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With President Biden’s inauguration, a new era of US-Japan relations starts on January 20. Now that the cozy personal relationship between President Trump and Prime Minister Abe is in the rearview mirror, what can we expect in the Biden-Suga era? While the Biden administration is widely expected to drop Trump’s America First foreign policy and return to multilateralism and alliance-based diplomacy, its foreign policy priorities in the Asia-Pacific are still largely unknown. What role will the US-Japan alliance play in the new geo-political landscape in the region, and how would it handle the growing influence of China and build partnerships with other players in the region? This panel, featuring a leading expert on US politics and US-Japan relations, Fumiaki Kubo (University of Tokyo), and a rising star in the Liberal Democratic Party and an alum of the Ministry of Foreign Affairs, Rui Matsukawa (House of Councilors), examines these questions, moderated by the Director of APARC Japan Program, Kiyoteru Tsutsui.

SPEAKERS

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Portrait of Fumiaki Kubo

Fumiaki Kubo (University of Tokyo) 

Fumiaki Kubo has been the A. Barton Hepburn Professor of American Government and History at the Graduate Schools for Law and Politics, the University of Tokyo since 2003. He is affiliated with the Nakasone Peace Institute as the Executive Research Director, the Japan Institute for International Affairs as a Senior Adjunct Fellow, the 21st Century Public Policy Institute as the Director of the US Studies Project, as well as with the Tokyo Foundation as a Senior Research Scholar. He studied at Cornell University in 1984-1986, at the Johns Hopkins University in 1991-1993, and at Georgetown University and the University of Maryland in 1998-99. He was also an Invited Professor at SciencesPo in Paris in the spring of 2009, and a Japan Scholar at the Woodrow Wilson International Center for Scholars in 2014. Kubo received his B.A. in 1979 and Ph.D. in 1989 from the University of Tokyo. He is the author of many books which include: Modern American Politics (with Hitoshi Abe), Ideology and Foreign Policy After Iraq in the United States ( editor ), A Study on the Infrastructure of American Politics( editor ). In 1989, he received the Sakurada-Kai Gold Award for the Study of Politics and the Keio Gijuku Award. Kubo was the President of the Japanese Association for American Studies from 2016 to 2018.

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Portrait of Representative Matsukawa

Rui Matsukawa (House of Councilors)

Rui Matsukawa is a Member of the House of Councilors (Liberal Democratic Party), and her current responsibilities include Parliamentary Vice-Minister of Defense, Parliamentary Vice-Minister of Cabinet Office. She graduated from the University of Tokyo, Faculty of Law and earned an MS in Foreign Service from Georgetown. She joined the Ministry of Foreign Affairs in 1993, where she won the Southern Bluefin Tuna Case at the International Court of Justice, negotiated free trade agreements with Thailand, Philippines, and other countries, and worked on the negotiations for disarmament as a first Secretary of the Japan Delegation to the Conference on Disarmament in Geneva. She was in charge of analysis of China and the Korean Peninsula in the Intelligence and Analysis Service. She also promoted cooperation between Japan, China, and South Korea as Counsellor of the Embassy of Japan in Korea. In 2014, Ms. Matsukawa established WAW! (World Assembly for Women) to promote women’s empowerment and gender mainstreaming as the first Director of the Gender Mainstreaming Division in the Foreign Policy Bureau. In 2016, she left MOFA, and was elected to represent Osaka in the House of Councilors.

MODERATOR 

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Kiyoteru Tsutsui

Kiyoteru Tsutsui (Stanford University) 

Kiyoteru Tsutsui is Henri H. and Tomoye Takahashi Professor and Senior Fellow in Japanese Studies at the Walter H. Shorenstein Asia-Pacific Research Center at Stanford University, where he is also Director of the Japan Program, a Senior Fellow of the Freeman Spogli Institute for International Studies, and a Professor of Sociology. He is the author of Rights Make Might: Global Human Rights and Minority Social Movements in Japan (Oxford University Press, 2018), co-editor of Corporate Responsibility in a Globalizing World (Oxford University Press, 2016) and co-editor of The Courteous Power: Japan and Southeast Asia in the Indo-Pacific Era (University of Michigan Press, forthcoming 2021). 

