Four months before Mitt Romney signed his health care plan into law in Massachusetts in 2006, he told a conservative group that the state's tax code would be the hammer that would make the plan work.For those who refused to comply with the state's mandate to buy health insurance, he said in remarks to the Heritage Foundation, "they are going to lose their personal tax exemption.""We will withhold any of their tax refund," he said.As the Massachusetts governor and then as a presidential candidate, Mr. Romney spent the next six years describing in a variety of different ways the possible punishments for ignoring the Massachusetts mandate: as "free-rider surcharges," "tax penalties," "tax incentives" and sometimes just as "penalties."But regardless of the terms he used, his intentions were clear: Massachusetts residents who chose not to buy health insurance would see their state income taxes go up.
Americans made about 160 million doctors visits per quarter in the mid-2000s, but around 2009 they cut back to around 140 million, and, at least through 2011, haven't gone back to the old level, Kaiser and IMS Institute for Healthcare Infomatics estimate. Citigroup Global Markets surveys find year-over-year declines in hospital admissions for nearly every quarter since the beginning of 2008. The Congressional Budget Office has been scaling back Medicare projections because spending has been lower than it anticipated.The big question now: Will spending on health bounce back when the U.S. economy does or is this change longer lasting?Adjusted for inflation, U.S. per-person spending on health care grew at an annual average rate of 2.1% between 2005 and 2010 compared with 4.3% in the five previous years and 3.2% in the five years before that. Government actuaries predict that spending will grow slowly for another couple of years, and then bounce back. Over the next five years, they see per-person spending climbing 3.3% a year, driven in part by the expansion of coverage under Mr. Obama's Affordable Care Act. But they're basically making educated guess. The health system has so many moving parts that accurate predictions are impossible. Take prescription-drug spending. It's below projections because so many brand-name drugs are going off patent, which means patients are using cheaper generics, while pharmaceutical firms haven't found many new blockbusters. In March, CBO shaved $100 billion over 10 years for its Medicare prescription-drug spending estimate.
The uniqueness of our American identity is that it is, above all, contagious. While critics of immigration are quick to claim that new arrivals "don't want to be American" or "are weakening our common identity," Tufts political scientist Deborah Schildkraut's new book, Americanism in the Twenty-First Century, finds something much more benign, even graceful, in the American narrative. A nationwide survey validated a fact that is rather obvious to most Americans: Immigrants and those born in the country share similar views of what it means to be an American.Regarding those great American notions of economic and political freedom, there is barely a distinction. Better still, Schildkraut told me, "This is not just about rights, but also about obligations and being engaged through this notion of civic republicanism." Immigrants and those born here believe in giving as much as they do in taking.Schildkraut's book eviscerates misconceptions about a struggle for America's soul, fears that have lingered since our independence. Benjamin Franklin lamented an influx of Germans into colonial life. Present policy debates aside, the fear of America's identity being overwhelmed has affected a broad range of groups: the Irish Catholics in the 1840s; the Chinese in the 1880s; the Japanese in the 1940s.
The greatest target was Stalinism--a taboo subject since the failed Khrushchev thaw of the mid-1950s and early 1960s. Even if the Soviet Union had been an economic, cultural and social success story, it could scarcely have survived the revelation that it was based on the murder by shooting and starvation of millions of innocent people, and the enslavement of tens of millions. As Mr. Aron recounts, secret archives were opened and firsthand accounts by former prisoners were aired. "In the November 27, 1988, issue of Moskovskie novosti . . . Marxist historian and former dissident Roy Medvedev for the first time in the Soviet press" estimated the number of arrested, imprisoned or executed under Stalin before 1937--"no less than" 10 million died.Mr. Aron also captures well the sensational 1989 revelation of the secret protocols of the Molotov-Ribbentrop nonaggression pact of 1939. The public emergence of the pact's details destroyed the great myth of Soviet wartime history: that Stalin's deal with Hitler was a wise tactical ruse to buy time for the Soviet war machine, when in truth it was a sincere and disastrous miscalculation. The valor of the Soviet Union's soldiers was the only aspect of the war, Mr. Aron says, that did not come "under assault by the glasnost mythslayers."On top of all the historical truth-telling came public soul-searching about the corrosive effects of the modern Soviet system on morals and behavior. As Maya Ganina wrote in Literaturnaya gazeta in 1988: "Let's find out at what point in our lives bribery, thievery, lies, humiliation of the powerless and servility towards the powers that be have become more than just a deviation from the norm."Mr. Aron writes: "The most urgent concern was not the economy itself but rather what it did to the men and women who worked in it: their ideas, their views of themselves, their conscience--their 'souls.' Surrounded by waste and negligence, poverty and neglect, arbitrariness and incompetence of all-powerful bureaucracies implementing myriad irrational laws and regulation, men and women were found to have lost much of what was needed to make their country free and prosperous."
