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Rate Setting

The United States federal government should establish all-payer rate-setting,

including global budgeting and administered by an independent, bipartisan
federal commission, in the United States.

Solves health care costs and lowers premiums

David Dayen 17, contributor to The Intercept and also writes for Salon, the Fiscal Times, the
New Republic, and more, “Single Payer, Meet All Payer: The Surprising State That is Quietly
Revolutionizing Health Care,” 7/24/17, https://theintercept.com/2017/07/24/single-payer-
meet-all-payer-the-surprising-state-that-is-quietly-revolutionizing-healthcare/
MARYLAND IS THE only state in America where all hospitals must charge the same rate for services to
patients, regardless of what insurance they carry. There’s some variance between hospitals, but every patient in a
particular hospital pays the same. Other states experience huge, seemingly random differences in hospital costs, depending on the
insurer (or lack thereof).
Maryland’s Health Services Cost Review Commission has set hospital reimbursement rates for over 40
years. The state obtained a federal waiver to include Medicaid and Medicare in its all-payer system, with the goal of keeping cost
increases below Medicare growth. And it’s worked, creating the lowest rate of growth in hospital costs in
America.
In 2014, to prevent hospitals from making up profit margins through volume, Maryland tweaked the
system, adding global budgeting . “The traditional way it worked, every hospital got a rate card,” said Joshua Sharfstein,
an associate dean at Johns Hopkins’s Bloomberg School of Public Health, and a former head of Maryland’s Health Department.
“Now you get a number, which is the total revenue for the year.”
this creates hospital incentives
Because the global budget doesn’t change based on the number of admissions,
toward better outcomes . “It makes the health system focused on keeping people healthy
rather than just treating illnesses,” said Vincent DeMarco, president of the Maryland Citizen’s Health Initiative, a state
advocacy group. That includes increased preventive treatment, using case managers to connect patients to primary care, eliminating
unnecessary tests, and encouraging good health outside the hospital walls.
Three years into global budgeting, the state is “meeting or exceeding” its goals , according to a January
Health Affairs study. Hospital revenue growth is well below counterparts nationwide , or the growth of
Maryland’s economy. Plus, state hospitals have saved $429 million for Medicare , more in three years than it
targeted for five. Most important, every state hospital (all of which are nonprofit) and every insurer in Maryland are on board with
the system.
If a centralized rate-setter bands every insurer together to negotiate prices , all payer can
functionally act like single payer in terms of bringing down costs . All payer reduces
hospital and insurer overhead , since billing costs are known in advance. And because the
Affordable Care Act caps the amounts insurers can take in as profits, lower hospital costs should flow back to the
individual in the form of smaller premiums .
This is why five countries — France, Germany, Japan, Switzerland, and The Netherlands — use all-payer rate setting
as the basis for their universal health care systems. These countries have been found to control costs far better
than America’s fragmented system.
The system only applies to hospital payments, not primary care doctors or clinicians. However, last year Maryland submitted a
“progression plan” to the Center for Medicare and Medicaid Services, with the goal of expanding the system by January 2019. That
would line up with the swearing in of Maryland’s next governor.
Other states have looked to Maryland as a model. Pennsylvania has adopted global budgeting for rural hospitals. And in the wake of
its single-payer failure, Vermont moved to an all-payer accountable care organization, where providers are paid based on health
outcomes for the population. “In some ways it’s more radical [than single payer] if you’re able to
get the incentives right,” said Joshua Sharfstein. But the true test of Maryland-style all payer is whether it can support
universal coverage for every resident.
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Medicare Part E

The United States federal government should:

-- establish a Medicare Part E program that guarantees coverage to all individuals

not enrolled in qualified employer-provided plans or Medicaid, and add a
government-provided drug benefit and a cap on out-of-pocket costs to Medicare,
including compensating future treatments according to therapeutic value

-- mandate that Medicare negotiate rates with providers

-- require employers to provide equivalent or better coverage than Medicare Part

E or pay a contribution towards the cost of Medicare Part E

-- automatically enroll eligible individuals in Medicaid and increase Medicaid

payment rates to approximately equal Medicare

The counterplan achieves the universality and cost savings of single payer while
preserving employer-based insurance and Medicaid---that’s key to public
acceptance and policy durability
Jacob S. Hacker 18, the Stanley Resor Professor of Political Science at Yale University, 1/3/18,
“The Road to Medicare for Everyone,” http://prospect.org/article/road-medicare-everyone
But Democrats should not make the opposite mistake either. A proposal must have a realistic path to enactment.
But it also has to be ambitious enough to inspire supporters, and compelling and understandable enough to
convince others to become supporters. It has to be grounded in policies that are popular and known to
work—policies that can actually reach universal coverage and restrain health-care
prices .
Perhaps most important, it has to be able to command support not just before it passes, but also
afterward . If the troubled saga of the exchanges tells us anything, it’s that even the most technically
sound policy will fall short if it does not generate and sustain pressure for
continuing expansion and improvement . Successful policies do not just reflect the
politically possible; they reshape it .
I’ve already said I don’t think the public option is robust enough to create such pressure, even though it would do
much good. As a rallying cry, “Make Medicare available to the 12 million people buying insurance through the ACA marketplaces!”
leaves much to be desired. Instead, the message should be at once simpler and bolder: “Make Medicare available to
everyone.” All Americans should be guaranteed good coverage under Medicare if they don’t
receive it from their employer or Medicaid.
To achieve this goal, a new part of Medicare would need to be created for those not already covered by the
program. I’ve been calling this new component “Medicare Part E” (for “everyone”)—a term that’s been used before by
Johns Hopkins’s Gerard Anderson and others. Medicare Part E would cover the broad range of benefits covered
by Medicare Parts A (hospital coverage), B (coverage of physicians’ and other bills), and D (drug coverage).
The central feature of Medicare Part E is guaranteed insurance. All Americans would be presumed to
be covered. They would not need to go through complicated eligibility processes or hunt down
coverage that qualified for public support or even re-enroll on an annual basis. Once someone was in Part E, they
would remain in Part E unless and until they were enrolled in a qualified alternative —whether an
employment-based health plan with good benefits or a high-quality state Medicaid program.
Thus, the centerpiece of Medicare Part E is the same as that of single-payer : a
guarantee that Medicare is there for everyone. Unlike single-payer , however, Medicare Part E
seeks to improve employers’ role rather than replace it . It does so by establishing new
standards for employment-based plans and requiring that all employers contribute to Medicare if
they do not provide insurance directly to their employees.
In this respect, Medicare Part E builds on the ACA’s requirement that large employers provide
coverage or pay a penalty. Under the 2010 law, companies with more than 50 full-time workers are
already required to pay a penalty if they don’t offer insurance and their workers get subsidized
ACA marketplace coverage. The penalty, however, is modest compared with the cost of health benefits, and there’s no
guarantee workers whose employers pay it actually get marketplace coverage.
Democrats knew this was a problem back in 2010. In fact, they tried to fix it: The House version of the Affordable Care Act required
that employers that didn’t insure their workers not only pay a fee, but also provide the federal government with the information to
enroll those workers in health coverage though the marketplaces. Like the public option, however, this provision was dropped in the
Senate.
It should be resurrected. Under the proposal I’m describing, employers would either provide insurance that was
at least as generous as Medicare Part E’s or they would contribute to the cost of Medicare Part E,
which would automatically enroll their workers. Because the contribution requirement is central to signing people
up, it should cover the entire workforce—including independent contractors and other self-
employed workers (who would pay the contribution directly, as they do Medicare and Social Security taxes). But the level
of contribution should vary with wages. That’s how the House bill worked: The contribution would have risen from
nothing for the lowest-wage firms up to 8 percent of payroll for the highest-wage firms.
Health policy wonks call this “play or pay .” Employers would either play by offering qualified coverage to their workers
(and their workers’ families) or pay the federal government to cover their workers (and their workers’ families) through Medicare
Part E. Under this system, everyone who worked or lived in a family with a worker—including the self-
employed—would be automatically covered. Those without any tie to the workforce could be
signed up when they received other public benefits or filed their taxes or sought care
without insurance . But just as important as signing people up is making sure they remain signed up. Once people
were enrolled in Medicare Part E, they would remain enrolled for as long as they didn’t have
verified alternative insurance.
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IRS Tradeoff

The IRS is focused on implementing the new tax reform bill---it will take all of
their resources
Roger Russell 18, senior editor for tax with Accounting Today, “Tax reform means tough times
at the IRS,” 1/30/18, https://www.accountingtoday.com/news/tax-reform-means-tough-times-
at-the-irs
Everson noted that the IRS will have to be very careful about prioritizing the guidance they will
need to promulgate. “Taxpayers will try to figure out what is most beneficial and still be within the law,” he explained. “ The
IRS has to clarify what the proper interpretation of the law is. There will be litigation on top of that,
and many challenges will go to court. It will take a long time to get these new issues resolved.”
“Anytime you have a tax bill of this magnitude, a lot of people will be waiting for the IRS take on how the bill
will work,” agreed Roger Harris, president of Padgett Business Services. “Most tax professionals are concerned about IRS
funding because whether you like them or not, they are a reality and they need to do their job properly.”
A junkyard dog
The IRS is overloaded and underfunded, but they will do what is absolutely necessary to
administer the new law, according to Marty Davidoff, CPA, Esq., of E. Martin Davidoff & Associates CPAs. “The IRS is
going to do what it has to do , minimally, to make sure the new law is enforced,” he said. “They’re
not going to help people learn it or answer questions about it, because they don’t have enough personnel to answer questions on the
existing law. Their dramatically reduced budget and dramatically reduced personnel over the last seven years has caused a
diminution in services, and a diminution in enforcement.”
Davidoff cited a recent phone call from an Appeals officer as evidence of the degree to which the service is constrained: “We had
already agreed on the adjustment, had agreed on the numbers, and all we needed was a conversation regarding the wording in the
report they asked us to sign, because the wording was unclear. I wanted clarification of the wording, and she basically told me,
‘Marty, accept the wording as is or I’m going to close the case as unagreed.’ She was going to take the deal off the table, which would
have meant dozens of hours to start over. It wasn’t normal for this Appeals officer to act this way. She just seemed under intense
pressure.”
“What’s happening to the IRS is that they’re so pressured by a shortage of staff, and the work doesn’t go
away, that they’re not allowing processes to happen the way they’re designed,” Davidoff continued. “Imagine a dog that’s well-
cared for and which the owner likes. It’s a friendly, happy dog. But take the exact same dog, don’t feed it regularly, and the owner
says, ‘You’re a bad dog.’ It ends up as a nasty dog in a junkyard. That’s what is happening. Congress — the owner — is turning the
IRS into a junkyard dog.”

The plan drains IRS resources and causes backlash which crushes tax compliance
Kristin E. Hickman 16, Harlan Albert Rogers Professor of Law at the University of Minnesota
Law School, “The IRS's Multi-Mission Mismatch Problem,” 3/14/16,
http://www.taxanalysts.org/content/irss-multi-mission-mismatch-problem
Congress has burdened the IRS with too many secondary social welfare and regulatory programs, most of which
have little to no relation to its primary function: collecting taxes . These secondary functions
divert too many resources from the IRS's core mission. The IRS and its personnel lack the
expertise to assess the political consequences of many of the day-to-day administrative decisions
that must be made. Politically controversial decisions upset taxpayers and give rise to
skepticism regarding the fairness and legitimacy of the tax system, thus imperiling tax
compliance. Spinning off some of the largest and most politically fraught non-revenue-raising functions from the IRS, such as
exempt status determinations or health policy administration, would allow the IRS to avoid this political turmoil and return its focus
to its core expertise.

Effective tax reform key to semiconductor competitiveness

TT 17 – Trefis Team, led by MIT engineers and Wall Street analysts, “Why Trump's Proposed
Tax Policy Could Benefit The U.S. Semiconductor Industry,” 6/21/17,
https://www.forbes.com/sites/greatspeculations/2017/06/21/why-trumps-proposed-tax-
policy-could-benefit-the-u-s-semiconductor-industry/#4dc4fd565f4f
Corporate tax reform was one of the major agendas of President Trump’s election campaign. The
proposed changes include a significant cut in the current corporate tax rate of 35%, which is
among the highest in the world, and lowering the repatriation taxes on U.S. companies' overseas cash
from the current 35% to a special one-time rate of 10% payable over a period of 10 years. If the policy does come into place then it
could have a positive impact on the semiconductor sector , as most semiconductor companies
derive a significant portion of their revenue from outside the U.S. and have stashed away
billions of dollars in earnings abroad to avoid paying taxes in the U.S.
The semiconductor industry is highly capital intensive and spends a large chunk of revenue on
R&D and capital expenditures. The industry’s supply chain is spread across the globe . While
the U.S. based companies are rich in intellectual property, manufacturing of chips is concentrated in South Korea and Taiwan, and
packaging and testing in Japan. China accounts for a majority of the global chip sales.
China’s share in global semiconductor consumption: 58.5%
South Korea & Taiwan’s share of global wafer capacity: 42.2%
Given the unfavorable tax rate in the U.S. (35%) compared to most of the abovementioned economies, U.S. semiconductor
companies keep most of their cash outside the U.S., which is then often reinvested in their foreign subsidiaries or
in some cases used for acquisitions. For example, Qualcomm used its overseas cash to fund its acquisition of Netherlands-based
NXP Semiconductors in 2016.
The high tax rate puts some U.S. companies at a disadvantage compared to their foreign
counterparts . Many other countries provide lower corporate tax rates, more robust incentives
for R&D, modern international tax systems that do not subject business activities outside their borders to taxation,
and other beneficial tax provisions. A favorable U.S. tax code can thus help increase the
competitiveness of U.S. semiconductor companies , which has been facing an increasing
threat from China as the country looks to reduce its dependence on the global semiconductor industry by
becoming self sufficient in semiconductor manufacturing .