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Fumiaki Kubo, University of Tokyo
Rui Matsukawa, House of Councilors
Kiyoteru Tsutsui, Stanford University
Panel Discussions
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This event is Co-Sponsored by the Center for South Asia (CSA)

How are India and the United States responding to the growing political and military power of China in the Indian Ocean region? India has traditionally sought to maintain strategic preeminence in the region and sees its influence as being increasingly contested. The United States sees the region as an integral part of the wider “Indo-Pacific,” defined by intensifying strategic competition with China. Military planners at U.S. Indo-Pacific Command are refining their strategy in the region, including their approach to mitigating security risks and deepening the U.S. Major Defense Partnership with India, alongside other allies and partners. In this off-the-record webinar, the Command’s senior policy advisor and two leading experts on the Indian Ocean will share their assessments of the key strategic challenges facing India and the United States in the region.

Speakers:

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David Brewster
David Brewster is a Senior Research Fellow at the National Security College at the Australian National University, where he focuses on security in India and the Indian Ocean region, and Indo-Pacific maritime affairs. His books include India as an Asia Pacific Power, about India’s strategic role in the Asia Pacific, India’s Ocean: the Story of India’s Bid for Regional Leadership, which examines India’s strategic ambitions in the Indian Ocean, and the edited volume, India and China at Sea: Competition for Naval Dominance in the Indian Ocean. He is the author of several reports, including The Second Sea, which examines Australia’s role in the Indian Ocean proposes a new roadmap for Australia’s strategic engagement in that region. Brewster holds a PhD from the Australian National University.
 

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Shezi Khan
Shehzi Khan is the Senior Policy Advisor in the Strategic Planning and Policy Directorate at Indo-Pacific Command, supporting senior leadership on key regional policy initiatives.  Ms. Khan served on the Secretary of State’s Policy Planning Staff, as Executive Officer to the Principal Deputy Director of National Intelligence, and as senior South Asia analyst at the State Department.  Ms. Khan briefed the President of the United States in 2013.  She has been posted in Pakistan, China, and New Zealand and also lived and worked in India, Egypt, and France. Ms. Khan speaks five foreign languages and holds an MBA in International Finance and an MA in International Relations.  She is a recipient of the National Intelligence Superior Service Medal and was named State Department’s Analyst of the Year in 2014.

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Nilanthi Samaranayake
Nilanthi Samaranayake directs the Strategy and Policy Analysis Program at CNA. She has led several studies on Indian Ocean and South Asia security. Recently Samaranayake has worked on U.S.-India naval cooperation, water resource competition in the Brahmaputra River basin, and Sri Lankan foreign policy. She also has conducted research on the navies of Bangladesh and Pakistan, the Maldives Coast Guard, security threats in the Bay of Bengal, and relations between smaller South Asian countries and China, India and the United States. Prior to joining CNA, Samaranayake held positions at the National Bureau of Asian Research and the Pew Research Center. Samaranayake holds an M.Sc. in International Relations from the London School of Economics and Political Science and a B.A. in International Studies from American University.


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Arzan Tarapore
Arzan Tarapore (Moderator) is the South Asia research scholar at the Shorenstein Asia-Pacific Research Center at Stanford University, where he leads the newly-restarted South Asia research initiative. He is also a senior nonresident fellow at the National Bureau of Asian Research. Tarapore’s research focuses on Indian military strategy and contemporary Indo-Pacific security issues. This includes a forthcoming paper on “Building Strategic Leverage in the Indian Ocean Region.” He previously held research positions at the RAND Corporation, the Observer Research Foundation, and the East-West Center in Washington. Prior to his scholarly career, he served as an analyst in the Australian Defence Department. Tarapore holds a PhD in war studies from King’s College London.

