The Freeman Spogli Institute's Center on Democracy, Development, and the Rule of Law (CDDRL) has established a new Program on Good Governance and Political Reform in the Arab World, the result of a generous gift from the Foundation for Research and Development in the Middle East (FDRDME), based in Geneva, Switzerland.  The program, which runs for five years beginning in September 2009, conducts research, organizes conferences and seminars and sponsors visiting scholars at CDDRL.  The program's scholarly research examines the different social and political dynamics within Arab societies and the evolution of political systems, with an eye on the prospects, conditions, and possible pathways for political reform.

The new program brings together scholars and practitioners from Arab countries and their Western counterparts, as well as local actors of diverse backgrounds, to consider how democratization and more responsive and accountable governance might be achieved, as a general challenge and within specific Arab countries.  Among the program's first research projects is one on transitions from absolute monarchy in historical and comparative perspective. To this effect, are there any lessons that can be drawn from past experiences, and across different settings, and to what degrees can they apply to the Arab world?  A conference taking stock of democratic progress and conditions in the Arab world is planned for May 10-11, 2010.

Center Director Larry Diamond thanked the Foundation for its visionary contribution. "This gift puts Stanford on the map in contemporary Arab studies and will make CDDRL one of the most important academic sites for studying these issues.  In the modern history of the Arab world, there has never been a more compelling and opportune moment to examine current conditions of governance and factors that might facilitate or obstruct democratic change.

"In the modern history of the Arab world, there has never been a more compelling and opportune moment to examine current conditions of governance and factors that might facilitate or obstruct democratic change"

"The striking political continuity in the Arab world is not just of analytic interest, but is a challenge to sustained long-term economic development, stability, and peace." Diamond stated. "From the expressions and actions of vibrant and diverse civil societies in the region, and a growing wealth of public opinion-survey evidence, we know that peoples of the region desire political emancipation and self-determination no less than others around the world.  The challenge is to figure out how indigenous democratic change might be negotiated in ways that generate broad societal consensus and do not risk violence or instability."

"From the expressions and actions of vibrant and diverse civil societies in the region, and a growing wealth of public opinion survey evidence, we know that peoples of the region desire political emancipation and self-determination"

The program is supervised by Diamond and CDDRL Deputy Director Kathryn Stoner-Weiss, and managed by Lina Khatib, in interaction with Professor Olivier Roy, in his capacities as a leading Western scholar of political Islam and as director of FDRDME. Roy, a long-time scholar and research director at the French National Center for Scientific Research (CNRS) who has recently been named Professor of Mediterranean Studies at the European University Institute in Florence, will be a frequent participant in program events and a recurrent visitor to CDDRL.  Other program participants include Hicham Ben Abdallah and Hind Arroub from Morocco, Visiting Scholars at CDDRL, and Sean Yom, a political science PhD from Harvard University, who is a postdoctoral fellow at CDDRL in 2009-10.

The Director of the Asia Health Policy Program, Karen Eggleston, served as guest editor of the International Journal of Healthcare Finance and Economics for the June 2009 issue. The eight papers of that issue evaluate different provider payment methods in comparative international perspective, with authors from Hungary, China, Thailand, the US, Switzerland, and Canada. These contributions illustrate how the array of incentives facing providers shapes their interpersonal, clinical, administrative, and investment decisions in ways that profoundly impact the performance of health care systems.

The collection leads off with a study by János Kornai, one of the most prominent scholars of socialism and post-socialist transition, and the originator of the concept of the soft budget constraint. Kornai’s paper examines the political economy of why soft budget constraints appear to be especially prevalent among health care providers, compared to other sectors of the economy.

Two other papers in the issue take up the challenge of empirically identifying the extent of soft budget constraints among hospitals and their impact on safety net services, quality of care, and efficiency, in the United States (Shen and Eggleston) and – even more preliminarily – in China (Eggleston and colleagues, AHPP working paper #8).

The impact of adopting National Health Insurance (NHI) and policies separating prescribing from dispensing are the subject of Kang-Hung Chang’s article entitled “The healer or the druggist: Effects of two health care policies in Taiwan on elderly patients’ choice between physician and pharmacist services” (AHPP working paper #5).

