FSI's research on the origins, character and consequences of government institutions spans continents and academic disciplines. The institute’s senior fellows and their colleagues across Stanford examine the principles of public administration and implementation. Their work focuses on how maternal health care is delivered in rural China, how public action can create wealth and eliminate poverty, and why U.S. immigration reform keeps stalling.
FSI’s work includes comparative studies of how institutions help resolve policy and societal issues. Scholars aim to clearly define and make sense of the rule of law, examining how it is invoked and applied around the world.
FSI researchers also investigate government services – trying to understand and measure how they work, whom they serve and how good they are. They assess energy services aimed at helping the poorest people around the world and explore public opinion on torture policies. The Children in Crisis project addresses how child health interventions interact with political reform. Specific research on governance, organizations and security capitalizes on FSI's longstanding interests and looks at how governance and organizational issues affect a nation’s ability to address security and international cooperation.
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A Tale of Two Systems: The Impact of Universal Health Coverage on Financial Risk Protection in Taiwan and South Korea
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Abstract:
One of the key objectives of introducing a compulsory health insurance is to provide citizens, regardless of socioeconomic status, with financial risk protection against unexpected catastrophic expenditures in the face of illness. South Korea and Taiwan achieved universal health coverage (UHC) through mandatory social insurance schemes in 1989 and 1995, respectively. Despite both countries' efforts to achieve the goal of financial risk protection for more than two decades, past research has demonstrated that household out-of-pocket (OOP) payment still accounts for more than one-third of total health expenditures in both countries. When OOP payment represents a significant share of financial sources for health care, one should be particularly concerned about the distribution of such payments, in particular, catastrophic health expenditures, across households of differing economic levels. This talk sets out to examine the change in the incidence and distribution of catastrophic health expenditures before and after the introduction of the National Health Insurance programs in South Korea and Taiwan.
Given similarity in the health and National Health Insurance (NHI) system characteristics observed in South Korea and Taiwan, substantial variation in the distribution of catastrophic payment among households was noted. The rich are more likely to incur catastrophic payment in South Korea, but the opposite trend is noted in Taiwan. Further assessment on the impact of universal health coverage (UHC) on reducing catastrophic headcount (defined as the proportion of households incurring catastrophic health payment) is observed in Taiwan, but not in South Korea. We found that when South Korea introduced the NHI program with a limited benefit package and high copayment, it produced little effect (if not none) in reducing financial burden in terms of proportion of catastrophic headcount. On the contrary, the impact of universal health coverage on catastrophic headcount ranged from -1.82% to -4.08% for Taiwan, due to the provision of a rather comprehensive benefit package with modest copayment. While UHC is a well-lauded policy goal and may be a magic word for many countries striving for the achievement, it is definitely not a panacea to resolve the incidence of catastrophic payment and potential medical impoverishment. To provide sufficient financial protection against unexpected medical expenses, the design of the benefit coverage and risk sharing mechanism is key to the success of effectively achieving UHC.
Bio
Jui-fen Rachel Lu, Sc.D., is the Fulbright Visiting Scholar at Center for East Asian Studies, Stanford University, and a Professor at Chang Gung University (CGU) in Taiwan, where she teaches comparative health systems, health economics, and health care financing and has served as department chair (2000-2004), Associate Dean (2009-2010) and Dean of College of Management (2010-2013). She earned her B.S. from National Taiwan University, and her M.S. and Sc.D. from Harvard University, and she was also a Takemi Fellow at Harvard (2004-2005). Prof. Lu is currently the President of Taiwan Society of Health Economics (TaiSHE) and an Honorary Professor at Hong Kong University (2007-2017). Dr. Lu was also the recipient of IBM Faculty Award in 2009.
Her research focuses on 1) the equity issues of the health care system; 2) impact of the NHI program on health care market and household consumption patterns; 3) comparative health systems in Asia-Pacific region. She is a long-time and active member of Equitap (Equity in Asia-Pacific Health Systems) research network and was the coordinator for the catastrophic payment component of Equitap II research project which involved 21 country teams and was jointly funded by IDRC, AusAID, and ADB. Professor Lu has also been appointed to serve as a member on various government committees dealing with health care issues in Taiwan.
