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How will population aging impact the economies and social protection systems of Japan, South Korea, China, and India? This colloquium showcases research addressing that question by contributors to a new Shorenstein APARC book, Aging Asia, co-edited by Karen Eggleston and Shripad Tuljapurkar. Dr. Bloom discusses how aging of the baby boom generation, declines in fertility rates, and an increase in life expectancy imply several changes for the economies of the region. Notwithstanding the potential challenges, Bloom argues that population aging may have less of a negative effect on economic growth than some have predicted. Bloom will also discuss the longitudinal aging study in India.

David Bloom is Clarence James Gamble Professor of Economics and Demography at Harvard University, Chair of the Department of Global Health and Population at the Harvard School of Public Health, and Director of Harvard University’s Program on the Global Demography of Aging (funded by the National Institute of Aging). He is Research Associate at the National Bureau of Economic Research, where he serves as a member of three research programs: Labor Studies, Aging, and Health Economics. He co-chairs the Public Policy Committee of the American Foundation for AIDS Research. Bloom received a B.S. in Industrial and Labor Relations from Cornell University in 1976, an M.A. in Economics from Princeton University in 1978, and a Ph.D. in Economics and Demography from Princeton University in 1981.

Philippines Conference Room

David Bloom Clarence James Gamble Professor of Economics and Demography Speaker Harvard University
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Many researchers have concluded that longer life expectancies prompt increased investment in education, as a prolonged labor supply raises the rate of return on education. Besides explaining the empirical evidence behind this conclusion (at an absolute level), there is another issue to be discussed: does time spent in studying and working increase proportionally with higher longevity? Building on an extended life-cycle model with an assumption on a more realistic distribution of life cycle mortality rates, this article considers dynamic effects of prolonging longevity on economic development by directly introducing changes in longevity into the economy, which is more preferable than comparative static analysis that relies on changes in relevant parameters. It shows that prolonged life expectancy will cause individuals to increase their time in education but may not warrant rises in labor input. Later we show that higher improvement rate of longevity will also promote economic growth, even if we exclude the mechanism of human capital formation and only consider the growth effects of the higher improvement rate of life expectancy from physical capital investment.

Forthcoming in The Chinese Journal of Population, Resources and the Environment

Published: Qiong, Zhang. "Longevity, Capital Formation and Economic Development." Chinese Journal of Population Resources and Environment 10.1 (2012): 53-63.

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Working Papers
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Asia Health Policy Program working paper #16
Authors
Qiong Zhang
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This issue of the International Journal of Healthcare Finance and Economics features eight
articles evaluating different provider payment methods in comparative international perspective, with authors from Hungary, China, Thailand, the US, Switzerland, and Canada. These contributions illustrate how the array of incentives facing providers shapes their interpersonal, clinical, administrative, and investment decisions in ways that profoundly impact the performance of health care systems. Taken as a whole, the articles show that in addition to the specifics of the reimbursement or remuneration scheme for individual providers and provider organizations, other factors matter—including ownership, allocation of control rights (such as in public-private partnerships), and expectation of a bail-out (soft budget constraints). All of these facets of payment and accountability systems shape the quality and efficiency of service delivery.

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International Journal of Healthcare Finance and Economics
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Karen Eggleston
Karen Eggleston
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When one can circle the globe in less than the time of incubation of most infectious pathogens, it is clear every country relies to some extent on the health systems of other countries to prevent and protect their citizens from global health threats. Therefore, creating and maintaining a good health system in one country requires attention to interregional and international cooperation. Domestic and international spheres of public health policies are becoming more intertwined and inseparable.

PUBLISHED: Qiong Zhang, Karen Eggleston (翁笙和), and Michele Barry, 2009. “Pandemic Influenza and the Globalization of Public Health” (流感大流行与公共卫生全球化), Comparative Studies 比较 (42):  (Beijing: China CITIC Press): 47-52.

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Asia Health Policy Program working paper #11
Authors
Michele Barry
Karen Eggleston
Karen Eggleston
Qiong Zhang
Authors
Karen Eggleston
Karen Eggleston
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In December 2009, the Asia Health Policy Program celebrates the first anniversary of the launch of the AHPP working paper series on health and demographic change in the Asia-Pacific. The series showcases research by AHPP’s own affiliated faculty, postdoctoral fellows, and visiting scholars, as well as selected works by other scholars from the region.

