Stanford University

Innovation

Brian Chen

Shorenstein APARC
Stanford University
Encina Hall, Room E-301
Stanford, CA 94305-6055

(650) 736-0771 (650) 723-6530
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2011 AHPP/CEAS Visiting Scholar
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Dr. Brian Chen is currently a visiting scholar with the Asia Health Policy Program and Center for East Asian Studies at Stanford University. He was recently Shorenstein Asia-Pacific Research Center's 2009-2010 postdoctoral fellow in Comparative Health Policy. As a visiting scholar, Dr. Chen will conduct collaborative research about health of the elderly and chronic disease in China.

As an applied economist, Chen’s research focuses on the impact of incentives in health care organizations on provider and patient behavior. For his dissertation, Chen empirically examined how vertical integration and prohibition against self-referrals affected physician prescribing behavior. His job market paper was selected for presentation at the American Law and Economics Association’s Annual Meeting, the Academy of Management, the Canadian Law and Economics Association, the Conference on Empirical Legal Studies, and the First Annual Conference on Empirical Health Law and Policy at Georgetown Law Center in 2009.  The paper was also nominated for best paper based on a dissertation at the Academy of Management.

Chen comes to the Shorenstein Asia-Pacific Research Center not only with a multidisciplinary law and economics background, but also with an international perspective from having lived and worked in Taiwan, Japan, and France. He has a particularly intimate knowledge of the Taiwanese health care system from his experience as an assistant to the hospital administrator at a medical college in Taiwan.

During his past residence as a postdoctoral fellow with the Asia Health Policy Program, Chen conducted empirical research on cost containment policies in Taiwan and Japan and how those policies impacted provider behavior. His work also contributed to the program’s research activities on comparative health systems and health service delivery in the Asia-Pacific, a theme that encompasses the historical evolution of health policies; the role of the private sector and public-private partnerships; payment incentives and their impact on patients and providers; organizational innovation, contracting, and soft budget constraints; and chronic disease management and service coordination for aging populations.

Dr. Brian Chen recently completed his Ph.D. in Business Administration in the Business and Public Policy Group at the Haas School of Business, University of California at Berkeley. He received a Juris Doctor from Stanford Law School in 1997, and graduated summa cum laude from Harvard College in 1992.

Prescribing Cultures and Pharmaceutical Policy in the Asia-Pacific

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PrescribingCultures front cover

Pharmaceutical policies are interlinked globally and at the same time deeply rooted in local culture. Prescribing Cultures examines how pharmaceuticals and their regulation play an important and often contentious role in the health systems of the Asia-Pacific.

The first section of this timely book analyzes pharmaceutical policy in China, Korea, Japan, Thailand, Taiwan, Australia, and India. The second section focuses on two cross-cutting themes: differences in "prescribing cultures" and physician dispensing; and the challenge of balancing access to drugs with incentives for innovation.

The book's contributors discuss important issues for U.S. policy. These include such hot-button topics as drug imports from Asia, regulation of global supply chains to assure drug safety and quality, new legislation to encourage development of drugs for neglected diseases, and the impact that decisions about pricing, regulation, and bilateral trade agreements have on access to medicines at home and abroad. In Prescribing Cultures, pharmaceutical policy reveals the economic trade-offs, political compromises, and historical trajectories that shape health systems.

Prescribing Cultures also illustrates how cultural legacies shape and are shaped by the forces of globalization, and thus will be of interest to students and scholars well beyond the confines of health policy.

Desk, examination, or review copies can be requested through Stanford University Press. 

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Prescribing Cultures and Pharmaceutical Policy in the Asia-Pacific: A Book Launch Event

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Pharmaceutical policies are interlinked globally, yet deeply rooted in local culture. The newly published book Prescribing Cultures and Pharmaceutical Policy in the Asia-Pacific, edited by Karen Eggleston, examines how pharmaceuticals and their regulation play an important and often contentious role in the health systems of the Asia-Pacific.

In this colloquium, contributors to Prescribing Cultures discuss how the book analyzes pharmaceutical policy in China, Korea, Japan, Thailand, Taiwan, Australia, and India, focusing on two cross-cutting themes: differences in “prescribing cultures” and physician dispensing; and the challenge of balancing access to drugs with incentives for innovation.

As Michael Reich of Harvard University says in his Forward to Prescribing Cultures,

“The pharmaceutical sector…promises great benefits and also poses enormous risks.… Conflicts abound over public policies, industry strategies, payment mechanisms, professional associations, and dispensing practices—to name just a few of the regional controversies covered in this excellent book.

