of infant and child mortality and a remarkable expansion of longevity.
Of course, with all of this said, it should not be denied that the Maoist era saw some extremely serious problems. Most notable is the Great Leap Forward, which was a colossal failure, contributing to the Great Chinese Famine. A study in the Journal of Health Economics notes that the famine had major long-term effects on health and economic development in China, leading to reduced population height, and having a negative impact on labor supply and earnings of famine survivors. Even still, it cannot be denied that the Maoist period brought massive gains to the Chinese people, massively improving health, education, and nutrition, and laying the groundwork for China's later economic development.
Socialism with Chinese Characteristics
In 1978, in response to a perceived lack of necessary economic progress, the Communist Party of China embarked on an ambitious reform program, leading to the development of socialism with Chinese characteristics (SWCC). These reform programs have produced impressive results; according to a 2020 study in the Journal of Economic Issues:
Succinctly, in terms of economic development, the model has simultaneously achieved the following, all on unprecedented scales, particularly since the turn of the century: rapid expansion in both investment and consumption, rapid rises in both productivity and the wage rate, and rapid increases in job creation. All these have provided the necessary material conditions for broader social development: the fundamental enhancement of the power of labor, the reconstruction of a publicly-funded comprehensive healthcare system, and the acceleration of the process of urbanization.
We may now go over some of these achievements in more detail. To begin with, poverty in the PRC has been dramatically reduced. According to a 2019 report from Philip Alston (UN Special Rapporteur on Extreme Poverty and Human Rights):
China’s achievements in alleviating extreme poverty in recent years, and in meeting highly ambitious targets for improving social well-being, have been extraordinary. [...] Over the past three decades, and with particular speed in recent years, China has lifted hundreds of millions of people out of poverty. This is a staggering achievement and is a credit to those responsible.
Economic growth has also increased dramatically. According to a study from the National Bureau of Economic Research, "reforms yielded a significant growth and structural transformation differential. GDP growth is 4.2 percentage points higher and the share of the labor force in agriculture is 23.9 percentage points lower compared with the continuation of the pre-1978 policies." These results are remarkably impressive, and indicate that SWCC has been successful at its principal goals of developing China's productive forces and meeting the needs of the proletariat.
For those who argue that China is no longer socialist, or that SWCC is simply a form of "state capitalism," I would remind them of what Lenin said in his pamphlet The Impending Catastrophe and How to Combat It:
You will find that, given a really revolutionary-democratic state, state-monopoly capitalism inevitably and unavoidably implies a step, and more than one step, towards socialism! For if a huge capitalist undertaking becomes a monopoly, it means that it serves the whole nation. If it has become a state monopoly, it means that the state (i.e., the armed organization of the population, the workers and peasants above all, provided there is revolutionary democracy) directs the whole undertaking. In whose interest? Either in the interest of the landowners and capitalists, in which case we have not a revolutionary-democratic, but a reactionary-bureaucratic state, an imperialist republic. Or in the interest of revolutionary democracy—and then it is a step towards socialism. For socialism is merely the next step forward from state-capitalist monopoly. Or, in other words, socialism is merely state-capitalist monopoly which is made to serve the interests of the whole people and has to that extent ceased to be capitalist monopoly.
This perfectly describes the situation in the People's Republic of China: while there are capitalists and markets, they are under the constant control of the Communist Party and the proletarian state. In addition, state-owned enterprises continue to play an essential role in the Chinese economy, as we will now see.
The Continued Role of Public Ownership
Contrary to the popular perception that China's growth has been the result of a transition to capitalism, the evidence shows that public ownership continues to play a key growth-driving role in the PRC's economy. A 2019 study in the Review of Radical Political Economics found that "a higher share of state-owned enterprises is favorable to long-run growth and tends to offset the adverse effect of economic downturns on the regional level." Similarly, the aforementioned study in the Journal of Economic Issues found that China's state-owned enterprises "appear to have performed well in terms of productivity and profitability." They also "appear to have fulfilled the functions of broadly-based social and economic development." In other words, public ownership continues to play a leading role in the Chinese economy, being a major driver of growth.
