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2. 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
3. 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
4. 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
5. 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
6. 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
7. Vote of Confidence, A? Voting Protocol and Participation in China's Village Elections
- Author:
- Xiaopeng Pang and Scott Rozelle
- Publication Date:
- 01-2007
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- The goal of our paper is to provide an empirical basis for understanding progress (or stagnation) in the evolution of China's village committee elections. To meet this goal, we pursue three specific objectives. First, we seek to identify patterns (and trends) of voting behavior and develop ways to measure participation in the voting process. Second, we analyze who is voting and who is not (and document the process by which their votes are cast). Finally, we see to understand the correlation between propensity to vote and the quality of village elections.
- Topic:
- Government and Politics
- Political Geography:
- China and Asia
8. Village Elections, Public Goods Investments and Pork Barrel Politics, Chinese-style
- Author:
- Jikun Huang, Renfru Luo, Linxiu Zhang, and Scott Rozelle
- Publication Date:
- 01-2007
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- A key issue in political economy concerns the accountability that governance structures impose on public officials and how elections and representative democracy influences the allocation of public resources. In this paper we exploit a unique survey data set from nearly 2450 randomly selected villages describing China's recent progress in village governance reforms and its relationship to the provision of public goods in rural China between 1998 and 2004. Two sets of questions are investigated using an empirical framework based on a theoretical model in which local governments must decide to allocate fiscal resources between public goods investments and other expenditures. First, we find evidence—both in descriptive and econometric analyses—that when the village leader is elected, ceteris paribus, the provision of public goods rises (compared to the case when the leader is appointed by upper level officials). Thus, in this way it is possible to conclude that democratization—at least at the village level in rural China—appears to increase the quantity of public goods investment. Second, we seek to understand the mechanism that is driving the results. Also based on survey data, we find that when village leaders (who had been elected) are able to implement more public projects during their terms of office, they, as the incumbent, are more likely to be reelected. In this way, we argue that the link between elections and investment may be a rural China version of pork barrel politics.
- Topic:
- Democratization, Government, Political Economy, and Politics
- Political Geography:
- China
9. Water User Associations and the Evolution and Determinants of Management Reform: A Representative Look at Northern China
- Author:
- Jikun Huang, Qiuqiong Huang, Jinxia Wang, and Scott Rozelle
- Publication Date:
- 02-2007
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Increasing demand for China's limited water resources (across China, but mostly in northern China) from rapidly growing industry, urban populations and agriculture implies potentially dire consequences for the sustainability of water use and drastic changes in cultivation patterns (Zhang, 2001). Problems in the water sector also have significant implications for China's future trade position in key crops and may affect the income of the farming sector (Huang et al., 1999).
- Topic:
- Agriculture, Development, Environment, and Government
- Political Geography:
- China and Asia
10. Water Management Reform and the Choice of Contractual Form in China
- Author:
- Siwa Msangi, Qiuqiong Huang, Jinxia Wang, Jikin Huang, and Scott Rozelle
- Publication Date:
- 02-2007
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- This paper explains the puzzling fact that in organizing the management of surface water, village leaders have provided incentives to canal managers in some areas, but not in all. Our study indicates that the optimal contractual choice depends on the relative abilities of the leader and the manager, the design of the cultivated land, the characteristics of the canal system and the opportunity costs of the leader and the pool of managerial candidates. The unifying mechanism is the relative change in the ability of the leader and manager to perform the unmarketable activities that are needed to provide irrigation services.
- Topic:
- Agriculture, Development, Environment, and Government
- Political Geography:
- China
11. Why Did the Communist Party Reform in China, But Not in the Soviet Union? The Political Economy of Agricultural Transition
- Author:
- Johan Swinnen and Scott Rozelle
- Publication Date:
- 01-2007
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- The dramatic transition from Communism to market economies across Asia and Europe started in the Chinese countryside in the 1970s. Since then more than a billion of people, many of them very poor, have been affected by radical reforms in agriculture. However, there are enormous differences in the reform strategies that countries have chosen. This paper presents a set of arguments to explain why countries have chosen different reform policies.