Semiconductors are key to US defense dominance---speeding up the pace of

innovation is key
John Holdren 17, Assistant to the President for Science and Technology and Director, Office of
Science and Technology Policy, “Report to the President: Ensuring Long-Term U.S. Leadership
in Semiconductors,” January 2017,
https://obamawhitehouse.archives.gov/sites/default/files/microsites/ostp/PCAST/pcast_ensur
ing_long-term_us_leadership_in_semiconductors.pdf
Semiconductors are essential to modern life . Progress in semiconductors has opened up new frontiers
for devices and services that use them, creating new businesses and industries, and bringing massive benefits to American workers
and consumers as well as to the global economy. Cutting-edge semiconductor technology is also critical to
defense systems and U.S. military strength , and the pervasiveness of semiconductors
makes their integrity important to mitigating cybersecurity risk.
U.S. semiconductor innovation, competitiveness, and integrity face major challenges. Semiconductor innovation is already slowing
as industry faces fundamental technological limits and rapidly evolving markets. Now a concerted push by China to
reshape the market in its favor, using industrial policies backed by over one hundred billion dollars in government-
directed funds, threatens the competitiveness of U.S. industry and the national and global
benefits it brings.
The global semiconductor market has never been a completely free market: it is founded on science that historically has been driven,
in substantial part, by government and academia; segments of it are restricted in various ways as a result of national-security and
defense imperatives; and it is frequently the focus of national industrial policies. Market forces play a central and critical role. But
any presumption by U.S. policymakers that existing market forces alone will yield optimal outcomes – particularly when faced with
substantial industrial policies from other countries – is unwarranted. In order to realize the opportunities that semiconductors
present and to effectively mitigate major risks, U.S. policy must respond to the challenges now at hand.
Our core finding is this: the United States will only succeed in mitigating the dangers posed by Chinese
industrial policy if it innovates faster . Policy can, in principle, slow the diffusion of technology, but it cannot stop
the spread. And, as U.S. innovators face technological headwinds, other countries’ quest to catch up will only become easier. The
only way to retain leadership is to outpace the competition .
Nuclear war
The Economist 18, 1-27-18, “The growing danger of great-power conflict,”
https://www.economist.com/news/leaders/21735586-how-shifts-technology-and-geopolitics-
are-renewing-threat-growing-danger
Even if China stays out of a second Korean war, both it and Russia are entering into a renewal of
great-power competition with the West. Their ambitions will be even harder to deal with than
North Korea's. Three decades of unprecedented economic growth have provided China with the wealth to transform its armed
forces, and given its leaders the sense that their moment has come. Russia, paradoxically, needs to assert itself now
because it is in long-term decline. Its leaders have spent heavily to restore Russia's hard power,
and they are willing to take risks to prove they deserve respect and a seat at the table.
Both countries have benefited from the international order that America did most to establish and guarantee. But they see its
pillars--universal human rights, democracy and the rule of law--as an imposition that excuses foreign meddling and undermines
their own legitimacy. They are now revisionist states that want to challenge the status quo and look at their regions as spheres of
influence to be dominated. For China, that means East Asia; for Russia, eastern Europe and Central Asia.
Neither China nor Russia wants a direct military confrontation with America that they would surely lose. But they are using
their growing hard power in other ways, in particular by exploiting a "grey zone" where aggression and
coercion work just below the level that would risk military confrontation with the West. In Ukraine
Russia has blended force, misinformation, infiltration, cyberwar and economic blackmail in ways that democratic societies cannot
copy and find hard to rebuff. China is more cautious, but it has claimed, occupied and garrisoned reefs and shoals in disputed
waters.
China and Russia have harnessed military technologies invented by America, such as long-range
precision-strike and electromagnetic-spectrum warfare, to raise the cost of intervention against them
dramatically. Both have used asymmetric-warfare strategies to create "anti-access/area denial"
networks. China aims to push American naval forces far out into the Pacific where they can no longer safely project power into
the East and South China Seas. Russia wants the world to know that, from the Arctic to the Black Sea, it can call on greater firepower
than its foes--and that it will not hesitate to do so.
If America allows China and Russia to establish regional hegemonies, either consciously or because its
politics are too dysfunctional to muster a response, it
will have given them a green light to pursue their
interests by brute force . When that was last tried, the result was the first world war.
Nuclear weapons, largely a source of stability since 1945, may add to the danger. Their command-and-
control systems are becoming vulnerable to hacking by new cyber-weapons or "blinding" of the
satellites they depend on. A country under such an attack could find itself under pressure to choose
between losing control of its nuclear weapons or using them.
Vain citadels
What should America do? Almost 20 years of strategic drift has played into the hands of Russia and China. George W.
Bush's unsuccessful wars were a distraction and sapped support at home for America's global role. Barack Obama pursued a foreign
policy of retrenchment, and was openly sceptical about the value of hard power. Today, Mr Trump says he wants to make
America great again, but is going about it in exactly the wrong way . He shuns multilateral organisations,
treats alliances as unwanted baggage and openly admires the authoritarian leaders of America's adversaries. It is as if Mr Trump
wants America to give up defending the system it created and to join Russia and China as just another truculent revisionist power
instead.
America needs to accept that it is a prime beneficiary of the international system and that it is
the only power with the ability and the resources to protect it from sustained attack. The soft
power of patient and consistent diplomacy is vital, but must be backed by the hard power that China and
Russia respect. America retains plenty of that hard power, but it is fast losing the edge in
military technology that inspired confidence in its allies and fear in its foes .
To match its diplomacy, America needs to invest in new systems based on robotics, artificial
intelligence, big data and directed-energy weapons. Belatedly, Mr Obama realised that America required a
concerted effort to regain its technological lead, yet there is no guarantee that it will be the first to innovate. Mr Trump and his
successors need to redouble the effort.
The best guarantor of world peace is a strong America . Fortunately, it still enjoys advantages. It
has rich and capable allies, still by far the world's most powerful armed forces, unrivalled war-fighting experience, the best systems
engineers and the world's leading tech firms. Yet those advantages could all too easily be squandered. Without
America's commitment to the international order and the hard power to defend it against
determined and able challengers, the dangers will grow . If they do, the future of war could be
closer than you think.
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Recruitment DA

The plan causes a crisis in military recruitment---makes warfighting impossible

Floyd Norris 8, former chief financial correspondent of The New York Times and The
International Herald Tribune, 5/30/08, “Health’s Gain May Be Army’s Loss,”
http://www.nytimes.com/2008/05/30/business/30norris.html?
ex=1369886400&en=48a84acfacec6f7c&ei=5124&partner=permalink&exprod=permalink
Call it the law of unintended consequences. When you fix one thing, it messes up other things.
If the Democrats win the election this year, and are able to enact a health care plan that extends adequate
coverage to all Americans, the loser could be the Army . Getting enough people to enlist could
become a major problem for the next president.
Senator John McCain, the presumptive Republican candidate, has already pointed out that Senator Barack Obama, the likely
Democratic candidate, never served in the military. It remains to be seen how potent that will be as an issue, given the fact that the
last four presidential elections have been won by the candidate with the less impressive military resume.
But there is something else that distinguishes Mr. Obama from all recent candidates for the presidency. He would be the first
presidential nominee to come of age after the draft was abolished in the administration of Richard M. Nixon. He never had to decide
how to deal with the draft, and legally was under no more pressure to enlist than he was to go to medical school or become a bus
driver. Joining the military was a career option like any other.
And that has made it harder to put the Army together. Government polls show that the proportion of young people who think they
might enlist is roughly half what it was in the late 1980s. The military has responded with more recruiters and
higher cash enlistment bonuses, and has met its goals. A significant factor for many recruits,
it turns out, is the military’s generous health benefits for dependants.
Michael Massing, writing in the April 3 issue of The New York Review of Books, tells the story of one part-time college student from
Brooklyn, who was holding down two jobs but still going into debt. “Meanwhile, he got married, his wife got pregnant, and he had no
health care. From a brother in the military, he had learned of the Army’s many benefits, and, visiting a recruiter, he heard about
Tricare, the military’s generous health plan.” He enlisted.
It seems a bit perverse that the incentives for a young person with children to join are greater than the incentives for his childless
friend. But that is the way it is. All
that could change if the push for some kind of n ational h ealth
i nsurance program were to be successful.
It is true, of course, that Democrats have been talking about such things for generations. The failure of health care legislation during
Bill Clinton’s first two years in office left some viewing the issue as political dynamite — good for a campaign but fatal to anyone who
tries to pass a specific program. It is quite unclear how the government would pay for a comprehensive program, and no candidates
seem eager to discuss ways to hold down health care spending.
But if such a program were adopted, it seems likely that the military, and particularly the Army,
would feel the immediate effect. To expand the Army, as all the candidates say they want to do, would require some
other incentive for enlistment, particularly when the economy recovers.
In the near term, it is possible that a recession will improve the military’s recruiting success. The official unemployment rate is still
low, but the proportion of Americans who expect the job picture to improve is at its lowest level in a quarter century, according to
the Conference Board’s consumer confidence survey. That survey shows that younger people are still more confident than older
ones, but the confidence of both groups has fallen sharply this year.
One partial solution to the negative effect on enlistment of a health care plan for all could be a new G.I. education benefit. Both the
House and Senate have approved such a plan, but as part of the Iraq funding bill on which there are major differences. President
Bush is opposed to the legislation, which its sponsors say would cost $50 billion over 10 years, and it is far from clear it will be
enacted.
The bill approved by the Congress would give enhanced education benefits to all veterans who spent three years in the military after
Sept. 11, 2001. They would be eligible for full tuition at a public university, and about $1,000 a month for living expenses and more
for books.
Senator Jim Webb, a freshman Democrat and Vietnam veteran, is the principal Senate sponsor of the legislation. He argued — with
something less than precise data — that passage of the bill would increase enlistment by 16 percent, and bring in more high-quality
recruits who valued the education benefit. Both Senator Obama and his Democratic rival, Senator Hillary Rodham Clinton, support
that bill.
Senator McCain has proposed a less costly alternative that would provide better benefits to those who stay in the military longer. He
may have a point. Last year about three-quarters of Army volunteers who completed their first term of enlistment, and nearly as
many marines, chose not to re-enlist. Offering better education benefits after three years could encourage enlistment and discourage
re-enlistment.
If we get a real health care plan for all Americans, it might require something like the Webb bill — or a very
unpopular revival of the draft — just to keep fighting in Iraq and Afghanistan . The backers
of health care legislation do not want to hurt the Army, but that is what could happen.
Military recruitment is key to readiness---solves hotspot escalation
Radha Iyengar 17, senior economist at the nonpartisan, nonprofit RAND Corporation, former
director of Personnel on the White House National Security Council, 7/27/17, “MILITARY
POWER IS ALL ABOUT PEOPLE: A RETURN TO PERSONNEL POLICY,”
https://warontherocks.com/2017/07/military-power-is-all-about-people-a-return-to-
personnel-policy/
The U.S. military is often described as the “best fighting force in the world,” and we agree. It’s superior to its possible adversaries in
nearly every way. No other military has the globe-spanning responsibilities, the all-domain combat experience, or the technological
edge. Yet, as the United States remains militarily engaged around a world that demands unyielding
attention and unwavering commitment, its military faces a dynamic threat environment
that includes new and resurgent challenges in emerging battle domains such as cyber . With
tensions on the Korean peninsula, a continuing series of crises in the Middle East , a rising
China , and a resurgent Russia , it would be wise to keep front and center the key source
of strength in the armed forces — our people .
Policy debates have raged about Syria, Yemen, NATO, North Korea, and beyond. At the same time, defense acquisition experts
publicly debated options related to new technologies and acquisition reform. But the new and growing challenges facing the
country are all the more reason to also think about what additional approaches are needed to acquire the key personnel
skills and capabilities needed to meet America’s growing and changing military requirements.
The new administration has called for “a larger, more capable, and more lethal joint force,
driven by a new National Defense Strategy that recognizes the need for American superiority not only on land, at sea,
in the air, and in space, but also in cyberspace.” To do this, the D epartment o f D efense has become increasingly
focused on three key objectives: sustaining and improving the deterrent and warfighting prowess; establishing a
force with the capabilities needed to meet the challenges in the coming years; and resetting and
rebalancing after decades of conflicts.
 1NC
Midterms

Dems win the midterms in a wave now, but health care policy saves the GOP
Peter Roff 3-2, U.S. News & World Report contributing editor for opinion, formerly senior
political writer for United Press International, visiting scholar at Asian Forum Japan, senior
fellow at Frontiers of Freedom, 3/2/18, “How to Win in 2018,”
https://www.usnews.com/opinion/thomas-jefferson-street/articles/2018-03-02/how-
republicans-win-the-2018-midterms
IN CASE YOU MISSED IT, a new USA Today/Suffolk University poll has more than eight out of every 10 Democrats
and seven out of 10 independents saying the country is on the wrong track. That's bad news for
the GOP because it suggests the upcoming November 2018 contest is going to be a change election .
Sure, seven out of 10 Republicans in the same survey said things are on the right track. If the GOP could win elections all by its
lonesome, that wouldn't be a problem. But if Republicans are going to keep control of Congress and of the
various statehouses and governorships they won during the Obama years, they're going to have to convince at least some
of those who self-identify as independents to come along. So far, at least according to this one poll, they're not
doing that .
There's already enough evidence to allow for the possibility of a big, blue wave in November . Nearly
40 state legislative seats, which admittedly is a fraction of the total, have flipped from R to D since Trump was
elected despite the fact some of these districts went to Trump by overwhelming numbers in 2016.
The Republicans have also had to fight tooth and nail to keep control of seats in the U.S. House that have come vacant since Trump
was elected. These include several that are among the safest in the country like Georgia's Sixth Congressional District. That should
have been an easy win for the GOP after Tom Price resigned; instead, it turned into a very expensive almost loss.
The key finding in this phone survey of 1,000 registered voters nationwide is "By close to 2-1, 58%-32%, those surveyed say they
want to elect a Congress that mostly stands up to the president, not one that mostly cooperates with him."
60 percent of those surveyed said they disapproved of the job
That should come as no surprise. According to the poll,
Trump is doing as president. Outside his base, which is considerable, he's not popular. His policies may be
working but, seeing as how he and his appointees are hounded at every turn by his opponents in the advocacy media as well as by
no one should
those who pretend to be actual, authentic conservatives but are instead simply solid "never Trumpers,"
expect his numbers or his image to improve in time to make a meaningful
difference .
If they're going to hold on to power, the Republicans need to look to other leaders besides Trump to
expand their electoral coalition. If they were smart, and there's no reason to believe they're not, House Speaker Paul Ryan
and Senate Majority Leader Mitch McConnell should use the next recess period to schedule a summit meeting of the parties
legislative leaders with an eye to hammering out something like 1994's Contract with America to develop an agenda GOP
majorities can begin work on in the summer and through the fall and which, if they are returned to office in the majority,
they can finish implementing.
One issue that has started to show up with considerable consistency is the cost of health care .
Continually rising premiums and drug costs are breaking family budgets. The voters want relief , but congressional
Republicans, having failed on several occasions to repeal Obamacare (admittedly by a single vote, at least when it mattered)
are reluctant to take the issue up again.
It may be that those who say Obamacarewill never be repealed "root and branch" are right. That means
alternatives that work within the existing system or which can be achieved by tinkering with it need to be pursued.
The focus must change from repealing what Obama and the Democrats hath wrought to finding ways to bring
costs down and generally make the system more consumer friendly. The president has taken the first step in
this regard by expanding the availability of temporary policies that can be purchased outside the annual window in which policies
can be changed, but there's more to be done.
Working together federal and state leaders can develop a pathway forward to make it easier for states to engage in experimentation
in the insurance markets. They can find ways to make it possible for insurance to be bought across state lines – something that
would alleviate the problem that has arisen for some many families now that so many of the nation's counties are served by only one
or two providers.
Kentucky Republican Gov. Matt Bevin is leading the way by establishing sensible work requirements for able-bodied individuals
enrolled in Medicaid, which, thanks to Obamacare, many states have expanded. There's more to be done in this regard. Bevin and
the Republican leaders in the Kentucky legislature could point the way for other states, as well as advise McConnell and Ryan on just
what is needed from Washington to get the bureaucracy out of the way.
There are perhaps a thousand good ideas out there for health care reform. If the debate centers
on the repeal of Obamacare, most of them will never get off the ground . McConnell and Ryan
could provide the forum and the impetus for making them reality . What works can be replicated, what fails
can be set aside – but only if the GOP maintains the majority of the majorities it currently holds.
That's means congressional leaders need to take the polls seriously, get the focus off Trump as much as
possible as fast as possible and onto the exchange of ideas that will improve the quality of life for the

average American much like the tax cuts are doing. Trump can always come along later and
claim credit . He's not being cut out of the process, he's just being put in the place where the
voters the GOP needs to earn re-elected majorities next November seem to
want him .

