International Relations

FSI researchers strive to understand how countries relate to one another, and what policies are needed to achieve global stability and prosperity. International relations experts focus on the challenging U.S.-Russian relationship, the alliance between the U.S. and Japan and the limitations of America’s counterinsurgency strategy in Afghanistan.

Foreign aid is also examined by scholars trying to understand whether money earmarked for health improvements reaches those who need it most. And FSI’s Walter H. Shorenstein Asia-Pacific Research Center has published on the need for strong South Korean leadership in dealing with its northern neighbor.

FSI researchers also look at the citizens who drive international relations, studying the effects of migration and how borders shape people’s lives. Meanwhile FSI students are very much involved in this area, working with the United Nations in Ethiopia to rethink refugee communities.

Trade is also a key component of international relations, with FSI approaching the topic from a slew of angles and states. The economy of trade is rife for study, with an APARC event on the implications of more open trade policies in Japan, and FSI researchers making sense of who would benefit from a free trade zone between the European Union and the United States.

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On April 3, 2014, Karen Eggleston provided testimony before the U.S-China Economic and Security Review Commission at the "Hearing on China’s Healthcare Sector, Drug Safety, and the U.S.-China Trade in Medical Products."

Some of the questions addressed included:

  • How has the nature of disease in China changed in recent decades? What kind of burden might it place on China's future development?
  • If providers are "inducing" demand by overprescribing drugs, it this a public health crisis in the making?
  • Can you outline the pros and cons of market reform in China's healthcare sector? What might be the proper role of the state of improving healthcare delivery?
  • Kan bing nan, kan bing gui (inaccessible and unaffordable healthcare) is one of the top concerns of ordinary Chinese. Which groups are most affected? Is this a global problem, what lessons can we learn from China?
  • The pharmaceuticals industry features in China's Medium and Long-term Plan for Science and Technology (2006-2020), as well as in more recent measures to promote indigenous innovation and industrial upgrading. Is it fair to say that the Chinese government is prioritizing domestic pharmaceutical companies, which foster economic growth, over the welfare of patients?
  • What were major successes and failures of the 2009 healthcare reforms [in China]? How have those reforms been supplemented by more recent measures (e.g. last November's Third Plenum)?
  • What aspects of China's healthcare reform should the U.S. government and U.S. companies pay most attention to?
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Karen Eggleston
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This study analyzes the effects of Indonesia's conditional cash transfer program on the local health care market in terms of price, utilization, and quality of care. The CCT program is associated with increased delivery fees and increased utilization of prenatal care and trained attendants for delivery assistance. Consequently, program participants experience improvements in prenatal care quality. 

Margaret Triyana is the Asia Health Policy Post-doctoral fellow. Her main interests are inequality and human capital investments, particularly early health investments in developing countries.

Philippines Conference Room
Encina Hall 3rd Floor Central
616 Serra Street,
Stanford University

Shorenstein APARC
Encina Hall C331
616 Serra Street
Stanford, CA 94305-6055

(650) 724-5656 (650) 723-6530
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2013-2014 Asia Health Policy Postdoctoral Fellow
triyana_photo.jpg PhD

Margaret (Maggie) Triyana’s main research interests are inequality and human capital investments in developing countries. In particular, she is interested in the effects social policy changes on children’s health outcomes. As a Postdoctoral Fellow, she will analyze the effects of rural-urban migration in Indonesia and China, as well as the impact of health insurance expansion in Indonesia and Vietnam.

Triyana received a PhD in Public Policy from the University of Chicago in 2013.

 

Working Papers

“Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia“

“The Effects of Community and Household Interventions on Birth Outcomes: Evidence from Indonesia”

“The Longer Term Effects of the ‘Midwife in the Village’ Program in Indonesia”

“The Sources of Wage Growth in a Developing Country” (with Ioana Marinescu)

Margaret Triyana Postdoctoral Fellow in Asia Health Policy Speaker Stanford University
Seminars
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Co-sponsored by the Stanford Center for International Development

Recent scholarship has documented an alarming increase in the sex ratio at birth in parts of East Asia, South Asia and the Caucuses. In this paper, I argue that parents in these regions engage in sex selection because of patrilocal norms that dictate elderly coresidence between parents and sons. Sex ratios and coresidence rates are positively correlated when looking across countries, within countries across districts, and within districts across ethnic groups. The paper then examines the roots of patrilocality and biased sex ratios using the Ethnographic Atlas (Murdock 1965). I find that ethnic groups in areas with land conducive to intensive agriculture have stronger patrilocal norms, higher modern coresidence rates, and higher sex ratios at birth. The paper concludes with an examination of the expansion to old age support in South Korea. Consistent with the paper’s argument, I find that the program was associated with a normalization in the sex ratio at birth.

