"Stability Maintenance," Mediation, and Chinese Hospitals

Official “stability maintenance” (weiwen) efforts in China have created pressures on local authorities to hold down citizen discontent and protests at all costs. This has also created markets for people capable of filling this role – the hiring of informally recruited security forces (or more simply - “goons”) by some local authorities being one example.

The May 31 edition of the Southern Weekend has an article on another element of this dynamic - the emergence of private firms who handle security/dispute resolution efforts in Chinese hospitals, all under the rubric of “mediation.”

The basic concept is relatively simple. Chinese hospitals face pressure from family members who are upset at the death or care of a relative, or who have a dispute over the cost. They may sue, stage petitions, or retaliate against hospital staff. A number of hospitals have entered into contracts with firms that promise to provide security and handle such disputes. In Shandong, this has taken the form of firms that accept a fixed annual sum from the hospital in return for providing internal security in the hospital and conducting “mediation” proceedings with families of patients to resolve such disputes. If payouts exceed the agreed amount, the contracting firm pays out of pocket. If the payouts are under the annual amount, the contracting firm keeps the difference.

Two elements of the practices described in the article are particularly interesting.

First – who the contractors are actually hiring. Qualifications for “mediation assistants” in the firm discussed in the article include – “Male, taller than 180cm, 22-28 years old, quick reflexes, strong observation skills, preference given to graduates from police academies, athletes, and retired military personnel.” As the former chief of security for the firm notes, such assistants provide security during mediation proceedings and create a degree of pressure on the families of patients.

Second – the identity of the contracting firm. The firm described in the article is a real mix of government and private interests. It is collocated in the same building as the “medical mediation committee” for the city of Jinan. Firm employees also work simultaneously for the government committee. The CEO of the firm is also the head of the committee’s center for determining responsibility for medical errors.

The article flags multiple problems with these practices – here are just two:

1) The incentives associated with "stability maintenance" efforts gives rise to dispute resolution institutions (operating under the rubric of “mediation”) that have quasi-mafia characteristics.

2) The interests of the contracting firms in maintaining a steady supply of disputes (if there are no problems – why hire them?) means that, in some cases, contractors may actually encourage the families of patients to escalate or exacerbate their disputes – thereby allowing the contractors to convince the hospitals to expand their use of the security contractors.

For more on this topic - follow the work of Ben Liebman at Columbia Law School - he's doing some very interesting research on the subject.

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The basic concept is relatively simple. Chinese hospitals face pressure from family members who are upset at the death or care of a relative, or who have a dispute over the cost.

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