The changes at University Avenue are symbolic of the dramatic shifts that have occurred over the past two years in Myanmar, which outside of North Korea was probably the most repressive and isolated country in the world, ruled for five decades by a military regime. Under the watchful eye of a new president, Thein Sein, Myanmar's military officially ended its rule, handing power to a civilian parliament. Thein Sein then inaugurated rapid reforms: he freed many of the country's political prisoners, launched efforts to achieve permanent peace with many insurgent armies, began opening up the media and the economy, and publicly called for exiles to return and rebuild the country, a tacit admission that years of military rule had impoverished what was once a promising economy. In April, Suu Kyi's party was allowed to compete in by-elections for a handful of parliamentary seats, for the first time since 1990. The party dominated the voting, winning 44 out of 46 seats. Suu Kyi herself took one seat, and now sits in parliament, a shocking development given that only two years ago she was locked in her home.In response to this surprising shift, most western nations are re-engaging with the country. The US, European Union, Australia and Japan have already dropped some economic sanctions, and many companies are laying plans to invest heavily in Myanmar. Coca-Cola, General Electric and other big multinationals have already launched exploratory plans to get into Myanmar. In April, David Cameron, the British prime minister, became the first major western leader to visit the country in two decades. And yet, the pace of reform after so many years of repression, and the absence of any public explanation for why the military now decided to cede power, has left some citizens, and outside observers, both wary and thrilled.If Myanmar could change so rapidly, what lessons might it offer for the world's other most repressive nations, countries with seemingly intractable problems and dictatorial rulers like North Korea, Uzbekistan, or Eritrea? Or, perhaps this Myanmar spring is as false as other brief periods of hope the country enjoyed. After all, despite the dramatic changes some nagging questions remain. Why has the military maintained the right to step back into power if need be? Why is the country seemingly intent on building a nuclear and missile programme? Why, as politics opens up has the military stepped up its war against several ethnic militias, leading to a refugee outflow from the country's north?[E]ven the most astute observers in Myanmar are left wondering why these changes have occurred. No country was likely to invade Myanmar, the regime was sitting on piles of cash, and with Suu Kyi ageing, the NLD's leadership had been shattered by years of repression. What's more, the previous economic and financial sanctions imposed by the West had achieved little. Yet several Myanmar officials suggest that world events did have an impact, that the generals realised that, by working with Suu Kyi, they could avoid a troublesome fate."The events around the world [the Arab uprisings], the generals saw this," said Priscilla Clapp, a former US diplomat in Myanmar. In fact, by overseeing a managed transition, the generals could keep the vast wealth they had amassed illegally, and often deposited overseas - a lesson, potentially, for other dictatorships like Syria, where leaders are very reluctant to leave the scene. "We may want a process of justice and accountability [for the former military leaders] in Burma [Myanmar]," said one senior US official, "but they may feel they just want to move beyond the past."Indeed, the generals seem to have made a wise move. Suu Kyi herself, despite her credentials as a critic of the regime, has reciprocated their trust. In a speech to the Council on Foreign Relations, she played down the idea of severe punishment for the military rulers' past abuses, and called for forgiveness for their crimes, including those perpetrated against her.In addition, the world around Myanmar began to change, helping, in a backwards kind of way, to create political change in the country - and perhaps in other long-standing dictatorships in Asia as well.For nearly two decades, Myanmar had been dependent on China, even though many senior generals actually had little love for Beijing. Over time, as China became Myanmar's largest trading partner, and hundreds of thousands of migrants moved to Myanmar for business, average citizens also started to have second thoughts about that relationship. When I travelled through Mandalay, a city whose central business district is now dominated by Chinese guesthouses, Chinese-built malls, and Chinese vendors, I found resentment running very high. Some locals accused the Chinese of dumping products on the Myanmar market, or pushing locals out of flats and office spaces; others angrily complained that big Chinese companies were exploiting Myanmar's resources.Beijing has also shed its hands-off foreign policy and adopted a much tougher approach. In the 2000s, China, still trying to win the friendship of its neighbours, lavished aid on countries like Myanmar, Cambodia, Pakistan, Sri Lanka and others in the region, all the while insisting that China, unlike the bad old western powers, would respect other countries' concerns.In a book of the same title, I called this winning Chinese diplomacy of the 2000s a "charm offensive". But, by the late 2000s and early 2010s, that charm had begun to fade. With the West reeling from economic downturn, China was no longer willing to simply play the noninterventionist card. Instead, it began to claim larger areas of disputed waters in South East Asia, to jostle with India over borders, to build dams on the upper portions of rivers that flowed into other countries, and to demand greater fealty from friends, asking that the Myanmar government crack down on cross-border refugee flows and drugs, offer China more favourable trade deals, and essentially carry China's water in regional organisations.Increasingly worried about being so dependent on China, Myanmar's regime began to open up in order to court the West as a counter balance to Beijing. In a strange way then, since sanctions pushed the Myanmar government into the hands of China, and then the generals tired of their relationship, sanctions began to foster a rapprochement with western nations. Across Asia, the US government has taken advantage of countries' concerns about a rising, increasingly aggressive China, and the White House has used that fear to build stronger relationships with Vietnam, the Philippines and Singapore.