In “Does your health care depend on how your insurer pays providers? Variation in utilization and outcomes in Thailand” (AHPP working paper #4), Sanita Hirunrassamee of Chulalongkorn University and Sauwakon Ratanawijitrasin of Mahidol University study the impact of multiple provider payment methods in Thailand, providing striking evidence consistent with standard predictions of how payment incentives shape provider behavior. For example, patients whose insurers paid on a capitated or case basis (the 30 Baht and social security schemes) were less likely to receive new drugs than those for whom the insurer paid on a fee-for-service basis (civil servants). Patients with lung cancer were less likely to receive an MRI or a CT scan if payment involved supply-side cost sharing, compared to otherwise similar patients under fee-for-service. (This article is open access.)

The fourth paper in this special issue is entitled “Allocation of control rights and cooperation efficiency in public-private partnerships: Theory and evidence from the Chinese pharmaceutical industry” (AHPP working paper #6). Zhe Zhang and her colleagues use a survey of 140 pharmaceutical firms in China to explore the relationships between firms’ control rights within public-private partnerships and the firms’ investments.

Hai Fang, Hong Liu, and John A. Rizzo delve into another question of health service delivery design and accompanying supply-side incentives: requiring primary physician gatekeepers to monitor patient access to specialty care (AHPP working paper #2).

Direct comparisons of payment incentives in two or more countries are rare. In “An economic analysis of payment for health care services: The United States and Switzerland compared,” Peter Zweifel and Ming Tai-Seale compare the nationwide uniform fee schedule for ambulatory medical services in Switzerland with the resource-based relative value scale in the United States.

Several of the papers featured in this special issue were presented at the conference “Provider Payment Incentives in the Asia-Pacific” convened November 7-8, 2008 at the China Center for Economic Research (CCER) at Peking University in Beijing. That conference was sponsored by the Asia Health Policy Program of the Shorenstein Asia-Pacific Research Center at Stanford University and CCER, with organizing team members from Stanford University, Peking University, and Seoul National University.

As Eggleston notes in the guest editorial to the special issue, AHPP and the other scholars associated with the issue “hope that these papers will contribute to more intellectual effort on how provider payment reforms, carefully designed and rigorously evaluated, can improve ‘value for money’ in health care.”

During 2007–2008 the forum on contemporary Europe launched the second phase of its comprehensive, multi-year analysis of Europe and the EU’s global relations in the context of an expanding European Union. What began last year with analysis of political membership this year added a focus on implications of expanded membership in key areas, including social integration of immigrant communities. Forum researchers and invited scholars addressed questions central to understanding the process of European integration and areas of concern it raises. During the fall of 2007, in seminars, keynote speeches, and international conferences, Forum researchers addressed such questions as:

• What explains the electoral results of populist parties, with their nationalist and anti-immigrant platforms, gaining where they had previously remained marginal (Switzerland) and declining where they had regularly held influence (France)?
• How should OSCE member states and election monitors respond to the denial of visas for monitoring Russia’s parliamentary elections?
• What is inflaming renewed outbursts of violence in multiple urban centers? Do the riots reveal urban youth segregated by race? Compelled by fundamentalism? Or disaffected with the promised EU economic mobility?
• Do instances of violence against ethnicminorities reveal a return to a pre-modern xenophobia or an old behavior used to express a new rejection of EU integration?
• Will laws protecting historical memory, such as the Spanish act to rebury victims of Fascist forces and German and Austrian laws criminalizing holocaust denial, resolve or inflame neo-fascist parties?
• What stance can the EU take in regard to Turkey’s article 301 criminalizing historical comments as denigrating the heritage of the Turkish state?
• Does EU membership mollify or magnify cultural tensions behind separatist movements in cases such as Flanders, Catalonia, Corsica, Basque homelands, and, potentially, Kurdish regions of Turkey?

Highlights of the following fall 2007 events illustrate forum research on these vital questions.

INTERNATIONAL CONVERENCE ON ETHNICITY IN TODAY'S EUROPE

The forum joined with the Stanford Humanities Center to organize an international conference on “Ethnicity in Today’s Europe.” Amir Eshel, director of the forum, opened the conference with remarks on the growth of immigrant communities, and their increasingly widespread origins, as well as implications for security and integration. The Stanford faculty organizing committee identified and attracted the top scholars on the subject from both sides of the Atlantic, including professors Saskia Sassen (sociology, Columbia), Alec Hargreaves (French, Florida State), Leslie Adelson (German studies, Cornell), Kader Konuk (Germanic languages and literatures, Michigan), Rogers Brubaker, (sociology, UCLA), Carole Fink (history, Ohio State), Salvador Cardus Ros (sociology, Universitat Autònoma de Barcelona), and Bassam Tibi (international relations, University of Gottingen). Panels were moderated by Stanford faculty: Helen Stacy (law school), J.P. Daughton (history), Joshua Cohen (political science, philosophy, FSI), Pavle Levi (art), and Josef Joffe (FSI).

