International Development

FSI researchers consider international development from a variety of angles. They analyze ideas such as how public action and good governance are cornerstones of economic prosperity in Mexico and how investments in high school education will improve China’s economy.

They are looking at novel technological interventions to improve rural livelihoods, like the development implications of solar power-generated crop growing in Northern Benin.

FSI academics also assess which political processes yield better access to public services, particularly in developing countries. With a focus on health care, researchers have studied the political incentives to embrace UNICEF’s child survival efforts and how a well-run anti-alcohol policy in Russia affected mortality rates.

FSI’s work on international development also includes training the next generation of leaders through pre- and post-doctoral fellowships as well as the Draper Hills Summer Fellows Program.

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One of the most persistent and important questions in international comparisons of health systems pertains to the wide divergence in costs between countries. Japan has significantly lower per capita health care costs than does the United States, despite having a fee-for-service reimbursement system and universal coverage, and aggressively purchasing and utilizing equipment-embodied medical technologies. 1 One important factor in the increase in American health care costs over time has been the substitution of surgical intervention for medical treatment. 2 This leads us to consider differential rates of surgery as a potential explanation for divergent cost performances. Indeed, although Japan has one-half the inpatient admission rate of the United States, it has only one-quarter the surgery rate per capita

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Reprint from Lawrence R. Klein and Chuan-Tao Yu, eds., Economic Development of ROC and the Pacific Rim in the 1990's and Beyond (World Scientific Publishing, 1994).

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We use newly released data on Japanese hospitals to explore patients’ perceptions of hospital quality, the implications of these assessments for the structure of demand for hospital care, and the role of the availability and quality of hospital care in influencing access. We find that the primary influences on hospital choice for Japanese patients are interpersonal aspects of care, that Japanese hospital markets are not segmented, and that availability has no influence on access. These results are interpreted in light of institutional differences between the Japanese and American health care systems.

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