Transitions to genuine democracy can be difficult and time-consuming, and they don't always move forward in straight lines. Egypt and the Egyptian people still have a way to go to complete the transition. Many questions still have to be answered. But based on what has happened already, and on the Egyptians' collective ability to resolve those issues not only peacefully, but successfully, I have much confidence in the future of your great country. I believe that you will continue to do right and to demand a democratic society that respects human rights and enables broad participation in political affairs. I believe the trend toward democracy in Egypt is inevitable.
Roberts's opinion will not have the dramatic conservative effects that are being claimed for it. In this case, the first headlines were correct: Roberts actually exercised judicial restraint -- and the decision is a victory for anyone who believes that such restraint is a good thing.The first topic of revisionism is Roberts's statement that Congress lacked authority to enact the ACA under the Commerce Clause, because the health-care-reform law regulates inaction (failure to buy insurance) rather than action. Roberts, writing only for himself, essentially bought the broccoli argument: If Congress can require you to buy health insurance, what is to stop it from making you buy (and eat) your vegetables?On the surface, this looks like a win for conservatives and a restriction on Congress' commerce power. It isn't. The reason isn't that the four conservatives, including Justice Anthony Kennedy, deliberately chose not to join Roberts's opinion (maybe because they were angry at him for breaking ranks). It is that in the real world, as opposed to the realm of legal theory, there is no meaningful difference between action and inaction. In the future, Congress can simply phrase Commerce Clause commands in the affirmative.Consider the Civil Rights Act: Does it require public businesses to serve customers regardless of race? Or does it prohibit them from refusing to serve customers on the basis of race? See the difference? Oh yes, there isn't one.If that weren't enough, there is also Congress's power to tax, on which Roberts relied. If Congress wants to penalize you for not doing something in the future, it can impose a tax. And as Roberts's ACA decision affirmed explicitly, Congress doesn't even have to call it a tax. In short, in practical terms, Congress has no less power than it had prior to the decision.We have been down this road of pseudo-limitations on the commerce power before. In the 1990s, the Supreme Court twice struck down laws for exceeding the commerce power, once in the case of the Gun Free School Zones Act and once concerning a provision of the Violence Against Women Act. Constitutional lawyers sweated over whether the extensive commerce power had been meaningfully restrained. In practice, they concluded, it had not. Congress could find ways to do what it needed -- and it still can.
No intelligent person would choose organic food over conventional food on objective grounds. Its support is based on a number of false assumptions.For example, it is assumed that conventional food usually contains pesticide residues. Overall, this is not true. As confirmed by repeated surveys, most food is almost completely free of pesticide residues.It is also assumed that tiny residues of pesticides are harmful. This is similarly false except for rare individuals with specific allergies. All pesticides are scrutinised in exhaustive detail before they may be sold and there are huge safety margins built into their use rates. Some of them are certainly dangerous straight out of the container, but so is laundry bleach and swimming pool chlorine. Legal pesticide residues do not cause acute or chronic illness.AdvertisementIt is assumed that organic food is free of pesticides. In fact, certain pesticides are permitted under the various organic codes and many organically grown plants produce endogenous pesticides that are chemically similar to manmade pesticides. And there are also occasional organic farmers who are forced to apply pesticides to save their crops. Not surprisingly, they don't talk about that much.It is assumed that organic production is better for the environment. That this is false is shown by the approach to controlling weeds. A conventional farmer will use herbicides to kill weeds and avoid disturbing the soil to conserve moisture, minimise erosion and preserve topsoil organic matter. Organic farmers are not permitted to use herbicides, so they have to use cultivation.The assumption that pesticides wipe out bees and other beneficial insects is also false. Modern insecticides are highly selective and increasingly used in conjunction with beneficial insects in integrated pest management programs. Hypocritically, none of the organic codes recognise genetically-modified crops in spite of their need for little or no pesticides.And it is assumed that organic production is a viable alternative to conventional agriculture, and the world would be better off it was adopted globally. In fact, organic methods are significantly less productive that conventional agriculture, producing on average 20% lower yields. More land is needed to produce the same amount of food using organic production methods, meaning higher prices or less set aside for conservation. The poor farmers who clear the rainforests in Indonesia and Brazil typically do not use pesticides.