The public expects a Dem wave now---failure means they’ll assume Russia hacked
the results---sparks mass controversy over the election’s legitimacy
Charlie Savage 3-3, Washington correspondent for The New York Times, 3/3/18, “What if
Republicans Win the Midterms?,” https://www.nytimes.com/2018/03/03/sunday-
review/what-if-republicans-win-the-midterms.html?
mtrref=www.google.com&assetType=opinion
A sizable portion of the American population has been convulsing with outrage at President
Trump for more than a year. Millions of people who previously took only mild interest in politics have participated in protests,
fumed as they stayed riveted to news out of Washington and filled social media accounts once devoted to family updates and funny
videos with furious political commentary.
Yet public life on the whole has remained surprisingly calm. A significant factor in keeping the
peace has surely been anticipatory catharsis : The widespread expectations of a big
Democratic wave in the coming midterm elections are containing and channeling that
indignation, helping to maintain order.
What will happen if no such wave materializes and that pressure-relief valve jams shut?
The country was already badly polarized before the plot twist of election night in 2016, of course, but
since then liberals and much of what remains of America’s moderate center have been seething in a
way that dwarfs the usual disgruntlement of whichever faction is out of power . While nobody can know
for sure whether Mr. Trump would have lost but for Russia’s meddling, many of his critics clearly choose to believe he is in the White
House because Vladimir Putin tricked the United States into making him its leader.
For Mr. Trump’s opposition, this premise — to say nothing of the question of whether his campaign conspired with
Russia or merely benefited from its manipulations — has
thickened the faint stink of illegitimacy that would hover over any
president who lost the popular vote, supercharging policy disagreements into nearly existential
threats to democracy . The regular cycles of consternation spun up by Mr. Trump’s unconventional approach to the job
of being president help keep that wound raw.
Despite simmering unrest, there have been only a few extraordinary moments that broke the mold of public stability. Those include
peaceful demonstrations, like the post-inaugural women’s march and the airport protests against Mr. Trump’s initial ban on
travelers from seven Muslim countries. Far more disturbing, they also include the near-fatal shooting of a Republican congressman
and several other people at a baseball practice by a man who was furious at Mr. Trump and Republicans, and the spectacle of
throngs of white supremacists emboldened by the era to march in Charlottesville, Va. — culminating in an apparent neo-Nazi
sympathizer plowing his car into anti-racist counterprotesters, injuring dozens of people and killing a woman. Fortunately, those
two moments of extreme political violence have been exceptions.
For a counterexample of how a time of intense political bitterness can start to tear this country apart, look back exactly half a century
to 1968. In that chaotic year, America slashed and clawed at itself amid the assassination of the Rev. Dr. Martin Luther King Jr. and
the riots that followed; the assassination of Robert F. Kennedy as he ran for president; swelling antiwar demonstrations on college
campuses amid growing recognition that the government had been lying about the course of the Vietnam War; and the police
beatings of protesters in Chicago outside the Democratic National Convention.
Factors like the draft and the race relations of the period made that tumultuous year a particular historical moment. But one
difference between then and now is salient: Arguably, there was little reason to believe that the November 1968 election was likely to
provide immediate relief.
We are lucky that so far 2018 does not look like a new 1968. But the relative
calm may be like an unexploded
bomb , its volatility not so much defused as contained by the thought that Trump
Republicans will be punished in the Nov. 6 midterm elections. These expectations are widespread.
After the big Democratic special election victories in places handily carried by Mr. Trump in 2016, from Virginia and Alabama to
Wisconsin, Republican lawmakers in purple districts are retiring to avoid ending their careers in humiliating defeats.
Democrats, meanwhile, relish visions of a new congressional majority wielding its subpoena power
to flay the Trump administration with oversight investigations. They can see it now: Making public Mr. Trump’s hidden
tax returns and otherwise laying bare any financial dealings between foreign governments and his businesses. Inviting the women
who have accused him of sexual misconduct to testify at a televised hearing. Unearthing what his appointees have been doing in
places like the Environmental Protection Agency, where collection of fines from polluters has plummeted.
Almost taking a House flip for granted, Democrats whisper that a tsunami-level wave would also flip the Senate and stop Mr.
Trump’s assembly line for turning conservative lawyers into life-tenured federal judges. Some even fantasize about impeachment.
Such vivid anticipation steers those sputtering at Mr. Trump's presidency to take deep breaths and bide their time until Nov. 6,
which draws closer every day: The 2018 campaign cycle formally starts this week with primary voting in Texas.
But a significant Democratic wave may not materialize . Good economic news, for example, tends to blunt
anti-incumbent sentiments. The country is still mostly using House districts that were redrawn after the 2010 census, just as
Republicans’ big 2010 midterm wave victory gave them an unusual degree of control over state legislatures. Beyond deliberate
partisan gerrymandering, the impact of a Democratic turnout surge would be partly diluted by their voters’ disproportionate
concentration in cities, piling up extra votes in districts Republicans would have lost anyway.
But inevitably , many eyes would turn to Russia . It appears to still be covertly spreading disinformation and
amplifying tensions on American social media with the intention of having “an impact on the next election cycle,” Mike Pompeo, the
Central Intelligence Agency director, told Congress last month.
Another poll-defying election night surprise, like 2016’s, would further fuel suspicions of
unseen manipulation . After all, the public only later found out — apparently thanks to the National Security Agency
contractor Reality Winner, whom the Justice Department is prosecuting for leaking — that shortly before the 2016 election, Russian
hackers infiltrated the servers of an elections systems software supplier and tried to trick 122 state elections officials into
downloading malware. While there is no evidence that Russian hackers tampered with Election Day
results last time, the government has disclosed that it thinks they probed elections systems in 21
states and penetrated several.
“There should be no doubt that Russia perceives its past efforts as successful and views the 2018 U.S. midterm elections as a
potential target for Russian influence operations,” Dan Coats, the director of national intelligence, recently testified. “Throughout
the entire community, we have not seen any evidence of any significant change from last year.”
disappointed Trump opponents will be primed to believe the worst :
Against that backdrop,
that Russia rigged two elections in a row for Republicans. And if their anticipatory catharsis and
faith in the democratic process evaporates, the anger could seek a different outlet — in turn
risking a backlash from Trump supporters and a downward spiral .
The White House’s approach to issues raised by Russian election meddling has been backward-
looking, minimizing the problem in a way that seems to preclude focusing on protecting the country from future threats.
Preoccupied with defending the legitimacy of the 2016 results, Mr. Trump repeatedly
insists not only that his campaign did not collude with Moscow, but also that Russia’s effort to
torque that election was either “ a made-up story ” or had no impact on the outcome. Asked recently whether Mr.
Trump has specifically directed the Federal Bureau of Investigation or the N.S.A. to take actions to confront and
blunt continuing Russian influence operations , their respective directors testified that the
president has not done so.
Intelligence community leaders say their agencies are nevertheless trying to mitigate the risk, helping
states strengthen cyberdefenses and hinting at other, classified steps. Such efforts to bolster the credibility
of the election system are crucial, but may prove insufficient if there is another
expectation-defying result .
Three days after the directors’ testimony, the Justice Department announced that a grand jury had indicted a group of Russians
accused of running the social media manipulation operation. The unsealed indictment quoted internal Russian
documents obtained by Robert Mueller, the special counsel. In them, the Russians were said to have described the
original stated goal of what they called “information warfare against the United States of America,” before it morphed into
helping Mr. Trump win, as spreading mistrust toward “the American political system in general .”
if the wave turns out to be a mere trickle, we could see the
This November,

accomplishment of that goal take hold .

That forces Trump to defend the election’s legitimacy by confronting Russia---

extinction
Jeffrey Tayler 17, the Russia correspondent for the Atlantic Monthly and a contributor to
several other magazines as well as to NPR's All Things Considered, 4/20/17, “Anti-Russian
Hysteria, American Hypocrisy, and the Risk of Nuclear Confrontation,”
http://quillette.com/2017/04/20/anti-russian-hysteria-american-hypocrisy-risk-nuclear-
confrontation/
Though Trump himself has recently tweeted, “Things will work out fine between the U.S.A. and
Russia. At the right time everyone will come to their senses & there will be lasting peace! ” the whole
Trump-Russia-collusion affair is dangerous , melding, as it does, high-stakes U.S. domestic
politics with our increasingly tense relationship with an adversarial Russia. At stake, of course, is no
fictional kingdom. Given the nuclear arsenals of Russia and the U nited S tates and the “completely ruined

relations” between the two powers, the fate of our planet may well hang in the balance . We
need to examine the Trump-Russia scandal with sangfroid and figure out where it is leading us internationally. Nowhere good, it
turns out. But I’m getting ahead of myself.
To clarify the facts – or lack thereof. Just about every day new accounts from mostly anonymous sources in the United States and
now the United Kingdom emerge in the press and allege that Trump and his team colluded – or are still colluding — with the
Russians. The most authoritative wellspring for suspicion is, however, a report jointly produced by U.S. intelligence agencies and
released in January, “Background to ‘Assessing Russian Activities and Intentions in Recent US Elections’: The Analytic Process and
Cyber Incident Attribution.” (Read it here, if you haven’t already.)
The report merits a quick review now. What strikes careful readers of the document is not flagrant evidence of Trump’s treason, but
the guarded language the authors deploy in presenting “assessments” (essentially, speculation, with varying degrees of confidence)
about the Russian government’s motives, intentions, preferences for candidates, and cyber tactics. In sum, the report does not so
much as state facts but make a case.
The report’s main conclusion: as the 2016 campaign progressed, the Kremlin developed a preference for Trump over Hillary Clinton
and decided to help put him in the White House. Through its GRU intelligence service, the Kremlin (on orders from President
Vladimir Putin personally) arranged for the purloining of emails from the Democratic National Committee and passed them on to
Wikileaks and other collaborating sites, and, additionally, used trolls and state-controlled media (mostly the satellite channel RT,
formerly Russia Today), to “undermine public faith in the US democratic process, denigrate Secretary Clinton,” and swing the odds
against her. Critically, the report does not “assess” that Russia hacked American voting machines. The Kremlin, says the document,
will likely continue its efforts to undermine the American democratic enterprise.
A species of peculiarly American blindness and hypocrisy characterizes the report and much of the anti-Russian hysteria deriving
therefrom. Exempli gratia: the authors saw fit to republish as an annex information from the Open Source Center that first appeared
in 2012 and provides quotes and commentary on programming from RT. The Open Source Center noted that, “RT’s leadership has
candidly acknowledged its mission to expand its US audience and to expose it to Kremlin messaging. However, the leadership
rejected claims that RT interferes in US domestic affairs.”
Let’s pause to consider this statement, so indicative of the aforementioned American blindness and hypocrisy. RT is licensed
(through TV Novosti, a subsidiary) to broadcast in the United States and has a legal right to offer American viewers whatever it sees
fit. It may surprise someone somewhere on the planet that the Kremlin heavily influences what the network airs; informed viewers
might have already suspected as much, given that RT is, well, Russian state media, and not, say, the Voice of America or Radio
Liberty, which the U.S. Congress funds, or CNN or MSNBC, both beholden to corporate masters. Does presenting a point of view to
Americans, even one held by the government of another country, constitute “interference” in “US domestic affairs”? If it does, one
would assume, Russia has every right to jam the Voice of America and Radio Liberty. The Soviet Union did this; Russia does not.
And just how much could RT have “interfered in US domestic affairs” with its nefarious shows? That depends on how many watch
them. It’s tough to say how big RT’s American audience is. The annex tells us that, “RT states on its website that it can reach more
than 550 million people worldwide and 85 million people in the United States; however, it does not publicize its actual US audience
numbers (RT, 10 December).” But the real figure may only be a fraction of that – a number so small that the Nielsen Company does
not bother to rate the channel. RT’s “social media footprint” is impressive on Youtube, but not so at all – critically – on Twitter or
Facebook, where in “likes” and followers, CNN and the BBC crush it. In sum, RT’s “interference” in the American democratic process
could not have amounted to much.
The same cannot be said about the hacked DNC emails, which the report accuses Russia of providing to Wikileaks and other sites
last summer for subsequent, well-timed release to the public. The emails showed that the DNC skewed the primaries against Senator
Bernie Sanders, Clinton’s contender for the nomination; news of this led to the resignation, in disgrace, of DNC chairperson Debbie
Wasserman Schultz.
No one contests the veracity of these emails. That the DNC so mistreated Sanders in favor of Clinton should outrage American voters
and be the key issue for Democrats today. After all, Sanders, polling data showed, would have defeated Trump in November by as
many as fifteen points. That it has not been the issue has everything to do with the Clinton campaign’s decision to dispense with the
inconvenient affair by declaring, in effect, that a vote for Trump was a vote for Putin; and Clinton’s insistence, even now, that Russia
helped win the election for Trump.
Moving away from the intelligence agencies’ report, we need to ask questions rarely raised in all the Trump-Clinton-Russia hubbub.
The Russian media did openly broadcast in favor of Trump; and Russians did, by and large, hope he would win. Why? There are
objective reasons. For starters, the Obama administration had openly opposed Putin’s reelection to the presidency in 2012, with Vice
President Joseph Biden showing up in Moscow the previous year to announce that the White House did not want Putin to run;
Obama had dissed Putin publicly and spoken disparagingly of Russia, and, lest we forget, overseen the imposition of a burdensome
sanctions regime on Russia following the outbreak of the Ukraine crisis. The sanctions in particular have made life harder for
Russians, and they blame Obama for them. Clinton, held to be Obama’s chosen heir, had compared Putin to Hitler and promised
more of the same hard line. Trump, in contrast, famously declared his desire to repair relations with Russia and cooperate with it in
Syria in the fight against ISIS; and, of course, he had voiced his admiration for the Russian leader many times.
Despite all this, solid grounds exist for assuming that the Kremlin would not have wanted to mount a
clandestine operation to help Trump win. In retrospect, they seems obvious, but in prospect, not so much. The
Kremlin had to believe that American pollsters and media would be correct in predicting a Clinton victory. A cyber campaign against
her, the certain victor, carried the risk of discovery. Would Putin – who is nothing if not calculating – really have wanted
to risk making a future President Clinton even more hostile toward him than she seemed to be
in her public pronouncements? Privately, Putin, Wikileaks revealed, had an amicable working relationship with Clinton
when she was secretary of state. He surely knew her to be reasonable and forthright, someone he could do business with. Trump,
in contrast, appeared impetuous, unpredictable, and irrational, with a penchant for lying and no
demonstrable political skills – something he could not do without if he had to , say, persuade a
hostile Congress to go along with a future deal with Russia . A candidate who evinced almost daily his sui
generis lack of qualification for the White House might reasonably have appeared dangerous to the Russian leadership (just as he
did to most of the rest of us).
As for Trump, if he really were colluding with Russia, would he have so recklessly asked Russia to find Clinton’s thirty thousand
missing emails? Would he have so often expressed a desire to “get along with Russia” if he thought he might be unmasked as
conspiring with the Kremlin to steal the elections? One has to assume he would do just the opposite.
All the ifs and assumptions and anonymous sources and innuendo are wearying. We need a nonpartisan
investigation to settle the whole affair. That Republicans and the White House are doing their best to prevent this
is worrisome, but not proof of guilt. We just do not know the truth.
The question of Russia’s possible role in Clinton’s loss aside, from the tornado of Russia-related accusations swirling around Trump
and his team, one might be tempted to conclude that meddling with elections was a peculiarly Russian sin committed against a
uniquely chaste United States, the institutions and practices of which stand as paragons of probity unparalleled in the annals of
human history. One would, of course, be wrong.
A peculiarly American sin in this mess is one of omission. Those bewailing Russia’s evil ways do not mention the longstanding U.S.
penchant – covertly indulged but thoroughly documented – of influencing the outcome of elections abroad and even overthrowing
governments. Russians certainly have not forgotten how Americans engineered the 1996 reelection of President Boris Yeltsin, a U.S.
ally, who, by then, was ailing and alcoholic, with popularity ratings in the single digits, a corrupt entourage, and a legacy of national
ruin. Remember that, and much of the indignation over Russia’s alleged misdeeds in 2016 evaporates. We at the very least need
some historical perspective – and, of course, the facts an objective Trump-Russia investigation would give us.
The intelligence agencies’ report has served as a backdrop for what amounts to a bipartisan campaign
in political circles and the media to discredit and eventually unseat Trump and compel him to
renounce his oft-expressed hopes for a rapprochement with Russia . Secretary of
State Rex Tillerson has visited Moscow and met with Putin, which may have reduced tensions between the
But this may last only until the next Trump tweet or Trump
two countries somewhat.

missile volley . The situation remains dangerous .

