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State and the sick role: a study of sick models in the pre-reform China

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Abstract

This study revisited the sick role theory and proposed that the doctor–patient dyadic system be expanded to include state as a major actor to extend the applicability of the theory to other political systems. I argue that state not only exercises coercive power in the social control mechanism, but also practices persuasion in the socialisation mechanism. Drawing on evidence from China, the paper notes that the establishment of the state medicine in the 1950s and 1960s significantly changed illness behavioural patterns of the people covered by public health insurances. To counteract abuse of health insurance and secondary gains, the Chinese Party-state propagated official sick role expectations and norms through sick models—sick persons who thought and behaved as the Party-state expected. Two types of sick models were identified: the cooperative and the ‘defiant’. These models were propagated to serve the Party-state’s political and economic agenda.

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References

  • 1954. The constitution of the People’s Republic of China. China.

  • Ai, B. 1958. Zai Dang de lingdao xia chuangzao de qiji (Miracles created under the leadership of the Party). Renmin Ribao (People’s Daily), 1 July.

  • All-China Federation of Trade Unions. 1964 [1985]. Laodong baoxian weiyuanhui gongzuo gangyao (Working guidelines for Labour Insurance committee). In Laodong Baoxian Shenghuo Fuli Wenjian Xuanbian (Selected government documents about labour insurance and welfare), ed. Shanxi Provincial Labour Bureau. Taiyuan: Shanxi Provincial Labour Bureau.

  • Allsop, J. 1995. Shifting spheres of opportunity: The professional powers of general practitioners within the British National Health Service. In Health professions and the state in Europe, ed. T. Johnson, G. Larkin, and M. Saks. London: Routledge.

    Google Scholar 

  • Arluke, A., L. Kennedy, and R.C. Kessler. 1979. Reexamining the sick-role concept: An empirical assessment. Journal of Health and Social Behavior 20: 30–36.

    Article  Google Scholar 

  • Boden, J. 2008. The wall behind China’s open door: Towards efficient intercultural management in China. Brussels: Academic and Scientific Publishers.

    Google Scholar 

  • Burnham, J. 2012. The death of the sick role. Social History of Medicine 25: 761–776.

    Article  Google Scholar 

  • Cai, Y. 1958. Weishenme zhidong dui shenghuo fuli de yijian henduo? (Why are the employees not happy about life and welfare?). Renmin Ribao (People’s Daily), 18 Jan.

  • Campbell, J.D. 1978. The child in the sick role: Contributions of age, sex, parental status, and parental values. Journal of Health and Social Behavior 19: 35–51.

    Article  Google Scholar 

  • Cockerham, W.C. 2016. Medical sociology. Boston: Pearson.

    Google Scholar 

  • Dixon, J. 1981. The Chinese welfare system, 1949–1979. New York: Praeger.

    Google Scholar 

  • Editor. 1966. Gong nong bing tan Gongchan Zhuyi daode (Workers, peasants and soldiers tallking about communist morality). Renmin Ribao (People’s Daily), 17 Mar.

  • Editor 1998. Guangci Yiyuan qiangjiu Qiu Caikang bingshi dangan xuan zai (Selected medical records of Qiu Caikang in the process of recuing his life in Guangci Hospital). Shanghai Dangan (Shanghai Archives), 52–58.

  • Frank, A.W. 1991. From sick role to health role: Deconstructing Parsons. In Talcott parsons: Theorist of modernity, ed. R. Robertson and B.S. Turner. London: Sage.

    Google Scholar 

  • Frazier, M.W. 2002. The making of the Chinese industrial workplace: State, revolution, and labor management. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Freidson, E. 1970. Profession of medicine: A study of the sociology of applied knowledge. Chicago: The University of Chicago Press.

    Google Scholar 

  • Gallagher, E.B. 1976. Lines of reconstruction and extension in the Parsonian sociology of illness. Social Science and Medicine 10: 207–218.

    Article  Google Scholar 

  • Gill, D.G., and G.W. Horobin. 1972. Doctors, patients and the state: relationships and decision-making. Sociological Review 20: 505–520.

    Article  Google Scholar 

  • Haug, M.R., and B. Lavin. 1981. Practitioner or patient—Who’s in charge? Journal of Health and Social Behavior 22: 212–229.

    Article  Google Scholar 

  • Jiao Yulu Cadet College (ed.). 2014. Yongheng de Fengbei: Jiao Yulu de Gushi (The everlasting mounument: The story of Jiao Yulu). Zhengzhou: Daxiang Publishing House.

    Google Scholar 

  • Johnson, J.T. 1972. Professions and power. London: The Macmillan Press Ltd.

    Google Scholar 

  • Landy, D. 1977. Culture, disease, and healing: Studies in medical anthropology. New York: Macmillan.

    Google Scholar 

  • Larkin, G. 1995. State, control and the health professions in the United Kingdom: historical perspectives. In Health professions and the state in Europe, ed. T. Johnson, G. Larkin, and M. Saks. London: Routledge.

    Google Scholar 

  • Lucas, A. 1982. Chinese medical modernization: Comparative policy continuities, 1930–1980s. New York: Praeger.

    Google Scholar 

  • Michailakis, D., and W. Schirmer. 2010. Agents of their health? How the Swedish welfare state introduces expectations of individual responsibility. Sociology of Health & Illness 32: 930–947.

    Article  Google Scholar 

  • Ministry of Health & Ccp Beijing Committee. 1966. Guanyu zai dang nei taolun gaige gongfei yiliao zhidu laobao yiliao zhidu de tongzhi (Circular to launch the internal discussion within the Party about public health insurance and labour insurance).