The tension between emphasizing innovation versus access -- a topic of hot debate on today’s global health policy agenda -- is examined in several chapters…

This book makes a special contribution to our understanding of the pharmaceutical sector in China… Globalization is galloping forward, with Chinese producers pushing the pace at breakneck speed. More and more, our safety depends on China’s ability to get its regulatory act together…”

The colloquium features presentations by Naoko Tomita (Keio University), Anita Wagner (Harvard University), and Karen Eggleston (Stanford FSI Shorenstein Asia-Pacific Research Center). They will give specific examples of how pharmaceutical policy serves as a window into the economic tradeoffs, political compromises, and historical trajectories that shape health systems, as well as how cultural legacies shape and are shaped by the forces of globalization.

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Oksenberg Conference Room

Anita Wagner Speaker Harvard University
Naoko Tomita Speaker Keio University

Karen Eggleston

Shorenstein APARC
Stanford University
Encina Hall E301
Stanford, CA 94305-6055

(650) 723-9072 (650) 723-6530
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Senior Fellow at the Freeman Spogli Institute for International Studies
Center Fellow at the Center for Health Policy and the Center for Primary Care and Outcomes Research
Faculty Research Fellow of the National Bureau of Economic Research
Faculty Affiliate at the Stanford Center on China's Economy and Institutions
karen-0320_cropprd.jpg PhD

Karen Eggleston is a Senior Fellow at the Freeman Spogli Institute for International Studies (FSI) at Stanford University and Director of the Stanford Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center at FSI. She is also a Fellow with the Center for Innovation in Global Health at Stanford University School of Medicine, and a Faculty Research Fellow of the National Bureau of Economic Research (NBER). Her research focuses on government and market roles in the health sector and Asia health policy, especially in China, India, Japan, and Korea; healthcare productivity; and the economics of the demographic transition.

Eggleston earned her PhD in public policy from Harvard University and has MA degrees in economics and Asian studies from the University of Hawaii and a BA in Asian studies summa cum laude (valedictorian) from Dartmouth College. Eggleston studied in China for two years and was a Fulbright scholar in Korea. She served on the Strategic Technical Advisory Committee for the Asia Pacific Observatory on Health Systems and Policies and has been a consultant to the World Bank, the Asian Development Bank, and the WHO regarding health system reforms in the PRC.

Economics of Health and Aging in Asia

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Director of the Asia Health Policy Program, Shorenstein Asia-Pacific Research Center
Stanford Health Policy Associate
Faculty Fellow at the Stanford Center at Peking University, June and August of 2016
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Quality of Democracy Project

As democracy has spread over the past three decades to a majority of the world's states, analytic attention has turned increasingly from explaining regime transitions to evaluating and explaining the character of democratic regimes. Much of the democracy literature of the 1990s was concerned with the consolidation of democratic regimes. In recent years, social scientists as well as democracy practitioners and aid agencies have sought to develop means of framing and assessing the quality of democracy.

Youth Movements in Post-Communist Societies: A Model of Nonviolent Resistance

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Over the past decade, the rise of youth movements applying nonviolent methods of resistance against autocratic incumbents occurred in the post-Soviet region. This protest cycle was set in motion by the spectacular mobilization of Serbia's social movement Otpor against Slobodan Milosevic in 2000. Similarly, Ukraine's Pora in 2004 and, to a lesser extent, Georgia's Kmara in 2003 mobilized large numbers of young people to demand political change in the aftermath of fraudulent elections. In contrast, Belarus' Zubr in 2001/2006 and an assortment of Azerbaijan's youth groups in 2005 were less effective in staging nonviolent struggle against autocratic incumbents. This paper provides an explanation for divergent social movement outcomes in non-democracies by investigating the dynamics of tactical interaction between challenger organizations and the ruling elite. The paper argues that both civic activists and autocratic incumbents engaged in processes of political learning. Hence, tactical innovation was vital to the success of youth movements, especially late risers in the protest cycle.

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Olena Nikolayenko

Swedish Crisis Management: Past and Present

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Swedish Minister of Employment, Sven Otto Littorin, will present the strategies of the Swedish Government for handling the financial crisis and the challenges on the labor market. He will talk about the previous Swedish financial crisis in the 1990's, when he had a central role in handling the crisis. Salvaging the Swedish Banking System at that time is today much discussed as the model for the present US banking crisis. Sweden starts its Presidency of the European Union on July 1, 2009, a role which will encompass the addressing of these issues. Minister Littorin will be the president of the European Council of Ministers for Employment, Social Policy, Health and Consumer Affairs.

