Working papers

Job market paper

Discipline without Slack: Anti-Corruption in China's Health Sector

Dissertation chapter

Abstract

Why doesn't curbing corruption always improve service outcomes? I argue that gaps in formal institutions create room for corrupt exchanges that provide integral organizational support. As organizations become dependent on these exchanges, curbing corruption can also remove operating capacity. Drawing on over twelve months of fieldwork in China's health sector, I identify two mechanisms through which privately beneficial corruption becomes publicly useful: (1) efforts to conceal payments and advance professional careers channel resources into publicly beneficial investments in hospital equipment, research, and staff training; and (2) trust among bribe givers and recipients, built through repeated exchange, facilitates information sharing and flexible credit.

To test this argument empirically in China's public hospitals, I use AI-assisted extraction of health yearbooks and firm disclosures and construct a novel proxy for reliance on corruption-generated resources with the pre-reform drug share of outpatient expenditure. Leveraging the staggered rollout of China's National Volume-Based Procurement reform, which centralized drug purchasing to constrain hospital discretion and curb corruption, I compare early- and later-exposure provinces in a difference-in-differences analysis covering all 31 provinces over 2010–2023. Contrary to standard accountability expectations, early exposure to reform was associated with higher rather than lower outpatient bills: an additional RMB 46.23 per visit, equivalent to 18% of the 2017 national average bill. Consistent with the argument that corruption fills gaps in formal support, this counterintuitive increase was especially pronounced in provinces with greater prior dependence on drug-linked informal resources. For every ten-percentage-point higher pre-reform drug share, the estimated increase was RMB 76.25 larger, equivalent to 30% of the 2017 national average outpatient bill. This pattern persists across alternative measures and specifications. Complementary analyses show sharp procurement-price reductions for covered drugs and declining selling-expense shares among firms, consistent with a real decline in corruption despite rising bills. The findings suggest that anti-corruption can expose formal deficiencies previously concealed by informal support. Lasting service improvements require not only curbing extraction, but also replacing lost funding and coordination.

License-Out: How Chinese Pharmaceutical Companies Sustained Innovation under Cost Containment Reform

Dissertation research

Abstract

How did China emerge as a global leader in pharmaceutical innovation when domestic cost containment reforms compressed the generic-drug profits that financed research? Existing scholarship emphasizes domestic regulatory and commercialization institutions but pays less attention to how innovation proceeds while these institutions are still developing. This paper develops a two-step argument: domestic reforms pushed firms toward drug development by undermining their established business model, while access to global markets through cross-border licensing helped sustain that transition.

In the first part of the paper, I link 4.1 million pharmaceutical sales records with drug registrations and licensing transactions to investigate how domestic cost containment stimulated a shift toward innovation by making generic production less profitable. I measure reform exposure across 1,035 firms using their pre-reform product and geographic sales portfolios. A continuous-exposure difference-in-differences analysis shows that greater exposure to cost containment reform is associated with a reorientation toward drug development.

However, pressure to innovate does not itself provide the commercial returns needed to sustain research. In the second part of the paper, I examine how firms sustained this transition when reform pressure outpaced domestic institutional support. I identify the global market for novel drugs as an alternative source of institutional support, with cross-border licensing providing financing and access to overseas markets. Out-licensing is an arrangement in which a domestic firm grants a global partner commercialization rights in specified overseas markets in exchange for an upfront payment that can finance further research at home. Combining risk-set matching with stacked difference-in-differences, I compare firms completing their first license-out with firms exhibiting similar development histories and reform exposure. Firms securing these deals sustain larger increases in domestic clinical activity, with an estimated 10.2 additional weighted Phase I–III trial registrations for novel drugs over three years relative to matched firms and no comparable increase in bioequivalence registrations.

The findings have three implications. First, China illustrates a recurring dilemma of industrial upgrading. Domestic institutions are costly and difficult to build, yet firms need institutional support to develop innovative capabilities. Cross-border licensing offers a way through this sequencing problem, allowing innovation to advance while domestic institutions develop. Second, as pharmaceutical innovation shifts toward Asia, this pathway raises distributional questions about who bears the burdens of clinical trials and who gains access to the resulting drugs. Third, the findings underscore the importance of international cooperation in sustaining innovation, even amid heightened political tensions.

