Taiwan’s National Health Insurance (NHI), now in its 30th year, is internationally recognized for achieving universal coverage, providing comprehensive, low-cost, and accessible care to more than 99% of the population. Its strong digital infrastructure—most notably the smart card system—proved instrumental during the COVID-19 pandemic, significantly enhancing the program’s effectiveness.

Yet alongside these achievements, the NHI faces pressing challenges in financial sustainability and care delivery. Taiwan’s rapidly aging population, combined with the emergence of new medical technologies and therapeutics, has heightened public expectations and demand for better care, further straining the system’s finances. Over three decades, stringent expenditure controls have helped contain costs but at the expense of workforce adequacy, timely adoption of innovations, and quality management of chronic diseases.

Future reforms will inevitably need to focus on raising premiums, diversifying funding sources, and optimizing healthcare delivery to balance quality with sustainability. The core dilemma, however, lies in how public finance instruments can be leveraged to ensure adequate and sustainable funding to meet the population’s growing healthcare needs. Paradoxically, the NHI’s consistently high public approval rating—hovering around 90% in recent years—may make substantive reform politically more difficult if not impossible.

Taiwan’s experience offers important lessons for other countries. First, strong political commitment is essential for both the establishment and ongoing success of universal health coverage. Second, robust information technology infrastructure is critical to efficiency. Third, there is no “free lunch”: in a system like Taiwan’s, where health expenditure is kept at a relatively low at 7% of GDP, stringent cost controls inevitably carry serious adverse consequences. Finally, Taiwan demonstrates that even the most celebrated and popular systems face continual challenges, reforms are rarely straightforward, and long-term sustainability can never be taken for granted.

Hongjen Chang is the current Chairman and CEO of YFY Biotech Management Co., in addition to serving as the Chairperson for several other private biotech firms. Before joining the YFY Group—which has grown from a paper mill into a conglomerate with interests in electronics, finance, biotech, and agriculture—Dr. Chang dedicated over 16 years to Taiwan’s Health Ministry. From 2005 to 2021, he also led Taiwan Global BioFund as its CEO. Widely recognized in Taiwan for his extensive public health administration experience, Dr. Chang is credited with implementing the smart card program during his time as President and CEO of BNHI, the country’s universal health care institution. This initiative was crucial to Taiwan's early success in containing the COVID-19 pandemic in 2020. Dr. Chang holds a medical degree from National Yang-Ming Medical College, an M.S. in Public Health from National Taiwan University, and an M.S. in Health Policy and Management from Harvard School of Public Health.

SCCEI Seminar Series (Fall 2025)

Friday, November 21, 2025 | 12:00 pm -1:20 pm Pacific Time
Goldman Room E409, Encina Hall, 616 Jane Stanford Way

Public Displays of Alignment: Firm Speech in Autocratic Regimes

Political speech by firms is increasingly common around the world. The research examines the government as an important, yet understudied, audience for such speech, focusing on how Chinese firms rhetorically align with the state. We construct a new measure of firms’ rhetorical alignment with the ruling regime and implement it in China, where such behavior is widespread. To interpret the function of rhetorical alignment, we develop a model that nests three common explanations —cheap talk, benefit-seeking, and insurance commitment— and derive testable predictions. Using the new measure, we show that aligned firms’ stock returns fall more when regime reputation deteriorates; alignment rises after regulatory investigations that heighten expropriation risk; and alignment correlates negatively with profitability but positively with performance on political objectives. These patterns are difficult to reconcile with cheap talk or benefit-seeking alone and point to insurance-commitment as a central motive for this form of political speech.

Please register for the event to receive email updates and add it to your calendar. Lunch will be provided.

About the Speaker 
 

Jaya Wen is an Assistant Professor in the Business, Government and the International Economy Unit at Harvard Business School. ​Her research focuses on issues in development economics, political economy, and firm behavior. 

She serves as the Director of Research for the China Econ Lab and a faculty co-chair of the China and the Global Economy Initiative. Wen is also an affiliate of the Center for International Development and the Weatherhead Research Cluster on Business and Government. 