Healthcare in Modern China
In the Maoist period, China built one of the developing world's most robust public healthcare systems, based on rural primary care, barefoot doctors, and regular mass campaigns, known as "patriotic health campaigns." Since the beginning of the reform period, China's healthcare system has gone through a number of phases. After an unfortunate period of regression and privatization, China has spent the last decade making rapid progress towards a new universal healthcare system. A 2020 study in the British Medical Journal (BMJ) summarizes many of the goals and programs of China's recent health reforms:
Priority was given to expanding the scope and health service package of the basic insurance coverage, improving provider payment mechanisms, as well as increasing the financing level, fiscal subsidies and reimbursement rates. [...] The government has increased investment in primary care, with initiatives that include strengthening the infrastructure of primary healthcare (PHC) facilities, expanding human resources for primary care through incentives and supporting projects, establishing a general practitioner system and improving the capacity of PHC personnel through training and education, such as general practice training and continuous medical education programmes. [...] The ‘equalization of basic public health services’ policy implemented the national BPHS programme and the crucial public health service (CPHS) programme. [...] This policy seeks to achieve universal availability and promote a more equitable provision of basic health services to all urban and rural citizens.
The study goes on to note that China has made significant progress towards meeting its reform goals, and building a developed and equitable universal healthcare system:
During the past 10 years since the latest round of healthcare reform, China made steady progress in achieving the reform goals and UHC [i.e. universal health coverage].
In short, while China's healthcare system is not perfect, and is still in need of development, it is certainly moving in the right direction, following the general trend of the PRC's progress towards building a developed socialist society. As with many other aspects of China's socialist construction, this provides a model for other developing nations; according to the aforementioned BMJ study:
The lessons learnt from China could help other nations improve UHC in sustainable and adaptive ways, including continued political support, increased health financing and a strong PHC system as basis. The experience of the rapid development of UHC in China can provide a valuable mode for countries (mainly LMICs) planning their own path further on in the UHC journey.
This is another benefit of China's rise to prominence on the world stage. China demonstrates to the world that it is possible for a desperately poor country to rise from poverty, develop its economy, and meet the needs of its people.
Democracy and Popular Opinion in China
Polls conducted by Western researchers have consistently found that the Chinese people have a high level of support for their government, and for the Communist Party. A 2020 analysis by the China Data Lab (based at UC San Diego) found that support for the government has been increasing as of late. Similar results were found in a 2016 survey done by Harvard University's Ash Center:
The survey team found that compared to public opinion patterns in the U.S., in China there was very high satisfaction with the central government. In 2016, the last year the survey was conducted, 95.5 percent of respondents were either “relatively satisfied” or “highly satisfied” with Beijing. In contrast to these findings, Gallup reported in January of this year that their latest polling on U.S. citizen satisfaction with the American federal government revealed only 38 percent of respondents were satisfied with the federal government.
It is worth noting that the Chinese people are significantly less satisfied with local government than they are with the central government. Still, these results disprove the common notion that the Chinese people are ruled by an iron fisted regime that they do not want. Indeed, one official from the Ash Center noted that their findings "run counter to the general idea that these people are marginalized and disfavored by policies." As he states:
We tend to forget that for many in China, and in their lived experience of the past four decades, each day was better than the next.
In addition, most Chinese people are satisfied with the level of democracy in the PRC. A 2018 study in the International Political Science Review notes that "surveys suggest that the majority of Chinese people feel satisfied with the level of democracy in China." However, the study notes that "people who hold liberal democratic values" are more likely to be dissatisfied with the state of democracy in China. By contrast, those who hold a "substantive" view of democracy (i.e. one based on the idea that the state should focus on providing for the material needs of the people) are more satisfied.
Many of the other claims surrounding authoritarianism in China are highly overblown, to say the least. For instance, an article in Foreign Policy (the most orthodox of liberal policy journals) notes that the Chinese social credit system was massively exaggerated and distorted in Western media. An article in the publication Wired discusses how many of these overblown perceptions came to be. None of this is to suggest that China is a perfect democracy, with zero flaws; it certainly has issues relating to transparency, treatment of prisoners, etc. That being said, it is far from the totalitarian nightmare that imperialist media generally depicts it as being.