Panelists and a large, engaged public audience convened for a screening of the award-winning film Fortress Europe and a discussion with the film-maker Zelimir Zilnik. The conference-related Presidential Lecture by Partha Chatterjee (political science, Centre for Studies in Social Sciences, Calcutta; anthropology, Columbia), brought a capacity audience to open the conference with a study of the historical foundations of inter-ethnic relations in post-colonial Europe. The forum’s assistant director, Roland Hsu, has invited participants to contribute to a volume he will edit and introduce on Ethnicity in Today’s Europe to be published in 2008.

FSI INTERNATIONAL CONFERNCE: FCE PANEL ON EUROPE - A CHANGING CONTINENT?

The forum invited three leading figures on EU policy to speak on the FCE panel at the FSI international conference. Engaging the theme of power and prosperity, Wolfgang Münchau, writer for the Financial Times; Monica Macovei, former justice minister, Romania; and Mark Leonard, executive director of the European Council on Foreign Relations and Open Society [Soros] Foundation, spoke on the challenge of interpreting recent EU electoral, juridical, economic, and social reforms. This panel examined economic growth in the newest member states in the East, the challenge of political and social integration in the West, and countervailing pressures for consolidating post-communist governments and transparency reforms. The European Union’s expansion to 27 member nations promises a vast Euro-zone and a stronger trans-Atlantic partner. Questions from the audience engaged the panel on what level of confidence should be placed in this promise. The dilemma over Kosovo, pending Serbian EU accession, the expansion eastward to include societies bordering former Soviet republics, the question of Turkey’s membership, as well as tightening labor markets and welfare budgets in Western Europe, led the panel and audience to anticipate with cautious optimism the potency of EU integration and foreign policy initiatives.

AN EVENING WITH ORHAN PAMUK

Forum-affiliated faculty brought such questions to a special lunch with Nobel Laureate Orhan Pamuk; and then joined an overflow audience event at Memorial Auditorium titled An Evening with Orhan Pamuk. The forum co-sponsored the visit by Pamuk, along with Mediterranean Studies, the Office of the Provost, and the FSI S.T. Lee lecture series.

Research and public programs on these subjects will continue at the forum in the following selected events:

INTERNATIONAL CONFERENCE ON THE TRAFFICKING OF WOMEN POST-COMMUNIST EUROPE

Designed by forum acting director Katherine Jolluck, this international conference will examine the trafficking of women for sexual slavery, a trade that has rapidly expanded since the collapse of communism in Eastern Europe and the USSR. The conference will bring together scholars, policy experts, and NGO analysts to discuss the issue from economic, legal, and human rights perspectives. Special attention will be devoted to strategies to combat the problem and address the needs of victimized females. Madeline Rees, head of Women’s Rights and Gender Unit, U.N. Office of the High Commissioner for Human Rights, former U.N. high commissioner for human rights in Bosnia, has been invited to give the keynote speech.

JAN ELIASSON: THE FUTURE OF DARFUR

The forum has invited Jan Eliasson, former Swedish foreign minister and current U.N. special envoy to Darfur, to speak on his work on behalf of the international community and the EU-African Union mission to bring peace and humanitarian relief to Darfur and its neighboring states.

KOSOVO: PROSPECTS FOLLOWING THE DECEMBER 2007 U.N. STUTS TALKS

The forum has invited multiple affiliated centers including the Center for Russian, Eastern European, and Eurasian Studies, the Department of History, and the Stanford Law School to co-sponsor a panel discussion following the December 2007 U.N.-EU deadline for status talks. Elez Biberaj, director of the Eurasia division at VOA, and Obrad Kesic, formerly at IREX and also former advisor to Yugoslav President Panic, will speak on prospects for the status of Kosovo and the efficacy of potential EU membership to mediate Kosovo-Serbian relations.