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Begin New Search Political Geography Taiwan Publishing Institution Walter H. Shorenstein Asia-Pacific Research Center

1. Economic Dimensions of Personalized and Precision Medicine in Asia: Evidence from Breast Cancer Treatment in Taiwan

Author:
Jui-fen Rachel Lu and Karen Eggleston
Publication Date:
04-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
High costs of precision medicine raise concerns about exacerbating income-related disparities in healthcare utilization and health outcomes. One approach to expanding coverage in Asia has been to cover the precision therapy but require the pharmaceutical firm to cover the costs of the companion diagnostic test. Taiwan’s National Health Insurance (NHI) adopted this approach for lung cancer, colorectal cancer and leukemia, but not for the first target therapy covered by NHI, trastuzumab for the treatment of HER2-positive breast cancer. Analyzing a unique dataset linking medical claims, cancer registry data and proxies for income between 2004 and 2015, we find that lower-income patients are more likely to be diagnosed with later stages of breast cancer, and this pattern renders NHI coverage of anti-HER2 therapy pro-poor even before full coverage of the diagnostic tests. Moreover, the expansion of NHI coverage—including the FISH diagnostic test and trastuzumab for early-stage breast cancer—strengthened the pro-poor distribution of genetic testing and target treatment, albeit only marginally. The extent of pharmaceutical company coverage of testing and its impact on patient access are topics of our ongoing research, contrasting breast cancer with colorectal cancer.
Topic:
Health, Health Care Policy, Economic Inequality, and Medicine
Political Geography:
Taiwan and Asia

2. Taiwan's Place in the Evolving Security Environment of East Asia

Author:
Kharis Templeman
Publication Date:
07-2018
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
In March 2018 the Taiwan Democracy and Security Project, a part of the U.S.-Asia Security Initiative at Stanford University’s Shorenstein Asia- Pacific Research Center, convened a workshop that examined Taiwan’s place in the evolving security environment of East Asia. Participants from the United States, Taiwan, and elsewhere in Asia were experts on a wide array of economic, diplomatic, and security topics. The discussions at the workshop were intended to place Taiwan’s security challenges in a broader regional context, to consider possible obstacles to and opportunities for greater multilateral cooperation on security issues, and to devise a set of recommendations for steps that Taiwan and its friends and partners could take to enhance regional security relationships.
Topic:
International Relations, Security, Military Strategy, and Democracy
Political Geography:
China, Taiwan, and Asia

3. Strict Liability for Medical Injuries? The Impact of Increasing Malpractice Liability on Obstetrician Behavior: Evidence from Taiwan

Author:
Brian Chen
Publication Date:
05-2010
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
Policy makers and academics have long debated the existence and extent of defensive medicine in the face of medical malpractice liability pressure. In this paper, I investigate how physicians' test-ordering behavior and propensity to perform cesarean sections were affected first by a series of court rulings in Taiwan that increased physicians' liability risks, and then by a subsequent amendment to the law that reversed the courts' rulings. I find that physicians faced with higher malpractice pressure increased laboratory tests as expected but unexpectedly reduced cesarean sections. The reduction in cesarean deliveries may be due to the fact that liability risks were more closely aligned with physicians' standard of care after the court rulings. After the law was amended to negate the court decisions, physicians reversed their previous behavior, reducing laboratory tests and increasing cesarean deliveries. This pattern of behavior strongly suggests that physicians in Taiwan practice defensive medicine.
Political Geography:
Taiwan

4. The healer or the druggist: Effects of two health care policies in Taiwan on elderly patients' choice between physician and pharmacist services

Author:
Kang-Hung Chang
Publication Date:
03-2009
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
When both physicians and pharmacists in Taiwan prescribed and dispensed drugs, many elderly people considered the two types of health care providers more or less synonymous (i.e., close substitutes). Two policies mandated in the 1990s changed this perception: National Health Insurance (NHI), which provides insurance coverage to all citizens, and a separation policy (SP) that forbids physicians from dispensing and pharmacists from prescribing drugs. The author finds that by providing an economic incentive to the previously uninsured elderly, NHI raised the probability that they would visit physicians, relative to their continuously insured counterparts. In particular, some previously uninsured elderly who once only visited pharmacists were more likely to also visit physicians after NHI was implemented. Following this, the SP made it more likely that all elderly patients would only visit physicians and buy drugs from on-site pharmacists hired by physicians—a result different than its policy goal.
Topic:
Demographics, Health, and Human Welfare
Political Geography:
Israel, Taiwan, and Asia