Okimoto Conference Room, Encina Hall 3rd Floor, East Wing
Rachel Jui-fen Lu
Visiting Scholar, Center for East Asian Studies
Stanford University
Seminars
Repression and Foreign Aid in Autocracies: Exploiting Debt Relief Negotiations in Post-Cold War Africa
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Does dependence on development aid from Western sources constrain the use of repression among autocrats? To answer this question, I employ a novel dataset of Africa's post-Cold War autocracies in which the unit of analysis is the country-day rather than the country-year. This day-level dataset enables me to address three potential sources of bias that obscure the relationship between Western aid dependence and repression. The evidence suggests that, when the threat of nancial sanction is credible, Western donors have reduced the daily odds of repression in Africa's post-Cold War autocracies by a factor of 10. Western aid dependence is constraining even during election seasons, when rates of protest and repression are high relative to other times of year. Most broadly, these results suggest that modern autocrats who rely on Western donors for nancial support lack the easy recourse to repression enjoyed by their Cold War era predecessors.
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Reflections on Chinese Governance
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I am very happy to have the opportunity to revisit my ideas about Chinese governance, and to offer some speculations about its future. I have written on this subject in my two most recent books, The Origins of Political Order: From Prehuman Times to the French Revolution , and Political Order and Political Decay: From the Industrial Revolution to the Globalization of Democracy. These books have been widely read in China and have attracted a good deal of comment; they have also produced considerable misunderstanding so I think it is important to clarify some of my judgments about the nature and the future of Chinese government. I will therefore summarize the conceptual framework I have tried to establish, describe how contemporary China fits into it, and then go on to discuss some possible futures for the Chinese political system.
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The Anatomy of Authoritarianism in the Arab World
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In this talk Joseph Sassoon discusses his recently released book Anatomy of Authoritarianism in the Arab Republics (Cambridge University Press, 2016). By examining the system of authoritarianism in eight Arab republics, the book portrays life under these regimes and explores the mechanisms underpinning their resilience. How did the leadership in these countries create such enduring systems? What was the economic system that prolonged the regimes’ longevity, but simultaneously led to their collapse? Why did these seemingly stable regimes begin to falter? This book seeks to answer these questions by utilizing the Iraqi archives and memoirs of those who were embedded in these republics: political leaders, ministers, generals, security agency chiefs, party members, and business people. Taking a thematic approach, the book begins in 1952 with the Egyptian Revolution and ends with the Arab uprisings of 2011. It seeks to deepen our understanding of the authoritarianism and coercive systems that prevailed in these countries and the difficult process of transition from authoritarianism that began after 2011.
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Joseph Sassoon is an Associate Professor at Georgetown University’s School of Foreign Service and the Sheikh Sabah Al Salem Al Sabah Chair at Georgetown’s Center for Contemporary Arab Studies. His work focuses on the history, politics, and political economy of the Arab world, and he has published extensively on Iraq and its economy. Sassoon’s book Saddam Hussein’s Ba`h Party: Inside an Authoritarian Regime (Cambridge University Press, 2013) won the British-Kuwait Prize for the best book on the Middle East. His previous publications include The Iraqi Refugees: The New Crisis in the Middle East (London, I.B. Tauris, 2009). He was a fellow at the Woodrow Wilson Center for International Scholars during the 2014-15 academic year. Born in Baghdad, Sassoon completed his PhD at St Antony’s College, University of Oxford.
Philippines Conference Room
Encina Hall, 3rd Floor Central
616 Serra St
Stanford, CA 94305
Joseph Sassoon
Associate Professor
Georgetown University
Seminars
Oil and Urban Life in Kuwait
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In this talk Farah Al-Nakib will discuss her recently released book Kuwait Transformed: A History of Oil and Urban Life (Stanford University Press, 2016), in which she traces the relationships between the urban landscape, patterns and practices of everyday life, and social behaviors and relations in Kuwait, from its settlement in 1716 through the bridge of oil discovery to the twenty-first century. The history that emerges reveals how decades of urban planning, suburbanization, and privatization have eroded an open, tolerant society and given rise to the insularity, xenophobia, and divisiveness that characterize Kuwaiti social relations today. However, over the past decade several social forces and youth-based movements—from political protesters to architects and small entrepreneurs—have been staking claims to the city and demanding a different kind of urban experience. Beyond simply reviving the declined urban center, Al-Nakib argues, their efforts have the potential to restore Kuwaiti society’s lost urbanity.
