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  • Author: Brian K. Chen
  • Publication Date: 09-2013
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: How do demand - and supply - side incentives interact, when there are potentially large provider income effects? We develop a simple model and empirically test it with data from China's Essential Medications List (EML) policy, which reduced patient copayments and changed provider incentives by removing a large source of revenue from primary care providers: drug dispensing revenues. Using a panel of patient - level spending and clinical data for Chinese patients with diabetes or hypertension over two and a half years, we find evidence of strategic provider response that dampened the impact of patient copayment reductions. Resource use and patient out - of - pocket spending did not change, when taking account of patient utilization outs ide primary care.
  • Topic: Communism, Health, Governance
  • Political Geography: China, Israel
  • Author: Tetsuji Yamada, Chia-Ching Chen, Chie Hanaoka, Seiritsu Ogura
  • Publication Date: 08-2013
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: Background: For the past two decades, more and more women in certain European countries, Japan, and the United States are giving birth to their first child at a considerably later age than ever before. It remains unclear as to what extent this age-related general fertility decline is affected by changing social and cultural norms. Method: The Global Centers of Excellence Survey was conducted by Osaka University in Japan (n=5313) in 2009. Multivariate regression analyses were conducted to examine the impact of psychosocial norms, cultural differences, and economic conditions on the perception of childbearing. Results: The findings suggest that a subjective measure of happiness has a significant influence on childbearing. A society with income inequalities between classes discourages childbearing. It is observed that women's higher labor force participation generates a negative impact on motherchild relations which causes discouragement of childbearing. A higher female labor force participation stemmed from a transition of a traditional society into a modern and marketoriented society discourages childbearing. Conclusions/implications: A woman's decision to delay childbearing is based on her perception of psychosocial norms with surrounding economic environment and her own value of opportunity in the market oriented society. Childbearing also imposes psycho-economic burdens on the working population under mix of a traditional, patriarchal society, and a modern market oriented framework. Childbearing incentives could be a strategic policy to encourage positive attitudes of childbearing in general and proper welfare policy, labor law(s), employment conditions, and social security system for a working mother with a child or children.
  • Topic: Economics, Gender Issues, Health, Poverty, Social Stratification, Labor Issues
  • Political Geography: United States, Japan, Europe, Israel, Asia
  • Author: Marjorie Pajaron
  • Publication Date: 07-2013
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: This paper shows that the individual's bargaining power within the household, proxied by gender and educational attainment of household head, affects how remittances sent by Overseas Filipino Workers are spent in the Philippines. Gender of the household head, not of the remitter, matters in the allocation of remittances. As remittances increase, female heads with absent spouses spend less on alcohol and tobacco while male heads with absent spouses spend more on these goods; regardless of gender, household heads with less education allocate more to education than those with more education.
  • Topic: Economics, Education, Gender Issues
  • Political Geography: Israel, Asia, Philippines
  • Author: Walter H. Shorenstein
  • Publication Date: 06-2013
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: Meeting after North Korea had raised tensions on the Korean Peninsula in the spring, participants in the Tenth Korea-U.S. West Coast Strategic Forum focused on the implications for the Korean Peninsula of leadership changes in North and South Korea and especially China. Participants also focused on regional dynamics, including increased confrontation between China and Japan and various, sometimes conflicting, efforts to increase regional economic integration in Northeast Asia.
  • Topic: Conflict Resolution, Defense Policy, Arms Control and Proliferation, Diplomacy, Nuclear Weapons, Weapons of Mass Destruction, Bilateral Relations, Sanctions
  • Political Geography: United States, Japan, China, Israel, Asia
  • Author: Masahiko Aoki, Geoffrey Rothwell
  • Publication Date: 10-2011
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: This paper analyzes the impacts of the March 11, 2011, Tōhoku earthquake and tsunami on the Fukushima nuclear power plant in Japan. These impacts were amplified by a failure of horizontal coordination across plant, corporate, regulatory, and governmental levels, resulting in a nuclear catastrophe, comparable in cost to Chernobyl. Lessons learned include identifying two shortcomings of the typical Japanese horizontal coordination mechanism: instability under a large shock and the lack of defense in depth. The suggested policy response is to harness the power of “open-interface, rule-based modularity” by introducing an independent nuclear safety commission in Japan and an independent system operator to coordinate sellers and buyers on publicly-owned transmission grids.