  • Moran, M., and B. Wood. 1993. States, regulation, and the medical profession. Buckingham: Open University Press.

    Google Scholar 

  • Mu, Q., J. Feng, and Y. Zhou. 1966. Xiangwei shuji de bangyang—Jiao Yulu (Jiao Yulu: A model for county party secretaries). Renmin Ribao (People’s Daily), 7 Feb.

  • Nursing Team of the Affiliated Hospital of Henan Medical College. 1966. Huiyi Jiao Yulu tongzhi zai zhuyuan de shihou (Recalling the time when comrade Jiao Yulu was hospitalised). Huili Zazhi (Journal of Caring), 119–120.

  • Ossenberg, R.J. 1962. The experience of deviance in the patient-role: A study of class differences. Journal of Health and Human Behavior 3: 277–282.

    Article  Google Scholar 

  • Parsons, T. 1978. The sick role and the role of physician reconsidered. In Action theory and human condition, ed. T. Parsons. New York: The Free Press.

    Google Scholar 

  • Parsons, T. 1979. Definitions of health and illness in the light of American values and social structure. In Patients, physicians, and illness: A sourcebook in behavioral science and health, 3rd ed, ed. E.G. Jaco. New York: The Free Press.

    Google Scholar 

  • Parsons, T. 2012 [1951]. The social system. New Orleans: Quid Pro Books.

  • Qian, X., and Y. Zhang (eds.). 1999. Zhongguo Weisheng 50 Nian Licheng: 1949–1999 (Fifty years of Chinese Health Care: 1949–1999). Beijing: Zhongyi Guji Chubanshe (TCM Ancient Texts Publisher).

    Google Scholar 

  • State Council. 1955. Guojia jiguan gongzuo renyuan bingjia qijian shenghuo daiyu shixing banfa (Trial measures for livelihood benefits for employees of state institutions during sick leaves). In Renshi Gongzuo Wenjian Xuanbian (Selected documents of personnel work), ed. National Personnel Bureau. Beijing: National Personnel Bureau.

    Google Scholar 

  • Twaddle, A.C. 1969. Health decisions and sick role variations: An exploration. Journal of Health and Social Behavior 10: 105–115.

    Article  Google Scholar 

  • Wolinsky, F.D. 1980. The sociology of health: Principles, professions, and issues. Boston: Little, Brown and Company.

    Google Scholar 

  • Wu, W. 2014. Xin Zhongguo chuqi gongfei yiliao zhidu jianshe yanjiu - jiyu fan langfei de shijiao (A study of the construction of public health insurance institutions in the early years of the New China—From the perspective of anti-waste). Jishu jingji yu guanli yanjiu (Technological economy and management study), 86–90.

  • Xinhua News Agency. 1958a. Qiu Caikang jiang dao Beijing chuxin Quanguo Qingnian Shehuizhuyi Jianshe Jiji Fenzi Dahui (Qiu Caikang is coming to Beijing to attend National Young Enthusiasts of Socialist Construction). Renmin Ribao (People’s Daily), 12 Nov.

  • Xinhua News Agency. 1958b. Yingxiong lian gangtie, gangtie lian yingxiong (Heros make steel, steel makes heros). Renmin Ribao (People’s Daily), 26 Nov.

  • Xinhua News Agency. 1964. Qiu Caikang zai xin gangwei shang qinfeng gongzuo (Qiu Caikang worked hard in his new position). Renmin Ribao (People’s Daily), 28 Feb.

  • Yang, J. 2017. Informal payments and regulations in China’s Healthcare system. Singapore: Palgrave Macmillan.

    Book  Google Scholar 

  • Yuan. 1958. Geming yizhi de shengli (The victory of revolutionary willpower). Renmin Ribao (People’s Daily), 9 Aug.

  • Zborowski, M. 1952. Cultural components in responses to pain. Journal of Social Issues 8: 16–30.

    Article  Google Scholar 

  • Zhai, W. 1958. Dang jiu huo le ta (The Party saved his life). Renmin Ribao (People’s Daily), 1 July.

  • Zhang, X. 2007. Xin Zhongguo jiuye zhidu de lishi fenxi (A historical analysis of New China’s employment system). Lilun Xuexi (Theoretical Studies), 40–41.

  • Zheng, H., and F. Liu. 2019. Chinese rurual health-seeking behaviour and the dilemma of sufferers of chronic sickness: A case study from inner Mongolia. The Asia Pacific Journal of Anthropology 20: 147–164.

    Article  Google Scholar 

  • Zhou, E. 1992. Guanyu laodong gongzi he laobao fuli zhengce de yijian (Opinions about wages and labour protection and welfare policies). In Zhou Enlai Jingji Wenxuan (Selected works on economy by Zhou Enlai), ed. Chinese Communist Party Literature Research Center. Beijing: Zhongyang Wenxian Chubanshe (Central Literature Publishing House).

    Google Scholar 

  • Zi, L. 2009. Qiu Caikang: 50 nian hou de “gangtie yingxiong” (Qiu Caikang: “steel hero” after 50 years). Lao Tongzhi zhi You (Friends of Old Comrades), 12–13.

  • Zola, I.K. 1966. Culture and symptoms: An analysis of patients’ presenting complaints. American Sociological Review 31: 615–630.

    Article  Google Scholar 

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Correspondence to Jingqing Yang.

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Yang, J. State and the sick role: a study of sick models in the pre-reform China. Soc Theory Health 18, 395–409 (2020). https://doi.org/10.1057/s41285-019-00114-z

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