What counts is that Trump, notoriously sensitive to slights and humiliatingly derided
by the press and others as “Putin’s puppet ,” may once again feel that he has
to demonstrate he’s nothing of the sort. This is where things could get perilous. What if,
for instance, Trump, notwithstanding Russia’s newly drawn “red line” in Syria, decides to bomb the “animal” Bashar al-
Assad in Damascus? What would Putin, whose only significant opposition in Russia is to his hardline, nationalist right,
then find himself obliged to do in response? Escalation would likely ensue. Who would stop it from
eventually resulting in armed conflict between the United States and Russia? We can hope all we want that one of the
adults around Trump (Secretary of Defense James Mattis, National Security Adviser H.R. McMaster) might get him to
act with restraint, but that hope may be unfounded, and, of course, Trump will still have the
final word. As well as the nuclear codes .
Even without a Trump blunder we are still in danger. Accidents happen. What if American fighter jets bomb Russian troops in Syria
by mistake? What if a mishap takes place in the Baltics, where NATO and Russian forces face off? Already, experts worry that major
Russian military exercises planned for the region this autumn may result in a miscalculation that could spark a war. In 1983, the
U nited S tates, in its faceoff with the Soviet Union, conducted drills that almost ignited a planetary
holocaust . We don’t want to tempt fate again. But we are perfectly poised to do just that .
Other frightening possibilities abound (think North Korea), but what transpires is the urgent need to enact a new détente with
Moscow such as I described not long ago in Quillette. A détente is not an alliance, but only a series of practical measures that would
ease tensions and reduce the chances of armed conflict with Russia.
Beyond that, we should undertake a reevaluation of Russian-American relations, one based not on the diatribes of self-interested
politicians and grandstanding cable news commentators, but on how the world works and how the United States and Russia have
behaved in it.
This means taking an honest look at the global military postures of the two countries. The United States possesses nearly eight
hundred military bases in more than seventy countries and territories overseas, and spends about $600 billion annually on defense
(which Trump wants to increase by another $54 billion) – more than the next seven biggest defense spenders, including Russia,
combined. Russia has one base outside its “near abroad” – a naval base in Tartus, Syria – and spends less than $70 billion a year on
defense, an amount it is about to reduce. Objectively speaking, at least if we discount Russia’s nuclear arsenal, it is the United States
that is positioned to threaten Russia, not the other way around.
More broadly, NATO, despite promises made to the Soviet Union at the Cold War’s end, has expanded up to Russia’s borders; Russia
has done nothing comparable. In 2002 the United States unilaterally withdrew from the Anti-Ballistic Missile Treaty (signed with
the Soviet Union in 1972), one of the cornerstones of security in the nuclear age, and opened missile defense bases in Eastern
Europe. Russia, considering such bases a threat to its deterrent capability, has pledged to counter the United States’ move. The
United States is intervening in Syria without legal sanction; Russia, in contrast, is there at the invitation of Syria’s internationally
recognized government. With its military operations in the Middle East, Russia is acting defensively, backing Bashar al-Assad to
squelch the Islamist threat to the his regime – and to itself. After all, Russia has some twenty million Muslims, a good number of
whom reside in the North Caucasus, which has suffered a decades-long Islamist insurgency (now mostly low-intensity) that hardly
makes the news in the West. Russia has good reason to fear contagion.
The leaders of great powers are generally not pacifist do-gooders, but men and women willing to take, at times, strong measures to
protect their countries. (Just ask Nobel Peace Prize Laureate Barack Obama, who authorized ten times more drone strikes than his
more bellicose predecessor.) Understanding this renders incomprehensible the vilification to which the American media and
politicians have subjected Putin. Putin has, yes, presided over Russia’s return to autocratic governance, which may be distasteful to
Americans, but he prevented the collapse of the Russian state – a real possibility at the end of the Yeltsin era. (Read this if you would
like an alternative view of the Russian leader and his time in office.) And no one can reasonably equate Russia’s human rights record
with that of, say, Saudi Arabia, a longstanding U.S. ally, despite the Saudis’ beheadings, stonings, amputations of hands, and so on.
Until allegations of collusion between the Trump camp and the Kremlin are dispelled, there is
little chance that the U nited S tates and Russia will manage to restore relations and lessen
the risk of catastrophe . Trump stands center stage in this unseemly drama, and on his
Rabelaisian flaws may depend our future. About the only way we can avert disaster is for us to come to our senses about
what Russia is, what it can and cannot do, and what the United States’ role has been in triggering this confrontation.
 1NC
The United States federal government should maintain current levels of regulation
on prescription drugs and preempt new state laws regulation prescription drugs.

The United States federal government should establish a national system of health
care financing for pharmaceutical and prescription drugs in the United States,
compensating future treatments on the basis of therapeutic value.
 Econ Advantage
Economy growing now
Katy Ruth Camp 2/5, feature editor at the Cobb Business Journal, citing Dr. Roger Tutterow,
Professor of Economics, Director of the Econometric Center at Georgia State, Kennesaw State
University, Ph.D. in Economics from Georgia State, 2-5-18, “Economist expounds on economy,”
http://www.mdjonline.com/cobb_business_journal/economist-expounds-on-
economy/article_3be9107a-0854-11e8-87f5-b7504f6e43e4.html
Dr. Roger Tutterow, one of the state’s most preeminent economist and a noted economics professor at Kennesaw State University,
spoke last month to the Kiwanis Club of Marietta to provide insight into where the economy has been the past few years, where it is
now and what to expect in the future.
Here are some highlights of his speech:
Due for a recession?
We’ve strung together four quarters at 3 percent or better GDP growth . It’s the second-
longest expansion in the post-World War II era. It’s exceeded only by the one from March 1999 to March 2000.
Does that necessarily mean we’re due for a recession? I would suggest not . The truth is,
economies aren’t ever due for a recession . We get expansions that turn into recessions
because of bad politics. Because asset pricing bubbles pop. Because of inventory overaccumulations. And because of a
plethora of what on-economists would call, “weird stuff that happened.”
With a forecast for global growth of about 4 percent this year — some of that is because of China and India —
here in the U.S., it’s quite likely we’ll have 2.8, 2.9 percent GDP growth in 2018 .
Causes of growth
There are two various parts of the economy that are doing quite well. One of them is
manufacturing and the other is consumer sentiment .
When the value of the dollar ran up by 3 percent from early 2014 to a peak in early 2017, it made U.S.-produced products more
expensive on global markets and hurt our exports.
The good news is, in
2017, the value of the dollar dropped. Manufacturers were increasing
their output again. We were making gains in terms of exports.
The other is consumer confidence retail sales. For three months between October and
January 2017, we saw consumer sentiment go up by 11 points . That was a result of the election.
Current economic climate

Health care growth is high---volatility has upsides and won’t collapse the sector
Brad Sorensen 17, CFA, Managing Director of Market & Sector Analysis, Schwab Center for
Financial Research, “Health Care Sector Rating: Outperform,” 9/14/17,
https://www.schwab.com/resource-center/insights/content/healthcare-sector
In general, health care companies’ balance sheets are solid , their stocks have offered
attractive dividend yields and the sector’s overall cost structure appears to have
improved. Demand appears to be on the rise for health care products and services. On the other hand, political rhetoric around
the Affordable Care Act can be expected to fuel continued volatility.
Market outlook for the health care sector
The health care sector has a lot of positives going for it and has had a good run as of late: Valuations
appear fair to slightly
below average, balance sheets are solid, stocks generally have good dividend yields, and the overall cost
structure appears to be much improved. Also, demand appears to be on the rise for health care products and services,
partly as a result of an aging population.
The Affordable Care Act continues to be a source of volatility for the sector, but we believe this has
created potential opportunities for investors and are currently rating the group at
outperform. While the most recent effort to “repeal and replace” the ACA has now been effectively shelved, both sides of the
aisle agree the status quo can’t continue, so some changes seem likely to occur, but what form those will come in is virtually
impossible to know at this point. This is a story that will continue to develop over the next several months, at least. This will likely
keep the health care sector a bit more volatile than usual, but also create some opportunities for
investors willing to ride the potential roller coaster. Another factor potentially helping the group, the Federal
Reserve continues to raise rates and—according to BCA Research—the sector has outperformed during Fed hiking cycles on average
since 1970. Since past performance does not guarantee future results, we acknowledge that there are risks and it could be a bit of a
bumpy ride, but we
believe that brighter prospects are ahead and remain comfortable with our
outperform rating on the group.

Single payer spikes short-term inflation---no stimulus effect

Jordan Weissman 16, Slate’s senior business and economics correspondent, 2/18/16, “The
Sanders Campaign Thinks It Can Give Us 5 Percent Economic Growth. It’s Deluded.,”
http://www.slate.com/blogs/moneybox/2016/02/18/the_sanders_campaign_is_living_in_an
_economic_fantasy_world.html
So what's going on? It's not stated clearly in the paper, but Friedman starts from the premise that the U.S. is still
essentially in a depression—not in the sense that we're staring at mass job losses and bread lines, but in the sense
that the country is operating at far, far below its economic potential . As a result, he thinks a
sufficiently massive amount of government stimulus spending could create a fast burst of
growth, pushing the economy's output back to where it naturally belongs and returning the U.S. to full employment.
By Friedman's accounting, the first few years of Sanders' plan would give us just that sort of a jolt. In 2017 alone—again, assuming
Sanders can pass all his proposals—the country would get a roughly $400 billion boost from things like government
infrastructure projects and increased consumer spending resulting from an increase in the minimum wage. It would get roughly
$400 billion injection due to single-payer , since Washington would start paying
another

premiums before increasing taxes to cover them. Loosely speaking, it would be like dumping the
entire Obama stimulus package on the country in one year .
Over time, Friedman
thinks the push largely from government spending will bring the U.S. back to
full employment. As the labor market gets tighter, the improved economy will attract more immigrants, expanding the size of
the workforce, and employees will simultaneously become more productive. More people producing more stuff per hour will then
sustain the relatively speedy pace of growth under President Sanders, even as things like tax increases take more of a bite.
Is that really so absurd?
The problem with Friedman's forecast is that it involves a series of questionable assumptions that,
stacked on top of each other, aren't really credible.
Take his stimulus math. In general, economists believe that government spending is more effective at
sparking growth—in academic speak, it has a higher “fiscal multiplier”— when the economy is weak than
when it's strong. If we're in a severe recession, $1 of extra federal cash could create $2 or so in growth, as businesses rev back
up and the unemployed return to work. But if the economy is already firing on all cylinders, that same dollar
probably won't lead to much extra growth at all , since there won't be a lot of jobless Americans to hire or
unused factory lines to turn back on. Instead, it's more likely to bring about inflation , in which case the
Federal Reserve would likely intervene by raising interest rates to slow the economy and
keep prices from rising.
Friedman believes government spending could be enormously helpful at first because, again, in his view the U.S. is still stuck in a
ditch. He told me he thinks the economy would be roughly $1 trillion larger if it were operating at its potential. The Congressional
Budget Office, in contrast, thinks the output gap is about half that size, and its guess is on the high end. Even if Friedman is right on
that point—and he might be, since estimating this stuff is tricky— he still assumes that new spending will have an fairly strong
effect way past the point at which the economy should hit full employment in his model, when you'd expect the fiscal multiplier to be
closer to zero. All the while, inflation
averages 3 percent , which is above the Federal Reserve's target, and yet the
bank never steps in to cool things off. Both the inflation estimate, which still seems a bit low, and the
idea that the Fed would stand pat seem like a stretch .
And it goes on. In order for more spending to grow the economy once you hit full employment, the U.S.
either needs a larger or more productive labor force. Friedman argues that in spite of retiring Baby Boomers, the
influx of ready-to-work immigrants he envisions will still boost the country's employment-to-population ratio to 65 percent. That
has never happened before. He also thinks productivity growth will average 3.2 percent per year, which the
U.S. has also never managed on any kind of sustained basis in the modern era. His basis for that particular prediction is
a concept known as Verdoorn's law, which says that lower unemployment drives productivity higher. It's a very interesting idea, but
not exactly a mainstream one.
There are more bits to nitpick—Friedman’s estimates about the effect of minimum-wage increases on consumer spending growth
seem atypically large, for instance—but you probably get the idea. In a vacuum, any one of Friedman's predictions about productivity
or the labor force or inflation might just seem a bit sunny. But in the end, he's predicting one low-probability outcome after another.
As Jared Bernstein from the liberal Center on Budget and Policy Priorities said to me, “ When you throw all those
assumptions together, they’re implausible .”

