Health and Medicine

FSI’s researchers assess health and medicine through the lenses of economics, nutrition and politics. They’re studying and influencing public health policies of local and national governments and the roles that corporations and nongovernmental organizations play in providing health care around the world. Scholars look at how governance affects citizens’ health, how children’s health care access affects the aging process and how to improve children’s health in Guatemala and rural China. They want to know what it will take for people to cook more safely and breathe more easily in developing countries.

FSI professors investigate how lifestyles affect health. What good does gardening do for older Americans? What are the benefits of eating organic food or growing genetically modified rice in China? They study cost-effectiveness by examining programs like those aimed at preventing the spread of tuberculosis in Russian prisons. Policies that impact obesity and undernutrition are examined; as are the public health implications of limiting salt in processed foods and the role of smoking among men who work in Chinese factories. FSI health research looks at sweeping domestic policies like the Affordable Care Act and the role of foreign aid in affecting the price of HIV drugs in Africa.

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All research in progress seminars are off-the-record. Any information about methodology and/or results are embargoed until publication.

Mark McClellan, MD, PhD, is a senior fellow and director of the Health Care Innovation and Value Initiative at the Brookings Institution. Within Brookings, his work focuses on promoting quality and value in patient - centered health care.  Dr. McClellan is a former administrator of the Centers for Medicare & Medicaid Services (CMS) and former commissioner of the U.S. Food and Drug Administration (FDA), where he developed and implemented major reforms in health policy. He previously served as a member of the President’s Council of Economic Advisers and senior director for health care policy at the White House, and was an associate professor of economics and medicine at Stanford University.

Mark McClellan Senior Fellow and Director of the Health Care Innovation and Value Initiative at the Brookings Institution
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All research in progress seminars are off-the-record. Any information about methodology and/or results are embargoed until publication.

Older scientists are often seen as less open to new ideas than younger scientists. We put this assertion to an empirical test. Using a measure of new ideas derived from the text of nearly all biomedical scientific articles, we compare the tendency of younger and older researchers to try out new ideas in their work. Our main finding is that, in biomedicine, papers published by younger researchers are more likely to build on new ideas. Collaboration with a more experienced researcher matters as well. Papers with a young first author and a more experienced last author are more likely to try out new ideas than papers published by other team configurations. Given the crucial role that the trying out of new ideas plays in the advancement of science, our results buttress the importance of funding scientific work by young researchers.

Jay Bhattacharya CHP/PCOR
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All research in progress seminars are off-the-record. Any information about methodology and/or results are embargoed until publication.

Abstract:

Multi-criteria decision analysis enables the user to explicitly consider multiple attributes of a decision, including qualitative factors.  This technique was first developed by management scientists and has been endorsed by the European Medicines Agency.  It has the potential to transcend some of the limitations of traditional cost-effectiveness analysis.  We worked together on an Institute of Medicine committee that produced SMART Vaccines (Strategic Multi-Attribute Ranking Tool for Vaccines) -- a pioneering decision-support software tool to help prioritize new vaccines for development.  In this talk, we will describe the MCDA method, demonstrate its application in SMART Vaccines, and discuss work in progress using MCDA in influenza vaccination policy and cancer genomic screening.

Tracy Liu Director, Division of Research Kaiser Permanente Northern California
Guru Madhavan Senior Program Officer and Project Director Institute of Medicine, National Academy of Sciences
Charles E. Phelps University Professor and Provost Emeritus University of Rochester
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China’s State Council has put forth draft legislation that would ban smoking in public spaces, part of the government’s larger advocacy efforts to help curb tobacco use nationwide. Matthew Kohrman, a professor of anthropology at Stanford University, said it’s a step forward but the ban’s long-term success would depend on local enforcement.

Despite popular belief, global cigarette production has tripled worldwide since the 1960s. Leading the surge has been China.

“China has become the world’s cigarette superpower,” said Kohrman, in an interview on National Public Radio’s program, Marketplace.

