The Impact of Taiwan's National Health Insurance's 20-year Journey: How has the market responded and will respond?
The single-payer NHI program, operated by National Health Insurance Administration (NHIA), was established through integrating three existing social insurance schemes and extended the coverage to the then uninsured 43% of the population. Taiwan NHI offers comprehensive benefit coverage that includes ambulatory care as well as inpatient services. On the service side, Taiwan has a market-oriented health care delivery system, reflecting its free-enterprise economy, as evidenced by the pluralistic organization of health services. Hospital ownership is mixed where public hospitals only account for 35% of all beds. Sixty-three percent of allopathic physicians are salaried employees of hospitals; the remainder, fee-for-service private practitioners. Over the years, hospitals have developed large outpatient departments and affiliated clinics for primary care in order to maintain inpatient volume and compete with private practitioners who operate free-standing clinics with beds. There is no gate keeping mechanism and the insured essentially enjoy complete freedom of choice which is likely a source of overuse.
NHI revenue mainly relies on payroll-based premiums, supplemented by a levy on non-payroll income and government subsidies. In 2013, NHI spent roughly NTD 492 (USD 16.4) billion on medical claims, accounting for approximately 52% of national health expenditures, and in total, Taiwan devoted 6.6% of GDP to health. As a single payer, NHIA has effectively exploited its market power to experiment with various payment reforms in its 20-year history. NHIA gradually set up separate global budgets for dental services, Chinese medicines, primary care services, and hospital services since 1998. The annual growth rate of the total NHI budget is negotiated among stakeholders.
Our seminar will look to the future with presentations on innovative healthcare delivery models and coping strategies by private hospitals.
Karen Eggleston
Shorenstein APARC
Stanford University
Encina Hall E301
Stanford, CA 94305-6055
Karen Eggleston is a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University and Director of the Stanford Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center at FSI. She is also a Fellow with the Center for Innovation in Global Health at Stanford University School of Medicine, and a Faculty Research Fellow of the National Bureau of Economic Research (NBER). Her research focuses on government and market roles in the health sector and Asia health policy, especially in China, India, Japan, and Korea; healthcare productivity; and the economics of the demographic transition.
Eggleston earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii and a BA in Asian studies summa cum laude (valedictorian) from Dartmouth College. Eggleston studied in China for two years and was a Fulbright scholar in Korea. She served on the Strategic Technical Advisory Committee for the Asia Pacific Observatory on Health Systems and Policies and has been a consultant to the World Bank, the Asian Development Bank, and the WHO regarding health system reforms in the PRC.
Economics of Health and Aging in Asia
View Research Cluster
Third Annual Stanford Summer Juku on Japanese Political Economy
The Japan Program held the third annual Stanford Summer Juku on Japanese Political Economy from August 10-13. Over 40 scholars from various parts of the US and Japan participated in the conference, which took place at the Bechtel Conference Center at Encina Hall. The first two days focused on political science and the second day on economics. Distinctive features of the Summer Juku are the long times allotted to each paper to allow for two in-depth discussants and discussion among participants, as well as ample time for informal discussions and interactions among participants allowing for collaborations and expansion of the network of researchers on Japan in political science and economics. Particularly notable this year was a large number of cross-disciplinary and cross-national collaborations between scholars ranging from political science, economics, management, infomatics, and medicine.
The first day included four papers in political science. Amy Catalinac from New York University presented her paper, "Positioning Under Alternative Electoral Systems: Evidence from 7,497 Japanese Candidate Election Manifestos", with discussants Gary Cox (Stanford) and Harukata Takenaka (National Graduate Institute for Policy Studies, Japan).
Daniel Smith (Harvard University) presented a paper co-authored by Yusaku Horiuchi (Dartmouth College) and Teppei Yamamoto (MIT) entitled "Identifying Multidimensional Policy Preferences of Voters in Representative Democracies: A Cojoint Field Experiment in Japan". The Discussants for the paper were Kay Shimizu (Columbia University) and Karen Jusko (Stanford).