Unexpected spike in inflation causes short-term recession

Avi Salzman 12-30, columnist for Barron’s, 12/30/17, “What Inflation Could Mean for the
Market,” https://www.barrons.com/articles/what-inflation-could-mean-for-the-market-
1514604543
Largely absent during the economy’s eight-year recovery from the financial crisis, inflation is on track to
pick up in 2018—and it might just catch investors off-guard.
For now, price pressures are benign , even as U.S. economic growth cruises into the new year at a 3% clip, with
business-friendly tax cuts on the way. The core consumer price index, which strips out energy and food, was up just 1.7% year over
year in November.
Economists have raised the specter of inflation for several years, only to be disproved time and again. There’s reason to believe,
however, that 2018 will be different—that prices will finally rise in a more sustained pattern, forcing stock- and
unanticipated acceleration in inflation is
bond-market investors to react to a new trend. “An

probably the biggest risk for markets in 2018 ,” says Larry Hatheway, chief economist at GAM
Investments and head of GAM Investment Solutions.
Economists like Hatheway aren’t expecting runaway inflation , as in the days of disco and leisure suits,
when prices rose by double digits. They’re girding for an annual increase of 2% to 2.5% at the most.
Yet the return of inflation would change market psychology. “You don’t really need inflation
of a great
magnitude here to get an inflation surprise,” says Don Rissmiller, chief economist at Strategas Research Partners.
“ Just a little bit more inflation from where we are today is probably enough to
generate an inflation scare in 2018.”
Such a jolt could reshuffle the market. Since 1950, stocks have traded at an average multiple of 18.1 times earnings when inflation
has ranged between zero and 2%—the “sweet spot,” says SunTrust Chief Market Strategist Keith Lerner. At 2% to 4%, the multiple
slips to 17.2.
Inflation is “the ultimate enemy of financial assets,” says Lloyd Khaner, president of Khaner Capital Management.
“Name your financial asset—inflation tends not to help, if not kill it.”
Stocks that are sensitive to rising interest rates —from utilities to telecom companies—would be particularly
vulnerable, while financial, energy, and materials stocks could ride a wave of accelerating growth in prices.
IN THE PAST TWO WEEKS, investors got an early taste of what could happen during an inflationary period, as weakness in the
dollar helped send copper up 8%, even as stocks gained just 1.3%.
Bonds face a more dangerous reckoning. It won’t take much to turn investment-grade bonds into ugly
investments, says David Lafferty, chief market strategist for Natixis Investment Managers. “Unless you think the economy is
going to tank and rates are going to fall, the returns to high-quality bonds are somewhere between unimpressive and somewhat
negative,” he says. Inflation could increase the pain “even if core CPI goes from 1.7% to 1.9%,” he adds.
Making the outlook so unpredictable is the peculiar economic cycle that followed the global financial crisis. Ultralow interest rates
around the world inflated the value of some assets, but not wages or the prices of goods and services, leaving central bankers
befuddled.
If the postcrisis recovery had followed a more typical pattern, the U.S. would have faced more aggressive inflation years ago.
It wasn’t for a lack of trying. Inflation ramped up briefly with the Obama administration’s stimulus package and payroll tax cuts, and
the Fed’s aggressive quantitative easing. Some items, including rent and auto prices, spiked for brief periods, but those increases
never spread to the rest of the economy.
In 2012, then-Fed Chairman Ben Bernanke issued a target inflation rate of 2%, a landmark move for the Federal Reserve, whose
leaders had never before made explicit inflation targets. But just saying the words “two percent” failed to make prices and wages rise.
Fed Chair Janet Yellen called the lack of inflation a “mystery,” one that will soon be Jerome Powell’s to solve.
A CONFLUENCE of factors has weighed on prices. Indeed, the low-inflation trend precedes the recent recovery, as the Fed has
grown more aggressive about responding to price increases, and free trade has led to cheap consumer goods.
Other factors have also tamped down price growth. Banks didn’t lend all of the money that the Fed pumped in because they needed
to shore up their balance sheets to account for bad loans and adhere to new regulations. Businesses, coming out of a long period of
economic uncertainty and global instability, were slow to spend capital. Prices of goods haven’t risen because the postrecession
period coincided with an aggressive shift to e-commerce and price comparison. Apparel prices alone fell 1.3% in November, as
clothing stores cut prices to keep up with cheaper online competitors.
Labor markets have changed, too, with workers less able to demand the higher wages that historically have coincided with greater
inflation. Unions are weak and borders are porous, allowing businesses to shift production to lower-cost countries rather than raise
employee pay. And a talent gap is outweighing the wage gap right now: Businesses often can’t find workers because people don’t
have the right skills, not because the pay isn’t high enough. Other macro factors have kept prices low. Oil crashed in 2014,
restraining prices of related goods. A strong dollar has likewise damped inflation by making imports cheaper.
As a result, inflation as measured by the core CPI has risen at an average rate of 1.76% since 2009. The inflation tracker that the Fed
prefers—the core Personal Consumer Expenditures, or PCE, index—was up 1.5% as of November.
Most economists expect prices to rise at the same gradual pace next year. By next December, the
broader CPI, which was growing at 2.2% as of November, will probably have risen 2.1% from today’s level, according to 52
economists surveyed in Blue Chip Economic Indicators. The Fed sees core inflation rising 1.9% next year. The 10-
year break-even inflation rate, a proxy for the market’s inflation expectations, sits at 1.9%, around where it was at the start of the
year.
WITH SUCH A LOW BAR , however, Wall Street easily could trip .
“People have gotten really used to 1.5% inflation ,” says Natixis’ Lafferty. “The service economy and wage pressure
are going to gradually continue to put upward pressure on interest rates. It’s not a shock story; it’s more like we’re going to wake up
in six or eight months and the Fed will be saying, ‘I think we’re there.’ ”
Strains on prices are already evident higher up the supply chain, says Rissmiller of Strategas. Deliveries by suppliers to
manufacturers have slowed in recent months, according to the Institute for Supply Management, a sign that the suppliers are
becoming busier. That kind of pressure can force prices higher. “With less slack, if something has to get done, you may have to pay
up,” Rissmiller says.
The producer price index, which measures the prices that goods and services producers get, rose 3.1% on a year-over-year basis in
November, the fastest rate since January 2012. Lumber prices have risen this year and are expected to continue trending higher next
year, potentially forcing home prices higher, too. The Federal Reserve Bank of New York introduced an inflation measure this year,
the Underlying Inflation Gauge, which tracks consumer and producer prices, commodity prices, and real and financial asset prices.
Based on prior data, it is at an 11-year high, near 3%.
And wages seem to be reacting, rising at an annual rate above 2.5% this year, faster than since the end of the recession. Growth has
been choppy and unimpressive, but expect a steeper slope next year. Job openings are at the highest level since records were first
tracked, in 2000.
Already, prices are rising in some quarters, although not in a sustained fashion. Restaurants have been increasing prices over the
past year or so to deal with new city and state minimum-wage laws and higher food prices. Apple clearly feels comfor charging
higher prices, as evidenced by its $1,000 iPhone X. And Netflix raised its monthly streaming fee for the first time in two years.
Fiscal policy also points in an upward direction. The tax cut passed at the end of December should spur business investment and,
potentially, employment. An infrastructure plan, while still a difficult sell in Congress, would stimulate even more investment.
Minimum-wage laws are pushing up wages in several cities.
President Donald Trump’s aggressive posture on trade raises the possibility of trade restrictions that boost prices. Lumber prices
have already spiked in part because of new U.S. duties. “Trade wars are inflationary,” Khaner of Khaner Capital says.
An inflationary market isn’t a bad place to invest, particularly if earnings are still rising. Indeed, some inflation would be heralded as
a sign that economic growth has fully taken hold. But investors would have to step gingerly.
Stocks that trade like bonds would probably be at a disadvantage. Jim Paulsen, chief investment strategist at the Leuthold Group,
tracked the performance of Standard & Poor’s 500 sectors since 2010, and found that relative returns for bond-like stocks trailed the
overall market considerably during weeks when the 10-year-note yield rose.
Utilities underperformed by the widest margin, a staggering 36% annualized. Beloved for their dividends, utilities get less attractive
as yields on less-risky assets rise. And because most utilities are highly regulated, they would probably have a harder time raising
prices to keep up with inflation. Telecom stocks would likewise lose their shine as dividend investments. And consumer staples, seen
as havens, have tended to trail.
On the flip side, inflation tends to lift commodities, which have risen by over 15% since the summer. If the dollar weakens,
commodities—most of which are priced in dollars—generally become more valuable. And a rise in inflation would probably coincide
with greater economic growth, sparking more demand for oil, agricultural products, and other building blocks of the economy.
Materials could rise because of the same factors.
Other sectors would be in a strong position, too. Presuming that long-term interest rates rise faster than short-term rates, banks
could make money off wider spreads between the money they take in and the money they lend out. They could earn higher returns
on the customer deposits they hold.
Still, inflation rarely proceeds in a predic fashion. It can be spurred by geopolitical events that drive oil prices higher, by Fed policy
or currency shifts, or some combination.
The last time core CPI rose above 2.5% for a sustained period, a nine-month stretch starting in June 2006, telecom and utility stocks
rose more than 20%, while financials lagged behind. The prior period of price growth above 2.5% coincided with the dot-com crash.
Consumer staples, financials, and materials led the market, while tech, utilities, and telecom fell.
In short, it’s tricky to prepare for accelerated inflation. Even investors who believe that conditions
are ripe for price growth say they’re not making large changes to their portfolios in
anticipation. Risk, profits, and valuations remain the best ways to evaluate an investment. Inflation adds a new
wrinkle, for sure. And if it complicates the Fed’s job and causes it to ramp up rates before the economy is ready, it could
spur a recession .
Their Cassidy card says they cause wage growth---that causes a market crash and
fast interest rates hikes---recent reports assuage fears now---no alt causes
Pedro da Costa 3/13, senior correspondent at Business Insider, 3/13/18, “Wall Street gets a
reprieve on 2 of its biggest worries about the economy,” http://www.businessinsider.com/low-
inflation-lack-of-wage-growth-should-calm-wall-street-fed-fears-2018-3
Two of Wall Street's biggest worries on the economy, inflation and wage growth , showed
signs of moderation in February.
Labor Department data shows not only a subdued inflation trend but also suggests wage
growth is moderating rather than picking up steam.
Diplomatic tensions with No rth Ko rea. A criminal investigation into possible conspiracy against the United States.
The sudden, unexpected firing of Secretary of State Rex Tillerson.
Such massive turbulence has barely registered on the market's radar . Instead, traders
are fretting over the possibility that slightly higher inflation might drive the Federal Reserve to raise
interest rates more aggressively , possibly compromising the economic expansion.
Two major economic reports out Tuesday allowed investors to put their concerns into
perspective: Consumer prices rose only modestly and, more importantly, median wages are
actually trending lower.
It was a surprise spike in wages reported last month that sparked a large selloff in stocks that
reintroduced volatility into placid financial markets, a wild ride that has since persisted.
US consumer prices rose 2.2% in the year to February while prices excluding food and energy rose just 1.8%. Fed officials target a 2%
rate on another inflation measure, the personal consumption expenditures index, which has remained below the central bank's goal
for much of the recovery.
A separate Labor Department report was even more instructive. It showed average hourly earnings adjusted for inflation are
weakening, not strengthening— as Fed officials hope and market participants fear. Not only did earnings stagnate last month,
the following chart shows just how much conditions have deteriorated in the last year — for workers across the board
and for non-management employees in particular .
The Fed has telegraphed its intention to raise interest rates three times this year. Wall Street, accustomed to the stunted optimism of
recent years, shifted rapidly from not believing officials would move more than twice to suddenly pricing in the possibility of four
interest rate hikes for 2018.
The latest inflation figures should, at the very least, assuage worries that the central bank will
need to react more rapidly to an unexpected spike in consumer prices — and/or wages.

Fed Rate hikes cause recession---low threshold for the link because the fed is
skittish
Mark Kolakowski 18, M.B.A. in finance from the Wharton School of the University of
Pennsylvania, 1/16/18, “Why The 1929 Stock Market Crash Could Happen In 2018,”
https://www.investopedia.com/news/1929-stock-market-crash-could-it-happen-2018/
After the experience of 1929 , the Fed has been indisposed to tighten monetary policy in an attempt
to deflate asset bubbles. However , as economic growth reports improve, the Fed is
increasingly concerned today about keeping inflation in check. Any miscalculation that
raises interest rates too high, too fast could spark a recession and send both stock and bond
prices tumbling downwards . (For more, see also: How The Fed May Kill The 2018 Stock Rally.)

Quick rate increases pop the renewable energy bubble---crushes the industry
Peter Schiff 3/8, CEO and chief global strategist of Euro Pacific Capital Inc., a broker-dealer,
“Could Rising Interest Rates Pop the Renewable Energy Bubble?,” https://schiffgold.com/key-
gold-news/could-rising-interest-rates-pop-the-renewable-energy-bubble/
Could rising interest rates pop the renewable energy bubble ?
As the Federal Reserve and other central banks try to turn off the easy money spigot, we
will likely see a growing
number of corporate bankruptcies in the coming years. The renewable energy sector is
particularly vulnerable and exemplifies broader problems in the global economy.
Last year, we saw a number of high-profile corporate bankruptcies, particularly in the retail sector. Toys R Us was probably the most
high profile. It ranks as the second-largest US retail bankruptcy ever, according to S&P Global Market Intelligence. The story behind
the Toys R Us bankruptcy gives us a glimpse at a fundamental problem eroding the strength of the economy – easy money created
by Federal Reserve monetary policy. The ability to borrow a lot of money at low interest rates fueled borrowing and speculation.
Malinvestment has distorted the economy and inflated bubbles that will eventually pop. This is exactly what happened at Toys R Us.
The rate of bankruptcies will likely accelerate over the next several years and spread into other sectors if the Fed follows through on
its monetary tightening policies. The ugly truth is that these overleveraged companies simply can’t survive in anything remotely
resembling a normal interest rate environment.
As economist Daniel Lacalle noted in an article on the Mises Wire, the past eight years of easy money and massive liquidity enabled
companies to increase imbalances and create complex debt structures. Two facts bear this out.
Corporate net debt to EBITDA levels is at record highs. About 20% of US corporates face default if rates rise, according to the IMF.
The number of zombie companies has risen above pre-crisis levels according to the Bank of International Settlements (BIS).
The incredible transformation of the renewable energy sector over the last decade was
built on easy money and government subsidies. Lacalle said understanding that disruptive technologies
cannot be more leveraged than traditional technologies is key to understanding what’s
going on in the renewable energy sector.
When technology reduces costs and disrupts inflationary models, basing the business on ever-increasing subsidies and higher prices
and financing it with massive debt is suicidal. In
the era of cheap money and extreme liquidity, many companies
used the ‘green’ subterfuge to implement an extremely leveraged builder-developer model, ignoring demand,
costs, and competition . A model whose sole objective was to install for the sake of installing
capacity , whether there was a demand or not, and that pursued subsidies while stating that it is very competitive.”
Even in a period of low interest rates and ample liquidity, we’ve seen a number of spectacular
bankruptcies in the renewable energy sector . In fact, solar company bankruptcies have exceeded those of
coal and fracking companies combined. As Lacalle says, if the renewable sector is already struggling, imagine what will
happen as interest rates rise.