Moreover, local governments in China have become dependent on tax revenues generated from tobacco sales, thus reinforcing the cigarette’s ubiquity and ease of access.

China has implemented smoking bans in the past, but with varied success. Now rising healthcare costs caused by tobacco-related diseases are creating urgency for new regulations.

“Whether or not these new regulations will be enforced will, in the end, come down to local politics,” he said.

Matthew Kohrman is part of the Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center, and leads the project, Cigarette Citadels, a peer-sourced mapping project that compiles more than 480 cigarette factories globally.

The full audioclip is available on the Marketplace website.

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A cigarette stand in Shantou, China.
Flickr/Merton Wilton
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A middle class is emerging in China, and simultaneously, its population is rapidly aging. These two phenomena are impacting the country’s traditional consumer habits, including spending on healthcare. Experts say private-sector services are one important part of the future of China’s healthcare system, and perhaps also a sign of what’s to come for other countries in the region. Entrepreneurs can provide innovative services that cater widely to consumers and support a shift toward integrated care for health promotion and long-term management of chronic disease, also supplementing resources available in traditional public facilities.

Three experts visited the Walter H. Shorenstein Asia-Pacific Research Center and shared perspectives on those trends at the panel discussion, “Healthcare Entrepreneurs in East Asia: Innovations in Primary Care and Beyond,” hosted by the Asia Health Policy Program.

Historically, healthcare services in China have been almost entirely government-run. A patient would go to a public clinic, stand in a queue, and receive treatment within a few hours – being referred elsewhere if additional treatment was required.

Now, the private sector is growing, based on the promise of improved care and an enhanced experience, both removing the waiting line and ushering in new technologies. The government has also issued several policies encouraging “social capital” investment in health and fitness services.

The private sector for preventative care services now holds around fifteen percent of the entire marketplace in China, and “is expected to get much bigger over the next five years,” said Lee Ligang Zhang, the founding chairman and chief executive officer of iKang, a healthcare group based in Beijing.

Zhang oversees the company’s operation of 50 self-owned healthcare centers and an extended network of 300 affiliates. iKang is one of many groups catering to a growing consumer base of corporate workers and senior managers seeking care outside of the public system.

Comparative view

Increased development of premium healthcare facilities is not only emerging in China, but also in neighboring Taiwan. Since 1995, Taiwan implemented a national health insurance system, and has been lauded for its success in service provision.

Taiwan transitioned its healthcare market to universal coverage. Under this system, a patient can essentially “shop around” and select where to go for services, most of which are covered under the country’s insurance collective system at public or private providers.

“On average, every Taiwanese goes to see a doctor 14 times a year, compared to five times a year in the United States, and two times [a year] in China,” said Dr. Fred Hun-Jean Yang, a physician and chairman of MissionCare, Inc.

Such numbers reflect the higher availability of services compared to China, he said. Even as a small island, Taiwan has over 15,000 clinics and the price for services is generally affordable for the average citizen. Despite this availability of public and private services, Taiwan’s newer healthcare entrepreneurs seek to fill a market demand shaped by similar factors as in China. Yang says technology and the efficiency of the private sector healthcare system is attracting new consumers.

Missioncare is headquartered in northern Taiwan’s Taoyuan City and consists of four community hospitals with a larger network of clinics across the country as well as coordinated long-term care services for the elderly and those with chronic disease. The group has already expanded into China, and plans to integrate healthcare innovations, such as wearable monitoring and mobile payment.

Patient-centric service

Chinese citizens, particularly those with greater expendable income, are more willing to pay out-of-pocket for an improved patient experience, the panelists said.

“The consumer psyche is important,” said Dr. Wei Siang Yu, the founder of the Borderless Healthcare Group (BHG), a group of companies based in Singapore that focuses largely on health telecommunications.

One perspective is that consumers desire a “high-end” environment made possible by tailored design aesthetics and effective branding. Guided by this trend, Yu, a business executive and physician by training, started the “smart cities, smart homes” initiative at BHG.

