The Japan Program held the third annual Stanford Summer Juku on Japanese Political Economy from August 10-13. Over 40 scholars from various parts of the US and Japan participated in the conference, which took place at the Bechtel Conference Center at Encina Hall. The first two days focused on political science and the second day on economics. Distinctive features of the Summer Juku are the long times allotted to each paper to allow for two in-depth discussants and discussion among participants, as well as ample time for informal discussions and interactions among participants allowing for collaborations and expansion of the network of researchers on Japan in political science and economics. Particularly notable this year was a large number of cross-disciplinary and cross-national collaborations between scholars ranging from political science, economics, management, infomatics, and medicine.

The first day included four papers in political science. Amy Catalinac from New York University presented her paper, "Positioning Under Alternative Electoral Systems: Evidence from 7,497 Japanese Candidate Election Manifestos", with discussants Gary Cox (Stanford) and Harukata Takenaka (National Graduate Institute for Policy Studies, Japan).

Daniel Smith (Harvard University) presented a paper co-authored by Yusaku Horiuchi (Dartmouth College) and Teppei Yamamoto (MIT) entitled "Identifying Multidimensional Policy Preferences of Voters in Representative Democracies: A Cojoint Field Experiment in Japan". The Discussants for the paper were Kay Shimizu (Columbia University) and Karen Jusko (Stanford).

Harukata Takenaka from the National Graduate Institute for Policy Studies presented his paper on “Changes in Power of Japanese Prime Minister: Still Away from a Westminster Model.” Tsuneo Akaha (Middlebury Institute of International Studies at Monterey) and Kenji Kushida (Stanford University) were the discussants.

The fourth paper was “Territorial Issues and Support for the Prime Minister: A survey Experiment on Rally-‘Round-the Flag Effect in Japan” by Tetsuro Kobayashi (National Institute of Informatics, Japan) and Azusa Katagiri (Stanford), discussed by Tsuneo Akaha (Middlebury Institute of International Studies at Monterey) and Daniel Smith (Harvard).

The second day focused on political economy and international relations. Gene Park (Loyola Marymount University, and former Shorenstein Fellow at APARC) presented his paper co-authored with Saori Katada (University of Southern California) and Giacomo Chiozza (Vanderbilt University) entitled “Policy ideas and monetary policy: The Bank of Japan's delayed break with the monetary orthodoxy". Discussants were Azusa Katagiri (Stanford) and Ayako Saiki (De Netherlandsche Bank).

The second paper of the day was "The Political Economy of the Trans-Pacific Partnership: Implications beyond Economics" by Hiroki Takeuchi (Southern Methodist University), discussed by Kay Shimizu (Columbia University) and Gene Park (Loyola Marymount University). 

After lunch, Llewelyn Hughes (Australian National University) presented "Lead Markets, Vertical Specialization, and Standards Competition in Electric Vehicles" with discussants Kenji Kushida (Stanford University) and Phillip Lipscy (Stanford University). The final session was "Renegotiating the World Order: Institutional Change in International Relations” which were select chapters from a book manuscript by Phillip Lipscy (Stanford University). The discussants were Amy Catalinac (New York University) and Llewelyn Hughes (Australian National University). A group dinner followed the second day.

The third day was the kick-off for economics papers, where we also saw cross-disciplinary collaborations with colleagues from the US and Japan.

Karen Eggleston (Stanford University) presented “Medical spending and health care utilization in Japan, 2010-2014: Projections from Future Elderly Model microsimulation”, which was co-authored by Hawre Jajal (Stanford University), Brian K. Chen (University of Southern California), Hideki Hashimoto (University of Tokyo), Toshiaki Iizuka (University of Tokyo), Lena Shoemaker (Stanford University), and Jay Bhattacharya (Stanford University). Yong Suk Lee (Stanford University) was the discussant.

The second paper, "The adverse effects of value-based purchasing in health care: dynamic quantile regression with endogeneity" by Galina Besstremyannaya (Visiting Scholar, Stanford University), was discussed by Jay Battacharya (Stanford University) and Takeo Hoshi (Stanford University).

The third paper was ""How Do Agricultural Markets Respond to Radiation Risk? Evidence from the 2011 Disaster in Japan" by Kayo Tajima (Rikkyo University), Masashi Yamamoto (University of Toyama), and Daisuke Ichinose (Rikkyo University). Discussants for the paper presented by Tajima were Satoshi Koibuchi (Chuo University and Visiting Scholar, Stanford University) and Yong Suk Lee (Stanford University).

The final paper for the third day was "Shocks and Shock Absorbers in Japanese Bonds and Banks During the Global Financial Crisis" by Hyonok Kim (Tokyo Keizai University), Yukihiro Yasuda (Hitotsubashi University), and James A. Wilcox (University of California, Berkeley). Discussants were Sabrina Howell (New York University) and Suparna Chakraborty (University of San Francisco).

