Building China’s Eldercare Market: The Imperatives of Capital Accumulation and Social Stability

The paper investigates China’s effort to create an eldercare market to shed light on how China’s economic reform entailed the creation of new institutions (e.g., eldercare market including eldercare labour market) and the reconfiguration of existing institutions (e.g., governance and regulation, the family, and the community). All this was needed for the market to flourish while maintaining and strengthening the regime. An urban eldercare market, including an eldercare labour market, was created by local governments (i.e., municipalities, districts, counties, and towns) with central government policy directives, in order to address China’s demographic aging and care crisis. However, once enough demand and supply were created, local governments turned to New Public Management (NPM) to operate publicly funded eldercare institutions. The paper argues that NPM has different rationalities in China than in liberal democracies; in China, they strengthen the Party and contribute to the durability of the authoritarian rule, rather than “shrink the state”. However, in China as in the West, bureaucratic logic hampers the implementation of NPM and the governance of the eldercare sector. The implication of bureaucratic logic driving the regulation of the eldercare sector is that care is not at the centre of eldercare. The paper also argues that the commodification and privatization of eldercare, in line with the global trend, was a deliberate government policy aimed at creating a positive condition for the market economy to flourish, but at the expense of social reproduction/care. Unlike many Western transitions to market provision, this one entailed the decline in the extended family as the main eldercare institution of the immediate past. However, the commodification and privatization of social reproduction have been incomplete and met with resistance, prompting the state to invest more in the sector to maintain social stability. Data for this paper derive from personal interviews with key informants and eldercare workers, official document analysis, and secondary literature analysis from Chinese scholars in mainland China.