Avi Ebenstein received his Ph.D. in economics from the University of California, Berkeley in 2007 is a Lecturer at the Hebrew University of Jerusalem in the Department of Economics. His fields of interest include environmental economics, economic demography, and international trade. Avi's past research has focused primarily on issues related to  China, including the health impacts of air and water pollution, causes and consequences for the country’s high sex ratio at birth, internal migration, and the impact of China’s entry into the global economy on wage patterns domestically and in the United States. He is currently a Visiting Research Scholar at the Center for Health and Wellbeing at Princeton University.

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Avraham Ebenstein Lecturer Speaker The Hebrew University of Jerusalem in the Department of Economics
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Shorenstein APARC
Encina Hall C331
616 Serra Street
Stanford, CA 94305-6055

(650) 724-5656 (650) 723-6530
0
2013-2014 Asia Health Policy Postdoctoral Fellow
triyana_photo.jpg PhD

Margaret (Maggie) Triyana’s main research interests are inequality and human capital investments in developing countries. In particular, she is interested in the effects social policy changes on children’s health outcomes. As a Postdoctoral Fellow, she will analyze the effects of rural-urban migration in Indonesia and China, as well as the impact of health insurance expansion in Indonesia and Vietnam.

Triyana received a PhD in Public Policy from the University of Chicago in 2013.

 

Working Papers

“Do Health Care Providers Respond to Demand-Side Incentives? Evidence from Indonesia“

“The Effects of Community and Household Interventions on Birth Outcomes: Evidence from Indonesia”

“The Longer Term Effects of the ‘Midwife in the Village’ Program in Indonesia”

“The Sources of Wage Growth in a Developing Country” (with Ioana Marinescu)

Shorenstein APARC
Encina Hall E301
616 Serra Street
Stanford, CA 94305-6055

(650) 723-7568 (650) 723-6530
0
Visiting Associate Professor
XUE,_Qinxian_3_3x4.jpg
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Co-sponsored by the Center of East Asian Studies, Stanford University

Prominent health policy expert—Rachel Lu from Taiwan—will share her view on recent health policy developments in the region, drawing on her extensive research and policy background.

Jui-fen Rachel Lu, Sc.D., is a Professor in the Department of Health Care Management, at Chang Gung University (CGU) in Taiwan, where she teaches comparative health systems, health economics, and health care financing and has served as department chair (2000-2004), Associate Dean (2009-2010) and Dean of College of Management (2010-2013).  She earned her B.S. from National Taiwan University, and her M.S. and Sc.D. from Harvard University, and she was also a Takemi Fellow at Harvard (2004-2005) and is an Honorary Professor at Hong Kong University (2007-2014), a guest professor at Huazhong University of Science and Technology (2010-2013), and an adjunct professor at Xi’an Jiaotong University (2011-2014) in China.  Her devotion to teaching driven by her firm belief in the value of education and investment in human minds was recognized by the Award of Excellence in Teaching conferred by CGU in both 2002 and 2013.

Her research focuses on 1) the equity issues of the health care system; 2) impact of the NHI program on health care market and household consumption patterns; 3) comparative health systems in Asia-Pacific region.  She is a long-time and active member of Equitap (Equity in Asia-Pacific Health Systems) research network and is currently the coordinator for the catastrophic payment component of Equitap II research project which involves 21 country teams and is jointly funded by IDRC, AusAID, and ADB.  Professor Lu has also been appointed to serve as a member on various government committees dealing with health care issues in Taiwan, such as National Health Insurance Supervisory Committee (DOH), Hospital Management Committee(DOH), and Hospital Global Budget Payment Committee (BNHI), etc.  Dr. Lu received the Minister Wang Jin Naw Memorial Award for Best Paper in Health Care Management presented by Kimma Chang Foundation in 2002 and was the recipient of IBM Faculty Award in 2009.  She has published papers in Health Affairs, Medical Care, Journal of Health Economics, Health Economics, Social Science and Medicine, Health Economics, Policy and Law, Osteoporosis International, Health and Quality of Life Outcomes, and Taiwan Economic Review etc, and is the author of “Health Economics”(a textbook in Chinese) and various book chapters.  

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Jui-fen Rachel Lu Professor in the Department of Health Care Management Speaker Chang Gung University in Taiwan
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Homesickness, long hours, and demanding employers—many Filipinos who migrate to another country for temporary employment make personal sacrifices and face daunting working conditions.

To their family members receiving much-needed supplemental income and to the Philippine government bolstering its foreign reserves, they are the “new heroes.” Remittances from Overseas Filipino Workers (OFWs), as they are officially called, are now the country’s second largest source of foreign reserves, beating out foreign direct investment in terms of percentage of GDP. The government has even established an annual award to honor its most distinguished OFWs.

