February 19, 2026
Before coming to the Graduate Center, Stone Center Junior Scholar and Ph.D. candidate Shou-Ming Chang worked as a legislative assistant in the parliament of Taiwan, where he observed firsthand how political institutions and procedural rules influence public economic policy. He is currently working on his dissertation, which examines how the structure of healthcare systems affects inequality. Chang recently spoke to the Stone Center about his work, his interests in methods of measuring inequality, and what he learned from his government role. This interview had been edited for length and clarity.
Most of your research is focused on law and economics, and on public economics. How did your experience working for Taiwan’s parliament inform your perspective on these research areas?
Chang: I was involved in drafting legislative bills and conducting policy research and coordination. That experience provided me with a close-up view of how legal rules and procedural designs operate in practice, under conditions of strategic behavior and political pressure. It also made clear that many outcomes depend less on stated policy goals than on the institutional rules governing decision-making. This perspective has continued to inform my research. It also led me to think more systematically about how small differences in institutional design can produce large differences in policy outcomes.
I’m now working under the supervision of Professor Paul Krugman, and my research focuses on healthcare systems and inequality in high-income countries, with an emphasis on how institutional design shapes distributional outcomes, particularly in the United States and Taiwan. Broadly speaking, I’m interested in how rules — legal, fiscal, and other administrative rules — translate individual circumstances into collective outcomes, and how those translation mechanisms affect equity and efficiency. In particular, my work examines how these mechanisms shape inequality in healthcare systems.
In my thesis, I first study health inequality using life expectancy as a central indicator of health outcomes. Differences in life expectancy across income groups provide an intuitive way to measure disparities in health, while also allowing me to analyze how health inequality interacts with broader patterns of income inequality.
Second, I analyze expenditure inequality in healthcare systems. Although healthcare accounts for an increasing share of GDP in many high-income countries, the concentration of spending among a relatively small fraction of the population is particularly pronounced in the United States, where healthcare spending is both high and unevenly distributed.
And third, I look at revenue inequality: the financing side of healthcare systems. Even when healthcare is not funded solely through taxation, the concept of tax burden remains relevant. By examining how the financial burden of healthcare is distributed across income groups, I develop measures that help assess the equity of different healthcare financing policies.
What drew you to the topic of healthcare?
Chang: I took Professor Paul Krugman’s course on the economics of the welfare state when I was in my second year. The course covered many topics, including employment and healthcare systems. He mentioned Taiwan’s special institutions at that time, and I discussed the distinctive institutional features of Taiwan’s healthcare system through both class discussions and follow-up email exchanges. I realized this could become an important topic for further research.
In Taiwan, there are two special aspects of its healthcare system. The first is universal coverage: Everyone is covered, regardless of employment status. Income and age do not matter. Second, it is a single-payer system. In the United States, there are many private health insurance companies. In Taiwan, by contrast, the system is administered by a single government-run insurer, the National Health Insurance Administration (NHIA).
I’m currently working on a cross-country comparison of healthcare systems using OECD and Taiwan data, with a particular focus on the United States and Taiwan. Because I’m from Taiwan, I’m familiar with its institutions and hope to identify what insights Taiwan can offer.
What other research projects have you worked on during your time at the Graduate Center?
Chang: I also took Professor Janet Gornick’s course during my second year. I completed a term paper in her class that focused on the measurement of inequality. The Gini coefficient is the most popular measurement of inequality. And in my term paper, I tried to develop an alternative. That paper proposes a simple measure of inequality and a skewness approach. Skewness is a concept in statistics, and I think it is more straightforward than the Gini. I presented this work at the 2024 Annual Conference of the Asia Law and Economics Association in Taiwan.
More recently, I have been working on a project on electoral systems and political representation that has been invited for resubmission to the American Political Science Review. This work reflects my broader interest in how institutional rules shape political and economic outcomes.
What do you plan to do after you complete your Ph.D.?
Chang: I hope to work in academia, possibly in Asia — Singapore, Hong Kong, Japan, South Korea, or Taiwan. I also hope that my research will inform public policy. I plan to continue working on questions at the intersection of inequality, healthcare, and institutional design. I hope this work can contribute to ongoing conversations about inequality and policy design.