Questions? Contact Xinmin Zhao at xinminzhao@stanford.edu
 

Government healthcare payors in Asia and globally may face financial incentives to restrict use of high-cost medications. Yet, restrictions on access to high-value medications may have deleterious effects on population health. Advance purchase commitments (APCs), wherein a payor commits to purchase a certain quantity of medications at lower prices, offer payors incentives to increase access to high-value medications and companies guaranteed revenue; a potential win-win-win for patients, business and society.

Dr. Conti will discuss the United States payor experience with subscription models, a type of APC, to support increased access to high-value medicines. She will focus on direct-acting antivirals (DAAs), available since 2013, that can cure chronic infection with Hepatitis C virus (HCV). With prices upwards of $90,000 for a treatment course, many payors struggle to ensure access to DAAs to populations in need of treatment. Since 2018, several U.S. states have implemented HCV subscription models, and a national HCV elimination strategy featuring a DAA subscription model has been announced.

Dr. Conti will review the empirical evidence on impacts and lessons learned from implementation to date, as well as provide a framework for payors interested in pursuing subscription models targeting DAAs and other high-value, high-cost medicines.

Rena Conti is an associate professor of markets, public policy, and law at Questrom School of Business, Boston University. Professor Conti is the co-director of the Technology Policy and Research Initiative, a joint program between Questrom School of Business and the Law School, and the life sciences markets co-lead at the Ravi K. Mehrotra Institute for Business Markets and Society at Questrom School of Business.

Professor Conti holds a Ph.D. from Harvard University Graduate School of Arts and Sciences in health policy and economics. She was a faculty at the University of Chicago between 2006 and 2018. Professor Conti has published extensively on biopharmaceutical pricing, competition, and innovation. Professor Conti has testified on the economics of biopharmaceutical markets in hearings held by the U.S. Senate, the U.S. House of Representatives, the U.S. Food and Drug Administration, the Federal Trade Commission, and numerous state legislative houses. Professor Conti served as Special Government Advisor to the Centers for Medicare and Medicaid Services (CMS) 2022-2023 and has held additional advisory roles at the U.S. Food and Drug Administration (FDA). Professor Conti served as the lead economist on the establishment of the State of Louisiana’s landmark Subscription Model for Hepatitis C Virus Elimination (HepCfreeLa). Professor Conti currently serves as an appointed member of the New Jersey Drug Affordability Council and is an elected member of the Conference on Research in Income and Wealth. She currently serves as a board member of the Boston University Medical Group.

The research of Professor Conti has been featured in the New York Times, the Wall Street Journal, the Washington Post, Bloomberg News, USA Today, the Chicago Tribune, the Boston Globe, the LA Times, 60 Minutes, the Daily Show, Vox, the Atlantic, Statnews, and the Colbert Report, among other print and media outlets. Grants and awards from the National Cancer Institute, the National Institute of Mental Health, the National Institute on Drug Abuse, the National Science Foundation, the Sloan Foundation, the Commonwealth Fund, American Cancer Society, and Arnold Ventures, among other sources, support her research.     

SCCEI Seminar Series (Fall 2025)

Friday, October 17, 2025 | 12:00 pm -1:20 pm Pacific Time
Goldman Room E409, Encina Hall, 616 Jane Stanford Way

Due to room capacity limitations and high interest in this seminar, registration is now closed. 
 

Hamilton’s Nightmare: Financial Repression, Political Control, and the Rapid Rise of Local Debt in China

Hamilton’s Paradox highlights the moral hazard faced by local governments due to the implicit expectation of central government bailouts. This paper sets forth a framework where soft-budget constraints (SBC) intensify at the local levels when financial repression eliminates policing from external creditors, and local authorities can credibly threaten central authorities within stability. In such cases, central authorities, even if they could discipline local authorities, may repeatedly raise debt limits for local governments. Empirically, we demonstrate the benefits of financial repression to the central government by showing that rising government debt levels do not impact bond spreads, unlike in most developing countries. We then show that when local debts mature, Chinese local governments, backed by central approval, issue additional debt rather than impose austerity, regardless of outstanding debt levels. Second, by matching a comprehensive geospatial dataset of rainfalls and major floods with China’s provincial boundaries, we show that in those moments of heightened fiscal pressure escalating instability risks, the central government permits localities to borrow further for disaster relief and reconstruction.