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Farah Al-Nakib is Assistant Professor of History and Director of the Center for Gulf Studies at the American University of Kuwait. She obtained her PhD (2011) and MA (2006) in history from the School of Oriental and African Studies in London. Her research primarily focuses on the urban history of Kuwait City before and after oil, on which she has written her first book. She also writes about memory and forgetting in relation to the built environment. Her latest research analyzes the 1990-91 Iraqi invasion and occupation of Kuwait from a social historical perspective. Al-Nakib is currently a Carnegie Centennial Fellow at American University in Washington, DC. She is also a co-editor of Jadaliyya’s Cities Page.
Reuben Hills Conference Room
2nd Floor East Wing E207
Encina Hall
616 Serra Street
Stanford, California 94305
Farah Al-Nakib
Assistant Professor
American University of Kuwait
Seminars
Bassam Haddad Analyzes the Root Causes and Dynamics of the Syrian Uprising [VIDEO]
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As part of the Program on Arab Reform and Democracy's speaker series, George Mason University scholar Bassam Haddad explained the roots and dynamics of the tragic Syrian uprising, with particular attention to its background and to the recent Russian intervention, in a talk dated January 22, 2016. After nearly five years since the start of the uprising, Syria finds itself divided and embattled, with no end in sight. More significantly, more than half of the Syrian population is displaced and the death toll surpassed 300,000 by all counts. The Syrian tragedy persists and, more than any other case of mass uprising in the region, continues to be shrouded in political power-plays and contradictions at the local, regional, and international levels, Haddad explained.
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Tunisia’s Pathway to Democracy
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After having witnessed the beginning of the Arab Spring in December 2010, and the ouster of former President Zine El Abidine Ben Ali in January 2011, Tunisia went through a period of intense political turbulence, including a rapid succession of governments and a paralyzing political gridlock in the summer of 2013. The Tunisian national dialogue quartet, which represented the major stakeholders in civil society and is the recipient of the 2015 Nobel Peace Prize, paved the way for a technocratic government that helped bring the country’s democratic transition back on track. After discussing the conditions that led to these developments, this presentation will focus on how the technocratic government managed the challenges of organizing the country’s first fully democratic presidential and legislative elections, re-establishing security, and restoring economic fundamentals. Finally, the presentation will discuss the prospects for democratic and economic development in Tunisia, one year after the appointment of the government that resulted from the 2014 elections.
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CISAC Central Conference Room
Encina Hall, 2nd Floor
616 Serra St
Stanford, CA 94305
Kamel Ben Naceur
Director for Sustainability, Technology, and Outlooks
International Energy Agency
Seminars
LAD Course: Singapore Management University 2016
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This module addresses the challenges faced by public sector leaders as they foster economic growth in politically charged environments. Offered in partnership with the Leadership Academy for Development (LAD) at Stanford University and Johns Hopkins University School of Advanced International Studies, it uses case studies (mostly drawn from Asia) on how public policy can help the private sector be a constructive force for economic growth and development. A driving principle of the LAD module is that policy reform is not like engineering or other technical fields that have discrete skills and clear, optimal solutions. Instead, successful reformers must be politically aware and weigh a broad range of factors that influence policy outcomes. They must have a solid grasp of country-specific economic, financial, political and cultural realities. Most importantly, they must have a sense of how to set priorities, sequence actions and build coalitions. LAD provides participants with an analytical framework to build these leadership abilities and operate effectively under adverse conditions. Major themes are 1) Providing public goods efficiently 2) Bypassing Bureaucratic Obstacles, 3) Facilitating private Investment, and 4) Strengthening the role of the state as economic catalyst.
oster economic growth in
politically charged environments. Offered in partnership with the Leadership Academ
y for Development
(LAD) at Stanford University and Johns Hopkins University School of Ad
vanced International Studies, it
uses case studies (mostly drawn from Asia) on how public policy can help the
private sector be a
constructive force for economic growth and development. A driving principl
e of the LAD module is that
policy reform is not like engineering or other technical fields that have disc
rete skills and clear, optimal
solutions. Instead, successful reformers must be politically aware and weigh a
broad range of factors that
influence policy outcomes. They must have a solid grasp of country-spec
ific economic, financial, political
and cultural realities. Most importantly, they must have a sense of how to set
priorities, sequence
actions and build coalitions. LAD provides participants with an analytical
framework to build these
leadership abilities and operate effectively under adverse conditions. Major themes a
re 1) Providing
public goods efficiently 2) Bypassing Bureaucratic Obstacles, 3) Facilitating priv
ate Investment, and 4)
Strengthening the role of the state as economic catalyst.
Singapore Management University
Singapore