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12. Soft budget constraints in China: Evidence from the Guangdong hospital industry
- Author:
- Karen Eggleston, Mingshan Lu, Congdong Li, Jian Wang, Zhe Yang, Jing Zhang, and Yu-Chu Shen
- Publication Date:
- 03-2009
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Using data from 276 general acute hospitals in the Pearl River Delta region of Guangdong Province from 2002 and 2004, we construct a preliminary metric of budget constraint softness. We find that, controlling for hospital size, ownership, and other factors, a Chinese hospital's probability of receiving government financial support is inversely associated with the hospital's previous net revenue, an association consistent with soft budget constraints.
- Topic:
- Government, Health, and Financial Crisis
- Political Geography:
- China and Asia
13. The Emerging Role of Private Health Care Provision in China
- Author:
- Cunrui Huang, Haocai Liang, Cordia Chu, Shannon Rutherford, and Qingshan Geng
- Publication Date:
- 09-2009
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- China continues to face great challenges in meeting the health needs of its large population. The challenges are not just lack of resources, but also how to use existing resources more efficiently, more effectively, and more equitably. Now a major unaddressed challenge facing China is how to reform an inefficient, poorly organized health care delivery system. The objective of this study is to analyze the role of private health care provision in China and discuss the implications of increasing private-sector development for improving health system performance.
- Topic:
- Government and Health
- Political Geography:
- China and Asia
14. Crisis and Consensus; America and ASEAN in a New Global Context
- Author:
- Donald K. Emmerson
- Publication Date:
- 02-2009
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein 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, and International Political Economy
- Political Geography:
- United States, China, America, Israel, Asia, and Berlin
15. Allocation of control rights and cooperation efficiency in public-private partnerships: Theory and evidence from the Chinese pharmaceutical industry
- Author:
- Zhe Zhang, Ming Jia, and Difang Wan
- Publication Date:
- 03-2009
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein 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, and Human Welfare
- Political Geography:
- China, Israel, and Asia
16. Comparing Public and Private Hospitals in China: Evidence from Guangdong
- Author:
- Karen Eggleston, Mingshan Lu, Congdong Li, Jian Wang, Zhe Yang, and Jing Zhang
- Publication Date:
- 04-2009
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein 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, and Privatization
- Political Geography:
- China, Israel, and Guangdong
17. Incentives in China's Healthcare Delivery System
- Author:
- Karen Eggleston
- Publication Date:
- 10-2008
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein 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, and Human Welfare
- Political Geography:
- China, Israel, and Asia
18. The Political Economy of Successful Reform: Asian Stratagems
- Author:
- Dennis Arroyo
- Publication Date:
- 06-2008
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Major economic reforms are often politically difficult, causing pain to voters and provoking unrest. They may be opposed by politicians with short time horizons. They may collide with the established ideology and an entrenched ruling party. They may be resisted by bureaucrats and by vested interests. Obstacles to major economic reform can be daunting in democratic and autocratic polities alike.
- Topic:
- Economics, Government, and Political Economy
- Political Geography:
- China, India, Asia, South Korea, Vietnam, Singapore, and Thailand
19. Managing Pest Resistance in Fragmented Farms: An Analysis of the Risk of Bt Cotton in China and its Zero Refuge Strategy and Beyond
- Author:
- Fangbin Qiao, Jim Wilen, and Jikun Huang
- Publication Date:
- 02-2007
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- The goal of this study is to discuss why China and perhaps other developing countries may not need a refuge policy for Bacillus thuringiensis (Bt) cotton. We describe in detail the different elements that a nation—especially a developing one—should be considering when deciding if a refuge policy is needed. Drawing on a review of scientific data, economic analysis of other cases and a simulation exercise using a bio-economic model that we have produced to examine this question, we show that in the case of Bt cotton in China, the approach of not requiring special cotton refuges is defensible.
- Topic:
- Agriculture and Economics
- Political Geography:
- China and Asia
20. When Dragons and Kangaroos Trade: China's Rapid Economic Growth and Its Implications for China and Australia
- Author:
- Jikun Huang, Jun Yang, and Scott Rozelle
- Publication Date:
- 02-2007
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- China's economy has experienced remarkable growth since economic reforms were initiated in the late 1970s and pushed forward by a number of complementary policies. Since the mid-1980s, rural township and village-owned enterprises (TVEs) development; measures to provide a better market environment through domestic market reform; fiscal and financial expansions; the devaluation of exchange rate; trade liberalisation; the expansion of special economic zones to attract foreign direct investment (FDI); the state-owned enterprise (SOE) reform; agricultural market liberalisation, and many other reforms have all contributed to China's economic growth. In response, the annual growth rate of gross domestic product (GDP) was about nearly 10% in 1979–2004 (National Bureau of Statistics of China 2005).
- Topic:
- Agriculture and International Trade and Finance
- Political Geography:
- China, Asia, Australia, and Australia/Pacific