Bringing the Global Home: How China Shores Up Domestic Support for Foreign Policy on Social Media

Under review

Abstract

How do governments promote complex foreign policies to inattentive domestic audiences? Existing scholarship often treats nationalism as a necessary cognitive shortcut, translating abstract and distant foreign affairs into emotionally resonant narratives. Yet nationalist appeals risk domestic entrapment and may constrain long-term international cooperation. This paper challenges the presumed dominance of nationalist propaganda by identifying an alternative: localized communication of foreign policy. Focusing on China's domestic promotion of the Belt and Road Initiative (BRI), I argue that state media adapt to the digital media landscape by translating broad foreign policy initiatives into content relevant to regional audiences.

Using computational text analysis of a decade of Sina Weibo posts from 36 national and provincial Party newspapers, alongside a comprehensive survey of more than 3,400 WeChat Official Accounts, I document a consistent pattern of localized reporting. Provincial newspapers emphasize regional economic opportunities and cultural experiences associated with the BRI rather than nationalist mythmaking. I further show how this localized strategy mobilizes diverse nonofficial actors to promote the BRI to more specialized audiences through original content. The findings advance research on foreign policy communication by showing how states use localized digital media to cultivate domestic support beyond nationalist appeals.

Selected publications

What's Not Trending on Weibo: China's Missing Climate Change Discourse

With Jeremy Lee Wallace · Environmental Research Communications 5(1): 011002 · 2023

Abstract

Given the central role of People’s Republic of China (PRC) in the global climate crisis, discussion and analysis of Chinese actions and pledges on decarbonization abound. However, less examined are the popular "demand" side of climate change politics inside of China. Our article explores a new set of data to gauge public discourse in China related to climate change by looking at trending topics on the prominent social media platform, Sina Weibo. In over 348,000 trending topics on Weibo from June 2017 to February 2021, we find only 336 unique topics, that is 0.12%, related to climate change. Even in the rare occasions when climate-related topics start trending, we find a general lack of substantive engagement in Weibo posts.

Resistance under the Radar: Organization of Work and Collective Action in China's Food Delivery Industry

With Eli Friedman · The China Journal 86: 68–89 · 2021

Abstract

As services have come to account for an ever growing portion of employment in China, platform-based delivery work has grown exponentially, incorporating millions of workers. Based on a study of food-delivery company Ele.me, we first provide a detailed account of the structure of the platform-based food delivery industry, as well as worker grievances and resistance. While Ele.me workers are subjected to algorithmic control and intensive evaluation, the subcontracting structure of employment presents workers with new forms of leverage. Workers engage in quiet, small-scale, and WeChat-mediated strikes that target the subcontractors who are their direct employers, a phenomenon distinct from the occasional acts of collective resistance among food couriers in other countries. While these strikes have limitations in advancing worker interests, we show how labor unrest has emerged among such workers despite an increasingly constrained political environment and a high degree of online censorship.

Other writings

Democracy or Epistocracy: Why Participation Matters

The UBC Journal of Philosophical Enquiries 1: 28–42 · 2020

Abstract

The Brexit referendum and Donald Trump's electoral victory in 2016 renewed debates over the intrinsic value of democracy and equal voting rights. In Against Democracy, Jason Brennan argues that political ignorance and misinformation undermine “one person, one vote” and justify epistocracy, or rule by the knowledgeable. This essay defends democracy by drawing on Mary Parker Follett's model of robust participation, with its emphasis on creative citizenship and integration. I argue that Follett's account offers a response to Brennan's critique: democratic participation can cultivate civic competence while avoiding the illegitimate domination associated with restricting political authority to those deemed more knowledgeable.

Breaking Up the Belt and Road Initiative

Synergy: The Journal of Contemporary Asian Studies · 2020

Abstract

This essay evaluates a domestic challenge to the feasibility of the Belt and Road Initiative (BRI): limited central coordination and oversight. Drawing on principal-agent theory and the two-level game model, I argue that the proliferation of subnational diplomacy under the BRI exacerbates information asymmetries between central and local governments, weakening the center's capacity to oversee local initiatives. The analysis highlights the need to reconfigure local government incentives so that implementation remains aligned with central objectives.