  • Topic: Humanitarian Aid, Natural Disasters, Nuclear Power
  • Political Geography: Japan, Israel
  • Author: Young Kyung Do, Chetna Malhotra
  • Publication Date: 11-2010
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: The objective of this paper is to estimate the causal effect of coresidence with an adult child on depressive symptoms among older widowed women in South Korea. Data from the first and second waves of the Korea Longitudinal Study of Aging were used. Analysis was restricted to widowed women aged ? 65 years with at least one living child (N=2,449). We use an instrumental variable approach that exploits the cultural setting where number of sons predicts the probability of an elderly woman's coresidence with an adult child but is not directly correlated with the mother's depressive symptoms. Our models adjust for age, education, total assets, residence, functional limitations, self-rated health, and various illnesses. Our robust estimation results indicate that, among older widowed women, coresidence with an adult child has a significant protective effect on depressive symptoms, but that this effect does not necessarily benefit those with clinically relevant depressive symptoms. Future demographic and social transitions in South Korea portend that older women's increasing vulnerability to poor mental health is an important though less visible public health challenge.
  • Topic: Demographics, Gender Issues, Health
  • Political Geography: Israel, South Korea
  • Author: Meghan Bruce
  • Publication Date: 10-2010
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: Since 1978, China has been primarily market-focused in its provision of health care and social services. The market-driven health care system has been characterized by perverse incentives for individual providers, patients, and hospitals that are inducing improper provision of care: overprescription of pharmaceuticals and hightech testing, lack of effective primary care and gatekeeping, and competition for patients instead of referral. The national health care reform document that was made public in April 2009 recognizes this failure of the market in health care in China. The document suggests potential policies for improvement on the current system that are focused primarily on a targeted increase in government funding and an increased, changing role for the government. We assess the potential of this national health care reform to achieve the stated goals, and conclude that the reform as designed is necessary but insufficient. For the reform to meet its goals, the promised increase in funding should be accompanied by improved data collection, regional piloting, and a strong regulatory and purchasing role for the government in aligning incentives for individual and institutional payers, providers, and patients.
  • Topic: Health, Markets
  • Political Geography: China, Israel
  • Author: Donald K. Emmerson
  • Publication Date: 02-2009
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: No crisis is uniformly global. The suffering and the opportunity that a “global” crisis entails are always unevenly distributed across countries, and unevenly across the population inside any one country. That said, one can nevertheless argue that we—not the old royal “we” but, more presumptuously, the new global “we”—are in January 2009 experiencing the latest of four dramatic changes that major parts of the world have undergone over the last twenty years. In 1989, of course, the Berlin Wall was breached, ending the Cold War, followed by the implosion of Lenin's Soviet dystopia two years later. Nor did the 1989 massacre of proreform demonstrators in Tiananmen Square revive a command economy in China. Instead it kept the polity shut so that Deng's economy could continue to open.
  • Topic: International Relations, Globalization, International Political Economy
  • Political Geography: United States, China, America, Israel, Asia, Berlin
  • Author: Byong Ho Tchoe, Sang-Ho Nam
  • Publication Date: 02-2009
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: It is generally perceived that health care cost is increasing because of population aging. In Korea, the number of people over 65 years of age was 3.1 percent of the population in 1970, 5.1 percent in 1990, 7.2 percent in 2000, and 9.1 percent in 2005. These figures show that the period of time in which an aging population increases by 2 percent is getting shorter; thus aging has been accelerating.
  • Topic: Demographics, Health
  • Political Geography: Israel, Asia, Korea
  • Author: Kang-Hung Chang
  • Publication Date: 03-2009
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: When both physicians and pharmacists in Taiwan prescribed and dispensed drugs, many elderly people considered the two types of health care providers more or less synonymous (i.e., close substitutes). Two policies mandated in the 1990s changed this perception: National Health Insurance (NHI), which provides insurance coverage to all citizens, and a separation policy (SP) that forbids physicians from dispensing and pharmacists from prescribing drugs. The author finds that by providing an economic incentive to the previously uninsured elderly, NHI raised the probability that they would visit physicians, relative to their continuously insured counterparts. In particular, some previously uninsured elderly who once only visited pharmacists were more likely to also visit physicians after NHI was implemented. Following this, the SP made it more likely that all elderly patients would only visit physicians and buy drugs from on-site pharmacists hired by physicians—a result different than its policy goal.
