Abstract Research on the Chinese media has concentrated on understanding party-state control over an increasingly commercialized industry. And it has usually focused on reporting issues over which the central party-state has a clear and unified position. This article explores how the Chinese media reported a domestic policy issue—health reform—on which the party-state had no unified position. It examines three print publications during a major health care system review and consultation between 2005 and 2009 to see how much diversity there was in the reporting, what the principal narratives were, and which actors had voice. It finds the media took diverse positions, with narratives centering on market and state roles in health, but a vocal minority of pro-market articles challenged the dominant pro-state reporting. But pro-state positions were populist and paternalist, speaking for “the people” rather than giving them a direct voice. The neoliberal, pro-market challenge, meanwhile, was elitist, with the media venturing only at the margins to demand rights for vulnerable people and greater public participation in policy making. Keywords media, China, health, ideology

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