Marjorie Pajaron, the current Asia Health Policy Postdoctoral Fellow in Developing Asia, has been studying the significant economic benefit of OFW remittances to Philippine families and to the economy. She spoke recently with Shorenstein APARC about her research, which she will present at a seminar on May 9.

How many people from the Philippines are going abroad for temporary employment, and where are they finding work?

In 2008, OFWs numbered 2 million—representing 2 percent of the country’s total population. Fifty-one percent of these migrants were male, and 49 percent were female. Twenty percent went to Saudi Arabia; 14 percent to the Arab Emirates, Singapore, Hong Kong, Japan, Qatar, and Taiwan; 9 percent to Europe; and 8 percent to North and South America.

Where OFWs work depends on gender, education, and the type of employment. Many men go to the Middle East for construction-, mining-, and oil-related jobs. Women tend to go to Southeast and East Asia for caretaking and domestic jobs. In North America, most Filipino migrants work in professional jobs, including as nurses, doctors, and as other types of healthcare workers.

What is the “typical” profile of an Overseas Filipino Worker?

It often depends on the type of job. Healthcare professionals, for example, tend to be younger because they go abroad directly after graduation. Most of the nursing schools in the Philippines are linked to hospitals in the United States or Europe.

In general, overseas workers range from recent graduates to the median working age, from approximately 20 to 45 years old. Because of the large fixed cost associated with temporary overseas employment, families that are better off or who have the means to raise funds are those that are able to send family members abroad.

Most OFWs come from Manila or the surrounding urban areas. In the study I conducted, only 17 percent of rural households could afford to send a family member abroad. Usually several village families will pool together their resources, with the informal agreement that they will be repaid.

On average, male migrant remittances equal twice the amount sent by female migrants, who more frequently work in unskilled positions. For example, a well-educated man working in the Middle East in the construction and transportation industries earns higher than a woman working in a domestic position in Singapore. Some OFWs are overqualified in terms of education, but because of economic opportunity they decide to work abroad.

Do remittances provide short- or long-term economic benefits for families?

The benefits are both short and long term. Remittances can provide immediate assistance as needed, such as rebuilding after a natural disaster. From a longer-term perspective, many remittances in the Philippines go toward education, which is a form of human capital investment. Many families also invest in real estate, buying houses and land, and they also purchase durable goods, such as cars and appliances.

How do remittances benefit the country’s economy?

After exports, foreign remittances are actually the second largest source of foreign reserves in the Philippines. In 2006, remittances ranked even higher than foreign direct investment in terms of percentage of GDP. Some scholars have conjectured that OFWs have helped close the gap between the poor and the wealthy in the Philippines by contributing to a growing middle class. This is why migrant workers are called the “new heroes.” They sacrifice a lot by working in what are often unfavorable conditions. Because of the system of helping their families, they are also helping the entire country.

In your research, you have also looked at how rural farmers cope with natural disasters. What motivated you to study this issue, and what have you found based on recent years?

Farmers are the poorest of the poor in the Philippines, and since the country is in the Pacific Ring of Fire it is frequently hit by natural disasters, including earthquakes, typhoons, and drought. Filipino farmers are very vulnerable because most cannot afford to install irrigation. Instead, they have to depend on rain and their crops are continually susceptible to changes in the weather. There is limited government assistance available to them, and they do not have any formal insurance. In addition, they cannot take out loans because they do not have the collateral. So, I have been looking at how they survive after a natural disaster. The only possible explanation is that they depend on their networks of family and friends.

I had expected to find that they also depend on their family members abroad, but I have discovered that very few have been able to send relatives abroad in the first place. So this cannot be considered a reliable source of support. Instead, they seem to mainly rely on family members who have migrated to Manila and other cities.

There is much more work to be done on this issue. Studying how rural residents survive is important given they have limited access to formal credit, capital, and insurance markets; and government aid and transfers may also be limited or non-existent.

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Overseas workers from the Philippines line up to register as absentee voters in Hong Kong. East Asia is a major destination for temporary migrant workers from the Philippines.
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"Old while not affluent" situation, together with an unsustainable high investment rate and high dependency on foreign trade, spurs hot debates on the challenges of a fast-aging population and the exploitation of the second demographic dividend in today’s China. Literature related to elderly health in countries other than China often starts with medical concepts and then dwells on economic issues, mainly focusing on socioeconomic, behavioral, and environmental factors and their effects on the health of the elderly. This article reviews economic research on these topics and then discusses possible implications for the economic analysis of aging China.

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Asia Health Policy Program working paper # 34
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