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The Asia Health Policy Program hosted meetings of the Association of Pacific Rim Universities World Institute (AWI, www.apru.org/awi) public health research project, February 24-25 at the Shorenstein Asia-Pacific Research Center. Stanford University is a member of the Association of Pacific Rim Universities, and the Asia Health Policy Program coordinates with others on the steering committee for the AWI public health project. The project brings together scholars from leading Pacific Rim universities to focus on comparative study of chronic non-communicable disease – the number one cause of premature death worldwide – in selected Pacific Rim cities (Beijing, Danang, Hangzhou, Hong Kong, Singapore, Jakarta, Makassar, Nanjing, Sydney, Taipei, Vientiane and Wuhan).

 

Ambassador Michael H. Armacost, Acting Director of the Shorenstein Asia-Pacific Research Center, welcomed the participants -- researchers and deans of schools of public health from China, Hong Kong, Japan, Korea, Singapore, Vietnam, Malaysia, Indonesia, and Australia. During the deliberations, the participants agreed to establish a program of research and development to prepare tools for use by health systems worldwide to implement best practice in chronic disease prevention and management through four areas of research: risk factor surveillance; assessment of costs and organization of services; change management to implement best practice; and monitoring and evaluation.

 

The previous meeting of the AWI public health project was held in November 2008 in Singapore. The next meeting will be held in June 2009 at Johns Hopkins University (an Invited Member of the Association of Pacific Rim Universities World Institute).

 

On February 23, prior to the public health project meetings, the Asia Health Policy Program also hosted the planning meetings for the AWI 2009 public health workshop, to be held at Johns Hopkins University June 24-26, 2009.

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On February 26, 2009, the Asia Health Policy Program and the Stanford Center on Longevity co-sponsored a conference entitled Aging Asia: Economic and Social Implications of Rapid Demographic Change in China, Japan, and Korea. Held at the Bechtel Conference Center at Stanford University, the conference brought together scholars from China, Japan, Korea, Singapore, and the US with expertise in demography, economics, biology, political science, medicine, health services research, social policy, and psychology.

Topics of discussion included how demography shapes individual, social and economic transitions in China, Japan and Korea; intergenerational transfers and the impact of population aging on economic growth; the challenges to financing health care, long term care, and pensions in China, Japan and Korea; the chronic disease burden and comparative international experience with chronic disease management; and perspectives from Singapore on public policy for aging populations. 

A book gathering together the policy-relevant insights of the conference presenters will be forthcoming in 2010, edited by Asia Health Policy Program Director Karen Egglestonand Professor of Biology Shripad Tuljapurkar.

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Since 1995, the offshoring of services to India has rapidly evolved from a curiosity only studied by a few scholars to a phenomenon portending a major shift in the geography of global economic activity. The article examines the evolution of Indian global services provision quantitatively and qualitatively through the use of four case studies. The first case study examines the challenge that the Indian information technology systems integrators (ITSIs) pose to the formerly larger—but now roughly comparable in terms of employment—incumbent developed-nation ITSIs. Because IT systems have become central to nearly every enterprise, the second case study illustrates the wide variety of enterprises that now have significant Indian offshore operations. The third case study describes the rapid growth of offshore integrated circuit design in India, a nation with now commercial-scale integrated circuit production. The final case study describes the emergence of high-opportunity entrepreneurial startups in India and the increasing number of Silicon Valley startups that very early in their lives or even as part of their business model have significant operations in India. The concluding discussion situates India within the global economy and speculates upon its future evolution.

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Review of Policy Research
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Rafiq Dossani
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Do regime change and market reform disrupt patterns of intergenerational mobility? China's political trajectory is distinctive from that of other communist regimes in two ways. During its first three decades, the regime enforced unusually restrictive barriers to elite status inheritance. And during the subsequent market transition, unlike most of its counterparts, the Communist Party survived intact. Data from a multigeneration survey suggest that despite their obvious exclusion from the party and related administrative careers in the Mao era, certain prerevolution elites transmitted one type of elite status to their offspring to a surprising degree. Party elites, in contrast, were hit hard by radical Maoism but recovered quickly afterward, and their offspring inherited elite status at much higher rates.

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American Journal of Sociology
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Andrew G. Walder
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This article uses incomplete contract theory to study the allocation of control rights in public-private partnerships (PPPs) between pharmaceutical enterprises and nonprofit organizations; it also investigates how this allocation influences cooperation efficiency. We first develop a mathematic model for the allocation of control rights and its influence on cooperation efficiency, and then derive some basic hypotheses from the model. The results of an empirical test show that the allocation of control rights influences how enterprises invest in PPPs. A proper allocation provides incentives for firms to make fewer self-interested and more public-interested investments. Such an allocation also improves the cooperation efficiency of PPPs.

