FSI scholars approach their research on the environment from regulatory, economic and societal angles. The Center on Food Security and the Environment weighs the connection between climate change and agriculture; the impact of biofuel expansion on land and food supply; how to increase crop yields without expanding agricultural lands; and the trends in aquaculture. FSE’s research spans the globe – from the potential of smallholder irrigation to reduce hunger and improve development in sub-Saharan Africa to the devastation of drought on Iowa farms.
Private Hospital Behavior Under Government Insurance in India
This event is part of the Asia Health Policy Program (AHPP) 2020-21 Colloquium series "Health, medicine, and longevity: Exploring public and private roles"
Over the last decade, India has rapidly expanded government health insurance programs that entitle low-income households to free hospital care. In a major policy shift away from direct public provision of healthcare, these programs contract private hospitals for service delivery. This constitutes a sizeable public subsidy delivered through private agents, but there is relatively little evidence on how private hospitals perform. Using a unique dataset on 6 million insurance claims and 15,000 patient surveys, this talk will present several key insights on the behavior of private hospitals within a large government insurance program. 1) Private hospitals manipulate coding to increase their revenues at the government's expense. 2) They also charge patients out-of-pocket for care that is supposed to be free under program rules. 3) When the government increases hospital reimbursement rates, patient charges decrease substantially. 4) However, hospitals capture approximately half the increased subsidy and this is driven by less competitive markets. The results demonstrate that hospital reimbursement rates are a key policy lever shaping hospital behavior with implications for program outcomes. Improving program performance requires a combination of stronger hospital monitoring and attention to reimbursement rates; focusing on one without the other may reduce the efficiency of public spending or worsen patient welfare. Lastly, market structure, a factor rarely taken into consideration in health policy in India, may play a role in the extent to which public subsidies benefit patients.
https://aparc.fsi.stanford.edu/asiahealthpolicy/news/postdoctoral-spotlight-radhika-jain
She completed her doctorate in the Department of Global Health at Harvard University in 2019. Her dissertation examined the extent to which government subsidies for health care under insurance are captured by private hospitals instead of being passed through to patients, and whether accountability measures can help patients claim their entitlements. Dr. Jain's research has been supported by grants from the Weiss Family Fund and the Jameel Poverty Action Lab (JPAL). She has worked on impact evaluations of health programs in India and on the implementation of HIV programs across several countries in sub-Saharan Africa. She also held a doctoral fellowship at the Center for Global Development.
At Shorenstein APARC, Radhika is starting new work on understanding the factors that contribute to poor female health outcomes and interventions to increase the effectiveness of public health insurance.
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Radhika Jain
Radhika Jain was the Asia Health Policy Postdoctoral Fellow for 2019-2022 at the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC). Her research focuses on health care markets, the effectiveness of public health policy, and gender disparities in health.
She completed her doctorate in the Department of Global Health at Harvard University in 2019. Her dissertation examined the extent to which government subsidies for health care under insurance are captured by private hospitals instead of being passed through to patients, and whether accountability measures can help patients claim their entitlements. Dr. Jain's research has been supported by grants from the Weiss Family Fund and the Jameel Poverty Action Lab (JPAL). She has worked on impact evaluations of health programs in India and on the implementation of HIV programs across several countries in sub-Saharan Africa. She also held a doctoral fellowship at the Center for Global Development.
At Shorenstein APARC, Radhika began new work on understanding the factors that contribute to poor female health outcomes and interventions to increase the effectiveness of public health insurance.
Karen Eggleston is a senior fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University, director of the Stanford Asia Health Policy Program, and deputy director of the Walter H. Shorenstein Asia-Pacific Research Center at FSI. She is also a fellow with the Stanford Center for Innovation in Global Health and a faculty research fellow of the National Bureau of Economic Research (NBER). Eggleston earned her PhD in public policy from Harvard University, studied in China for two years, and was a Fulbright scholar in South Korea. Her research focuses on comparative health systems and health reform in Asia, especially China; government and market roles in the health sector; supply-side incentives; healthcare productivity; and economic aspects of demographic change.
Thomas Fingar is a Shorenstein Distinguished Fellow in the Shorenstein Asia-Pacific Research Center at Stanford University. From May 2005 through December 2008, he served as the first deputy director of national intelligence for analysis and, concurrently, as chairman of the National Intelligence Council. Previous positions include assistant secretary of state for Intelligence and Research (2000-2001, 2004–2005), principal deputy assistant secretary (2001–2003), deputy assistant secretary for analysis (1994–2000), director of the Office of Analysis for East Asia and the Pacific, and chief of the China Division. Fingar is a graduate of Cornell University (AB in government and history) and Stanford University (MA and PhD, both in political science). His most recent books are Uneasy Partnerships: China’s Engagement with Japan, the Koreas, and Russia in the Era of Reform (editor) (Stanford University Press, 2017); The New Great Game: China’s Relations with South and Central Asia in the Era of Reform (editor) (Stanford University Press, 2016); and Reducing Uncertainty: Intelligence Analysis and National Security (Stanford University Press, 2011).
Jean C. Oi is the William Haas Professor of Chinese Politics in the Department of Political Science and a senior fellow in the Freeman Spogli Institute for International Studies at Stanford University. She directs the China Program at the Walter H. Shorenstein Asia-Pacific Research Center and is the Lee Shau Kee Director of the Stanford Center at Peking University. Oi has published extensively on China’s reforms. Recent books include Zouping Revisited: Adaptive Governance in a Chinese County, coedited with Steven Goldstein (Stanford University Press, 2018), and Challenges in the Process of China’s Urbanization, coedited with Karen Eggleston and Yiming Wang (2017). Current research is on fiscal reform and local government debt, continuing SOE reforms, and the Belt and Road Initiative.
Andrew G. Walder is the Denise O’Leary and Kent Thiry Professor of Sociology in the School of Humanities and Sciences, and a senior fellow in the Freeman Spogli Institute for International Studies at Stanford University. A political sociologist, Walder has long specialized in the study of contemporary Chinese society and political economy. After receiving his PhD at the University of Michigan, he taught at Columbia, Harvard, and the Hong Kong University of Science and Technology. At Stanford he has served as chair of the Department of Sociology, director of the Asia-Pacific Research Center, and director of the Division of International, Comparative, and Area Studies in the School of Humanities and Sciences. His most recent books are Fractured Rebellion: The Beijing Red Guard Movement (2009), China under Mao: A Revolution Derailed (2015), and Agents of Disorder: Inside China’s Cultural Revolution (2019).