  • Topic: Demographics, Health, Human Welfare
  • Political Geography: Israel, Taiwan, Asia
  • Author: Zhe Zhang, Ming Jia, Difang Wan
  • Publication Date: 03-2009
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: This article uses incomplete contract theory to study the allocation of control rights in public-private partnerships (PPPs) between pharmaceutical enterprises and nonprofit organizations; it also investigates how this allocation influences cooperation efficiency. We first develop a mathematic model for the allocation of control rights and its influence on cooperation efficiency, and then derive some basic hypotheses from the model. The results of an empirical test show that the allocation of control rights influences how enterprises invest in PPPs. A proper allocation provides incentives for firms to make fewer self-interested and more public-interested investments. Such an allocation also improves the cooperation efficiency of PPPs.
  • Topic: Demographics, Health, Human Welfare
  • Political Geography: China, Israel, Asia
  • Author: Karen Eggleston, Mingshan Lu, Congdong Li, Jian Wang, Zhe Yang, Jing Zhang
  • Publication Date: 04-2009
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: Government and private roles in this segment of health service delivery remain controversial in China, as in many countries. Using 2004 data from over 360 government-owned and private hospitals in Guangdong Province, we find that non-government hospitals serve an overlapping but distinct market. They are smaller, newer market entrants, more likely to specialize, and less likely to be included in urban social insurance networks. We also document differences in staffing and financial performance, but no systematic ownership differences in simple measures of quality, controlling for size, location, case-mix and other confounding factors.
  • Topic: Demographics, Government, Health, Privatization
  • Political Geography: China, Israel, Guangdong
  • Author: Christian von Luebke
  • Publication Date: 10-2009
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: The relationship between economic concentration and governance remains controversial. While some studies find that high economic concentration strengthens collective action and reform cooperation, others stress dangers of rent-seeking and state capture. In this paper I argue that effects are neither strictly positive nor negative: they are best described as an inverted-u-shaped relationship, where better governance performance emerges with moderate economic concentration. Decentralization reforms in Indonesia and the Philippines Q unprecedented in scope and scale Q provide a unique opportunity to test this hypothesis. Subnational case studies and cross-sections, from both countries, indicate that moderately concentrated polities are accompanied by better service and lower corruption. The presence of Scontested oligarchiesT Q small circles of multi-sectoral interest groupsQ creates a situation where economic elites are strong enough to influence policymakers and, at the same time, diverse enough to keep each other in check. The results of this paper suggest that contested oligarchies compensate for weakly-developed societal and juridical forces and can become a stepping stone to good governance.
  • Topic: Economics, Government, Markets
  • Political Geography: Indonesia, Israel, Asia, Philippines
  • Author: Karen Eggleston
  • Publication Date: 10-2008
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: The economic approach of comparative and historical institutional analysis (Aoki 2001, Greif 2006) has virtually never been used in theoretical studies of healthcare incentives. This paper seeks to help fill this gap by exploring the explanatory power of such an approach for understanding incentives in China's healthcare delivery system. It focuses on positive analysis of why China's health system incentives evolved the way they did. The first section analyzes the institution of physician dispensing (MDD) and reforms toward separation of prescribing from dispensing (SPD), in historical and comparative perspective. It shows, for example, how MDD was a self-reinforcing institution; the longer a society remains under MDD, the higher the associated costs of supplier-induced demand can be before implementing SPD becomes the efficient self-enforcing social institution. Rapid technological change and adoption of universal coverage are likely to trigger SPD reforms. The second section seeks to explain the pattern and impact of price regulation and hospital payment reforms in contemporary China, which also reflect the legacy of MDD.
