Susan V. Lawrence is Head of China Programs at the Campaign for Tobacco-free Kids, a Washington, DC-based non-governmental organization that works to reduce tobacco use and its devastating health and economic consequences in the United States and around the world. She divides her time between Washington, DC and China.

The Campaign is a partner organization in the Bloomberg Initiative to Reduce Tobacco Use, launched in 2005 with funding from New York Mayor and philanthropist Michael Bloomberg. The initiative’s work is focused on low- and medium-income countries that together account for two thirds of the world’s smokers. Other partners in the initiative are the Centers for Disease Control Foundation, the Johns Hopkins University Bloomberg School of Public Health, the International Union Against Tuberculosis and Lung Disease, the World Health Organization, and the World Lung Foundation.

Before joining the Campaign for Tobacco-free Kids, Ms. Lawrence worked for 16 years as a journalist, including a cumulative 11 years between 1990 and 2003 as a staff correspondent in China. She served as China bureau chief and later Washington correspondent for the Hong Kong-based newsweekly Far Eastern Economic Review, as a Beijing-based staff correspondent for The Wall Street Journal, and as China bureau chief for the newsmagazine US News & World Report. A fluent Mandarin Chinese speaker, she holds Bachelor’s and Master’s degrees in East Asian Studies from Harvard University and was a Harvard-Yenching Institute Scholar in the History Department at Peking University from 1985-87. 

Her talk is the third in the colloquium series on tobacco control in East Asia, sponsored by the Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center, in coordination with FSI’s Global Tobacco Prevention Research Initiative.

The stated purpose of the Trade Act of 1974 was to promote free trade. Section 301 authorized the U.S. President to impose retaliatory trade sanctions if negotiations were unsuccessful in reducing unreasonable limits on trade. The Act was reinforced in 1984, became known as “Super 301”, and made annual assessment and retaliatory measures mandatory.

Because of trade imbalances, four emerging Asian countries gave the US firms access to cigarette markets: Japan (1987), Taiwan (1987), South Korea (1989) and Thailand (1990). These forced market opennings were called the “Second Opium War” by local protestors in these countries, challenging U.S. export of unwelcome and unhealthy products.

A sea change occurred in the decades that followed the cigarette market opening in Taiwan. Of particular interest are changes in areas marketing skills and market share; lower cigarette prices; paradoxical increased smuggling; increased youth consumption; evolution of the powerful tobacco industry lobby; and a sharp increase in tobacco-related cancer deaths. Accompanying the increased cigarette consumption, a special, unusual habit of chewing betel quid started and grew into a mainstream practice among adult males (nearly one out of four). Oral and esophageal cancer increased sharply soon after the market opened. At the same time, the patriotic protectionists, NGOs, and government galvanized an anti-smoking movement, which gradually transformed Taiwan's culture so that smoking in public is no longer socially acceptable. A new term, “de-normalization,” was coined about the favorable effect of market opening.

 The ironic outcome of Super 301 is that while the market was forced open solely by the US, in only ten years, US market share, once leading, shrunk to a distant fifth, after Japan, UK, Germany and domestic producers. The trade imbalance was little affected by the opening of the cigarette market.

Dr. Wen's colloquium continues the colloquium series on tobacco control in East Asia, sponsored by the Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center, in coordination with FSI’s Global Tobacco Prevention Research Initiative.

This seminar will feature two presentations: an attempt to evaluate the impact of health policy under a decade of progressive governments in Korea; and an investigation into the health and economic well-being of the elderly in Korea. The presenters will be Dr. Byongho Tchoe, a 2008-09 visiting scholar at Stanford University, and Dr. Young Kyung Do, the inaugural postdoctoral fellow in the Asia Health Policy Program at Stanford.

Korea achieved universal health care coverage in 1989 only twelve years after the introduction of social health insurance under an authoritarian government. In 1992 a civil government won the presidential election. Consistent with a conservative ideology oriented toward market principles and globalization, that government emphasized competitive principles in health care policy. However, at the end of 1997 in the face of economic crisis, the progressive party won the Korean presidential election; their health emphasized strengthening equity, redistribution, and regulation of providers’ rent seeking behavior. Under successive progressive governments from 1998 to 2007, ambitious health policy reforms integrated insurers, separated prescribing from dispensing, reformed provider payment, expanded benefits coverage, increased medical-aid enrollees, and increased the role of government providers in the health care market. But in the election of 2007, they were defeated by a conservative party, which insists that competition among insurers and providers will enhance efficiency and quality in health care, and stresses consumer choice and responsibility.

Dr. Tchoe's talk will attempt to evaluate impact of health care policy under a decade of progressive governments in Korea. Although equity in both access to care and financial responsibility appear to be enhanced, there is controversy about whether the policies were cost-effective or improved health, and what will happen as the new government repeals regulations in the health care market. The return of economic crisis also brings renewed urgency to debates of economic and social policy.

Byongho Tchoe is a 2008-09 visiting scholar at Stanford University. After working at the Korea Development Institute from 1983 to 1995, he took up his current post with the Korea Institute for Health and Social Affairs. He has been influential in formulating health and social policy in Korea, having served as an advisor to the minister of health and social welfare and participated in many task forces and committees. In 2007, he was awarded a National Medal in honor of 30 years achievement related to Korea’s National Health Insurance. He has published many articles and books and served as president of the Korean Association of Health Economics and Policy and as vice president of the Korea Association of Social Security. He holds a master’s degree in public policy from Seoul National University and a Ph.D. in economics from the University of Georgia.

Young Kyung Do is the inaugural Postdoctoral Fellow in Asia Health Policy Program at the Walter H. Shorenstein Asia-Pacific Research Center. He completed his Ph.D. in health policy and administration at the University of North Carolina at Chapel Hill School of Public Health in August 2008. He has also earned M.D. and Master of Public Health degrees from Seoul National University (in 1997 and 2003, respectively). He earned board certification in preventive medicine from the Korean Medical Association in 2004. He received the First Prize Award in the Graduate Student Paper Competition in the Korea Labor and Income Panel Study Conference in 2007. He also is the recipient of the Harry T. Phillips Award for Outstanding Teaching by a Doctoral Student from the UNC Department of Health Policy and Administration in 2007. In May 2008, he was selected as a New Investigator in Global Health by the Global Health Council.