Harukata Takenaka from the National Graduate Institute for Policy Studies presented his paper on “Changes in Power of Japanese Prime Minister: Still Away from a Westminster Model.” Tsuneo Akaha (Middlebury Institute of International Studies at Monterey) and Kenji Kushida (Stanford University) were the discussants.
The fourth paper was “Territorial Issues and Support for the Prime Minister: A survey Experiment on Rally-‘Round-the Flag Effect in Japan” by Tetsuro Kobayashi (National Institute of Informatics, Japan) and Azusa Katagiri (Stanford), discussed by Tsuneo Akaha (Middlebury Institute of International Studies at Monterey) and Daniel Smith (Harvard).
The second day focused on political economy and international relations. Gene Park (Loyola Marymount University, and former Shorenstein Fellow at APARC) presented his paper co-authored with Saori Katada (University of Southern California) and Giacomo Chiozza (Vanderbilt University) entitled “Policy ideas and monetary policy: The Bank of Japan's delayed break with the monetary orthodoxy". Discussants were Azusa Katagiri (Stanford) and Ayako Saiki (De Netherlandsche Bank).
The second paper of the day was "The Political Economy of the Trans-Pacific Partnership: Implications beyond Economics" by Hiroki Takeuchi (Southern Methodist University), discussed by Kay Shimizu (Columbia University) and Gene Park (Loyola Marymount University).
After lunch, Llewelyn Hughes (Australian National University) presented "Lead Markets, Vertical Specialization, and Standards Competition in Electric Vehicles" with discussants Kenji Kushida (Stanford University) and Phillip Lipscy (Stanford University). The final session was "Renegotiating the World Order: Institutional Change in International Relations” which were select chapters from a book manuscript by Phillip Lipscy (Stanford University). The discussants were Amy Catalinac (New York University) and Llewelyn Hughes (Australian National University). A group dinner followed the second day.
The third day was the kick-off for economics papers, where we also saw cross-disciplinary collaborations with colleagues from the US and Japan.
Karen Eggleston (Stanford University) presented “Medical spending and health care utilization in Japan, 2010-2014: Projections from Future Elderly Model microsimulation”, which was co-authored by Hawre Jajal (Stanford University), Brian K. Chen (University of Southern California), Hideki Hashimoto (University of Tokyo), Toshiaki Iizuka (University of Tokyo), Lena Shoemaker (Stanford University), and Jay Bhattacharya (Stanford University). Yong Suk Lee (Stanford University) was the discussant.
The second paper, "The adverse effects of value-based purchasing in health care: dynamic quantile regression with endogeneity" by Galina Besstremyannaya (Visiting Scholar, Stanford University), was discussed by Jay Battacharya (Stanford University) and Takeo Hoshi (Stanford University).
The third paper was ""How Do Agricultural Markets Respond to Radiation Risk? Evidence from the 2011 Disaster in Japan" by Kayo Tajima (Rikkyo University), Masashi Yamamoto (University of Toyama), and Daisuke Ichinose (Rikkyo University). Discussants for the paper presented by Tajima were Satoshi Koibuchi (Chuo University and Visiting Scholar, Stanford University) and Yong Suk Lee (Stanford University).
The final paper for the third day was "Shocks and Shock Absorbers in Japanese Bonds and Banks During the Global Financial Crisis" by Hyonok Kim (Tokyo Keizai University), Yukihiro Yasuda (Hitotsubashi University), and James A. Wilcox (University of California, Berkeley). Discussants were Sabrina Howell (New York University) and Suparna Chakraborty (University of San Francisco).
