In the four years since a State Council think tank, the Development Research Center, bluntly declared the failure of three decades of healthcare reform, China has placed a high political priority on designing, building and financing a modern, equitable health delivery system that serves every last one of its 1.3 billion people. As publisher of practice-building trade magazines for medical specialists in China and India, Jeffrey Parker has developed unique and valuable perspectives on what's wrong with China's healthcare system -- and how Indian practitioners are able to deliver results despite a per-capita GDP that is roughly half of China's. Through an unprecedented China-India training exchange, Mr. Parker has begun testing whether Indian models of self-financed grassroots medical startup practices can help doctors shake free of China’s Stalinist paralysis without having to wait for sweeping programmatic reforms that are always on the horizon, but seem never to come. What's more, would such grassroots empowerment models not create unprecedented opportunities for participation by international investors who up to now have been largely marginalized in China's healthcare development?

In this lunchtime colloquium, Mr. Parker reviews his experiences in China and India over the past six years and looks at several exciting recent developments in China. These include:

• An ambitious rural reimbursement scheme that already has begun to complete a nationwide healthcare safety net. The program is creating a vast pool of funds to finance rural medical services, but how will Beijing populate the countryside with sustainable grassroots practices?
• The first domestic healthcare IPO, by which Aier Ophthalmology raised some $50 million as one of 28 debut listings in the Shenzhen's new "ChiNext" Growth Enterprise Market. New wind in the sails of healthcare privatization?
• Licensing reforms that have begun delinking doctors' certification from their "work unit" hospitals under trials in Beijing and Yunnan, removing a vexing obstacle to hands-on surgical training of young practitioners. Will the breaking of senior doctors' "skills monopoly" create opportunities for private-sector training programs that will shake up China's Soviet-style residency programs?

Jeffrey Parker has lived in Greater China since 1990, first as a journalist and since 2003 as a publisher. His transition from chronicler of China's historic rise to active proponent of its economic development gives him a unique perspective on the opportunities still opening up in China -- and the challenges facing anyone keen to participate. With a twin B.A. in Asian Studies and Geography from U.C. Santa Barbara and Masters training in Journalism from Columbia University, Parker trimmed his sails for a China career from an early age. After early editorial jobs in New York and Washington, D.C., he was dispatched to Beijing by United Press International as senior correspondent in 1990. During the next 10 years with UPI and then Reuters, he covered a wide range of political, economic and social stories from postings in Hong Kong, Taiwan and the Peoples Republic. In his final two years at Reuters, Parker got his first taste of media development, launching local-language multimedia news and video feeds in China, Japan, Korea, India and Southeast Asia. Since 2003, Parker has built up a family of world-class doctors' magazines serving more than 50,000 specialists in China and India from the Shanghai base of ILX Media Group, where he is editorial director, chief operating officer, a corporate director and investor. Among his objectives is to help foster a badly needed transformation of medical practice across China by inspiring grassroots doctors to deliver high-quality, cost-effective services in rural and less-developed communities left behind by government health care.

The health sector's successes in Vietnam have been described as "legendary" by international donors, but there is always the other side of the story. One can question the objectivity of reports from the government of Vietnam, the World Bank, and the World Health Organization. One can wonder in what areas the health sector has failed, who has paid for a "success story" and at what cost, and how much information is well documented and has been made public. Are there "stylized facts" regarding those aspects of health that have been successfully reformed compared with those where reform has lagged? Given these concerns, how can the research community contribute to improving health policy in Vietnam?

Dr. Truong will share his thought on recent socioeconomic development in Vietnam, discuss key health policy issues, and reflect upon his experiences including a research project in which the University of Queensland collaborated with Ministry of Health of Vietnam. Additional evidence will be drawn from a study of the cost-effectiveness of interventions to reduce tobacco use in Vietnam.

Khoa Truong was a visiting faculty member at the Hanoi School of Public Health and a research fellow at the Health Strategy and Policy Institute in 2008-2009.  Prior to that he spent six years as a doctoral fellow at the RAND Corporation.  His research interests include tobacco, alcohol, and illicit drug control policies; the impacts of built environments on health; international health issues; and economic development.

He received his doctorate and master of philosophy in policy analysis from the Pardee RAND Graduate School and earned a master's degree in development economics from Williams College. A native of Vietnam, he began his career working with NGOs in bilateral and multilateral development projects in Southeast Asia. He was awarded a Fulbright scholarship and wrote “most outstanding paper” submitted at an AcademyHealth's Annual Research Meeting (acknowledged as the premier forum for sharing the results of scholarship on health services).

As part of health reforms announced in April 2009, China plans to expand and strengthen primary care (i.e., provision of first contact, person-focused, ongoing care over time, and coordinating care when people receive services from other providers). Other nations of Asia continue to grapple with how to promote population health and constrain healthcare spending. What is the evidence about the effectiveness of primary care in improving population health and making healthcare accessible and affordable?

In this talk, Dr. Starfield will speak about the robust evidence of the association between primary care and better health outcomes at lower cost; ways of measuring the effectiveness of primary care; how selected Asian countries compare in such rankings; and the broader implications of primary care research for health policy in Asia.

Dr. Starfield, a physician and health services researcher, is internationally known for her work in primary care; her books, Primary Care:  Concept, Evaluation, and Policy and Primary Care: Balancing Health Needs, Services, and Technology, are widely recognized as the seminal works in the field.  She has been instrumental in leading projects to develop important methodological tools, including the Primary Care Assessment Tool, the CHIP tools (to assess adolescent and child health status), and the Johns Hopkins Adjusted Clinical Groups (ACGs) for assessment of diagnosed morbidity burdens reflecting degrees of  co-morbidity.   She was the co-founder and first president of the International Society for Equity in Health, a scientific organization devoted to furthering knowledge about the determinants of inequity in health and ways to eliminate them.  Her work thus focuses on quality of care, health status assessment, primary care evaluation, and equity in health. She is a member of the Institute of Medicine and has been on its governing council, and has been a member ofthe National Committee on Vital and Health Statistics and many other government and professional committees and groups. She has a BA from Swarthmore College, an MD from the State University of New York, Downstate Medical Center, and an MPH from Johns Hopkins University School of Public Health.