- Topic:
- Agriculture, Development, Government, and Political Economy
- Political Geography:
- Russia, China, Europe, Asia, and Soviet Union
12. Water price policy analysis in China:An experimental approach
- Author:
- Jikun Huang, Qiuqiong Huang, Jinxia Wang, Jun Xia, Scott Rozelle, and Dean Karlan
- Publication Date:
- 01-2007
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Water scarcity is one of the key problems that affect northern China, an area that covers 40 percent of the nation's cultivated area and houses almost half of the population. The water availability per capita in North China is only around 300 m per capita, which is less than one seventh of the national average (Ministry of Water Resources, 2002). At the same time, expanding irrigated cultivated area, the rapidly growing industrial sector and an increasingly wealthy urban population demand rising volumes of water (Crook, 2000, Wang, et al., 2005). As a result, groundwater resources are diminishing in large areas of northern China (Wang, et al., 2005). For example, between 1958 and 1998, groundwater levels in the Hai River Basin fell by up to 50 meters in some shallow aquifers and by more than 95 meters in some deep aquifers (Ministry of Water Resource, et al., 2001).
- Topic:
- Agriculture, Development, Environment, Government, and Industrial Policy
- Political Geography:
- China
13. Spatial and Temporal Patterns of Urban Dynamics in Chengdu, 1975–2002
- Author:
- Douglas Webster, Jianming Cai, Binyi Luo, Annemarie Schneider, and Karen C. Seto
- Publication Date:
- 10-2003
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Chengdu, the provincial capital of Sichuan, has undergone rapid transformation during China's post-reform period between 1978 and 2003. One of the leading cities in southwest China, Chengdu is second only to Chongqing in population. Chengdu anchors one end of the Chongqing-Chengdu urban corridor, the fourth most populous urban cluster in China. Although the upgrading of Chongqing Municipality to the equivalent of provincial status in 1997 has increased the city's profile and potential as an administrative, land transportation, and manufacturing center, it is expected that Chengdu's regional and strategic importance as a service and high-tech center will increase in the future. With increased economic specialization among Chinese cities, it is expected that Chengdu and Chongqing cities will increasingly complement each other in terms of function, both enhancing their developmental prospects as a result. Further, the development of western China is a major objective of the Tenth Five Year Plan. The “Go West” policy was introduced in 1999.
- Topic:
- Economics, Government, and Politics
- Political Geography:
- China, Asia, Chongqing, and Chengdu
14. Tax Reforms for Enhancing the Stable Development of the Chinese Financial System
- Author:
- Lawrence J. Lau and Guijuan Wang
- Publication Date:
- 09-2003
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- The Chinese economy has had the highest rate of growth in the world in the past two decades. However, despite its rapid growth and the significant improvements in its financial system, serious risks and problems still exist in both the commercial banking sector and the stock market, that may potentially threaten the stable development and growth of the entire economy. In this paper, these risks and problems in the stock market and the commercial banking sector are identified. Possible solutions are then discussed. Finally, tax reforms are proposed that have the effects of (1) eliminating the double taxation on cash dividends from corporate profits; (2) encouraging the substitution of new equity for existing debt by corporations, which can lower the P/E ratios without lowering the stock prices and improve quality of commercial bank assets by reducing the probability of new nonperforming loans; and (3) attracting new and longer-term investors, both domestic and foreign, to the Chinese stock market. It is also shown that the proposed tax reforms will not result in a significant reduction in total fiscal revenue.