Published: Zhang, Zhe, Ming Jia, and Difang Wan. "Allocation of control rights and cooperation efficiency in public-private partnerships: theory and evidence from the Chinese pharmaceutical industry." International journal of health care finance and economics 9.2 (2009): 169-182.

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Asia Health Policy Program working paper #6
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Hospitals in Thailand operate in a multiple insurance payment environment. This paper examines 1) access to medicines and other medical technologies, 2) treatment outcomes, and 3) efficiency in resource use, among beneficiaries of the three government health insurance schemes in Thailand. Using 2003-2005 inpatient data for patients with three tracer diseases from three government hospitals, we find that utilization of more expensive items differs between patients whose insurers pay on a closed- or open-ended basis. Where new vs. conventional drugs are both available, patients whose insurer pays on a fee-for-service basis tend to have greater access to new drugs, compared to patients whose insurer pays on a capitated or case basis. Similar patterns were found where there are options between originator vs. generic drugs, drugs in different dosage forms, and more vs. less advanced diagnostic technologies. Effects of insurance payment are more pronounced where price gaps among the medical technologies are significant. Efficiency results are mixed, depending on nature of the disease conditions and type of resources required for treatment.

Published: Hirunrassamee, Sanita, and Sauwakon Ratanawijitrasin. "Does your health care depend on how your insurer pays providers? Variation in utilization and outcomes in Thailand." International journal of health care finance and economics 9.2 (2009): 153-168.

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Asia Health Policy Program working paper #4
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A group of writers and academics in China in recent years have come to be known as the "New Left." But the range of views encompassed under this rubric is broad and seemingly contradictory. Many are critical of the inequality that has come from the market reforms; some seem to look fondly back on the Maoist system and even the Cultural Revolution, while others hold very different views, preferring to call themselves "critical intellectuals," who see a "Chinese alternative" to a neoliberal market economy. This panel will explore the range of views within this group loosely termed the "New Left," to understand what exactly the "New Left" is. How are these "New Left" views different from the Old Left? What are the implications of these views for China's political and economic reforms? Discussing these issues are Wang Hui, a central figure in the "New Left" in China, and David Kelly, a leading Western scholar on the subject.

Wang Hui is professor of Chinese language and literature at Tsinghua University and guest professor at Nankai University. In May 2008, he was named one of the world's top 100 public intellectuals by Foreign Policy magazine. His essays, commentary, and teaching examine the paradoxes of social change in modern and contemporary China. He was editor-in-chief of Dushu, China's leading intellectual journal.

David Kelly is Professor of Chinese Politics at the China Research Centre, University of Technology Sydney. Professor Kelly's work ranges widely across Chinese politics: intellectual history, especially of Marxism and liberalism; political sociology, mainly of intellectuals, urban homeowners and migrant workers; and public policy, focusing on the dilemmas of governance under turbulent current conditions.

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Wang Hui Distinguished Practitioner and Visiting Professor, Center for East Asian Studies Speaker Stanford University
David Kelly Professor Speaker University of Technology Sydney
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Human Resource Management (HRM) is a core element of any organization.  This is especially true in public service organizations whose employees are often their most valuable resource. As an employee in a Japanese local government, Ichinomoto attempts to analyze the current problems in the personnel system that are severely criticized, to find a solution on how to develop more motivated government employees to provide efficient and customer satisfactory public service.

Mari Ichinomoto is a corporate affiliate visiting fellow at Shorenstein APARC for 2007-08 and 2008-09. She is also an official of the Industrial Recruitment and Location Division, Kumamoto Prefectural Government in Japan, with a mission to promote overseas direct investment into the country. Prior to this position, she was sent to Kumamoto trade promotion office in Singapore as a representative of the Kumamoto Prefectural Government dealing with trade promotion between Asia and Kumamoto. She graduated in foreign studies from Kitakyushu University.

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Mari Ichinomoto is a corporate affiliate visiting fellow at Shorenstein APARC for 2007-08 and 2008-09. She is also an official of the Industrial Recruitment and Location Division, Kumamoto Prefectural Government in Japan, with a mission to promote overseas direct investment into the country. Prior to this position, she was sent to Kumamoto trade promotion office in Singapore as a representative of the Kumamoto Prefectural Government dealing with trade promotion between Asia and Kumamoto. She graduated in foreign studies from Kitakyushu University.

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