There is a lack of trust in China's rule of law and beaurucratic systems, which is quite justified. Given that you can't expect the system to work well on its own, the next step is to intervene through the use of family, professional, and personal connections.

Foreigners are definitely included in these circles, it is just that their use is very limited (what good is an English teacher in your network, or a software engineer). Also, the FCPA makes participation dangerous for us Americans, at least. Even giving a doctor a red envelope at a state hospital is in violation.