Extinction
Yangyang Xu 17, Assistant Professor of Atmospheric Sciences at Texas A&M University; and
Veerabhadran Ramanathan, Distinguished Professor of Atmospheric and Climate Sciences at
the Scripps Institution of Oceanography, University of California, San Diego, 9/26/17, “Well
below 2 °C: Mitigation strategies for avoiding dangerous to catastrophic climate changes,”
Proceedings of the National Academy of Sciences of the United States of America, Vol. 114, No.
39, p. 10315-10323
We are proposing the following extension to the DAI risk categorization: warming greater than 1.5 °C
as “dangerous”; warming greater than 3 °C as “catastrophic?”; and warming in excess of 5 °C as
“unknown??,” with the understanding that changes of this magnitude, not experienced in the last 20+
million years, pose existential threats to a majority of the population. The question mark denotes the
subjective nature of our deduction and the fact that catastrophe can strike at even lower warming levels. The justifications for the
proposed extension to risk categorization are given below.
From the IPCC burning embers diagram and from the language of the Paris Agreement, we infer that the DAI begins at warming
greater than 1.5 °C. Our criteria for extending the risk category beyond DAI include the potential risks of
climate change to the physical climate system, the ecosystem, human health, and species
extinction . Let us first consider the category of catastrophic (3 to 5 °C warming). The first major concern is the issue
of tipping points . Several studies (48, 49) have concluded that 3 to 5 °C global warming is likely to be the
threshold for tipping points such as the collapse of the western Antarctic ice sheet, shutdown of
deep water circulation in the North Atlantic, dieback of Amazon rainforests as well as boreal forests, and
collapse of the West African monsoon, among others. While natural scientists refer to these as
abrupt and irreversible climate changes , economists refer to them as catastrophic events (49).
Warming of such magnitudes also has catastrophic human health effects . Many recent studies (50,
51) have focused on the direct influence of extreme events such as heat waves on public health by evaluating exposure to heat stress
and hyperthermia. It has been estimated that the likelihood of extreme events (defined as 3-sigma events), including heat waves, has
increased 10-fold in the recent decades (52). Human beings are extremely sensitive to heat stress. For example, the 2013 European
heat wave led to about 70,000 premature mortalities (53). The major finding of a recent study (51) is that, currently, about 13.6% of
land area with a population of 30.6% is exposed to deadly heat. The authors of that study defined deadly heat as exceeding a
threshold of temperature as well as humidity. The thresholds were determined from numerous heat wave events and data for
mortalities attributed to heat waves. According to this study, a 2 °C warming would double the land area subject
to deadly heat and expose 48% of the population . A 4 °C warming by 2100 would subject 47% of the land
area and almost 74% of the world population to deadly heat, which could pose existential risks to
humans and mammals alike unless massive adaptation measures are implemented, such as providing air
conditioning to the entire population or a massive relocation of most of the population to safer climates.
Climate risks can vary markedly depending on the socioeconomic status and culture of the population, and

so we must take up the question of “ dangerous to whom? ” (54). Our discussion in this study is
focused more on people and not on the ecosystem, and even with this limited scope, there are multitudes of categories of people. We
will focus on the poorest 3 billion people living mostly in tropical rural areas, who are still relying on 18th-century
technologies for meeting basic needs such as cooking and heating. Their contribution to CO2 pollution is roughly 5% compared with
the 50% contribution by the wealthiest 1 billion (55). This bottom 3 billion population comprises mostly subsistent farmers, whose
livelihood will be severely impacted, if not destroyed, with a one- to five-year megadrought, heat waves, or heavy
rise in sea
floods; for those among the bottom 3 billion of the world’s population who are living in coastal areas, a 1- to 2-m
level (likely with a warming in excess of 3 °C) poses existential threat if they do not relocate or migrate.
It has been estimated that several hundred million people would be subject to famine with warming in excess
of 4 °C (54). However, there has essentially been no discussion on warming beyond 5 °C.
Climate change-induced species extinction is one major concern with warming of such large
magnitudes (>5 °C). The current rate of loss of species is ∼1,000-fold the historical rate, due largely to habitat destruction. At
this rate, about 25% of species are in danger of extinction in the coming decades (56). Global warming of 6 °C or more
(accompanied by increase in ocean acidity due to increased CO2) can act as a major force multiplier
and expose as much as 90% of species to the dangers of extinction (57).
The bodily harms combined with climate change-forced species destruction, biodiversity loss, and threats
to water and food security, as summarized recently (58), motivated us to categorize warming beyond 5
°C as unknown??, implying the possibility of existential threats . Fig. 2 displays these three risk categorizations
(vertical dashed lines).

Single-payer doesn’t solve costs---usage will increase and administrative costs will
stay high
Jodi Liu 17, associate policy researcher at RAND, “Savings from a Single-Payer Health System
Would Not Be Automatic,” 9/26/17, https://www.rand.org/blog/2017/09/savings-from-a-
single-payer-health-system-would-not.html
Discussion of single-payer health care systems increased somewhat last week with the introduction by Sen. Bernie Sanders (I-Vt.) of
his Medicare-for-all legislation. Polls have shown increasing public support for single payer. Yet there is no agreement on how to set
up and pay for a single-payer system in the U.S. or how much that system would cost. Advocates assert that a single-payer
system would cost less than the status quo, but the savings are not automatic , and how much it would save is far from
clear.
The spending required for a single-payer system depends on the price of care and the services used. When health care is
free, people tend to use more health care services, some of which is beneficial and some is not. Under Sanders's Medicare-for-all
plan, the use of health care services would almost certainly increase .
First, everyone would be covered, compared with the 28 million uninsured under current law. Second, Sanders's plan would cover
nearly 100 percent of health care costs, meaning that people would not be charged deductibles or copayments except for some
prescription drugs. While the Sanders plan involves nearly no cost sharing, nothing about a single payer precludes having some level
of cost sharing or other cost control strategies.
Single-payer advocates argue that prices will decrease by more than enough to offset the increased use of services. Several studies,
primarily by authors affiliated with the Physicians for a National Health Program, have compared administrative costs between the
U.S. and other countries and between public and private health insurance within the U.S.
Although administrative costs could be reduced by a considerable amount in a national single-payer program,
reaching levels achieved in other countries or even in some existing U.S. public programs —
serving segments of the population and often involving private contractors — may be aspirational and is not
guaranteed .
How much a single-payer system can cut administrative costs depends on how the plan is designed and implemented. Insurer
administrative costs are typically lower for public health insurance programs compared to private insurance.
But who would administer a single-payer plan that covers every U.S. resident? Even Medicare
now involves private insurers that administer Part C (Medicare Advantage), Part D (prescription drug coverage),
and supplemental plans (e.g., Medigap and employer-sponsored plans). It's difficult to imagine a scenario in which
private companies are not involved at least as third-party contractors .
In addition, some administrative costs such as for tax collection and fraud detection could
increase with an insurance program that covers the entire U.S. population . Health care
provider administrative costs may decrease to some extent, as billing procedures could be simplified and streamlined with a single
payer.
Any provider administrative savings may mean that providers would receive lower total reimbursement (payment for health care
services along with associated administrative expenses), in which case providers may need to restructure their administrative and
billing functions in order to maintain their bottom lines.
Reductions to provider reimbursement are possible but depend on negotiated levels and payment models. Prices could be set by the
government as the single payer, but would likely involve negotiations with provider and industry groups. Given the American
Medical Association's historical opposition to single-payer efforts and the influence of the health
insurance and pharmaceutical lobbying groups , it remains to be seen if the
government could successfully negotiate lower rates.
What happens if the administrative savings and reimbursement reductions are not enough to offset the increased use of health care
services? The
government could establish a cap on overall spending, but enforcement could be
an issue if costs are overrun . The benefits covered by the plan could be reduced, or cost sharing could be increased.
Or taxes could be increased to fund the program. But large tax increases could be a deal breaker: Vermont's single-payer effort failed
in 2014 with the governor's office citing high expected tax increases for individuals and businesses, and the recent legislation in
California stalled largely due to the lack of a financing plan.
To curb the potential of dramatic tax increases, a single-payer plan should include explicit approaches to address increased spending
due to greater use of health care by more people.
it's a mistake to assume that a single-payer health care system will automatically come with
In short,
cost savings. It might be easy to support the concept of single-payer, but serious consideration should be given to addressing
how to pay for the plan and control costs.

Economic insecurity doesn’t cause leadership ---best social science studies

Pippa Norris 16, McGuire Lecturer in Comparative Politics at Harvard Kennedy School and
Ronald F. Inglehart, Institute for Social Research at the University of Michigan, “Trump, Brexit,
and the Rise of Populism: Economic Have-Nots and Cultural Backlash”, Faculty Research
Working Paper Series, PDF
What systematic empirical evidence would support this argument? If the economic insecurity thesis
is correct, the logic predicts that mass support for populism should be observed to be
concentrated among economically marginalized sectors who are the main losers from global markets,
technological advances, and knowledge societies. Thus populist votes should be strongest among unskilled workers ,
the unemployed, those lacking college degrees, house-holds dependent on welfare benefits as their main source of income, and those living in inner-city
urban areas, such as in London, Paris, Amsterdam and Munich, which typically attract some of the highest concentrations of foreign-born residents.
Populist support should also be predicted by subjective feelings of economic insecurity , such as among
those reporting difficulties in making ends meet. ¶ Some previous systematic empirical evidence supports the
economic argument; for example, Lubbers, Gijsberts and Scheepers report that radical right support at individual-level in Western Europe
was significantly stronger among the unemployed, blue-collar workers, and less educated sectors, as well as among men. 42 Yet these were

individual not macro-level effects : for example, they did not find stronger voting for these
parties in nations with higher unemployment rates . 43 In a five-nation comparison, Niedermayer also found that white
collar employees and professionals are consistently underrepresented in the electorates of radical right parties, although he also demonstrated that the
proportion of blue-collar workers and those with low educational achievement varied substantially among different parties such as the Austrian FPÖ,
 previous research suggests
the German Republicans, and the Danish Progress Party. 44 At the same time, however,

several reasons to doubt the more mechanical version on the economic argument . Hence a decade ago one
study concluded that: “We should look skeptically upon the idea that the radical right is purely a
phenomenon of the politics of resentment among the ‘new social cleavage’ of low-skilled and low-qualified workers in inner-city areas, or that their rise
can be attributed in any mechanical fashion to growing levels of unemployment and job
insecurity in Europe. The social profile is more complex than popular stereotypes
suggest .”45 Mudde is equally doubtful about purelyeconomic explanations for the
rise of populism. 46 Moreover populist parties have also arisen in several of the most egalitarian
European societies, with cradle-to-grave welfare states, containing some of the best educated
and most secure populations in the world, exemplified by Sweden and Denmark .
 Pharma
The drug pipeline is full of innovative new medical treatments
AG 17---Analysis Group, economic consulting firm. 7/17/17, “The Biopharmaceutical Pipeline
Innovative Therapies in Clinical Development” http://www.phrma.org/report/the-
biopharmaceutical-pipeline
The biopharmaceutical pipeline contains thousands of significant and innovative new
treatments with the potential to address unmet medical needs, save lives and improve
patients’ health. A new report by the Analysis Group, “The Biopharmaceutical Pipeline: Innovative Therapies in Clinical
Development,” examines the state of the drug development pipeline and provides insights into new approaches researchers are
pursuing.
Key Findings:
74 percent of medicines in clinical development are potentially first-in-class medicines, meaning
they represent a possible new pharmacological class for treating a medical condition.
822 projects – defined as unique molecule-indication combinations – are designated by the U.S. Food and Drug Administration
(FDA) as orphan drugs, which is critically important given only 5 percent of rare diseases have an approved medicine.
A range of novel scientific approaches are being pursued, including cell and gene therapies ,
DNA and RNA therapeutics and conjugated monoclonal antibodies.

The aff causes political uncertainty and revenue decline for pharma companies---
that causes them to cut new RnD programs
David Epstein 17, executive partner at Flagship Pioneering. March 17. “The next horizon of
innovation for pharma” http://www.mckinsey.com/industries/pharmaceuticals-and-medical-
products/our-insights/the-next-horizon-of-innovation-for-pharma
You also have to look at the external environment and think about what could go wrong. We should always
worry when there’s political change . For instance, when payors—which is the government in most
parts of the world—come under economic pressure, changes in legislation could disrupt the
innovation process. If all of a sudden investors had no hope of being able to take their
companies public and make a good return, that money would dry up, as would innovation . If
pharma companies saw prices fall so far that their margins came under huge pressure, they
would cut costs and reduce R&D as well as other spending. Eventually there would be an industry shakeout,
and it would correct itself, but you’d have several years or longer where things slowed down or paused, and
that’s an ongoing risk .

ABR won’t get close to extinction, intervening actors solve it, their internal link
can’t
Ed Cara 17, science writer for The Atlantic, Newsweek, and Vocativ, 1/27/17, “The Attack Of
The Superbugs,” http://www.vocativ.com/394419/attack-of-the-superbugs/
A nti b iotic- r esistant infections kill at least 700,000 people worldwide a year right now, according to an exhaustive
report commissioned by the UK in 2014, and without any substantial medical breakthroughs or policy changes that slow down
resistance, they may claim some 10 million deaths annually by 2050 — eclipsing cancer in
general as a leading cause. These deaths largely won’t come from pan-resistant infections , just tougher ones.
A preventable death there, a preventable death here.
Leaving that aside, antibiotics, along with proper sanitation and nutrition, gird our entire way of living. Most every invasive surgery,
pregnancy, organ transplant and chemotherapy session we go through will become riskier. Other diseases like HIV, malaria or
influenza will become deadlier, since bacteria often exploit the opening in our immune system they leave behind. And already
precarious populations like those living with cystic fibrosis, prisoners, and the poor will lose years off their lives.
For all the warranted gloom, though, Farewell does think there are reasons to be hopeful. “I don’t think we are
doing enough, but the
scientific community along with many governmental and private foundations
are very actively involved in finding not only new antibiotics, but new solutions to this problem,” she
said. There’s been a noticeable change in attitude and increased urgency surrounding antibiotic resistance,
she said, one that she hadn’t seen even five years ago, let alone twenty.
Until recently, that attitude change could be seen from places as high up as the U.S. federal government. In 2014, former President
Obama issued an executive order aimed at addressing antibiotic resistance , the first real
acknowledgement of the problem from an administration, devoting funding and outlining a national action for combatting
resistance. Through its federal agencies, the administration pushed to reduce antibiotic use on farms and encouraged doctors to stop
using them in excess.
“There has been a lot of work done the last couple of years, much of it spurned by [Obama’s] National Action Plan,” said
Dr. David Hyun, a senior officer for Pew Charitable Trusts’ Antibiotic Resistance Project. The CDC, in particular, has used its
funding to open up regional labs that allow them to better detect and respond to antibiotic-resistant outbreaks like the Nevada case,
he said. They ultimately hope to create an expansive surveillance system that can easily keep track of resistance rates on a national,
state and regional level. A parallel system also exists for monitoring resistance in the food chain, shepherded by the CDC and the
U.S. Department of Agriculture.
In fact, it was this sort of cooperation between national and local health agencies that enabled Nevada
doctors to stop the worst from happening, said Dr. Lei Chen. The swift identification of a possible CRE strain by the
hospital, coupled with the woman’s medical history, led to a precautionary quarantine, while also prompting Chen’s public health
department and eventually the CDC into action. And it may help prevent future cases from spilling into
the public . According to Chen, the CDC has allocated funding this year to all of Nevada’s state public health departments so
they can better detect CRE and other dangerous resistant strains.
Under the Trump administration, there’s no telling how these small victories will hold up or whether they will advance. All
references to antibiotics once found on the Whitehouse.gov site have been removed, including a link to the Obama administration’s
national action plan, and the fact that they’re already tried to bar USDA scientists from discussing their work with the public while
stripping funding from other public health agencies isn’t encouraging.
Even with the best public policy , however, there’s no clear light at the end of the tunnel.
Antibiotic resistance has gradually been worsening, even within the last 15 to 20 years, when superbugs like
methicillin-resistant Staphylococcus aureus (MRSA) first became widely known, said Hyun. The effort needed to develop
new drugs has been in short supply, hamstrung by pharmaceutical companies’ inability to
recoup the costs of bringing new antibiotics to market. That’s because, unlike the latest heart medication, any
new antibiotics will have to be treated like the last drops of water during a drought, used as little as possible — the exact opposite
way to make money off a new product. Yet, much like climate change, the financial toll of not doing anything will total in the trillions
years down the road. And it already numbers in the billions now, according to the CDC.
Of course, we need bacteria to survive. And most need or pay no mind to us in return. Even pan-resistant bacteria don’t really mean
harm. Some have been found in perfectly healthy people, a fact that’ll either comfort you or keep you awake at night, only causing
no army of sentient E. coli that will rise up
problems when our immune system wavers. There’s

and someday overthrow the human race .