5. Chinese and Indian Engineers and their Networks in Silicon Valley

Author:
Rafiq Dossani
Publication Date:
03-2002
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
In recent years, Asian immigrants have played an important role in Silicon Valley's growth, as suppliers of both engineering and entrepreneurial talent. Given their relatively large numbers, the Indian and Chinese communities' contributions have been particularly noted. The Indians' presence became more marked toward the last few years of the century, bolstered by arrivals working on the Year 2000 (Y2K) problem. The Chinese, by contrast, had older roots set down amid long-standing political, economic, and educational links with Taiwan. Both communities have formed extensive ethnic professional networks, with large memberships and well-attended, regular "networking" events, such as monthly meetings and special interest group sessions. The popularity of these events suggests that members find them valuable. While some of the value is probably noneconomic, the avowedly economic mission (see below) and long-term popularity of these gatherings means that most members primarily derive economic benefits. These networks and their members are the subject of this paper. The author acknowledges the collaboration of Professor AnnaLee Saxenian of the University of California, Berkeley, in the design of and data collection for the survey which forms part of this paper. The survey was partially funded by the Public Policy Institute of California.
Topic:
International Trade and Finance and Science and Technology
Political Geography:
United States, India, Taiwan, Asia, California, and Berkeley

6. Nesting the Alliances in the Emerging Context of Asia-Pacific Multilateral Processes: A U.S. Perspective

Author:
Douglas Paal
Publication Date:
07-1999
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
As Americans consider their options for protecting and advancing their interests in Asia in the twenty-first century, it is natural that there will be wide-ranging views and vigorous debate. Recent events such as the 1996 Taiwan crisis, the Asian economic meltdown in 1997, and the exchange of state visits by presidents Bill Clinton and Jiang Zemin in 1997 and 1998 have intensified, then moderated and redirected, much of the debate over a very short span of time. Two years ago, for example, the Chinese were worrying aloud about American efforts to “encircle” China. Now they talk about “building a constructive strategic partnership with the U.S.” Despite these ups and downs, however, the fundamental choices for the United States have remained largely the same.
Topic:
Security
Political Geography:
United States, China, America, Taiwan, and Asia

7. Show of Force: The PLA and the 1995-1996 Taiwan Strait Crisis

Author:
Andrew Scobell
Publication Date:
01-1999
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
China conducted a series of military exercises and missile tests in the vicinity of the Taiwan Strait between July 1995 and March 1996. On July 18, 1995, Beijing announced that missile tests would be conducted targeting an area some 90 miles off the coast of northern Taiwan. Then, on three consecutive days, July 21, 22, and 23, a total of six DF-15 missiles were launched from sites in Fujian province—two per day. The following month, after a five-day advance warning, PLA naval vessels and aircraft conducted ten days of live-fire tests off the coast of Fujian. Further military exercises were conducted in mid-November to the south of the Strait, including joint operations involving air, land, and naval arms of the PLA. On March 5, 1996, Beijing announced it would soon begin another round of missile tests. This time they were to be targeted at seas less than fifty miles from Taiwan's busiest ports. On March 8, three DF-15 missiles were fired from bases in Fujian. Five days later, another DF-15 missile was launched. Finally, also after advanced warning, live-fire tests and war games were conducted off the coast of Fujian to the north of the Strait and to the south of the Strait between March 12 and March 25. The maneuvers included amphibious landing exercises and aerial bombing. Some forty naval vessels, two hundred and sixty aircraft, and an estimated 150,000 troops participated.
Topic:
Security
Political Geography:
United States, China, Taiwan, Beijing, and Asia

8. The China-United States Bilateral Trade Balance: How Big Is It Really?

Author:
K.C. Fung and Lawrence Lau
Publication Date:
04-1996
Content Type:
Working Paper
Institution:
Walter H. Shorenstein Asia-Pacific Research Center
Abstract:
There are huge discrepancies between the official Chinese and U.S. estimates of the bilateral trade balance. The discrepancies are caused by different treatments accorded to re-exports through Hong Kong, re-export markups, and trade in services. Deficit-shifting between China, on the one hand, and Hong Kong and Taiwan, on the other, due to direct investment in China from Taiwan and Hong Kong, is partly responsible for the growth in the China United States bilateral trade deficit.
Topic:
International Political Economy and International Trade and Finance
Political Geography:
United States, China, Taiwan, Asia, and Hong Kong