I am an applied microeconomist studying health economics, development economics and industrial organization.
My research focuses on the roles of government and the private sector in health care, health insurance, and health systems broadly.
I am on the job market in 2023-2024.
[ Job Market Paper ] [ CV ]
Working Papers:
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Spatial Allocation of Public Hospitals with Endogenous Private Entry: Evidence from Malaysia (JMP).
[ Abstract ]
[ Draft ]
Public and private firms coexist in various sectors within developing countries, yet it remains unclear how new public firms affect private entrants. This paper studies these public-private interactions in the Malaysian hospital sector. I combine newly digitized data encompassing six decades of hospital construction records and spatial data to study what influences the allocation of public hospitals, and where private hospitals enter in response to public hospitals. I find that public hospitals are built in areas that are far from existing public hospitals and represented by politicians who become Ministers. Instead of crowding out private entrants, public hospitals crowd in private hospitals due to shared labor markets and demand-side complementarities. Given these incentives, I build a spatial entry model to quantify the gains from accounting for private entry when allocating public hospitals. Counterfactual simulations show that reallocating public hospitals can improve access by changing the incentives of where private hospitals choose to locate. These findings show how the spatial allocation of public investments can influence market incentives beyond conventional economic policies such as subsidies or tax incentives.
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Politics and Bureaucratic Allocation Rules: Evidence from Malaysian Hospitals.
[ Abstract ]
I combine six decades of elections data with hospital construction records from 1959-2013 to study how politics influences where public hospitals are built in post-colonial Malaysia. The allocation of public hospitals follows a two-stage process: districts are ranked according to a predetermined set of rules in the initial stage, but no defined rule governs the allocation within each district in the subsequent stage. I exploit differences in electoral seat and administrative district boundaries to identify the effects of patronage, electoral incentives and ethnic favoritism on the allocation of public hospitals. I find that political distortions occur within-administrative districts, but not across-districts. This suggests that clearly defined bureaucratic rules in allocating goods guard against political distortions, while ambiguity allows for distortions.
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Price Uncertainty and the Benefits of the Public Option.
[ Abstract ]
In many developing countries, consumers choose between subsidized public hospitals and private hospitals with variable health care prices. Consumers form ex-ante perception of prices for private hospitals, but the ex-post prices may differ. In this paper, I quantify the welfare effects of having a subsidized public option alongside a private option for CABG treatment in Malaysia. Using a nationally representative survey of price perceptions, I estimate a demand model for hospitals that incorporates ex-ante perception of prices, but welfare is realized ex-post. I find that private hospital patients incur average ex post welfare losses of $8,334, while public hospital consumers gain $2,569. These findings highlight that price uncertainty leads to matching inefficiencies and harms private health care consumers through differences between perceived and actual prices.
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.
[ Abstract ]
[ Draft ]
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.