The presentation is co-hosted by the recently launched VINNOVA-Stanford Research Center of Innovation Journalism and the Forum on Contemporary Europe.

Peter Wallenberg Learning Theater (Rm 124), Wallenberg Hall

Sven Otto Littorin Swedish Minister of Employment Speaker
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Toward a 21st-Century Health Care System: Recommendations for Health Care Reform

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The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform:

  1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment.
  2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions.
  3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions.
  4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange.
  5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make deidentified information from this database on clinical interventions, patient outcomes, and costs available to researchers.
  6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans.
  7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges. Employers should also be allowed to participate in these exchanges for their employees' coverage.
  8. Create a health coverage board with broad stakeholder representation to determine and periodically update the affordable standard benefit package available through state or regional insurance exchanges.
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Harold S. Luft
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Spies and Terrorists: Subversive Networks Across Ideologies and Times

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Clandestine craft and low-tech methods still serve to evade and attack hi-tech defenses. Technologies change, yet covert organizing principles persist. They can be traced through time and across different perpetrators - particularly terrorist and espionage networks - as different as al Qaeda and the Soviet KGB. The talk will use these two case studies to illustrate the underlying principles of how clandestine networks still apply strategies to limit information, connectivity, and traceable technology use in order to enhance their survival and asymmetric capabilities against superior opponents. Strategies evolve, but some of the core principles remain. Their better understanding sheds new light on organizational survival and national/international security issues. The research draws on the book manuscript in progress using organization and information theories, with discourse and technical analysis methods, to systematically examine documentary evidence found in the Hoover Institution Archives as well as the contemporary primary and other sources.

Katya Drozdova is a Senior Research Scientist at National Security Innovations (NSI) and Visiting Scholar at Stanford University's Hoover Institution. Dr. Drozdova's research focuses on the interplay between human and technological networks in organizations, with emphasis on asymmetric threats and US national security implications. Her work examines how organizations use technology to counter and conceal their human network vulnerabilities. This covers problems of countering terrorism, insurgency, espionage and weapons of mass destruction proliferation; advancing cyber- and energy security; and strengthening both security as well as liberty. She has published on issues ranging from organizational survival to intelligence analysis and defense policy. Katya conducts academic as well as applied research providing actionable findings and analytic tools to the US Department of Defense and Intelligence Community via NSI. Earlier, she has served as a Research Scholar at New York University's (NYU) Alexander Hamilton Center, as well as Science Fellow and researcher with NSA-funded Consortium for Research on Information Security and Policy at Stanford University's Center for International Security And Cooperation (CISAC), among others. Katya earned her PhD from NYU's Stern School of Business, Department of Information, Operations, and Management Sciences (MA in International Policy Studies and BA in International Relations and from Stanford University).

Martha Crenshaw is a senior fellow at CISAC and FSI and a professor of political science by courtesy. She was the Colin and Nancy Campbell Professor of Global Issues and Democratic Thought and professor of government at Wesleyan University in Middletown, Conn., from 1974 to 2007. Her current research focuses on innovation in terrorist campaigns, the distinction between "old" and "new" terrorism, why the United States is the target of terrorism, and the effectiveness of counterterrorism policies.

She has written extensively on the issue of political terrorism; her first article, "The Concept of Revolutionary Terrorism," was published in the Journal of Conflict Resolution in 1972. Her recent work includes "Terrorism, Strategies, and Grand Strategies," in Attacking Terrorism (Georgetown University Press), "Terrorism and Global Security," in Leashing the Dogs of War: Conflict Management in a Divided World (United States Institute of Peace Press), and "Explaining Suicide Terrorism: A Review Essay," in the journal Security Studies. She is also the editor of a projected volume, The Consequences of Counterterrorist Policies in Democracies, for the Russell Sage Foundation in New York.

She served on the Executive Board of Women in International Security and chaired the American Political Science Association (APSA) Task Force on Political Violence and Terrorism. She has also served on the Council of the APSA and is a former President and Councilor of the International Society of Political Psychology (ISPP). In 2004 ISPP awarded her its Nevitt Sanford Award for Distinguished Scientific Contribution and in 2005 the Jeanne Knutson award for service to the society. She serves on the editorial boards of the journals International Security, Orbis, Political Psychology, Security Studies, and Terrorism and Political Violence. She coordinated the working group on political explanations of terrorism for the 2005 Club de Madrid International Summit on Democracy, Terrorism and Security. She is a lead investigator with the National Center for the Study of Terrorism and the Response to Terrorism (START) at the University of Maryland, funded by the Department of Homeland Security. She was a Guggenheim Fellow in 2005-2006. She served on the Committee on Law and Justice and the Committee on Determining Basic Research Needs to Interrupt the Improvised Explosive Device Delivery Chain of the National Research Council of the National Academies of Science. She was a senior fellow at the National Memorial Institute for the Prevention of Terrorism in Oklahoma City for 2006-2007.