BHG is now launching an incubator model in Shanghai, which combines intelligent design aesthetics with patient care, and is planning to localize such centers across China. The model is referred to as an “experience center,” rather than a hospital or clinic, and healthcare services – examinations, operations and value-added activities like wellness and education activities – are all centralized in one location.

Looking ahead, Yu said healthcare is likely to move even further away from the traditional hospital setting, and more toward experiential and home-based care models.

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(L to R): Wei Siang Yu, founder of Borderless Healthcare Group; Lee Ligang Zhang, chairman and CEO of iKang Healthcare Group; and Fred Hung-Jen Yang, chairman of Missioncare, Inc. discuss healthcare innovation at the Walter H. Shorenstein Asia-Pacific Center.
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Stanford’s Program on Human Rights in the Center on Democracy, Development and the Rule of Law is collaborating with U.S. Fund for UNICEF and the Stanford Center for Innovation in Global Health to present the Children’s Human Rights Seminar Series for 2014-2015. This monthly series will bring together UNICEF representatives, academic experts, and global civil society leaders to discuss some of the most pressing issues facing children today. Each event will highlight one of UNICEF's main programmatic areas, in the following order: emergency response, HIV/AIDS, disabilities, child protection, nutrition, water and sanitation, health and immunizations, and education.

SPEAKERS BIOS

Nick Hellmann, MD is the Strategy and Science Advisor at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) and a consultant to the Bill and Melinda Gates Foundation on HIV-related issues. He previously worked from June 2008 to April 2014 as the EGPAF Executive Vice President of Medical & Scientific Affairs, responsible for strategic oversight and direction of the Foundation’s research initiatives and medical programs focused on ending HIV/AIDS in children and providing HIV prevention, care, and treatment services to children, women, and families at over 7000 foundation-supported sites in 14 countries across the globe.

Lisa Jacobs is a global health consultant with expertise in advocacy and communications, strategy, governance, and global health architecture. Lisa was a founding staff member at the GAVI Alliance, and served as head of governance for 10 years. In 2012 and 2013 she worked as a consultant to the UNICEF HIV/AIDS section in New York, supporting the development of UNICEF’s role in the global effort to eliminate mother-to-child transmission of HIV (eMTCT) and its strategy for adolescents and HIV/AIDS. Her other clients have included AVAC: Global Advocacy for HIV Prevention, WHO, UNAIDS, UCSF, and Clinton Health Access Initiative.

CISAC Central Conference Room

2nd FLoor Encina Hall

Nick Hellmann, MD Strategy and Science Advisor at the Elizabeth Glaser Pediatric AIDS Foundation
Lisa Jacobs Global Health Consultant
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SPEAKER BIO

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chaw chaw
Ms. Ohnmar Ei Ei Chaw is the Country Program Coordinator of the Australian-Asia Program to Combat Trafficking in Persons (AAPTIP) for Myanmar (Burma). Prior to this, she was the United Nations Inter-Agency Project on Human Trafficking’s Myanmar National Coordinator. She is responsible for the overall coordination and management of AAPTIP Myanmar Country Program, which is currently the largest of six country programs in the Australian $50 million five-year AAPTIP program. She liaises closely with whole-of-government partners on issues relevant to criminal justice sector capacity building, coordination, and law and policy harmonization, and other initiatives focusing on anti-trafficking in persons at the national level and regional level especially, ASEAN Trafficking in Persons Working Group’s initiatives. She has been engaged in the fight against human trafficking for more than a decade. She started her career working on the Street and Working Children Project of World Vision Myanmar in 1997. After attaining her post-graduate study on Gender and Development in 2001, she rejoined World Vision Myanmar to lead the first Anti-Trafficking Program which involved designing and implementation of prevention activities, facilitation of the return of trafficking survivors coming back from Thailand, and advocating government for the development of anti-trafficking legislation and national policy.