The final day included two papers. The first was "Impact of Financial Intermediary's Information Production on Market Value of Firm: Case Studies on the DBJ's Liquidity Providing During the Financial Crisis and the Environmental Rating of Firm" by Hiroaki Suzuoka (Development Bank of Japan), Atsushi Motohashi (Development Bank of Japan), Shinya Nakamura (Development Bank of Japan), Tomoya Maruoka (Development Bank of Japan), and Takamasa Uesugi (Development Bank of Japan), presented by Takamasa Uesugi. Discussants were Jess Diamond (Hitotsubashi University) and Masami Imai (Wesleyan University). The final paper was "Selective Disclosure: The Case of Nikkei Preview Articles" by William N. Goetzmann (Yale School of Management), Yasushi Hamao (University of Southern California), and Hidenori Takahashi (Kobe University), presented by Yasushi Hamao. Eiichiro Kazumori (University of Buffalo) was the discussant.
After the completion of four days of Summer Juku, participants who had enough time before their flights held an “uchiage” (completion celebration) gathering—a tradition at the conclusion of the Summer Juku—at “The Patio” in downtown Palo Alto for further informal exchange over drinks and appetizers.
Global Artform or Local Phenomenon? Demystifying K-Pop’s International Appeal
Joon Nak Choi is the 2015-2016 Koret Fellow in the Korea Program at Stanford's Shorenstein Asia-Pacific Research Center (APARC). A Stanford graduate and sociologist by training, Choi is an assistant professor at Hong Kong University of Science and Technology. His research and teaching areas include economic development, social networks, organizational theory, and global and transnational sociology, within the Korean context. He recently coauthored Global Talent: Skilled Labor as Social Capital in Korea which he developed the manuscript from 2010-11 while he was a William Perry postdoctoral fellow at APARC.
This event is made possible through the generous support of the Koret Foundation.
Joon Nak Choi
Shorenstein APARC
Encina Hall
Stanford University
Stanford, CA 94305-6055
Joon Nak Choi is the 2015-2016 Koret Fellow in the Korea Program at Stanford University's Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC). A sociologist by training, Choi is an assistant professor at Hong Kong University of Science and Technology. His research and teaching areas include economic development, social networks, organizational theory, and global and transnational sociology, within the Korean context.
Choi, a Stanford graduate, has worked jointly with professor Gi-Wook Shin to analyze the transnational bridges linking Asia and the United States. The research project explores how economic development links to foreign skilled workers and diaspora communities.
Most recently, Choi coauthored Global Talent: Skilled Labor as Social Capital in Korea with Shin, who is also the director of the Korea Program. From 2010-11, Choi developed the manuscript while he was a William Perry postdoctoral fellow at Shorenstein APARC.
U.S. Defense Strategy for the Asia-Pacific Region
Note: This event is open to Stanford community members only.
Stanford ID required for entry.
Remarks are off the record. Recording, reporting and citation of remarks is strictly prohibited.
P
Mr. Shear was a Rusk Fellow at Georgetown University’s institute for the Study of Diplomacy 1998-99. He is the recipient of the State Department’s Superior Honor Award and the Defense Department’s Civilian Meritorious Service Award for his work in U.S.-Japan defense relations.
Mr. Shear graduated from Earlham College and has a Master’s degree in International Affairs from the Johns Hopkins School of Advanced International Studies. He also attended Waseda University, Taiwan National University, and Nanjing University.
Stanford Summer Juku 2015
Stanford Summer Juku on Japanese Political Economy (SSJ-JPE)
August 10-13, 2015
Oksenberg Conference Room
Stanford Japan Program at Shorenstein Asia-Pacific Research Center
The Japan Program at the Walter H. Shorenstein Asia-Pacific Research Center (S-APARC) at Stanford University started Stanford Summer Juku (SSJ) in 2013. In SSJ, researchers on Japanese politics and Japanese economy get together and discuss their research in a relaxed setting. The third annual meeting is held at Stanford on August 10-13, 2015. The first two days again focus on research in political science/political economy and international relations, and the latter two days focus on research in economics and business.