Chinese "Imperialism" and the Belt and Road Initiative
China is often accused (typically by Western pseudo-leftists) of being an "imperialist" state, due primarily to its investments in Africa, as part of the Belt and Road Initiative. These critics ignore the actual views of the African people themselves, who overwhelmingly approve of China's role in their economic development. In addition, the extent of Chinese involvement in Africa is smaller than often believed; according to a 2019 paper from the Center for Economic Policy Research, "China’s influence in Africa is much smaller than is generally believed, though its engagement on the continent is increasing. Chinese investment in Africa, while less extensive than often assumed, has the potential to generate jobs and development on the continent."
A 2018 study in the Review of Development Finance also found that Chinese investment in Africa raises incomes in the African nations that receive the investment, in a similar way to foreign investments by other nations. The author state that these results "suggest that the win-win deal China claims when investing in Africa may hold, and Chinese investment contributes to growth in Africa. Put differently, Chinese investment is mutually beneficial for both China and Africa."
For those interested in learning more, the economist Yanis Varoufakis discussed the topic in a recent lecture given at the Cambridge forum. He helpfully debunks a number of myths on the matter.
Conclusion
The People's Republic of China is undoubtedly the world's leading socialist state, and it is essential for all socialists to understand it. While there are many legitimate criticisms that one can make of China (from past economic errors to current human rights violations), it has made enormous progress in improving life for the people, as well as providing investments in developing countries in a mutually beneficial way. For this, it deserves the respect of all socialists and communists.
Sources
submitted by flesh_eating_turtle to AsianSocialists

8

Masterpost on the People's Republic of China

Introduction
The People's Republic of China is the largest nation on Earth, and one of only four officially Marxist-Leninist states in the world today (alongside Vietnam, Laos, and Cuba). Over the last few years it has emerged as the world's leading economic power, and as a result has been subjected to near-constant demonization from Western media and propaganda outlets. In order to gain a proper understanding of the PRC, and to distinguish legitimate points of criticism (of which there are many, particularly relating to political and civil rights) from Sinophobic slanders, it is necessary to go over the history, economy, and development of the country. As always, all sources are cited at the end.
Pre-Communist China
Before going over the revolutionary and post-revolutionary periods in China, it is necessary to understand what the country was like before the People's Republic was declared in 1949. According to a study in the Journal of Global Health, China at this time was "one of the most impoverished nations on Earth." To quote:
After a century of domination by Europeans, the fall of the Qing Empire was followed by partial Japanese occupation and a 38-year civil war. The vast majority of the population were engaged in subsistence agriculture, and a survey on the causes of death conducted in 1929-31 revealed that more than half of all deaths were caused by infectious diseases.
In a book on China and India, Nobel-winning economist Amartya Sen (Harvard University) notes that pre-communist China suffered from "high levels of mortality, undernutrition, and illiteracy." According to a study from the London School of Economics:
Western visitors to China in the 1920s and 1930s paint a picture where land scarcity is the predominant cause of high levels of hunger and poverty. Famines were widespread and severe and periods of hunger were a fact of life for many Chinese peasants. Ownership of land was highly unequal. The best estimates from this period suggest that, taken together, landlords (who were rich enough to avoid doing agricultural labor) and rich peasants (who did agricultural labor but also relied heavily on tenants and hire labor) typically owned upward of half the land though their share in the population typically did not exceed 10 percent. Poor peasants and agricultural laborers who owned little or no land formed the majority of the population.
Educational standards in Kuomintang China were horrible. According to a study in the journal Population Studies, in 1949 "more than 80 per cent of China's population was illiterate. Enrollment rates in primary and middle schools were abysmal: 20 and 6 per cent, respectively." In addition, women's rights were highly curtailed and patriarchal norms were widespread; according to a study in the journal Modern China, this trend continued as Kuomintang rule took root in Taiwan. All-in-all, KMT China can be safely said to have been one of the poorest societies in the world, plagued by starvation, patriarchy, and feudal oppression.
The Maoist Period (1949-1976)
After the PRC's founding was declared in 1949 (an event captured on film, for those who are interested), the Communists quickly set to work implementing their new agenda. According to the aforementioned study in the Journal of Global Health:
The Communists were quick to make good on promises of land-reform and establishment of a national “people’s” government. In 1950 a Marriage Law was enacted, providing equal rights for women, and the first National Health Congress established a focus on rural health, disease prevention through campaigns, and collaboration between western and traditional Chinese medicine.