Please register for the event to receive email updates and add it to your calendar. Lunch will be provided.

About the Speaker 
 

Victor Shih is an expert on the politics of Chinese banking policies, fiscal policies, and exchange rate, as well as the elite politics of China. He is the author of two books published by the Cambridge University Press, "Factions and Finance in China: Elite Conflict and Inflation" and "Coalitions of the Weak: Elite Politics in China from Mao’s Stratagem to the Rise of Xi."  He is also editor of "Economic Shocks and Authoritarian Stability: Duration, Institutions and Financial Conditions," published by the University of Michigan Press. Shih also has published widely in a number of journals, including The American Political Science Review, Comparative Political Studies, Journal of Politics, The China Quarterly, and Party Politics.

Shih is a professor of political science, director of the 21st Century China Center, and the Ho Miu Lam Chair in China and Pacific Relations. He is currently engaged in a study of the activities of the Chinese elite and of Chinese defense firms around the world. He is also maintaining a large database on biographical information of elites in China.

At GPS, Shih teaches courses including Financing the Chinese Miracle, Chinese Sources and Methods, Chinese Politics and Political Economy of Authoritarian Regimes.  

Prior to joining UC San Diego, Shih was a professor of political science at Northwestern University and former principal for The Carlyle Group.

Questions? Contact Xinmin Zhao at xinminzhao@stanford.edu
 

SCCEI Seminar Series (Fall 2025)

Friday, October 10, 2025 | 12:00 pm -1:20 pm Pacific Time
Goldman Room E409, Encina Hall, 616 Jane Stanford Way

Due to room capacity limitations and high interest in this seminar, registration is now closed. 

Decoding China’s Industrial Policies

We decode China’s industrial policies from 2000 to 2022 by employing large language models (LLMs) to extract and analyze rich information from a comprehensive dataset of 3 million documents issued by central, provincial, and municipal governments. Through careful prompt engineering, multistage extraction and refinement, and rigorous verification, we use LLMs to classify the industrial policy documents and extract structured information on policy objectives, targeted industries, policy tones (supportive or regulatory/suppressive), policy tools, implementation mechanisms, and intergovernmental relationships, etc. Combining these newly constructed industrial policy data with micro-level firm data, we document four sets of facts about China’s industrial policy that explore the following questions: What are the economic and political foundations of the targeted industries? What policy tools are deployed? How do policy tools vary across different levels of government and regions, as well as over the phases of an industry’s development? What are the impacts of these policies on firm behavior, including entry, production, and productivity growth? We also explore the political economy of industrial policy, focusing on top-down transmission mechanisms, policy persistence, and policy diffusion across regions. Finally, we document spatial inefficiencies and industry-wide overcapacity as potential downsides of industrial policies.

About the Speaker 
 

Professor Hanming Fang is an applied microeconomist with broad theoretical and empirical interests focusing on public economics. His research integrates rigorous modeling with careful data analysis and has focused on the economic analysis of discrimination; insurance markets, particularly life insurance and health insurance; and health care, including Medicare. In his research on discrimination, Professor Fang has designed and implemented tests to examine the role of prejudice in racial disparities in matters involving search rates during highway stops, treatments received in emergency departments, and racial differences in parole releases. In 2008, Professor Fang was awarded the 17th Kenneth Arrow Prize by the International Health Economics Association (iHEA) for his research on the sources of advantageous selection in the Medigap insurance market.

Professor Fang is currently working on issues related to insurance markets, particularly the interaction between the health insurance reform and the labor market. He has served as co-editor for the Journal of Public Economics and International Economic Review, and associate editor in numerous journals, including the American Economic Review.

Professor Fang received his Ph.D. in Economics from the University of Pennsylvania in 2000. Before joining the Penn faculty, he held positions at Yale University and Duke University.  He is a research associate at the National Bureau of Economic Research, where he served as the acting director of the Chinese Economy Working Group from 2014 to 2016. He is also a research associate of the Population Studies Center and Population Aging Research Center, and a senior fellow at the Leonard Davis Institute of Health Economics at the University of Pennsylvania.

Questions? Contact Xinmin Zhao at xinminzhao@stanford.edu