 

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David Brewster <br><i>Senior Research Fellow at National Security College, Australian National University</i><br><br>
Shehzi Khan <br><i>Senior Policy Advisor in the Strategic Planning and Policy Directorate, Indo-Pacific Command</i><br><br>
Nilanthi Samaranayake <br><i>Director of Strategy and Policy Analysis Program, CNA</i><br><br>
Arzan Tarapore - Moderator <br><i>South Asia Research Scholar, Stanford University</i><br><br>
Seminars
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Reports of Chinese espionage, IP theft and military-civil fusion strategy have all fueled concerns regarding U.S. universities’ open research ecosystem, especially in STEM.  Many of the concerns focus not only on research integrity but also on potential adverse consequences to U.S. military and economic security.  This panel intends to deepen discussion on open access to U.S. universities, security risks involved, as well as the potential adverse consequences of limiting international access in science and technology (S&T) research.  Questions that panel members will be asked to address include:  What is our best estimate regarding the scale and scope of adverse influence in U.S. universities attributable to S&T collaboration with PRC personnel?  Scientific collaboration and higher education have traditionally been immune to the ups-and-downs of U.S.-China politics.  How did we get to where we are, and why?  What are remedial measures that universities can consider, optimized to balance security and ethical concerns while ensuring pre-eminent scientific advancements and continued U.S. innovation? 

 

Speakers 

Photo of Arthur BienenstockArthur Bienenstock is co-chair, with Peter Michelson, of the American Academy of Arts and Sciences’ Committee on International Scientific Partnerships.  He has also been a member of the National Science Board, the governing body of the National Science Foundation, since 2012.  From November 1997 to January 2001, he was Associate Director for Science of the White House Office of Science and Technology Policy.  At Stanford, he is Special Assistant to the President for Federal Research Policy, Associate Director of the Wallenberg Research Link and a professor emeritus of Photon Science, having joined the faculty in 1967.  He was Vice Provost and Dean of Research and Graduate Policy during the period September 2003 to November 2006, Director of the Stanford Synchrotron Radiation Lightsource from 1978 to 1977 and Vice Provost for Faculty Affairs from 1972 to 1977. 
 

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Photo of Elsa B. Kania
Elsa B. Kania is an Adjunct Senior Fellow with the Technology and National Security Program at the Center for a New American Security. Her research focuses on Chinese military strategy, defense innovation, and emerging technologies. Ms. Kania also works in support of the U.S. Air Force’s China Aerospace Studies Institute through its Associates Program and is a Non-Resident Fellow in Indo-Pacific Security with the Institute for the Study of War. She has been invited to testify before the House Permanent Select Committee on Intelligence, the U.S.-China Economic and Security Review Commission, and the National Commission on Service. Kania was named an official “Mad Scientist” by the U.S. Army’s Training and Doctrine Command and was a 2018 Fulbright Specialist with the Australian Strategic Policy Institute. Her first book, Fighting to Innovate, should be forthcoming with the Naval Institute Press in 2021. Currently, she is a PhD candidate in Harvard University's Department of Government.
 

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Portrait of Susan Shirk

Susan Shirk is the chair of the 21st Century China Center and a research professor at the School of Global Policy & Strategy at UC San Diego. She is also director emeritus of the University of California’s Institute on Global Conflict and Cooperation (IGCC), serving from 1992 to 1997, and again from 2007 to 2012. 

From 1997 to 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. Shirk founded in 1993 the Northeast Asia Cooperation Dialogue (NEACD), an unofficial “track-two” forum for discussions of security issues among defense and foreign ministry officials and academics from the United States, Japan, China, Russia, and the Koreas.