Takeo Hoshi, Kenji E. Kushida, Phillip Lipscy
Report - Stanford Summer Juku 2015
Program
8/10/2015
8:30-9:00 Breakfast
9:00-10:15 Session I:
"Positioning Under Alternative Electoral Systems: Evidence from 7,497 Japanese Candidate Election Manifestos", Amy Catalinac (Harvard University)
Discussants:
Gary Cox (Stanford University)
Harukata Takenaka (National Graduate Institute for Policy Studies)
10:15-10:45 Break
10:45-12:00 Session II:
"Identifying Multidimensional Policy Preferences of Voters in Representative Democracies: A Cojoint Field Experiment in Japan", Yusaku Horiuchi (Dartmouth College), Daniel Smith (Harvard University), and Teppei Yamamoto (Massachusetts Institute of Technology)
Discussants:
Kay Shimizu (Columbia University)
Karen Jusko (Stanford University)
12:00-1:00 Lunch
1:00-2:15 Session III:
"Changes in Power of Japanese Prime Minister: Still Away from a Westminster Model", Harukata Takenaka (National Graduate Institute for Policy Studies)
Discussants:
Tsuneo Akaha (Middlebury Institute of International Studies at Monterery)
Kenji Kushida (Stanford University)
2:15- 3:30 Session IV:
"Territorial Issues and Support for the Prime Minister: A Survey Experiment on Rally-‘Round-the Flag Effect in Japan", Tetsuro Kobayashi (National Institute of Informatics, Japan), Azusa Katagiri (Stanford University)
Discussants:
Tsuneo Akaha (Middlebury Institute of International Studies at Monterery)
Daniel Smith (Harvard University)
8/11/2015
8:30-9:00 Breakfast
9:00-10:15 Session I:
"Institutions and central bank norm diffusion: The Bank of Japan's delayed break with the monetary orthodoxy", Gene Park (Loyola Marymount University), Saori Katada (University of Southern California), Giacomo Chiozza (Vanderbilt University)
Discussants:
Azusa Katagiri (Stanford University)
Ayako Saiki (De Netherlandsche Bank)
10:15-10:45 Break
10:45-12:00 Session II:
"The Political Economy of the Trans-Pacific Parternship: Implications beyond Economics", Hiroki Takeuchi (Southern Methodist University)
Discussants:
Kay Shimizu (Columbia University)
Gene Park (Loyola Marymount University)
12:00-1:00 Lunch
1:00-2:15 Session III:
"Lead Markets, Vertical Specialization, and Standards Competition in Electric Vehicles", Llewelyn Hughes (George Washington University)
Discussants:
Kenji Kushida (Stanford University)
Phillip Lipscy (Stanford University)
2:15-3:30 Session IV:
"Renegotiating the World Order: Institutional Change in International Relations (select chapters from book manuscript)", Phillip Lipscy (Stanford University)
Discussants:
Amy Catalinac (Harvard University)
Llewelyn Hughes (George Washington University)
6:30 Group Dinner at Gravity Bistro and Wine Bar (544 Emerson St, Palo Alto, CA 94301)
8/12/2015
8:30-9:00 Breakfast
9:00-10:15 Session I:
"Medical spending and health care utilization in Japan, 2010-2040: Projections from a Future Elderly microsimulation", Hawre Jajal (Stanford University), Brian K. Chen (University of Southern California), Karen Eggleston (Stanford University), Hideki Hashimoto (University of Tokyo), Toshiaki Iizuka (University of Tokyo), Lena Shoemaker (Stanford University), and Jay Bhattacharya (Stanford University)
Discussants:
Yong Suk Lee (Stanford University)
TBD
10:15-10:45 Break
10:45-12:00 Session II:
"The adverse effects of value-based purchasing in health care: dynamics quantile regression with endogeneity", Galina Besstremyannaya (Visiting Scholar, Stanford University)
Discussants:
Jay Battacharya (Stanford University)
Takeo Hoshi (Stanford University)
12:00-1:00 Lunch
1:00-2:15 Session III:
How Do Agricultural Markets Respond to Radiation Risk? Evidence from the 2011 Disaster in Japan", Kayo Tajima (Rikkyo University), Masashi Yamamoto (University of Toyama), and Daisuke Ichinose (Rikkyo University)
Discussants:
Satoshi Koibuchi (Chuo University and Visiting Scholar, Stanford University)
