I am a Postdoctoral Research Fellow at the Harvard Kennedy School.
My research uses theories and tools from health economics and industrial organization to study how policy design affects market structure, firm behavior, and consumer outcomes.
I work on health insurance and health care markets in both the U.S. and emerging economies. I have five years of experience advising governments on health system reform at the World Bank, UNDP, and Harvard T.H. Chan School.
I received a Ph.D. from Harvard in 2024, and B.Sc. and M.Sc. from the University of Nottingham in 2014.
Working Papers:
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Competing Complements in Public-Private Hospital Markets
[ Abstract ] [ Draft ] - Comments welcome!Public hospitals in many developing countries provide subsidized care that competes with private providers while training medical specialists who later staff private facilities. I study this tension between competition and complementarities in Malaysia by exploiting the staggered construction of public hospitals between 1996 and 2013. Specialist public hospitals increase private entry by 61.5 percent, while non-specialist hospitals reduce entry by 56 percent. The difference is labor market spillovers. Specialist hospitals expand local specialist physician supply, with effects emerging only after training programs mature. A dynamic entry model shows that specialist hospitals reduce private entry costs by 19 percent through a thicker labor market, but also reduce producer surplus by 31.2 percent through intensified competition. Private entry increases because cost reductions dominate. Similar tradeoffs are likely relevant across developing countries where public hospitals monopolize specialist training.
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Hospital Allocation and Politicians: Evidence from Malaysia (In Review, World Development)
[ Abstract ] [ Draft ] - Comments welcome!Equitable access to healthcare requires efficient allocation of health infrastructure, yet politics may distort these decisions. This paper studies how politicians distort public hospital allocations in postcolonial Malaysia from 1959 to 2013. Malaysia first allocates hospital funding to districts, then selects specific locations within funded districts for construction. Using six decades of data on hospital construction and elections, I find that constituencies represented by deputy ministers are significantly more likely to receive new hospitals, but only at the location selection stage within districts. District-level funding decisions effectively direct resources to districts far from existing hospitals. I provide suggestive evidence that measurable guidelines for funding decisions exist but not for construction site selection. These results suggest that defining clear guidelines in hospital allocation can limit 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.
Selected Work-In-Progress:
- Strategic Auto-Enrollment and Health Insurance Market Design (with Mark Shepard and Myles Wagner).
- Word-of-Mouth in Low-Income Health Care Markets (with Bijetri Bose and Terence Cheng).