According to the aforementioned study from the London School of Economics, the land reforms "led to the destruction of feudal power relationships in agriculture," leading to "universal and egalitarian access to land within localities." The reforms also led to a dramatic reduction in poverty and hunger. To quote:
Mao's legacy of universal and egalitarian access to land represents a key means of avoiding hunger. This helps us to understand how China has managed to escape the high levels of hunger which typify low income countries.
Health outcomes improved dramatically after the Communists took power. To quote from the Journal of Global Health:
China’s progress on communicable disease control (CDC) in the 30 years after establishment of the People’s Republic in 1949 is widely regarded as remarkable. Life expectancy soared by around 30 years, infant mortality plummeted and smallpox, sexually transmitted diseases and many other infections were either eliminated or decreased massively in incidence, largely as a result of CDC.
The aforementioned study in Population Studies, confirms these findings, noting that "China's growth in life expectancy between 1950 and 1980 ranks as among the most rapid sustained increases in documented global history." Another study, this one from the journal Health Services Evaluation, makes similar observations:
The health of China’s population improved dramatically during the first 30 years of the People’s Republic, established in 1949. By the mid-1970s, China was already undergoing the epidemiologic transition, years ahead of other nations of similar economic status, and by 1980, life expectancy (67 years) exceeded that of most similarly low-income nations by 7 years.
According to the Journal of Global Health, these improvements "can be attributed to population mobilization, mass campaigns and a focus on sanitation, hygiene, clean water and clean delivery," as well as "clinical care and continuing public health programs to the masses through community-funded medical schemes and the establishment of community-based health workers."
Education also improved dramatically in the Maoist era. According to the aforementioned study in Population Studies:
China made large strides in primary and secondary education under Mao. [...] During the 1950s, capital investments in primary and secondary school infrastructure increased tenfold, and dramatic increases in attendance followed. Primary school enrolment rates rose to 80 per cent by 1958 and to 97 per cent by 1975, and secondary school rates increased to 46 per cent by 1977.
Amartya Sen makes similar observations, noting that literacy was greatly expanded under Mao:
China's breakthrough in the field of elementary education had already taken place before the process of economic reform was initiated at the end of the seventies. Census data indicate, for instance, that literacy rates in 1982 for the 15-19 age group were already as high as 96 percent for males and 85 percent for females.
These achievements of the Maoist era made possible China's later economic miracle. Amartya Sen states that "the accomplishments relating to education, healthcare, land reforms, and social change in the pre-reform [Maoist] period made significantly positive contributions to the achievements of the post-reform period. This is so not only in terms of their role in sustained high life expectancy and related achievements, but also in providing firm support for economic expansion based on market reforms." In his aforementioned book on the topic, Sen summarizes the achievements of the Maoist period thusly:
Because of its radical commitment to the elimination of poverty and to improving living conditions - a commitment in which Maoist as well as Marxist ideas and ideals played an important part - China did achieve many things… [including] The elimination of widespread hunger, illiteracy, and ill health… [a] remarkable reduction in chronic undernourishment… a dramatic reduction of infant and child mortality and a remarkable expansion of longevity.
Of course, with all of this said, it should not be denied that the Maoist era saw some extremely serious problems. Most notable is the Great Leap Forward, which was a colossal failure, contributing to the Great Chinese Famine. A study in the Journal of Health Economics notes that the famine had major long-term effects on health and economic development in China, leading to reduced population height, and having a negative impact on labor supply and earnings of famine survivors. Even still, it cannot be denied that the Maoist period brought massive gains to the Chinese people, massively improving health, education, and nutrition, and laying the groundwork for China's later economic development.
Socialism with Chinese Characteristics
In 1978, in response to a perceived lack of necessary economic progress, the Communist Party of China embarked on an ambitious reform program, leading to the development of socialism with Chinese characteristics (SWCC). These reform programs have produced impressive results; according to a 2020 study in the Journal of Economic Issues:
Succinctly, in terms of economic development, the model has simultaneously achieved the following, all on unprecedented scales, particularly since the turn of the century: rapid expansion in both investment and consumption, rapid rises in both productivity and the wage rate, and rapid increases in job creation. All these have provided the necessary material conditions for broader social development: the fundamental enhancement of the power of labor, the reconstruction of a publicly-funded comprehensive healthcare system, and the acceleration of the process of urbanization.