Shirk’s book China: Fragile Superpower helped frame the policy debate on China in the U.S. and other countries. Her other publications include The Political Logic of Economic Reform in China; How China Opened its Door; Competitive Comrades: Career Incentives and Student Strategies in China; and her edited book, Changing Media, Changing China. Her current book project is Overreach: How China’s Domestic Politics Derailed its Peaceful Rise


Portrait of Tim SternsTim Stearns holds the Frank Lee and Carol Hall Professorship in the Department of Biology at Stanford University and is Senior Associate Vice Provost of Research. He also holds appointments in the Department of Genetics, is a member of the Stanford Cancer Institute and Bio-X, is a Faculty Fellow in Chem-H, and is an affiliated faculty member of the Center for International Security and Cooperation (CISAC). He is a member of JASON, a national organization that advises the government on matters of science, technology and national security. He has also been an advisor to the National Academies of Science and the President's Council of Advisors on Science and Technology (PCAST). Dr. Stearns received a B.S. from Cornell University, a Ph.D. from MIT, and did his postdoctoral fellowship at the University of California, San Francisco. His research concerns the mechanism and regulation of cell division, the organization of signaling pathways within cells, and cell biology of fungal pathogens. Stearns was named an HHMI Professor in 2002 for his work in science education, and has taught international workshops in South Africa, Chile, Ghana, and Tanzania. He is the chair of the NCSD Study Section at the NIH and has served on the editorial boards of several journals.

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Arthur Bienenstock <br><i>Co-chair, American Academy of Arts and Sciences’ Committee on International Scientific Partnerships; Professor of Photon Science, Emeritus, Stanford University</i><br><br>
Elsa B. Kania <br><i>Adjunct Senior Fellow, Technology and National Security Program, Center for a New American Security</i><br><br>
Susan Shirk <br><i>Chair of the 21st Century China Center, UC San Diego; Research Professor, School of Global Policy & Strategy, UC San Diego</i><br><br>
Tim Stearns <br><i>Frank Lee and Carol Hall Professorship, Department of Biology, Stanford University; Senior Associate Vice Provost of Research</i><br><br>
Panel Discussions
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China’s role in the COVID-19 outbreak has elicited a growing global backlash, including dueling Republican and Democratic campaign ads, alongside praise for China’s success in curbing the coronavirus and sending medical assistance overseas. How will the pandemic reshape China’s domestic and international standing, and what lies ahead for U.S.-China relations? Weiss will discuss the Chinese government’s pandemic response and what it reveals about the CCP’s domestic and international intentions.

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Jessica Chen Weiss
Jessica Chen Weiss is an associate professor of Government at Cornell University, China/Asia political science editor at the Washington Post Monkey Cage blog and a nonresident Senior Associate at the Center for Strategic and International Studies.  She is the author of Powerful Patriots: Nationalist Protest in China’s Foreign Relations (Oxford University Press, 2014).  Her research appears in International Organization, China Quarterly, International Studies Quarterly, Journal of Conflict Resolution, Security Studies, Journal of Contemporary China, and Review of International Political Economy, as well as in the New York Times, Foreign Affairs, and Washington Quarterly.  She was previously an assistant professor at Yale University and founded FACES, the Forum for American/Chinese Exchange at Stanford, while an undergraduate at Stanford University.  Born and raised in Seattle, Washington, she received her Ph.D. from the University of California, San Diego in 2008, where her dissertation won the 2009 American Political Science Association Award for best dissertation in international relations, law and politics.  Weiss is a term member of the Council on Foreign Relations.


Image of red flag over the Shanghai BundThis event is part of the 2020 Winter/Spring Colloquia series, The PRC at 70: The Past, Present – and Future?, sponsored by APARC's China Program.

 

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Jessica Chen Weiss Associate Professor of Government, Cornell University
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In keeping with the State of California's shelter-in-place orders, this event is available through livestream only. Please register in advance for the webinar by using the link below.

REGISTRATION LINKhttps://bit.ly/3e1r7FZ

The time of this event has changed to 4:30pm-5:30pm PDT.

