This event is part of the Asia Health Policy Program (AHPP) 2020-21 Colloquium series "Health, medicine, and longevity: Exploring public and private roles"

This event is part of the Asia Health Policy Program (AHPP) 2020-21 Colloquium series "Health, medicine, and longevity: Exploring public and private roles"

Over the last decade, India has rapidly expanded government health insurance programs that entitle low-income households to free hospital care.  In a major policy shift away from direct public provision of healthcare, these programs contract private hospitals for service delivery. This constitutes a sizeable public subsidy delivered through private agents, but there is relatively little evidence on how private hospitals perform. Using a unique dataset on 6 million insurance claims and 15,000 patient surveys, this talk will present several key insights on the behavior of private hospitals within a large government insurance program. 1) Private hospitals manipulate coding to increase their revenues at the government's expense. 2) They also charge patients out-of-pocket for care that is supposed to be free under program rules. 3) When the government increases hospital reimbursement rates, patient charges decrease substantially. 4) However, hospitals capture approximately half the increased subsidy and this is driven by less competitive markets. The results demonstrate that hospital reimbursement rates are a key policy lever shaping hospital behavior with implications for program outcomes. Improving program performance requires a combination of stronger hospital monitoring and attention to reimbursement rates; focusing on one without the other may reduce the efficiency of public spending or worsen patient welfare. Lastly, market structure, a factor rarely taken into consideration in health policy in India, may play a role in the extent to which public subsidies benefit patients.

https://aparc.fsi.stanford.edu/asiahealthpolicy/news/postdoctoral-spotlight-radhika-jain

Radhika Jain is the Asia Health Policy Postdoctoral Fellow for 2019-2022 at the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC).  Her research focuses on health care markets, the effectiveness of public health policy, and gender disparities in health.

She completed her doctorate in the Department of Global Health at Harvard University in 2019.  Her dissertation examined the extent to which government subsidies for health care under insurance are captured by private hospitals instead of being passed through to patients, and whether accountability measures can help patients claim their entitlements. Dr. Jain's research has been supported by grants from the Weiss Family Fund and the Jameel Poverty Action Lab (JPAL). She has worked on impact evaluations of health programs in India and on the implementation of HIV programs across several countries in sub-Saharan Africa. She also held a doctoral fellowship at the Center for Global Development.

At Shorenstein APARC, Radhika is starting new work on understanding the factors that contribute to poor female health outcomes and interventions to increase the effectiveness of public health insurance.

This event is part of the Asia Health Policy Program (AHPP) 2020-21 Colloquium series "Health, medicine, and longevity: Exploring public and private roles"

A quarter century ago in a seminal paper, Hart, Shleifer and Vishny (NBER1996, QJE1997) developed a theory of the ‘Proper Scope of Government.’ In this webinar, Oliver Hart, 2016 Nobel Laureate, reflects on that framework and its place in economics, as well as the inspiration for his more recent work on norms and guiding principles, contracts as reference points, maximizing shareholder welfare, and exit versus voice. In discussion with Karen Eggleston, Hart answers questions posed by economists who have built upon that paper and offers insights on how the theory applies to understanding public and private roles in healthcare, education, and other publicly-financed services. With China, India, and many other emerging markets engaged in decades-long controversies about public and private roles in their health sectors, and international focus on public-private partnerships for COVID-19 response and harnessing innovation to address other global challenges, this is an opportune time to discuss how conceptually rigorous thinking can inform a sometimes divisive and ideological debate with vital implications for human welfare.

Oliver Hart is currently the Lewis P. and Linda L. Geyser University Professor at Harvard University, where he has taught since 1993. He is the 2016 co-recipient of the Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel, a Fellow of the Econometric Society, the American Academy of Arts and Sciences, the British Academy, and the American Finance Association, a member of the National Academy of Sciences, a Distinguished Fellow of the American Economic Association, and has several honorary degrees. Hart works mainly on contract theory, the theory of the firm, corporate finance, and law and economics. His research centers on the roles that ownership structure and contractual arrangements play in the governance and boundaries of corporations. He has published a book (Firms, Contracts, and Financial Structure, Oxford University Press, 1995) and numerous journal articles. He has used his theoretical work on firms and contracts in several legal cases. He has been president of the American Law and Economics Association and a vice president of the American Economic Association.

This keynote is part of the Stanford Asia Health Policy Program colloquium series entitled:  Health, medicine, and longevity: Exploring public and private roles

Governmental agencies and non-state actors interact within health systems in complicated and sometimes controversial ways that are vital for health and well-being. These run the gamut from developing and distributing vaccines and therapeutics for COVID-19 and mitigating the social and economic impact of the pandemic, to achieving and sustaining universal health coverage, addressing the social determinants of health, mitigating disparities, and encouraging innovations for healthy longevity, to name but a few. From the conceptual foundations to the daily reality of practitioners, this colloquium series will explore the evidence and experience of the public-private nexus in health sectors across Asia, in comparative global perspective. With colloquia throughout the academic year, the series features a keynote on February 10, 2021 from Nobel Laureate Oliver Hart, “A quarter century of ‘The Proper Scope of Government’: Theory and Applications” (dating from the 1996 NBER working paper subsequently published in the Quarterly Journal of Economics, QJE).

https://www.youtube.com/watch?v=g9JRhGpXC2Y&feature=emb_title

This event is part of the Asia Health Policy Program (AHPP) 2020-21 Colloquium series "Health, medicine, and longevity: Exploring public and private roles"

Co-sponsored by the Asia Health Policy Program and the Southeast Asia Program

Jakarta time: Friday, October 30, 2020, 7:30am - 9:00am

Apart from the 1998 Asian Financial Crisis (AFC), the current COVID-19 economic crisis is Indonesia’s most serious economic calamity in half a century with adverse impact. In March 2020, Indonesia’s poverty rate increased from 9.41% to 9.78% year on year, the equivalent of 1.28 million new people entering poverty.  By the end of 2020, it is expected that poverty rates will increase above 10%, wiping out two years of Indonesia’s poverty alleviation achievements. Social protection is key for crisis recovery. Indonesia’s social protection system has continually become stronger since the AFC. Over the past two decades, Indonesia has significantly expanded its social protection programs and coverage buttressed by a robust social registry that covers the poorest 40% of the population. The COVID-19 crisis is pushing the system to its limits. Insufficient data on Indonesians vulnerable to falling into poverty (and above the poorest 40%), coupled with response programs with complicated delivery and eligibility mechanisms, has made it challenging to deliver response-focused social protection. Dr. Sumarto will discuss whether the current social protection system is strong enough to weather the storm, especially to protect those working in the informal sector and marginal groups. Today, Indonesian policymakers have the choice to keep on following the same path and continue investing on the same social protection system, or take a radical move to reform it and make it better equipped to face future challenges.

Sudarno Sumarto is an economist specializing in poverty reduction, social protection, labor, health, education and political economy of public policy implementation. Before joining the TNP2K, he was previously a visiting scholar at the Shorenstein Asia Pacific Research Center (APARC) at Stanford University as well as Founder and Executive Director of The SMERU Research Institute. Well-versed in leading large-scale research projects, Sudarno also provides intellectual leadership to Indonesia’s RISE country team. His research has been widely published in high-impact journals such as the Journal of Political Economy, Journal of Development Economics, and World Bank Economic Review, and has extensively contributed to policy-making by the Government of Indonesia. Sudarno earned his doctoral and master’s degrees in economics from Vanderbilt University.