We may now go over some of these achievements in more detail. To begin with, poverty in the PRC has been dramatically reduced. According to a 2019 report from Philip Alston (UN Special Rapporteur on Extreme Poverty and Human Rights):
China’s achievements in alleviating extreme poverty in recent years, and in meeting highly ambitious targets for improving social well-being, have been extraordinary. [...] Over the past three decades, and with particular speed in recent years, China has lifted hundreds of millions of people out of poverty. This is a staggering achievement and is a credit to those responsible.
Economic growth has also increased dramatically. According to a study from the National Bureau of Economic Research, "reforms yielded a significant growth and structural transformation differential. GDP growth is 4.2 percentage points higher and the share of the labor force in agriculture is 23.9 percentage points lower compared with the continuation of the pre-1978 policies." These results are remarkably impressive, and indicate that SWCC has been successful at its principal goals of developing China's productive forces and meeting the needs of the proletariat.
For those who argue that China is no longer socialist, or that SWCC is simply a form of "state capitalism," I would remind them of what Lenin said in his pamphlet The Impending Catastrophe and How to Combat It:
You will find that, given a really revolutionary-democratic state, state-monopoly capitalism inevitably and unavoidably implies a step, and more than one step, towards socialism! For if a huge capitalist undertaking becomes a monopoly, it means that it serves the whole nation. If it has become a state monopoly, it means that the state (i.e., the armed organization of the population, the workers and peasants above all, provided there is revolutionary democracy) directs the whole undertaking. In whose interest? Either in the interest of the landowners and capitalists, in which case we have not a revolutionary-democratic, but a reactionary-bureaucratic state, an imperialist republic. Or in the interest of revolutionary democracy—and then it is a step towards socialism. For socialism is merely the next step forward from state-capitalist monopoly. Or, in other words, socialism is merely state-capitalist monopoly which is made to serve the interests of the whole people and has to that extent ceased to be capitalist monopoly.
This perfectly describes the situation in the People's Republic of China: while there are capitalists and markets, they are under the constant control of the Communist Party and the proletarian state. In addition, state-owned enterprises continue to play an essential role in the Chinese economy, as we will now see.
The Continued Role of Public Ownership
Contrary to the popular perception that China's growth has been the result of a transition to capitalism, the evidence shows that public ownership continues to play a key growth-driving role in the PRC's economy. A 2019 study in the Review of Radical Political Economics found that "a higher share of state-owned enterprises is favorable to long-run growth and tends to offset the adverse effect of economic downturns on the regional level." Similarly, the aforementioned study in the Journal of Economic Issues found that China's state-owned enterprises "appear to have performed well in terms of productivity and profitability." They also "appear to have fulfilled the functions of broadly-based social and economic development." In other words, public ownership continues to play a leading role in the Chinese economy, being a major driver of growth.
Healthcare in Modern China
In the Maoist period, China built one of the developing world's most robust public healthcare systems, based on rural primary care, barefoot doctors, and regular mass campaigns, known as "patriotic health campaigns." Since the beginning of the reform period, China's healthcare system has gone through a number of phases. After an unfortunate period of regression and privatization, China has spent the last decade making rapid progress towards a new universal healthcare system. A 2020 study in the British Medical Journal (BMJ) summarizes many of the goals and programs of China's recent health reforms:
Priority was given to expanding the scope and health service package of the basic insurance coverage, improving provider payment mechanisms, as well as increasing the financing level, fiscal subsidies and reimbursement rates. [...] The government has increased investment in primary care, with initiatives that include strengthening the infrastructure of primary healthcare (PHC) facilities, expanding human resources for primary care through incentives and supporting projects, establishing a general practitioner system and improving the capacity of PHC personnel through training and education, such as general practice training and continuous medical education programmes. [...] The ‘equalization of basic public health services’ policy implemented the national BPHS programme and the crucial public health service (CPHS) programme. [...] This policy seeks to achieve universal availability and promote a more equitable provision of basic health services to all urban and rural citizens.
The study goes on to note that China has made significant progress towards meeting its reform goals, and building a developed and equitable universal healthcare system:
During the past 10 years since the latest round of healthcare reform, China made steady progress in achieving the reform goals and UHC [i.e. universal health coverage].