Yong Suk Lee (Stanford University)
2:15-3:30 Session IV:
"Shocks and Shock Absorbers in Japanese Bonds and Banks During the Global Financial Crisis", Hyonok Kim (Tokyo Keizai University), Yukihiro Yasuda (Hitotsubashi University), and James A. Wilcox (University of California, Berkeley)
Discussants:
Sabrina Howell (New York University)
Suparna Chakraborty (University of San Francisco)
8/13/2015
8:30-9:00 Breakfast
9:00-10:15 Session I:
"Impact of Financial Intermediary's Information Production on Market Value of Firm: Case Studies on the DBJ's Liquidity Providing During the Financial Crisis and the Environmental Rating of Firm", Hiroaki Suzuoka (Development Bank of Japan), Atsushi Motohashi (Development Bank of Japan), Shinya Nakamura (Development Bank of Japan), Tomoya Maruoka (Development Bank of Japan), and Takamasa Uesugi (Development Bank of Japan)
Discussants:
Jess Diamond (Hitotsubashi University)
Masami Imai (Wesleyan University)
10:15-10:45 Break
10:45-12:00 Session II:
"Selective Disclosure: The Case of Nikkei Preview Articles", William N. Goetzmann (Yale School of Management), Yasushi Hamao (University of Southern California), and Hidenori Takahashi (Kobe University)
Discussants:
Eiichiro Kazumori (University of Buffalo)
TBD
12:00-1:00 Lunch
Stanford scholars assess North Korea's nuclear test
North Korea claimed it successfully tested a hydrogen bomb on Jan. 6, according to a broadcast from the nation’s Korean Central Television. Experts at the Freeman Spogli Institute for International Studies offered their analyses to media.
Scholars from the Walter H. Shorenstein Asia-Pacific Center (APARC) and the Center for International Security and Cooperation (CISAC) contributed to a Stanford news release. Although the scholars said they are skeptical of North Korea’s claim, they also said the test would have a destabilizing effect on the region.
In a Q&A, Siegfried Hecker answered nine questions, offering perspective on the situation and how the United States should respond. Hecker, a CISAC senior fellow, is a former director of the Los Alamos National Laboratory and has visited North Korea seven times since 2004.
David Straub, associate director of the Korea Program, commented on the North Korean nuclear program in an NK News article. He said the timing of the nuclear test, now the nation’s fourth, was likely only marginally influenced by external factors such as Kim Jong-un’s birthday. The primary factor is technical, he said. Straub also spoke with Yonhap News on Feb. 12. In the interview, Straub said "although the United States and the People's Republic of China certainly have differences [in dealing with the North Korean nuclear issue], they pale in comparison to U.S.-Soviet differences."
Straub also offered, in an extended interview with South Korea's Segye Ilbo newspaper, his thoughts on Pyongyang's motivations for pursuing nuclear weapons. He argued that the appropriate policy response is to continue to increase pressure on the regime. Pressure applied by Washington is meant to convince Pyongyang that nuclear weapons will bring more cost than benefit, while holding open the door to good-faith negotiations to resolve peninsular issues.
Shorenstein APARC Associate Director for Research Daniel Sneider talked with Al Jazeera America and Slate about the developments. He said the nuclear test signified North Korea’s uneasiness and was largely an accommodation of domestic politics.
In early February, South Korea announced temporary closure of Kaesong Industrial Complex (KIC), a jointly held project with North Korea. In Chosun Ilbo newspaper, Straub argued that South Korea's closure of KIC was a necessary response to North Korea's fourth nuclear test and latest satellite rocket launch. Two articles were published in Korean; the first is available here and the second here.