But barring the calvary showing up, a new fear of ours will learn to settle in, almost unnoticed. It’ll creep in when we pick our heads
up from a nasty fall that scrapes our skin open or breaks our bones; when we wave goodbye to our loved ones before they enter an
operating room, or when we cradle our newborns into a world teeming with the living infinitesimal, wishing there was still a way to
shield them from it as our parents once could for us. A fear of naked vulnerability.
The antibiotic apocalypse will be gentle , if it fully arrives, but it won’t be any less devastating to the
human spirit.

Trump makes disease response impossible---pandemics start internationally, and

we’re cutting funding for key prevention programs
Emily Baumgaertner 3/13, MPH, public health writer for the New York Times, “White House
Hails Success of Disease-Fighting Program, and Plans Deep Cuts,” 3/13/2018,
https://www.nytimes.com/2018/03/13/us/politics/trump-ebola-disease-cuts-global-health-
security-agenda.html?smid=tw-nytimes&smtyp=cur
But the United States is set to dramatically shrink its contributions to the initiative, a point that the
report omitted. The Centers for Disease Control and Prevention is preparing to narrow epidemic work from
49 countries to 10 , an agency spokeswoman said.
That has alarmed health policy experts.
“It’s
not a matter of if — but when — there will be another Ebola or Zika , and right now, the
world isn’t ready ,” said Dr. Thomas R. Frieden, who led the C.D.C. during the West African Ebola outbreak. “Many life-
threatening gaps have been identified, but most of them haven’t been closed.”
The Global Health Security Agenda first received almost $1 billion from a $5.4 billion emergency spending package in 2015 during
the Ebola outbreak that killed more than 11,000 people. Program directors had hoped that, after the five-year package expires in
October 2019, a comparable funding level would be added into the C.D.C.’s budget.
President Trump proposed an additional $59 million next fiscal year to make up for the loss of the emergency
spending in the C.D.C.’s Global Health Security Agenda activities. But that
amount would fall far short of the
emergency supplement, and even that sum would be drawn from other global health programs at the
agency.
Over all, Mr. Trump’s February budget proposal offered the C.D.C., the United States Agency for International
Development and the Defense Department’s health security programs about the same funding those agencies
received between 2006 and the Ebola crisis, “ objectively inadequate for the agencies’
activities ” since the outbreak, said Jennifer Kates, who studies global health policy at the Kaiser Family Foundation.
Without more funding, the C.D.C. would have to cut its health security fieldwork by 80 percent,
according to its plan reported by The Wall Street Journal. The new priority list would exclude nations like the
Democratic Republic of Congo, Haiti and Sierra Leone, where past outbreaks of diseases like
cholera and Ebola have rampaged .

No impact to failed states

Michael J. Mazarr 14, Professor of National Security Strategy at the National War College,
January/February 2014, “The Rise and Fall of the Failed-State Paradigm,”
http://www.foreignaffairs.com/articles/140347/michael-j-mazarr/the-rise-and-fall-of-the-
failed-state-paradigm
The threat posed by weak and fragile states, for example, turned out to be both less urgent and more
complex and diffuse than was originally suggested. Foreign Policy’s Failed States Index for 2013 is not exactly a roster of
national security priorities; of its top 20 weak states, very few (Afghanistan, Iraq, and Pakistan) boast geostrategic significance, and
they do so mostly because of their connection to terrorism. But even the threat of terrorism isn’t highly correlated
with the current roster of weak states; only one of the top 20, Sudan, appears on the State Department’s list of state
sponsors of terrorism, and most other weak states have only a marginal connection to terrorism at best .
A lack of definitional rigor posed a second problem. There has never been a coherent set of factors that define
failed states: As the political scientist Charles Call argued in a powerful 2008 corrective, the concept resulted in the
“agglomeration of diverse criteria” that worked to “throw a monolithic cloak over disparate problems that require tailored solutions.”
This basic methodological flaw would distort state-building missions for years, as outside powers forced generic, universal solutions
onto very distinct contexts.
The specified dangers were never unique to weak states, moreover, nor would state-building
campaigns necessarily have mitigated them. Take terrorism. The most effective terrorists tend to be
products of the middle class, often from nations such as Saudi Arabia, Germany, and the United Kingdom, not
impoverished citizens of failed states. And terrorist groups operating in weak states can shift their
bases of operations: if Afghanistan becomes too risky, they can uproot themselves and move to Somalia, Yemen, or even
Europe. As a result, “stabilizing” three or four sources of extremist violence would not render the
U nited S tates secure . The same could be said of threats such as organized crime, which finds comfortable
homes in functioning but troubled states in Asia, eastern Europe, and Latin America.
As the scholar Stewart Patrick noted in a 2006 examination of the purported threats issuing from weak states, “What is
striking is how little empirical evidence underpins these assertions and policy developments. Analysts and
policymakers alike have simply presumed the existence of a blanket connection between state weakness
and threats to the national security of developed countries and have begun to recommend and implement policy
responses.”
And although interconnectedness and interdependence may create risks, the dangers in such a world are more likely to
come from strong, well-governed states with imperfect regulations than weak ones with
governance deficiencies. Financial volatility that can shake the foundations of leading nations and cyberattacks that could
destabilize energy or information networks pose more immediate and persistent risks than, say, terrorism.
Government innovation solves the impact and private innovation fails – their ev is
corporate lobbying
Fran Quigley 16, Director of the Health and Human Rights Clinic at Indiana University
McKinney School of Law, JD from Indiana University, 8/5/2016, “The $100,000-Per-Year Pill:
How US Health Agencies Choose Pharma Over Patients”, http://www.truth-
out.org/news/item/37111-the-100-000-per-year-pill-how-us-health-agencies-choose-pharma-
over-patients
It turns out that the key role played by US funding in Xtandi's genesis story is a familiar one. Best estimates are that about 40
percent of pharmaceutical research and development costs are shouldered by governments and
private philanthropy, not the private corporations who end up holding the patents. The public
investment is way higher than suggested by pharmaceutical industry rhetoric, which tends to skip
over the fact that its companies spend more on marketing than on research.¶ Even the 40 percent
figure understates the key role played by government investments in medicine research, which
are heavily weighted at the front end of the process -- the basic research that is essential to
identifying how a disease may be vulnerable to attack by medicines. ¶ Since that early-stage
research is also time-consuming and several steps removed from a finished product that is ready
for sale, it is an unappealing investment for a for-profit drug corporation. So those corporations turn to governments, especially
the US National Institutes of Health (NIH), to handle this most risky part of medicine research. The NIH annual budget for medical
research is now $30 billion per year.¶ For the most valuable medicines, governments play a particularly crucial role.
Pharmaceutical corporations' research is inevitably focused on the search for the next big-selling
product. That product often targets less critical health needs (think erectile dysfunction or cosmetic
drugs) or is a "me too" drug, a non-innovative medicine aimed at carving out a piece of an existing lucrative market. So the NIH and
other government funders lead the way in discovering the most impactful medicines. A study of drugs receiving the priority review
status from the US Food and Drug Administration, meaning that the medicines would provide a significant improvement in
treatment, showed that two-thirds of them traced their roots back to government-funded research. ¶ Even the impressive results of
such studies understate the impact of governments on drug research. The studies only looked at direct government research funding,
which does not account for the significant indirect support given pharmaceutical industry research by way of tax credits that can
reach as high as 50 percent. Once direct government support and generous tax breaks are added to the equation, some analysts
calculate that private industry only pays for a third of US biomedical research -- and much of that
industry contribution is focused on drugs like erectile dysfunction medicines or cosmetic
treatments, whose chief value is profit, not better health.¶ There are many examples of lifesaving
medicines that exist only because of government research. The cancer drug paclitaxel was
developed with research funded by the National Cancer Institute , a division of the NIH. Government
funding played the critical role in the breakthrough development of the antiretroviral AZT and
the highly effective leukemia drug imatinib. The same is true for major mental health medicines and many
vaccines. There is every reason to believe that the reliance on federal funding for the most critical drugs will continue, given the
decreasing success of pharmaceutical companies in early-stage research and the much-discussed plans for a US-government-funded
$1 billion cancer "moonshot."¶ "Those Rights Are Legally Worthless"¶ Big Pharma wasn't always the beneficiary of US government-
funded medicine breakthroughs. Until the 1980s, the rights to those discoveries were either owned by the federal agency that
supported them or placed in the public domain. The idea was that patients could affordably access the medicines and other
researchers could build on the discoveries. But then the Patents and Trademark Amendments Act, eventually known as the Bayh-
Dole Act, was passed into law. Bayh-Dole allowed universities and small companies who receive federal research funding to claim
patents for the discoveries that came out of that research. ¶ After the law went into effect in 1981, universities and teaching hospitals
wasted no time beating a path to the patent office. In the first five years under Bayh-Dole, their human biology patent applications
increased 300 percent. Universities quickly began forming partnerships with small biotech companies, and ultimately with large
pharmaceutical corporations. If the risky government-funded research bears fruit, those corporations have proven to be happy to
buy the exclusive patent rights to the discoveries -- and the monopoly pricing powers that go with them. ¶ As a result, Bayh-Dole
changed the way medicine research was conducted. The consulting firm Bain recently conducted a study that showed that top
pharmaceutical corporations were earning more than 70 percent of their revenue from medicines that were developed by someone
else. That was the path Xtandi followed, going from UCLA labs to Medivation and then across the Pacific to Astellas, with NIH and
the Department of Defense (DOD) funding the trip. ¶ The text of the Bayh-Dole Act, however, suggests that US taxpayers and patients
should be protected from being asked to pay for both the medicine research and the monopoly-protected purchase price. To prevent
this kind of double billing, Bayh-Dole contains two safeguards. The first is called "march-in" rights, allowing the federal agency that
funded the research to issue a license to a generic manufacturer. The agency can exercise this right if the patent-holder is not making
the federally-supported drug "available to the public on reasonable terms." The second safeguard is a royalty-free license to the US
government, which allows the government to manufacture the patented invention itself or license someone else to do so, without
paying any fee to the patent-holder, as long as the product is for government use. As an example of this second option, the US could
allow generic manufacturing of a drug like Xtandi for use in the Medicare, Medicaid and Veterans' Administration health programs. ¶
The impact of these safeguards should be enormous: generic costs for medicines average over 80 percent less than patent prices.
There is only one problem. In the 35 years since Bayh-Dole's passage, federal agencies have not once used these rights to address the
cost of medicines. Over the years, a half-dozen requests have been made to the National Institutes of Health to license generic
manufacturing of drugs it paid to develop, including HIV/AIDS, leukemia, and glaucoma treatments. Each time, the agency refused
to do so.¶ Most of those requests to the NIH cited the high prices of federally supported medicines. But one request was based solely
on the fact that the medicine in question -- a key treatment for the rare Fabry's disease -- was not being manufactured in sufficient
supply by the patent-holder Genzyme. The medicine Fabrazyme was developed by the Mt. Sinai School of Medicine with NIH
funding. Yet, at the time US Fabry's patients filed their petition in 2010, they were being rationed at only 30 percent of the
recommended dose and newly diagnosed patients were being denied the drug altogether. The petition to the NIH asked for the
agency to exercise its Bayh-Dole march-in rights, licensing another manufacturer to make the drug and give a 5 percent royalty to
the patent-holder.¶ The patients' request was drafted by Pennsylvania attorney and law professor Allen Black, who filed the petition
on behalf of two friends who had Fabry's. Black thought that Bayh-Dole clearly called for the NIH to step in, especially since the drug
developed by US funds was fully available to European patients even while US patients were being turned away. But the NIH refused
to act, suggesting that a different manufacturer would not get up to speed quickly enough to address the problem. ¶ One of the two
original Fabrazyme petitioners has since died. To Black, if the NIH refused to act in the Fabry's case, it has no intention of ever using
Bayh-Dole to license generic drug manufacturing. "At this point, we know that those rights are legally worthless," he says. ¶ "The
Question Is: How Stupid Is the Government?"¶ The public and political attention to skyrocketing drug prices continues to build. An
AARP survey taken earlier this year showed that 81 percent of respondents aged 50-plus think drug prices are too high and over 90
percent want politicians to take action about it. Both Hillary Clinton and Donald Trump have sharply criticized drug makers and
vowed to push for Medicare drug price negotiation. With this increased frustration has come renewed attention to the government
powers reserved by Bayh-Dole. In January, 51 members of Congress wrote a letter to Francis Collins, director of the NIH, and Sylvia
Burwell, secretary of the Department of Health and Human Services (HHS), urging them to use their Bayh-Dole rights to address
the drug pricing crisis, and scolding the NIH for denying all previous requests. "The failure to act in the past has undoubtedly sent
an unfortunate signal that prices for federally-funded inventions can be set as high as a sick or dying consumer will pay," they
wrote.¶ A few days after the Congressional letter was sent, the advocacy groups Knowledge Ecology International (KEI) and the
Union for Affordable Cancer Treatment filed a request with the NIH, the HHS and the DOD, asking the agencies to license generic
manufacturing of Xtandi. The petition cited those agencies' extensive roles in funding the development of the drug, Xtandi's
significantly higher price in the US compared to similar nations, and the health risks endured by the US prostate cancer patients
facing Xtandi co-pay and insurance coverage barriers. Three months later, a Canadian manufacturer of generic cancer drugs
contacted the federal agencies, promising the ability to produce a generic version of Xtandi for $3 a pill, just 4 percent of the cost
Medicare pays for the patented version. "In this case, all the federal government has to say is that the monopoly will end if the prices
are excessive," said James Love, director of KEI and a longtime advocate for affordable medicines. ¶ Once again, the NIH flatly
rejected the petition with a four-paragraph letter from Collins refusing to step in. The letter never referenced Xtandi's cost and
stated only that the drug was physically available. HHS Secretary Burwell just as quickly declined a Congressional request to
formally set standards for exercising Bayh-Dole rights, and also rejected Congressman Lloyd Doggett's call for a public hearing on
the Xtandi petition.¶ Those decisions have brought the health agencies some unwanted scrutiny over their relationship with the
industry that benefits so handsomely from the lack of federal intervention. ¶ The pharmaceutical companies' outsize
influence in Congress is well-known -- the industry is the world's most prolific spender on both
lobbying and campaign contributions, and has a small army of 1,369 lobbyists working in Washington, D.C., alone. As
Senator Richard Durbin said as far back as 2002, two years before the industry managed to block Medicare from negotiating drug
prices, Big Pharma " has a death grip on Congress ."¶ But the top US health agencies also have their own close
ties to the industry. Pharma and the federal departments share a well-documented revolving door
of key staff. The Foundation of the NIH is managed by a board of directors stocked with pharmaceutical industry executives and
lobbyists. In April, when NIH director Collins was asked by Senator Durbin at a Senate hearing why he refused to exercise Bayh-
Dole licensing rights, Collins replied that he feared doing so would harm the agency's relationship with the drug companies. The
NIH also awards private companies exclusive licenses to some drugs it discovers in-house, and its process for doing so has been
criticized as non-transparent and overly solicitous of corporate priorities. In one public statement that may have been more
revealing than intended, a spokesperson for a brand-new company that received one of the licenses called his CEO's relationship
with an NIH official an "asset."
2NC
Innovation
 UQ
New data analytics and machine learning allow faster and more innovation---
prefer predictive evidence
Julian Mitchell 17, Entrepreneur, Forbes Contributor. 8/19/17, “This Biotech Startup Is Using
AI To Help Researchers Develop Cures Quicker”
https://www.forbes.com/sites/julianmitchell/2017/08/19/this-biotech-startup-is-using-ai-to-
help-researchers-develop-cures-quicker/#649b2bf08be3
The increased use of a rtificial i ntelligence and machine learning is steadily shifting the
paradigm of medical research and treatment, providing researchers real-time access to every
white paper and clinical case study conducted on a genetic disorder. Being able to develop such an
elaborate database of information allows researchers to not only understand the full scope of a
medical condition, but further shorten the amount of time it takes to develop a cure .
Founded in 2011, Innoplexus is a technology and product development company focused on solving complex challenges in the
pharmaceutical and life sciences industries. Their end-to-end platform for Life Sciences research uses artificial
intelligence to generate smart data and insights to assist in the discovery, clinical development
and regulatory compliance of pharmaceutical medicine.
On a mission to create self-service products that help enhance decision-making, their platform compiles hundreds of terabytes worth
of scientific information spread across clinical trial databases, biological databases, major patent offices, forums and regulatory
bodies.
In addition to strengthening research efforts, Innoplexus works to help life science and healthcare organizations leverage these
technologies to improve care. Whether a drug developer is seeking existing research, a medical researcher is searching for alternative
treatments, or a practitioner is attempting to find data on a particular disease -- increasing access to relevant
information removes roadblocks to discovery and fuels rapid growth.
I spoke with Co-Founder Guarav Tripathi about the vision behind Innoplexus, disrupting the medical research industry, and how
artificial intelligence is defining the future of modern medicine.
What was the specific void or opportunity you saw that inspired the idea behind Innoplexus?
Gaurav Tripathi: Most of the information the life sciences industry relied on was based on an outdated data and analytics consulting
model. Essentially, data was collected and curated manually, and then sold at high premium to clients. This kind of information may
be helpful in some industries, but when it comes to research-heavy fields like pharmaceutical development and medical research,
experts need more current and comprehensive data assets. Our response was to bring an automated Data as a Service (DaaS) model,
which makes the data available seamlessly in rea- time. We also built an Analytics as a Service model to deliver continuous and
custom insights for the industry in a way that was previously unattainable. Such insights that make data more useful for supporting
decisions were not available on a continual basis. Where they were available, it was often in time-consuming batches that required
immense amounts of manual effort. Since industries pertaining to our health move at a fast pace, the speed at which you can access
and analyze data is critical.
How is your company actively shifting the paradigm of medical research and treatment?
Gaurav Tripathi: Researchers are limited to what they know, what they can test, and the information
stored on whatever data platform they have access to. The wealth of medical, research, and
patient data is often unreachable for them, or it’s spread across tens, if not hundreds of sources .
Our goal is to democratize that information, bringing all of that information from thousands of sources into
one easy to use platform, leveraging the latest in A.I. and machine learning technologies to
give life sciences professionals access to information that will help them achieve their goals
faster and at a lower cost. This isn’t limited to just research either. Doctors and other health professionals equipped with
more data might identify diseases and treatments faster by tapping into their colleague’s experience and findings. When
professionals in these industries are empowered with better data, innovation will happen at a much quicker pace .

