Policy hybrids and bricolage: the life course of individual accounts in China’s health policy domain

Abstract China innovated a policy hybrid of ‘social pooling plus individual accounts’ for health protection in the 1990s and exnovated the individual accounts in the 2010s. On the basis of expert interviews and document analysis, this paper explores the life course of individual accounts from the perspective of Lévi-Strauss’s ‘bricoleur’. The individual accounts were grafted onto the social health insurance to signify the ideational shift from ‘egalitarianism’ to ‘fairness with considerable efficiency’. Meanwhile, piloting reform strategies provided a practical foundation for implementation of the policy. As China’s modern social security expanded and the capability for scientific policy-making grew, the government embarked on revising or removing the individual accounts. The analysis casts insights into the increasingly popular policy hybrid practices resulting from globalisation, responds to the debate on East Asian welfare regimes, provides a dynamic view on policy decoupling from world culture and furthers our understanding of policy innovation management.