The Failure of Political Institutionalization in China
Less than four years after Mao Zedong’s death, Deng Xiaoping declared that China needed to move away from an “over-concentration of power” by an individual leader to establish a more institutionalized system of governance. Xi Jinping’s ascension to power in 2013 promised a new era of reform of the Communist Party of China (CCP), specifically intended to preserve the party’s power. Rather than addressing governance issues, however, Xi’s actions, such as the anti-corruption campaign, have served to concentrate power in his hands, showing the weakness of political institutionalization in China after decades of collective leadership. While decision-making processes continue to be a black box, by reclaiming the CCP’s authority over policy-making, and by chairing CCP small leading groups, Xi appears to have moved China back to Mao-style personalistic rule. The puzzles that remain are how personalistic authoritarian rule has returned to a country characterized by a growing middle class and a modern open market economy; and what this reversion to personalistic leadership tells us about the ambiguities of institutions in communist ruling parties.
Susan Shirk is the Chair of the 21st Century China Program and Research Professor at the School of Global Policy and Strategy at the University of California - San Diego. She is also director emeritus of the University of California’s Institute on Global Conflict and Cooperation (IGCC). Susan Shirk first visited China in 1971 and has been teaching, researching and engaging China diplomatically ever since.
From 1997-2000, Shirk served as Deputy Assistant Secretary of State in the Bureau of East Asia and Pacific Affairs, with responsibility for China, Taiwan, Hong Kong and Mongolia.
In 1993, she founded, and continues to lead, the Northeast Asia Cooperation Dialogue (NEACD), a Track II forum for discussions of security issues among defense and foreign ministry officials and academics from the U.S., Japan, China, Russia, South Korea and North Korea.
Shirk's publications include her books, China: Fragile Superpower; How China Opened Its Door: The Political Success of the PRC's Foreign Trade and Investment Reforms; The Political Logic of Economic Reform in China; Competitive Comrades: Career Incentives and Student Strategies in China; and her edited book, Changing Media, Changing China.
Shirk served as a member of the U.S. Defense Policy Board, the Board of Governors for the East-West Center (Hawaii), the Board of Trustees of the U.S.-Japan Foundation, and the Board of Directors of the National Committee on United States-China Relations. She is a member of the Trilateral Commission, the Council on Foreign Relations, and an emeritus member of the Aspen Strategy Group. Dr. Shirk received her BA in Political Science from Mount Holyoke College, her MA in Asian Studies from the University of California, Berkeley, and her PhD in Political Science from the Massachusetts Institute of Technology.
This event is off the record.
China After the One-Child Policy
Please note this event has been moved to the Oksenberg Conference Room.
Thirty-five years after its nationwide implementation, China finally announced the end of the one-child policy in late 2015. How did this change come about? What are the demographic, economic, and social imperatives that have led to this much-delayed policy reversal? What are the historical legacies of this unprecedented birth control policy in human history, and what are the implications of this policy and China’s new demographics for China’s economy in the years to come? This presentation will address these questions and discuss in particular the roles of China’s changed demographics in its economic growth and political governance in the coming decades.
Feng WANG is a professor of sociology at the University of California, Irvine and at Fudan University, China, and a non-resident senior fellow of the Brookings Institution. Wang Feng is the author of several books and many articles on contemporary social and demographic changes in China, on comparative historical demography and social organization in Eurasia, and on income and social inequalities in post-socialist China.
This event is off the record.
China's New Normal
China’s leaders now acknowledge the reality of much slower growth, and refer to it as the “new normal”. But what does this mean, and what will be the consequences? Exports have slowed, but can domestic consumption pick up the slack? Will this slowdown lead to a rebalancing that will yield a more sustainable and robust growth? How does the end of the “one child policy” fit into this equation, and will this be sufficient to address the demographic challenges that China faces? What impact will Xi Jinping’s vigorous anti-corruption campaign have on this “new normal