Scottish Centre for China Research

When: Wednesday 12 February 2025 at 4–5.30pm 

Location: Online with registration at https://uofglasgow.zoom.us/meeting/register/w-zh93iGRAqoMLWk0wLM2g

 

 

Over 50 years ago, Hart (1971) argued that the “availability of good medical care tends to vary inversely with the need for it in the population served” (1971: 405). He found that although low-income social groups tend to suffer from more and earlier illnesses than middle- to high-income groups, they often do not have access to the same quantity and quality of care, calling this the “inverse care law”. While much research exists on developed countries, whether this law is observable in newly emerging social care systems in developing countries is under-researched. This talk discusses whether and to what extent the inverse care law applies to elder care services in PR China. Studying the case of Nanjing, I find that contrary to assumptions underlying the law, marketisation initially increased access to elder care due to increasing service quantity and diversity, thereby enabling older people who can afford services to purchase these from the market. However, over time, marketisation results in the inverse care law taking effect, suggesting that the inverse care law starts operating when marketisation of elder care services reaches a certain maturity. However, since other areas of the Chinese welfare state are less developed, the impact of the inverse care law is exacerbated in comparison to high-income countries.