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Reuben W. Hills Conference Room

Katya Drozdova Visiting Scholar, Hoover Institution, Stanford University, and Senior Research Scientist, National Security Innovations Speaker
Martha Crenshaw Professor of Political Science (by courtesy) and Senior Fellow at CISAC and FSI Commentator
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Mapping Militant Organizations

Latvia in Crisis: Where is a Way Out of It?

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Latvia is a country that has come through a crisis before; can it do it again? Professor Stranga examines the current crisis in Latvia, a country much evolved over the past 50 years. He focuses on a variety of social, economic, and political factors in assessing how Latvia can move forward.

Synopsis

Prof. Stranga begins by examining what he calls Latvia’s “first great crisis” from 1929-1933. At the time, Latvia was a democracy, a member of the League of Nations, but critically had no security guarantees and was stuck between Nazi Germany and Soviet Russia. Prof. Stranga explains that this crisis was overcome by the dictatorship of Karlis Ulmanis, whose regime lasted from 1934 until the Nazi occupation. Those years were seen as the ‘Golden Years,’ times of economic flourishing and national freedom from occupation. Prof. Stranga reveals this period had long lasting effects on the national psyche of Latvia.

To Prof. Stranga, Latvia is in a very different situation today. He argues that these are times of very limited sovereignty, particularly for his country. Prof. Stranga explains that this is mainly due to Latvia’s dependence on the EU, NATO, and the IMF which provide economic and military security. Prof. Stranga identifies the effects of Karlis Ulmanis’ regime as the perception in Latvia that a ‘strong man’ is needed to guide Latvia out of its current crisis. However, the necessity for Latvia to remain a democracy is made clear by the help it receives from the organizations mentioned above.

Although the help is clearly needed, Prof. Stranga feels that its consequences are often very painful. The IMF’s conditions for essentially saving Latvia’s economy include cutbacks in medical assistance and a reduction of teachers and schools, facets of public life deeply engrained in Latvia’s culture. In addition, Prof. Stranga examines the question of energy security. He looks particularly at Latvia’s absolute dependence on Russia exhibited by the fact that Gazprom’s first foreign office is in Latvia, and the fact that this has perhaps hindered Latvia’s progress.

At the same time, it seems clear that Prof. Stranga sees this crisis also as an opportunity. Firstly, he argues that now is probably the time to not be shy but to look for alternative energy sources such as nuclear energy, something Prof. Stranga further discussed when answering questions. Moreover, Prof. Stranga believes there are too many bureaucratic positions, and the crisis is an opportunity to cut these off and direct funding elsewhere. In addition, he feels the crisis is a chance to reconstruct exports. In particular, Prof. Stranga would like to see Latvia leaning more towards innovation rather than timber or agriculture. Finally, Prof. Stranga addresses Latvia’s issue of an internally divided society, particularly between Latvians and Russian speakers. He analyzes Latvian Russians’ diminishing impact as Russia’s economy falters but also expresses concern at the fact that Russian influence in Latvia seems to be heavily dependent on Russia’s economic state.

Prof. Stranga kindly takes the time to briefly answer a few questions and raises several issues in the process. Prof. Stranga cites Latvia's population reduction as perhaps the "greatest" problem it faces. However, he feels reassured by the help of the friendly states of Scandinavia and other organizations across the world. At the same time, Prof. Stranga explains such organizations are not having an entirely positive impact. In particular, he argues against the "inhuman" approach of solely focusing on cutting back capital of the IMF which he feels is an assault on Latvian life.

About the speaker

Aivars Stranga is professor and chair of the Department of History at the University of Latvia. He is the author of seven monographs and more than 150 scholarly and general publications on Latvian domestic and foreign policy andinternational relations between 1918 and 1940, and Latvian foreign policy from 1991 to 2000. Professor Stranga was a distinguished visiting professor at Stanford in 2003, teaching courses on Baltic History and the History of the Holocaust in the Baltics.

Jointly sponsored by the Forum on Contemporary Europe, Stanford Humanities Center, Department of History, Taube Center for Jewish Studies, and Center for Russian, East European and Eurasian Studies.

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Encina Ground Floor Conference Room

Aivars Stranga Professor of History Speaker University of Latvia
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