I am an applied microeconomist studying health economics, development economics, and industrial organization.
My research focuses on the roles of the government and the private sector in health care, health insurance, and health systems broadly.
Working Papers:
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Strategic Public Investment and Private Entry Incentives
Rising income and fiscal constraints lead countries from purely public provision of essential services to mixed public-private provision. How should the government make public investments when anticipating private entrants? I study this question in the Malaysian hospital market using a spatial dataset that combines hospital locations, entry timing, and demographics. Event studies show that, instead of crowding out private hospitals, new public hospitals crowd in new private entrants. Specialist public hospitals in urban areas drive these crowd-in effects, while non-specialist public hospitals in rural areas have null effects on entrants. Within the same district, new public hospitals crowd in more private entrants, and newer entrants choose to locate further away from the new public hospital. This suggests that governments can use public hospital placements to both expand healthcare access and influence the spatial distribution of private investment. Given these incentives, I build a spatial entry model to quantify the gains from anticipating private entry when allocating public hospitals. Counterfactual simulations show that reallocating public hospitals can improve welfare by changing the incentives of where private hospitals choose to locate. These findings show how public investments can not only crowd in private investments but can also influence firm locations beyond conventional economic policies such as subsidies or tax incentives.
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Politicians and Bureaucratic Planning: Evidence from Malaysian Hospitals
[ Abstract ] [ Draft ] - Comments welcome!I study how politicians and bureaucrats influence the allocation of public hospitals in Malaysia between 1959 and 2013. Exploiting differences in electoral seat and hospital district boundaries, I show that politicians distort hospital locations towards constituencies with deputy ministers. Political distortions occur during the construction stage but not during funding decisions. Using a simple model, I show that bureaucrats have higher bargaining power than politicians in funding decisions relative to hospital locations. Anecdotal evidence attribute these effects to codified bureaucratic guidelines. These results show how bureaucratic rules in allocating public goods during the planning stage can mitigate political distortions.
Publications:
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Consumer Choice and Public-Private Providers: The Role of Perceived Prices (with Wei Aun Yap and Winnie Yip). Health Economics 2022.
Governments often encourage health service providers to improve quality of care and reduce prices through competition. The efficacy of competition hinges on the assumption that consumers demand high quality care at low prices for any given health condition. In this paper, we examine this assumption by investigating the role of perceived price and quality on consumer choice for four different health conditions across public and private providers. We use a nationally representative survey in Malaysia to elicit respondents' perception on prices and quality, and their preferred choice of provider. We estimate a mixed logit model and show that consumers value different dimensions of quality depending on the health condition. Furthermore, increasing perceived prices for private providers reduces demand for minor, more frequent health conditions such as flu fever or cough, but increases demand for more complex, severe conditions such as coronary artery bypass graft. These findings provide empirical support for price regulation which differentiates the severity of underlying health conditions.