 

As the COVID-19 pandemic continues to spread throughout the world, Japan is experiencing its second wave of coronavirus outbreak, following a first wave early on, just as it had become clear that the virus was spreading rapidly from Wuhan. In late February, travel restrictions were followed by Prime Minister Abe’s call for school closures. But as the pandemic raged through parts of Europe and then the United States, and as a growing number of countries issued shelter-in-place orders and lockdowns, Japan seemed relatively unscathed. Concerns then escalated and calls for voluntarily restricting peoples’ movement started in earnest following the decision to postpone the 2020 Olympics. On April 6, Prime Minister Abe declared a state of emergency for seven prefectures.

This panel brings together expertise on Japan’s political leadership with experience in Japan’s crisis management. Professor Harukata Takenaka has long studied how Japan’s political leadership has evolved, while Mr. Akihisa Shiozaki, an expert on crisis management, was a core member of Japan’s first private-sector investigative report after the Fukushima nuclear crisis.

This is the first in an APARC-wide series of virtual seminars that explore Asian countries’ responses to the COVID-19 pandemic. Held throughout the spring quarter, each event is led by one of APARC’s programs.

PANELISTS

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Aki Shiozaki Headshot

Akihisa Shiozaki, Partner, Nagashima Ohno & Tsunematsu

Akihisa Shiozaki is widely recognized for his expertise in corporate crisis management, including regulatory investigations, white collar defense, product recall, labor/employment disputes, import/export control, cyber security, media interaction and various corporate governance issues, especially those with multi-jurisdictional or parallel civil and criminal components. In recent years, he has advised both domestic and foreign clients in resolving a number of the most high profile corporate crises cases relating to Japan, including the LIBOR/TIBOR manipulation investigation, FX manipulation investigation, global product recall by a Japan auto-parts manufacturer, international trade secret theft in the semiconductor industry, government investigations against a global pharmaceutical corporation operating in Japan, and his representation of the former CEO of Olympus Corporation who brought light to the company's recent accounting scandal. He is recognized by Legal 500 as a Leading Individual in the field of Risk Management and Investigations. In 2017, Akihisa was awarded the Compliance / Investigations Lawyer of the Year at the Asian Legal Awards hosted by The American Lawyer, in association with The Asian Lawyer, China Law & Practice and Legal Week.

Akihisa worked in the Prime Minister’s office as senior policy advisor from 2006 to 2007 and is knowledgeable in Japanese regulations /rules and governmental procedures, as well as having rich experience dealing with the media. He also serves as the vice-chairman of the Anti-Yakuza Committee at the Daiichi Tokyo Bar Association and has authored many related publications. He graduated from the University of Tokyo (LL.B.), holds an M.A. in international policy from Stanford University, and completed his MBA at the Wharton School of the University of Pennsylvania where he served as class president.

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Harukata Takenaka Headshot

Harukata Takenka, Professor of Political Science, National Graduate Institute for Policy Studies (GRIPS)

Harukata Takenaka is a professor of political science at the National Graduate Institute for Policy Studies in Tokyo.  He specializes in comparative politics and international political economy, with a particular focus on Japanese political economy. His research interests include democracy in Japan, and Japan's political and economic stagnation since the 1990s.  He received a B.A. from the Faculty of Law of the University of Tokyo and an M.A. and Ph.D. in political science from Stanford University.  He is the author of Failed Democratization in Prewar Japan: Breakdown of a Hybrid Regime, (Stanford University Press, 2014), and Sangiin to ha [What is House of Councillors], (Chuokoron Shinsha, 2010).