  • Topic: Government, Health, Human Welfare
  • Political Geography: China, Israel, Asia
  • Author: Young Kyung Do
  • Publication Date: 12-2008
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: Embedded in traditional culture perpetuating family-centered elderly care, informal care is still viewed as a family or moral issue rather than a social and policy issue in South Korea. Using newly available micro data from the Korean Longitudinal Study of Aging, this study investigates the effect of informal caregiving on labor market outcomes in South Korea. By doing so, this study provides evidence to inform elderly long-term care policy in South Korea, and also fills a gap in the international literature by providing results from an Asian country. Empirical analyses address various methodological issues by investigating gender differences, by examining both extensive and intensive labor market adjustments with two definitions of labor force participation, by employing different functional forms of care intensity, and by accounting for the potential endogeneity of informal care as well as intergenerational co-residence. Robust findings suggest negative effects of informal caregiving on labor market outcomes among women, but not among men. Compared with otherwise similar non-caregivers, female intensive caregivers who provide at least more than 10 hours of care per week are at an increased risk of being out of the labor force by 15.2 percentage points. When examining the probability of employment in the formal sector only, the effect magnitude is smaller. Among employed women, more intensive caregivers receive lower hourly wages by 1.65K Korean Won than otherwise similar non-caregivers. Informal care is already an important economic issue in South Korea even though aging is still at an early stage.
  • Topic: Demographics, Health, Markets
  • Political Geography: Israel, Asia, South Korea
  • Author: Mary Comerford Cooper
  • Publication Date: 06-2003
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: This paper considers two questions. First, why did the Chinese government establish stock markets? Second, how have political interests shaped the key features of these markets? Based on both interviews and statistical analysis, the paper argues that China's top Party-State leaders attempted to create stock market institutions that allow the state to maintain control over listed companies, and over “the market” as a whole.
  • Topic: Economics, Government
  • Political Geography: China, Israel, East Asia, Asia
  • Author: Michael H. Armacost, Daniel I. Okimoto, Gi-Wook Shin
  • Publication Date: 04-2003
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: North Korea's renewed bid for nuclear weapons poses an urgent, serious foreign policy challenge to the United States. The current situation—though it bears a resemblance to the events of 1993–1994—is far more dangerous and difficult. North Korea has developed longer-range ballistic missiles; South Korea's growing nationalism has put its U.S. relations on shakier ground; and the United States is distracted by the wars on terrorism and for regime change in Iraq.
  • Topic: Nuclear Weapons, Weapons of Mass Destruction
  • Political Geography: United States, Iraq, Israel, East Asia, Asia, South Korea, North Korea, Palestine
  • Author: Henry Rowen, A. Maria Toyoda
  • Publication Date: 10-2002
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: How much does it matter that Japan creates relatively few new high technology companies? Many observers estimate, or at least assume, that entrepreneurial dynamism and its associated innovations promote economic growth and in the long run are necessary for it. In recent years there has been much attention devoted to fostering such new firms in many countries, including Japan, with much of this interest derived from the example of Silicon Valley. Before the 1990s, after several decades of excellent performance by the Japanese industry, any observer noting that it had few new high tech companies would probably have met with indifference. Success spoke for itself. Now, after an economic plateau lasting over a decade, questions about the late and relatively small-scale emergence of high tech startups have become increasingly salient.
  • Topic: Industrial Policy, Science and Technology
  • Political Geography: Japan, Israel, East Asia, Asia
  • Author: Jimmy Carter
  • Publication Date: 08-2002
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: The Oksenberg Lectures honor the legacy of Professor Michel Oksenberg (1938–2001), Senior Fellow at the Asia/Pacific Research Center, professor of political science, and a foremost authority on China.
  • Topic: Development
  • Political Geography: China, Israel, East Asia, Asia
  • Author: Nicole Pole
  • Publication Date: 07-2002
  • Content Type: Working Paper
  • Institution: Asia-Pacific Research Center
  • Abstract: Foreign banks have long faced difficulties in attempting to enter certain Japanese financial markets. This is due partly to regulatory practices and partly to specific Japanese socioeconomic conditions, for instance the system of relationship banking. While retail banking is still a sector in which almost no foreigners have been able to succeed, some foreign financial institutions have been able to gain market share in investment and wholesale banking.
  • Topic: Economics, International Trade and Finance
  • Political Geography: Japan, Israel, East Asia, Asia