The final day included two papers. The first was "Impact of Financial Intermediary's Information Production on Market Value of Firm: Case Studies on the DBJ's Liquidity Providing During the Financial Crisis and the Environmental Rating of Firm" by Hiroaki Suzuoka (Development Bank of Japan), Atsushi Motohashi (Development Bank of Japan), Shinya Nakamura (Development Bank of Japan), Tomoya Maruoka (Development Bank of Japan), and Takamasa Uesugi (Development Bank of Japan), presented by Takamasa Uesugi. Discussants were Jess Diamond (Hitotsubashi University) and Masami Imai (Wesleyan University). The final paper was "Selective Disclosure: The Case of Nikkei Preview Articles" by William N. Goetzmann (Yale School of Management), Yasushi Hamao (University of Southern California), and Hidenori Takahashi (Kobe University), presented by Yasushi Hamao. Eiichiro Kazumori (University of Buffalo) was the discussant.

After the completion of four days of Summer Juku, participants who had enough time before their flights held an “uchiage” (completion celebration) gathering—a tradition at the conclusion of the Summer Juku—at “The Patio” in downtown Palo Alto for further informal exchange over drinks and appetizers.

The prestigious panel of medical experts who provoked a nationwide debate when it suggested fewer mammograms is standing by its recommendation that women 50 and older only get the screening every other year.

The U.S. Preventive Services Task Force issued an update of its 2009 guidelines on Tuesday, noting that women in their 40s with an average risk of breast cancer should discuss mammography with their clinicians and make individual decisions about whether to have the screening.

When the panel made the panel first made the recommendation, it provoked an outcry from some medical associations and cancer-awareness advocates who feared the advice would lead some women to delay having mammograms and put them at greater risk of death.

“In 2015, contentious discussions about breast cancer screening and prevention continued, with physicians, advocates, lawmakers, and scientists all lending their voices to the debate,” the Task Force said in an editorial on its website.

“Many of these stakeholders focused on the need for women to be able to make more informed health care choices about when to start screening without having to worry about the cost of an insurance copayment,” said the panel of experts, including Stanford Health Policy’s Douglas K. Owens, director of the Center for Health Policy and the Center for Primary Care and Outcomes Research.

“The role of the U.S. Preventive Services Task Force (USPSTF) in these discussions has remained unchanged: to empower women with the best scientific data about the benefits and harms associated with breast cancer screening, so they can make an informed decision with their doctor.”

Breast cancer is the second-leading cause of cancer death among women in the United States, according to the National Cancer Institute. In 2015, an estimated 232,000 women were diagnosed with the disease and 40,000 women died. It is most frequently diagnosed among women aged 55 to 64 years, and the median age of death from breast cancer is 68 years.

The task force determined that while screening mammography in women aged 40 to 49 may reduce the risk for breast cancer death, the number of deaths averted is smaller than that in older women and the number of false-positive results and unnecessary biopsies is larger.

The balance of benefits and harms is likely to improve as women move from their early to late 40s, the task force said.

“In addition to false-positive results and unnecessary biopsies, all women undergoing regular screening mammography are at risk for the diagnosis and treatment of noninvasive and invasive breast cancer that would otherwise not have become a threat to their health, or even apparent, during their lifetime,” the Task Force said. “Beginning mammography screening at a younger age and screening more frequently may increase the risk for over-diagnosis and subsequent overtreatment.”

The independent panel of medical experts from around the nation said that women with a parent, sibling, or child with breast cancer are at higher risk for breast cancer and thus may benefit more than average-risk women from beginning screening in their 40s.

Not everyone is pleased with the recommendations.

Florida Congresswoman and chair of the Democratic National Committee, Debbie Wasserman Schultz, issued a statement that suggested the Task Force recommendations could put younger women at risk because their insurance companies may stop paying for their screenings.

“These guidelines indicate that screening for women under 50 is less beneficial in detecting breast cancer than for older women,” said Wasserman Schultz, herself a breast-cancer survivor. “However, because insurance companies often use these guidelines to determine coverage for these critical life-saving screenings, these new recommendations could potentially bar millions of women from getting coverage for screenings they need.”

Judy Salerno, president and CEO of the Susan G. Komen breast cancer charity, said she worries the recommendation could target African-American women in particular.

“A lack of coverage would be most harshly felt in high-risk and underserved populations,” Salerno said. “African-American women, for example, are often diagnosed at younger ages with aggressive forms of breast cancer – and die of breast cancer at rates over 40 percent higher than white women. Screening at younger ages is a critical tool for these women.”

Members of the Task Force, however, emphasized that it was their role to evaluate scientific evidence and not make insurance coverage decisions.

“The USPSTF acknowledges the important role that insurance coverage plays in access to and use of preventive services,” the Task Force said in its editorial. “Coverage decisions are the domain of payers, regulators and legislators. Whatever we may believe about the importance of coverage in shared decision-making about mammography, we cannot exaggerate our interpretation of the science to ensure coverage for a service. This would lead to confusion regarding the state of science versus the politics of coverage.”