The hybridization of policy learning in multilevel regimes: a case study of the long-term care insurance in China

We use the case of the long-term care insurance (LTCI) in China to examine the mechanisms of transnational policy learning in a complicated multi-level regime. The 15 pilot cities learned from either German or Japan model, and they also learned from each other. We reveal the first-, second-, and third-order learning processes, which suggest a hybridization of international best practices, pioneering lessons, and local conditions. Local governments have both symbolic and substantive motivations in adopting LTCI, and both the rational-instrumental and instructional-cultural perspectives are relevant for the diversified policy learning processes.