Health system reform and political participation on the Chinese Internet

Authoritarian regimes, such as the Chinese Communist Party (CCP), seek to bolster legitimacy by facilitating communications between citizens and government officials. This article investigates the operation of online consultation, a process through which citizens offer feedback on draft laws and regulations. The article specifically examines the importance of demographic characteristics and subjective motivations in the expression of citizen sentiments in response to a proposed revision to China’s health system. By bringing together analysis of the content of citizen sentiment with a survey of participants, the article illuminates the determinants of the tone and substance of citizen feedback in health system reform. The primary finding is that participants who were internally efficacious and democratically oriented were, relative to respondents not possessing such traits, positive in tone and highly substantive in the submission of their comments concerning health system reform. This finding indicates that the health system reform commenting process offered citizens the opportunity to gain exposure to democratic principles and the process of articulating interests. More broadly, the analysis suggests the promise of online consultation in promoting citizen satisfaction with public policies, the legitimacy of the CCP, and, ultimately, stability in the Chinese political system.