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Portrait of Kenji Kushida

Kenji Kushida, Research Scholar, Shorenstein APARC Japan Program (Moderator)

Kenji E. Kushida is a Japan Program Research Scholar at the Walter H. Shorenstein Asia-Pacific Research Center and an affiliated researcher at the Berkeley Roundtable on the International Economy. Kushida’s research interests are in the fields of comparative politics, political economy, and information technology. He has four streams of academic research and publication: political economy issues surrounding information technology such as Cloud Computing; institutional and governance structures of Japan’s Fukushima nuclear disaster; political strategies of foreign multinational corporations in Japan; and Japan’s political economic transformation since the 1990s. Kushida has written two general audience books in Japanese, entitled Biculturalism and the Japanese: Beyond English Linguistic Capabilities (Chuko Shinsho, 2006) and International Schools, an Introduction (Fusosha, 2008). Kushida holds a PhD in political science from the University of California, Berkeley. He received his MA in East Asian studies and BAs in economics and East Asian studies, all from Stanford University.

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Akihisa Shiozaki, Nagashima Ohno & Tsunematsu
Harukata Takenka, National Graduate Institute for Policy Studies
Kenji Kushida, Shorenstein APARC Japan Program
Panel Discussions
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Many observers, and many investors, believe that young people are especially likely to produce the most successful new firms. Integrating administrative data on​ firms, workers, and owners, we study startups systematically in the U.S. and find​ that successfull entrepreneurs are middle-aged, not young. The mean age at​ founding for the 1-in-1,000 fastest growing new ventures is 45.0. The findings are​ similar when considering high-technology sectors, entrepreneurial hubs, and​ successful firm exits. Prior experience in the specific industry predicts much greater​ rates of entrepreneurial success. These findings strongly reject common hypotheses​ that emphasize youth as a key trait of successful entrepreneurs.

Speaker:

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dsc 0355 javier miranda

Javier Miranda, Principal Economist, Economy-Wide Statistics Division, US Census Bureau

Bio:

Javier Miranda is Principal Economist at the U.S. Census Bureau where he began his career in 1998. Javier received his Ph.D. in Economics from American University in 2004. Previous to joining the Census Javier was a research consultant at the World Bank and the Urban Institute. Javier has published papers in the areas of industrial organization, technological change, job creation, entrepreneurship and firm financing. Among his publications are articles in the American Economic Review, Journal of Economic Literature, American Economic Journal Macroeconomics, Review of Economic and Statistics, IMF Review, World Bank Economic Review, Journal of Business Valuation and Economic Loss, NBER Macroeconomics Annual, and multiple books and chapters.  Javier received the Director's Award for Innovation (2007) and the U.S. Department of Commerce Bronze Medal (2011). His contributions to data infrastructure are notable. Javier Miranda is responsible for the development of the Longitudinal Business Database and the Business Dynamics Statistics and is the Synthetic Longitudinal Business Database v3. Together with the USPTO Javier has led the development the Business Dynamics Statistics of Innovative Firms a longitudinal database of firms, patents, and inventors. Javier Miranda is also President of the Board of SEM an adult education and job readiness program designed to address the root causes of poverty, illiteracy, and violence in Washington DC.

Advisory on Novel Coronavirus (COVID-19)

In accordance with university guidelines, if you (or a spouse/housemate) have returned from travel to mainland China or South Korea in the last 14 days, we ask that you DO NOT come to campus until 14 days have passed since your return date and you remain symptom-free. For more information and updates, please refer to the Stanford Environmental Health & Safety website: https://ehs.stanford.edu/news/novel-coronavirus-covid-19.

 

 

Javier Miranda, Principal Economist, Economy-Wide Statistics Division, US Census Bureau
Seminars
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In Live Long and Prosper?, a new eBook edited by David Bloom, AHPP director Karen Eggleston contributes the chapter "Understanding 'Value for Money' in Healthy Ageing," in which she advocates for and explains the concept of "net value of medical care," a metric that helps quantify the social value of spending on healthcare. Understanding value for money, Eggleston writes, is a way of "determining which services and technologies are unnecessary and which are of high value," a determination that is of increasing importance for aging societies, in which "spending for chronic diseases represents a large and increasing part of public and private budgets." 