- Topic:
- Economics and Government
- Political Geography:
- China and Asia
15. The Politics of China's Shareholding System
- Author:
- Mary Comerford Cooper
- Publication Date:
- 06-2003
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein 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 and Government
- Political Geography:
- China, Israel, East Asia, and Asia
16. Local Governments and the Chinese Stock Market
- Author:
- Mary Comerford Cooper
- Publication Date:
- 04-2003
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- This paper examines a key aspect of the politics of stock markets in China—the distinct differences in interests between central government leaders and local governments. Central government leaders have a powerful incentive to promote macroeconomic stability and good performance of the stock market. Local leaders, for their part, are less concerned with the overall performance of the stock market than with gaining access to the stock market for companies under their own jurisdiction. The paper demonstrates that company listing brings tangible economic benefits to municipalities. Listed companies are associated with higher levels of gross domestic product (GDP), budgetary revenue, and industrial and commercial tax revenue. Therefore, it is not surprising that local officials put substantial effort into lobbying for the right to list additional companies on the national stock exchanges.
- Topic:
- Communism, Democratization, Economics, and Government
- Political Geography:
- China and Asia
17. Sociological Dimensions of China's Economic Transition: Organization, Stratification, and Social Mobility
- Author:
- Andrew G. Walder
- Publication Date:
- 04-2003
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Despite skepticism about official economic statistics, there is little doubt that China since 1978 has undergone an economic transformation of historic proportions. This outcome stands in stark opposition to arguments that were once widely accepted in several scholarly communities, and which are still highly influential even today. In the early 1980s there was wide agreement that “partial” reform, under a single party dictatorship that sought indefinitely to preserve public ownership, was a recipe for failure. China specialists, students of comparative economic systems, and economists who advised governments and international agencies about postcommunist restructuring in Eurasia were initially in broad agreement on this point.
- Topic:
- Economics, Government, and Politics
- Political Geography:
- China and Asia
18. International Organizations and Democratization: Testing the Effect of GATT/WTO Membership
- Author:
- Mary Comerford Cooper
- Publication Date:
- 04-2003
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Does the World Trade Organization promote democracy? A large part of the heated and protracted debate over China's application for WTO membership revolved around this question. Prior to China's WTO accession in December 2001, this debate had dragged on for nearly fifteen years. While one side argued that WTO membership would promote democratization in China, others argued that the wealth generated through economic integration would provide the resources to maintain authoritarian rule. Only time will tell whether WTO accession will contribute to pressures for democratization in China. In the meantime, however, this paper examines the empirical basis for these competing claims about the effects of GATT/WTO memberships on domestic political systems. Based on statistical analysis of a global data set, this paper concludes that members of the international trade regime are more likely than nonmembers to be democracies. However, there is little evidence that WTO membership in itself can promote democratic transition. Instead, it appears to be the case that democratic countries are more likely to seek to join the WTO.
- Topic:
- Communism, Democratization, Economics, and Government
- Political Geography:
- China and Asia
19. Politics and Property in Transitional Economies: A Theory of Elite Opportunity
- Author:
- Andrew G. Walder
- Publication Date:
- 04-2003
- Content Type:
- Working Paper
- Institution:
- Walter H. Shorenstein Asia-Pacific Research Center
- Abstract:
- Command economies gave communist-era elites administrative control and material privilege but severely restricted money income and private wealth. Markets and privatization inject new value into public assets and create unprecedented opportunities for elite insiders to extract incomes or assume ownership. These opportunities vary with the extensiveness of regime change and the barriers to asset appropriation. Within these limits, they further vary with the concentration and form of economic assets and structural changes induced by reform. Elite advantages are smallest where regime change is extensive and barriers to asset appropriation are high, and in small-scale economies that grow rapidly. In China, there has been no regime change and privatization has been delayed and slow. In the rural economy, elites keep their posts as a source of economic advantage, while low entry barriers to household enterprise and rapid growth have created new entrepreneurial elites. After two decades, rural officials nonetheless enjoy large net income advantages that grow along with the expansion of labor markets and private entrepreneurship. These are not generic outcomes of market reform, but the product of market reform in distinctive political and structural conditions.
- Topic:
- Communism, Economics, Government, and International Trade and Finance
- Political Geography:
- China and Asia