Reuben Hills Conference Room 2nd Floor, East Wing, Encina Hall

Ohnmar Ei Ei Chaw Country Program Coordinator, Australia -Asia Program to Combat Trafficking in Persons (AAPTIP)
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SPEAKERS BIOS

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chaw chaw
Ms. Ohnmar Ei Ei Chaw is the Country Program Coordinator of the Australian-Asia Program to Combat Trafficking in Persons (AAPTIP) for Myanmar (Burma). Prior to this, she was the United Nations Inter-Agency Project on Human Trafficking’s Myanmar National Coordinator. She is responsible for the overall coordination and management of AAPTIP Myanmar Country Program, which is currently the largest of six country programs in the Australian $50 million five-year AAPTIP program. She liaises closely with whole-of-government partners on issues relevant to criminal justice sector capacity building, coordination, and law and policy harmonization, and other initiatives focusing on anti-trafficking in persons at the national level and regional level especially, ASEAN Trafficking in Persons Working Group’s initiatives.

 

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mark taylor
Mr. Mark Taylor is the Team Leader for the Australia–Asia Program to Combat Trafficking in Persons (AAPTIP). The AAPTIP project was started in June 2013, and is a continuation of the Australian AID-funded Asia Regional Trafficking in Persons (ARTIP) Project. AAPTIP operates at both regional and national level and provides support to the Association of South East Asian Nations (ASEAN) and individual partner countries: Cambodia, Indonesia, Lao PDR, Myanmar, the Philippines, Thailand and Vietnam. Prior to this, Mr. Taylor spent 10 years working for the US State Department in Washington DC as a Senior Coordinator for Reports and Political Affairs. He spent two years based at the US Embassy in Nigeria where he opened the US State Department’s Narcotics and Law Enforcement Affairs Program in Lagos and Abuja, after years of aid embargo on Abacha ruled Nigeria. Mr. Taylor was in charge of developing and implementing over $12 million in projects over a range of eight issues including drug control, people smuggling, human trafficking, financial fraud, corruption, police reform and money laundering. Mr. Taylor also spent time in Yangon, Myanmar where he was responsible for reporting on the dynamic narco-insurgency landscape in the Shan State, and following the July 1995 release from house arrest of Daw Aung San Suu Kyi -- the political and human rights situation in the country, including coverage of NLD speeches, policy statements, and the party's leadership. He has a degree in Political Science and Government from Gordon College.


This seminar will also feature special discussant, Donald Emmerson, director of the Southeast Asia Program at Shorenstein APARC

The panel will be moderated by Helen Stacy, director of the Program on Human Rights at CDDRL.

 

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CISAC Central Conference Room
2nd Floor, Encina Hall
616 Serra St.
Stanford, CA

Mark Taylor Australia-Asia Program to Combat Trafficking in Persons
Ohnmar Ei Ei Chaw Australia-Asia Program to Combat Trafficking in Persons
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Senior Fellow Emeritus at the Freeman Spogli Institute for International Studies
Affiliated Faculty, CDDRL
Affiliated Scholar, Abbasi Program in Islamic Studies
aparc_dke.jpg PhD

At Stanford, in addition to his work for the Southeast Asia Program and his affiliations with CDDRL and the Abbasi Program in Islamic Studies, Donald Emmerson has taught courses on Southeast Asia in East Asian Studies, International Policy Studies, and Political Science. He is active as an analyst of current policy issues involving Asia. In 2010 the National Bureau of Asian Research and the Woodrow Wilson International Center for Scholars awarded him a two-year Research Associateship given to “top scholars from across the United States” who “have successfully bridged the gap between the academy and policy.”

Emmerson’s research interests include Southeast Asia-China-US relations, the South China Sea, and the future of ASEAN. His publications, authored or edited, span more than a dozen books and monographs and some 200 articles, chapters, and shorter pieces.  Recent writings include The Deer and the Dragon: Southeast Asia and China in the 21st Century (ed., 2020); “‘No Sole Control’ in the South China Sea,” in Asia Policy  (2019); ASEAN @ 50, Southeast Asia @ Risk: What Should Be Done? (ed., 2018); “Singapore and Goliath?,” in Journal of Democracy (2018); “Mapping ASEAN’s Futures,” in Contemporary Southeast Asia (2017); and “ASEAN Between China and America: Is It Time to Try Horsing the Cow?,” in Trans-Regional and –National Studies of Southeast Asia (2017).

