Complex Structures: Meaning Formation amid China’s New Rural Cooperative Medical Scheme

Abstract

The culture-centered approach (CCA) foregrounds meanings from the margins as entry points for interrogating structures of health care. Through a culturally centered ethnographic examination of the ways in which family members left behind in a village in China make sense of their (in)access to health services, we seek to develop an understanding of China’s new rural cooperative medical scheme (NCMS). Although structures have been theorized in earlier CCA projects, this article specifically focuses on the interpretations of health services under a newly introduced health policy framework. To our knowledge, this is the first culture-centered study of negotiations of health services in rural China amid the ongoing health reforms as China opens up to a global market economy and undergoes market reforms in the public sectors (e.g., health, education). Voices of community members point toward the inequities constituted in the structures of NCMS, corruption introduced by the transformation to a monetary economy from a cooperative-based economy of health care, and agentic expressions that imagine alternative structures of organizing health and care.