To date AHPP has released eleven research papers in the series, by authors from China, South Korea, Thailand, Taiwan, Pakistan, and the US, with more on the way from Japan and Vietnam. Topics range from “The Effect of Informal Caregiving on Labor Market Outcomes in South Korea” and “Comparing Public and Private Hospitals in China,” to “Pandemic Influenza and the Globalization of Public Health.”  The working papers are available at the Asia Health Policy website.

AHPP considers quality research papers from leading research universities and think tanks across the Asia-Pacific region for inclusion in the working paper series. If interested, please contact Karen Eggleston.

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Karen Eggleston
Karen Eggleston
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How do countries in the vast and diverse Asia-Pacific region differ in “prescribing cultures”? How do health systems in the region balance access to pharmaceuticals with incentives for innovation? How do the forces of globalization shape, and in turn are shaped by, cultural legacies about health and health care? These are the key questions addressed by the new Asia Health Policy Program book, Prescribing Cultures and Pharmaceutical Policy in the Asia Pacific.

AHPP held a book launch event September 23rd with three authors of the book detailing how pharmaceutical policies are interlinked globally and at the same time deeply rooted in local culture. 

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Aims The prevalence of Type 2 diabetes mellitus (DM) has grown rapidly, but little is known about the drivers of inpatient spending in low- and middle-income countries. This study aims to compare the clinical presentation and expenditure on hospital admission for inpatients with a primary diagnosis of Type 2 DM in India, China, Thailand and Malaysia.

Methods We analysed data on adult, Type 2 DM patients admitted between 2005 and 2008 to five tertiary hospitals in the four countries, reporting expenditures relative to income per capita in 2007.

Results Hospital admission spending for diabetic inpatients with no complications ranged from 11 to 75% of per-capita income. Spending for patients with complications ranged from 6% to over 300% more than spending for patients without complications treated at the same hospital. Glycated haemoglobin was significantly higher for the uninsured patients, compared with insured patients, in India (8.6 vs. 8.1%), Hangzhou, China (9.0 vs. 8.1%), and Shandong, China (10.9 vs. 9.9%). When the hospital admission expenditures of the insured and uninsured patients were statistically different in India and China, the uninsured always spent less than the insured patients.

Conclusions With the rising prevalence of DM, households and health systems in these countries will face greater economic burdens. The returns to investment in preventing diabetic complications appear substantial. Countries with large out-of-pocket financing burdens such as India and China are associated with the widest gaps in resource use between insured and uninsured patients. This probably reflects both overuse by the insured and underuse by the uninsured.

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Diabetic Medicine
Authors
Jeremy Goldhaber-Fiebert
Ratanawijitrasin S
Vidyasagar S
Wang XY
Aljunid S Aljunid S
Shah N Shah N
Wang Z
Hirunrassamee S
Bairy KL
Wang J
Saperi S
Nur AM
Karen Eggleston
Karen Eggleston
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PrescribingCultures front cover

Pharmaceutical policies are interlinked globally and at the same time deeply rooted in local culture. Prescribing Cultures examines how pharmaceuticals and their regulation play an important and often contentious role in the health systems of the Asia-Pacific.

The first section of this timely book analyzes pharmaceutical policy in China, Korea, Japan, Thailand, Taiwan, Australia, and India. The second section focuses on two cross-cutting themes: differences in "prescribing cultures" and physician dispensing; and the challenge of balancing access to drugs with incentives for innovation.

The book's contributors discuss important issues for U.S. policy. These include such hot-button topics as drug imports from Asia, regulation of global supply chains to assure drug safety and quality, new legislation to encourage development of drugs for neglected diseases, and the impact that decisions about pricing, regulation, and bilateral trade agreements have on access to medicines at home and abroad. In Prescribing Cultures, pharmaceutical policy reveals the economic trade-offs, political compromises, and historical trajectories that shape health systems.

Prescribing Cultures also illustrates how cultural legacies shape and are shaped by the forces of globalization, and thus will be of interest to students and scholars well beyond the confines of health policy.

Desk, examination, or review copies can be requested through Stanford University Press

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Books
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Authors
Karen Eggleston
Karen Eggleston
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Shorenstein APARC, distributed by Stanford University Press
Number
978-1-931368-16-2
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