Dr. Brian Chen's research has examined the tradeoffs between moral hazard and efficiencies in the integration of physician and non-physician medical services in the presence of asymmetric information. He has looked at a policy intervention in Taiwan that prohibited self-referrals of patients to physician-owned pharmacies unless the physician group integrated pharmacy services into the clinic by hiring an onsite pharmacist. He found that the policy reduced drug expenditures by close to thirty percent among physicians that did not have an onsite pharmacist. However, these physicians responded by increasing the overprovision of diagnostic services not covered by the policy, thereby reducing the effectiveness of the policy. Forty-five percent of the clinics that did not have an onsite pharmacist prior to the policy hired one subsequent to the implementation of the policy. Overall, after integration, the policy applied to only seventeen percent of clinics, and only reduced average discretionary expenditures by about two-point-five percent. Chen's research also shows that despite the reduction in drug utilization, patients treated at clinics without an onsite pharmacist did not have greater observable adverse health events than patients treated at integrated clinics. His results show that moral hazard costs of self-referral incentives are large, that the “safe harbor” exemption severely reduces the effectiveness of the policy, and that the exemption explains much of the recent integration of ancillary services into physician offices.

Dr. Brian Chen recently completed his Ph.D. in business administration in the Business and Public Policy Group at the Haas School of Business, University of California at Berkeley. He received a Juris Doctor from Stanford Law School in 1997, and graduated summa cum laude from Harvard College in 1992.

This colloquium will feature presentations by two visiting scholars from China. First, Dr. Huijun Liu will present research on health risks associated with gender imbalance in China. The problems of abnormal sex ratio at birth and high female infant mortality have plagued many Asian countries with a strong male preference and gender inequality. In China, these problems having lasted for more than twenty years and contributed to a serious gender imbalance in the population. As a direct consequence, “surplus men” or “forced bachelors,” are expected to increase to more than 30 million. Dr. Liu will discuss the potential health risks and other social problems likely to be exacerbated by this large-scale gender imbalance in China.

Second, Dr. Dahai Zhao will present “How Is Health Insurance Coverage Utilized among Migrant Workers in Shanghai, China?” According to the regulations of the Chinese national and Shanghai municipal governments, migrant workers employed in Shanghai should all be entitled to the Shanghai Migrant Worker Hospitalization Insurance (SMWHI) without premium and the vast majority should also have coverage through the New Rural Cooperative Medical System (NRCMS). Dr. Zhao will present results from research, conducted jointly with Dr. Wei Yu and Dr. Alan M. Garber, examining the status of the coverage and utilization of health insurance among migrant workers employed in Shanghai. Through their study, they found that a significant minority of migrant workers in Shanghai still had no health insurance, and that health insurance utilization among migrant workers was strongly limited by hospital location.

Huijun Liu is an associate professor in the Public Policy and Administration School at Xi'an Jiaotong University, China. She received her PhD in management science and engineering from the Management School of Xi'an Jiaotong University. Her main areas of research focus on gender imbalance, reproductive health, vulnerability, and social support. Her current research focuses on how gender imbalance and migration amplify the risk of HIV transmission in China. Liu has published over twenty papers in Chinese academic journals, including China Soft Science, Population and Economics, Psychological Science Advance, Collection of Women's Studies, and Modern Preventive Medicine.

Dr. Zhao is an assistant professor with the School of Public Economics and Administration at Shanghai University of Finance and Economics (SUFE), and a fellow with the Center for Health Policy at SUFE. He earned a master's degree in medicine in 2005 and a PhD in 2008, both from Fudan University, China.