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Jointly with partners throughout Asia, the Asia Health Policy Program (AHPP) at Shorenstein APARC has developed comparative research on health care use, medical spending, and clinical outcomes for patients with diabetes in the region and other parts of the world as a lens for understanding the economics of chronic disease management. Karen Eggleston, AHPP director and APARC deputy director, recently traveled to South Korea, where she led three project-related events.

On November 29, a workshop on Net Value Diabetes Management was held at Seoul National University (SNU) School of Medicine. This was the third such workshop convened through the project, following two previous ones held in Beijing at the Stanford Center at Peking University. Another workshop, on diabetes modeling, hosted by the Mt. Hood Diabetes Challenge Network, was held at Chung Ang University on December 1. Finally, on December 5, Eggleston held an information session, titled Comparative Economics Research on Diabetes, during the 2019 International Diabetes Federation (IDF) at BEXCO in Busan. These events were also made available through video conferencing to enable remote participation by collaborators who were unable to travel to Korea.

[Learn more about AHPP’s Net Value in Diabetes Management research project]

Diabetes Net Value Workshop

The workshop brought together team members from multiple health systems — including South Korea, Japan, Taiwan, Hong Kong, Thailand, India, the Netherlands, and the United States — to discuss comparative research on the economics of diabetes control. Eggleston shared the results of a study outlined in a working paper on the net value of diabetes management in Japan, the Netherlands, Taiwan, and Hong Kong. This research is part of a broader series of studies aimed to help address the policy challenge of finding the best strategies to improve health through cost effective prevention and healthcare productivity in chronic disease management.

The key to this research was to measure changes in quality or health outcomes over time by predicting mortality risk using blood pressure, blood sugar, and other factors amenable to patient and provider control and improvement (controlling for age and duration of diabetes diagnosis). The research seeks to understand how we can control cost and eliminate waste without cutting out the things that are valuable and improving people’s quality of life. Further studies probe determinants of relative net value of a pay-for-performance program in Taiwan, adherence to medications and vertical integration in Japan, and net value based on a randomized controlled trial in India.

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Karen Eggleston (left) with workshop participants.

Young Kyung Do of SNU reported that according to his evaluation project for diabetes care, the quality of care and treatment in South Korea has improved and is similar to Hong Kong and Singapore. The goal of the program is to provide more comprehensive care to diabetes patients.

Talitha Feestra of the Netherlands net value team presented her proposal for joint research to develop new prediction models for specific populations as a core component of health economics decision models in Diabetes. Feestra will take the lead to develop the plan and time frame for the continuation of this research in 2020.

Several additional comparative studies were proposed and discussed. Participants who attended the workshop and contributed to discussion included Junfeng Wang from the Netherlands net value team; Jianchao Quan and Carmen Ng from Hong Kong University; Daejung Kim from the Korea Institute for Health and Social Affairs (KIHASA); Taehoon Lee, Eun Sil Yoon, and Hongsoo Kim from SNU; Piya Hanvoravongchai from Chulalongkorn University; and Gregory Ang from National University of Singapore. Remote participants included Vismanathan Baskar from Madras Diabetes Research Foundation; Wasin Laohavinij from Chulalongkorn University (visiting Stanford University autumn quarter); and Rachel Lu from Chang Gung University.

Mt. Hood Diabetes Challenge Workshop on Diabetes Modeling

Philip Clarke from the Health Economics Research Center, University of Oxford, presented the history of insulin as a cure for diabetes and discussed in detail methods for economic modeling of diabetes, including quality of life and diabetes cost, drawing from his rich experience developing the UK Prospective Diabetes Study outcomes model. The second presenter was Andrew Palmer of University of Tasmania, Australia. His presentation included many additional economic modeling pointers, especially regarding drawing in the literature for building models.

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Karen Eggleston with participants at the Mt. Hood Diabetes Challenge Workshop; (right hand side) from left to right: Andrew Palmer, Karen Eggleston, Philip Clarke.