In short, while China's healthcare system is not perfect, and is still in need of development, it is certainly moving in the right direction, following the general trend of the PRC's progress towards building a developed socialist society. As with many other aspects of China's socialist construction, this provides a model for other developing nations; according to the aforementioned BMJ study:
The lessons learnt from China could help other nations improve UHC in sustainable and adaptive ways, including continued political support, increased health financing and a strong PHC system as basis. The experience of the rapid development of UHC in China can provide a valuable mode for countries (mainly LMICs) planning their own path further on in the UHC journey.
This is another benefit of China's rise to prominence on the world stage. China demonstrates to the world that it is possible for a desperately poor country to rise from poverty, develop its economy, and meet the needs of its people.
Democracy and Popular Opinion in China
Polls conducted by Western researchers have consistently found that the Chinese people have a high level of support for their government, and for the Communist Party. A 2020 analysis by the China Data Lab (based at UC San Diego) found that support for the government has been increasing as of late. Similar results were found in a 2016 survey done by Harvard University's Ash Center:
The survey team found that compared to public opinion patterns in the U.S., in China there was very high satisfaction with the central government. In 2016, the last year the survey was conducted, 95.5 percent of respondents were either “relatively satisfied” or “highly satisfied” with Beijing. In contrast to these findings, Gallup reported in January of this year that their latest polling on U.S. citizen satisfaction with the American federal government revealed only 38 percent of respondents were satisfied with the federal government.
It is worth noting that the Chinese people are significantly less satisfied with local government than they are with the central government. This points to major issues with responsiveness and accountability at the local level, which must be addressed. Still, these results disprove the common notion that the Chinese people are ruled by an iron fisted regime that they do not want. Indeed, one official from the Ash Center noted that their findings "run counter to the general idea that these people are marginalized and disfavored by policies." As he states:
We tend to forget that for many in China, and in their lived experience of the past four decades, each day was better than the next.
In addition, most Chinese people are satisfied with the level of democracy in the PRC. A 2018 study in the International Political Science Review notes that "surveys suggest that the majority of Chinese people feel satisfied with the level of democracy in China." However, the study notes that "people who hold liberal democratic values" are more likely to be dissatisfied with the state of democracy in China. By contrast, those who hold a "substantive" view of democracy (i.e. one based on the idea that the state should focus on providing for the material needs of the people) are more satisfied.
Many of the other claims surrounding authoritarianism in China are highly overblown, to say the least. For instance, an article in Foreign Policy (the most orthodox of liberal policy journals) notes that the Chinese social credit system was massively exaggerated and distorted in Western media. An article in the publication Wired discusses how many of these overblown perceptions came to be. None of this is to suggest that China is a perfect democracy, with zero flaws; it certainly has issues relating to transparency, treatment of prisoners, etc. That being said, it is far from the totalitarian nightmare that imperialist media generally depicts it as being.
Chinese "Imperialism" and the Belt and Road Initiative
China is often accused of being an "imperialist" state, due primarily to its investments in Africa, as part of the Belt and Road Initiative. These critics ignore the actual views of the African people themselves, who overwhelmingly approve of China's role in their economic development. In addition, the extent of Chinese involvement in Africa is smaller than often believed; according to a 2019 paper from the Center for Economic Policy Research, "China’s influence in Africa is much smaller than is generally believed, though its engagement on the continent is increasing. Chinese investment in Africa, while less extensive than often assumed, has the potential to generate jobs and development on the continent."
A 2018 study in the Review of Development Finance also found that Chinese investment in Africa raises incomes in the African nations that receive the investment, in a similar way to foreign investments by other nations. The author state that these results "suggest that the win-win deal China claims when investing in Africa may hold, and Chinese investment contributes to growth in Africa. Put differently, Chinese investment is mutually beneficial for both China and Africa."
For those interested in learning more, the economist Yanis Varoufakis discussed the topic in a recent lecture given at the Cambridge forum. He helpfully debunks a number of myths on the matter.
Conclusion
The People's Republic of China is undoubtedly the world's leading socialist state, and it is essential for all socialists to understand it. While there are many legitimate criticisms that one can make of China (from past economic errors to current human rights violations), it has made enormous progress in improving life for the people, as well as providing investments in developing countries in a mutually beneficial way. For this, it deserves the respect of all socialists and communists.
Sources
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