Earlier work includes “Sunnylands or Rancho Mirage? ASEAN and the South China Sea,” in YaleGlobal (2016); “The Spectrum of Comparisons: A Discussion,” in Pacific Affairs (2014); “Facts, Minds, and Formats: Scholarship and Political Change in Indonesia” in Indonesian Studies: The State of the Field (2013); “Is Indonesia Rising? It Depends” in Indonesia Rising (2012); “Southeast Asia: Minding the Gap between Democracy and Governance,” in Journal of Democracy (April 2012); “The Problem and Promise of Focality in World Affairs,” in Strategic Review (August 2011); An American Place at an Asian Table? Regionalism and Its Reasons (2011); Asian Regionalism and US Policy: The Case for Creative Adaptation (2010); “The Useful Diversity of ‘Islamism’” and “Islamism: Pros, Cons, and Contexts” in Islamism: Conflicting Perspectives on Political Islam (2009); “Crisis and Consensus: America and ASEAN in a New Global Context” in Refreshing U.S.-Thai Relations (2009); and Hard Choices: Security, Democracy, and Regionalism in Southeast Asia (edited, 2008).

Prior to moving to Stanford in 1999, Emmerson was a professor of political science at the University of Wisconsin-Madison, where he won a campus-wide teaching award. That same year he helped monitor voting in Indonesia and East Timor for the National Democratic Institute and the Carter Center. In the course of his career, he has taken part in numerous policy-related working groups focused on topics related to Southeast Asia; has testified before House and Senate committees on Asian affairs; and been a regular at gatherings such as the Asia Pacific Roundtable (Kuala Lumpur), the Bali Democracy Forum (Nusa Dua), and the Shangri-La Dialogue (Singapore). Places where he has held various visiting fellowships, including the Institute for Advanced Study and the Woodrow Wilson International Center for Scholars. 



Emmerson has a Ph.D. in political science from Yale and a BA in international affairs from Princeton. He is fluent in Indonesian, was fluent in French, and has lectured and written in both languages. He has lesser competence in Dutch, Javanese, and Russian. A former slam poet in English, he enjoys the spoken word and reads occasionally under a nom de plume with the Not Yet Dead Poets Society in Redwood City, CA. He and his wife Carolyn met in high school in Lebanon. They have two children. He was born in Tokyo, the son of U.S. Foreign Service Officer John K. Emmerson, who wrote the Japanese Thread among other books.

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Rapid urbanization has led to an enormous influx of people in China migrating from rural to urban areas. Professor Hai Fang will talk about health care disparities in the management of hypertension in China for rural-to-urban migrants and understand the role of health insurance in affecting these disparities. Rural-to-urban migrants are compared to residents remaining in the rural areas. Hypertension management means whether one individual is aware of his or her hypertension, and (if being aware) whether they use medication treatment, monitor blood pressure, receive physician advice, or control blood pressure to the normal range.  Professor Fang and his co-authors find that rural-to-urban migrants had worse hypertention management than residents permanently living in rural or urban areas.  These findings suggest that it is critical to extend urban health insurance coverage and primary care services to rural-to-urban migrants, and further integrate rural and urban health insurance plans to achieve universal coverage in China.

Professor Hai Fang is currently a Professor of Health Economics at the China Center for Health Development Studies at Peking University in China.  He is also a research associate at the Kennedy School of Government at Harvard University.  He graduated from Tianjin University (BA) and Nankai University (MA), and received his MA and PhD in Economics, and Master in Public Health from the State University of New York at Stony Brook.

Migration, Health Insurance and Health Care Disparities: Evidence from Hypertension Management in China
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Philippines Conference Room

Encina Hall Central, 3rd Floor

Stanford, CA 94305

Hai Fang Professor of Health Economics Professor of Health Economics, Peking University
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