We are grateful to Professors Clarke and Palmer for graciously allowing the AHPP network researchers to join the workshop both in person and remotely, adding to their chronic disease modeling skills, and for inviting Karen Eggleston to present a keynote at the Mt Hood conference that took place before the modeling workshop.

Information Session: Comparative Economics Research on Diabetes

The third and final component of the diabetes research events was held on December 5 as part of the International Diabetes Federation congress in Busan, Korea, and presented the network to clinicians and public health researchers. Participants from China, India, and Australia attended. They shared updates on their individual projects and discussed methods and ideas for future collaboration.

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Using a dynamic microsimulation model, a research team, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston, shows that there are differentially positive health gains of smoking reduction among subgroups of smokers in South Korea, Singapore, and the United States.

Tobacco use is responsible for the death of approximately eight million people worldwide, estimates the World Health Organization, and countries are increasingly making tobacco control a priority. Indeed the relationship between smoking and the burden of chronic diseases such as cancer, lung disease, and heart disease, and, in turn, premature mortality, is well documented. Yet little is known about the health effects of smoking interventions among subgroups of smokers.

Do interventions targeted at heavy smokers relative to light smokers lead to disproportionately larger improvements in life expectancy and prevalence of chronic diseases? And how do these effects vary across populations? In today’s rapidly aging world, it is crucial to understand the potential health gains resulting from interventions to reduce smoking, a leading preventable risk factor for healthy aging.

That’s why a research team, including APARC Deputy Director and Asia Health Policy Program Director Karen Eggleston as well as Stanford Health Policy faculty member Jay Bhattacharya, set out to examine the health effects of smoking reduction. To do so, the team simulated an elimination of smoking among subgroups of smokers in South Korea, Singapore, and the United States.

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The team’s findings, discussed in a new paper published by the journal Health Economics, show that smoking reduction can achieve significant improvements in lifetime health as measured by survival while also reducing the prevalence of major chronic diseases, though the effects are heterogeneous. Whereas interventions in both subgroups and in all three countries led to an increased life expectancy and decreased prevalence of chronic diseases, the life-extension benefits were greatest – 2.5 to 3.7 years – for those who would otherwise have been heavy smokers, compared with gains of 0.2 to 1.5 years among light smokers.

The team developed a dynamic microsimulation model to estimate the health gains of reducing smoking among heavy smokers and light smokers. Microsimulation models are powerful tools for assessing the value of health promotion: they model individual health trajectories while accounting for competing risks, thus providing valuable information about the impact of interventions and how they may interact with the changing demographics and socioeconomic profile of a population to determine future health. The team’s study applied microsimulation models tailored to the demographic and epidemiological context in the three countries, then compared the gains in survival and reduction in chronic disease prevalence from a given reduction in smoking and how these impacts vary depending on initial smoking intensity.

The team’s findings indicate that there are differentially positive health effects from smoking reduction. The life‐year gain among heavy smokers quitting well exceeds that of light smokers quitting in each country, but the magnitudes differ substantially: 11.2 times for South Korea, 6.8 times for Singapore, and 1.7 times for the United States. The lower life expectancy among Americans is related to the greater extent in which they suffer from risk factors, such as obesity, relative to the Asian counterparts in the study.

The findings illustrate how smoking interventions may have significant economic and social benefits, especially for life extension, that vary across countries. They are particularly important for aging societies that are concerned about the sustainability of their health insurance systems in the face of increasing burden of chronic disease.

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A man smokes in the street in Seoul, South Korea. Chung Sung-Jun/ Getty Images
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Shorenstein APARC's annual overview for academic year 2018-19 is now available.

Learn about the research, events, and publications produced by the Center's programs over the last twelve months. Feature sections look at U.S.-China relations and the diplomatic impasse with North Korea, and summaries of current Center research on the socioeconomic impact of new technologies, the success of Abenomics, South Korean nationalism, and how Southeast Asian countries are navigating U.S.-China competition. Catch up on the Center's policy work, education initiatives, and outreach/events.

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Annual Reports
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