Vaccine innovation is bringing new medicine to market more quickly and

efficiently
Bruce Carlson 16, Genetic Engineering And Biotech News contributor. 5/23/16, “For
Struggling Pharma Market, Vaccines Offer Path to Revenue”
http://www.genengnews.com/market-and-technology-analysis/for-struggling-pharma-market-
vaccines-offer-path-to-revenue/77900658
Vaccines Innovations
Innovations in vaccines are focused on new disease targets and new development strategies.
Vaccine development is a complex, expensive, and time-consuming process, typically costing $500
million or more and spanning several years. Some projects take considerably longer. For example, Sanofi Pasteur reportedly spent
$1.7 billion and 20 years developing the Dengvaxia® vaccine for dengue fever. Furthermore, many worthwhile projects are
terminated for reasons related to commercial viability. Several leading companies have established novel
collaborations to shorten development times and bring much-needed new products
to market more quickly and effectively. In one of these collaborations, Sanofi Pasteur, the Bill & Melinda Gates
Foundation, and the Infectious Disease Research Institute (IDRI) partnered to create the Global Health Vaccine Center of
Innovation (GHVCI), with a mission to create a new, cheaper model for vaccines development.
The challenge to develop needle-free vaccines has been taken up by researchers worldwide, and it is likely that within the forecast
period of this report, at least one new delivery system will be introduced commercially. Edible vaccines, mucosally delivered
vaccines, intranasal vaccines, vaccine patches, and vaccine chips are all under development, with the latter expected to be
commercialized within the next several years. Chips are an especially novel method of vaccine administration, having been
pioneered by scientists at several universities.
Production techniques are an important but overlooked area of vaccine development, because
improvements in production methods can significantly impact both speed to market and cost.
Tobacco plants, insects, and nanoparticle systems all offer a means to produce vaccines more
quickly and cost effectively than using chicken eggs. Of these, tobacco plants offer the greatest
immediate potential, with production scale-up expected within the forecast period of this report.

New market opportunities spur vaccine innovation

Bruce Carlson 16, Genetic Engineering And Biotech News contributor. 5/23/16, “For
Struggling Pharma Market, Vaccines Offer Path to Revenue”
http://www.genengnews.com/market-and-technology-analysis/for-struggling-pharma-market-
vaccines-offer-path-to-revenue/77900658
The revenue growth opportunity in vaccines looks far more promising when compared to the
overall market for pharmaceuticals. Revenues earned by vaccines manufacturers worldwide
reached $27.6 billion in 2015 according to Kalorama Information, up 11% from $24.7 billion in
2014, as sales in all segments expanded (Figure 1). This is, by Kalorama’s estimate, at least five to ten times the
revenue growth rate of the overall pharmaceutical market in recent years. The world vaccines market is predicted to
increase at a compound annual rate of 7.6% during 2013–2022, reaching $45.1 billion in 2022 as new
product introductions continue and usage of current products expands further.
Figure 2. Market share in vaccines
The vaccines market is generally categorized by pediatric and adult vaccines. Pediatric vaccines constitute the base market for
vaccines and the larger market, accounting for 57.6% of the total vaccines market. Adult immunization is an important, but
frequently overlooked, part of patient care.
Vaccination programs typically focus on children, yet adults in industrialized countries are more likely to die as a result of vaccine-
preventable diseases than are children. Vaccination protects not only individuals, but also entire
communities from diseases spread by person-to-person transmission. For example, vaccination
can prevent about 50% of deaths from pneumococcal disease and 80% of deaths from influenza-
related complications in the elderly. Pharmacoeconomic studies have demonstrated the value of influenza and
pneumococcal vaccines; however, immunization rates for these diseases continue to be low in the elderly populations.
Immunizations by public providers are generally paid for through federal and state government funding under public health
programs. These programs are intended to reduce barriers to immunization and to improve immunization rates by providing free
vaccines to qualifying infants and children.
Because of the complexity of vaccines, a barrier entry to market provides a shelter for a few companies that can handle the order
production, deal with production facilities and material vendors, and conduct efficient operations and distribution. The world
vaccines market is dominated by four major competitors: Sanofi Pasteur, GlaxoSmithKline, Merck & Co., and Pfizer. Pfizer and
Merck hold 45% of the market (Figure 2). As the market leader in 2015, Pfizer’s vaccine sales exceeded $6.4 billion
on strong growth of its Prevnar family, giving the company 23.3% of the market. Pfizer was followed by Merck with $5.9 billion.
Sanofi and Glaxo comprise the next category of market leaders, with the remaining share split by those companies and a dozen
others.
 Link

NHI creates uncertainty that stops venture capitalists from investing in medical
tech
Ray Leach 11, CEO of Jumpstart, expert in technology entrepreneurship. 10/17/11, “Medical
Technology: How Regulations, Reforms Threaten To Stifle U.S. Healthcare Innovation”
http://www.huffingtonpost.com/ray-leach/medical-technology-how-re_b_1015689.html
Regulatory burdens and healthcare reform are causing big uncertainties for venture capital
investors . That could limit the ability of young drug and medical device companies to bring
products already in the pipeline to market, thwarting billions of dollars of investment. It also
could stop promising drugs, therapies, and devices from being developed for patients who
really need them.
From my perspective, lack of new healthcare investment could limit the economic impact and jobs created by entrepreneurs. In
regions like Greater Cleveland, where a growing medical economy is powered by assets like the Cleveland Clinic and University
Hospitals, and where my own nonprofit venture development organization regularly supports biotech and
biomedical device entrepreneurs, this limitation could have devastating effects.
Consequently, the U nited S tates as a whole could lose its global lead in medical innovation , job
creation, and access to life-giving treatments for the first time in decades. Patients, workers, and
the national economy would suffer.
Here are a few of the factors impacting healthcare investing:
• FDA burden: According to a Vital Signs survey of more than 150 venture firms by the National Venture Capital Association’s
MedIC Coalition, U.S. Food and Drug Administration (FDA), regulation was cited as the top reason for a recent pull-back in
healthcare investing. I serve on the NVCA board and this pull-back was a major topic of discussion during our early October board
meeting, with conversation centering on the cost, time, and unpredictability the FDA’s current approval process can add to the
development of innovative products.
While the coalition found that a little over one-third of firms expect to cut their biopharmaceutical and medical device investing
(both regulated by the FDA), they expect to boost their investment in non-FDA regulated healthcare services and health information
technology companies. Meanwhile, other U.S. venture capital firms are putting more of their healthcare dollars in Europe and Asia,
where regulatory and product development costs are lower. Investors and their portfolio companies can show clinical and economic
efficacy of their treatments more quickly offshore. Overseas, “that means companies earn revenue — and investors realize returns —
sooner,” explains Mike Bunker, managing director at Early Stage Partners, a Northeast Ohio-based venture capital firm.
The good news is that the FDA seems aware of the risks of falling investment in U.S. healthcare companies. The agency already has
proposed, among other steps, to streamline and reform regulation to remove its process as a barrier to innovation. Still, more must
be done to improve predictability, clarity and transparency during the approval process in order to ease investors’ concerns and
ensure that America keeps its competitive edge in medical technology.
• Investment challenges: “FDA regulatory costs are only half the reason why investors have shied away from healthcare,” says Baiju
Shah, CEO of BioEnterprise, a JumpStart partner and Cleveland-based bioscience company developer. “There is an ongoing
contraction in venture capital available to later-stage companies.”
As institutional investors allocate fewer dollars to venture capital overall, many find themselves over-allocated in healthcare. So
when VC firms ask for new healthcare dollars, the investors say there aren’t any more. “The problem we all are facing is finding
alternative sources of capital,” adds Shah.
• Healthcare reform: In theory, healthcare reform should expand U.S. markets for innovative healthcare products and
services by providing insurance coverage — and new buying power — to the uninsured. An aging population also should fuel
healthcare markets. But investors are worried that potential cost controls and lower Medicaid and
Medicare reimbursements imposed by reforms could limit medical innovation and their
returns. Some investors are steering clear of healthcare companies except those that provide services for which government
reimbursements are not a factor.
 AT: Payment Switch
Providers say no---consolidation gives them leverage to refuse contracts that
incentivize quality
Douglas Singleterry 17, attorney who specializes in healthcare litigation and is co-author of
New Jersey Uniform Commercial Code, “Healthcare debate must confront industry
monopolization,” Mar 31 2017, http://thehill.com/blogs/pundits-blog/healthcare/326702-
healthcare-debate-must-confront-industry-monopolization
Some contend that alternative payment models, such as accountable care organizations (ACOs), contribute to industry consolidation. Since passage of the Affordable Care Act
both Medicare and private insurers have shifted towards payment reforms (replacing the
(ACA),

fee-for-service) that use performance based incentives to hold health care providers
traditional

accountable both for cost and quality of care.¶ ACOs coordinate a patient’s care across a network of
providers. A global budget is set for an entire patient population , with incentives to control spending and improve
healthcare outcomes. Approximately 30 percent of Medicare payments are now tied to value based incentives. But these reforms have prompted concern that providers would
consolidate in order to absorb the financial risks they pose. ¶ However, according to a new study published by Health Affairs there is little
evidence that health providers are consolidating to support ACOs. The study found no discernible differences in the pace of consolidation in markets with ACOs compared to
other healthcare markets. While participating physician groups did experience an increase in size, this was due to the addition of specialists and not directly related to ACOs.

suggest that some consolidation might be a

Moreover, consolidation trends were already underway prior to the ACA. ¶ The study does

“defensive reaction” to payment reform. In other words, facilitated to resist entering into such
arrangements. Interestingly, most of the Medicare savings from ACOs derives from independent
physician groups, not from larger health systems that have been less successful in controlling costs.¶ As the Harvard researchers
explain “Organizations that own hospitals and specialty practices have weaker incentives than those

that do not to limit use of inpatient and specialty care under ACO contracts, and evidence from Medicare and commercial
ACO initiatives suggests that providers can influence the use of care in multiple settings without formal ownership arrangements [i.e. consolidation] that unite providers.”

Profit motive means consolidated providers game the aff’s payment system---
causes high costs and low quality
Phillip Longman 11, senior editor at the Washington Monthly and the policy director at the
Open Markets Institute, “The Cure,” Washington Monthly, November/December 2011,
https://washingtonmonthly.com/magazine/novdec-2011/the-cure/
But not to worry, say defenders of “Obamacare”; we’ve got a plan to speed up those reforms. The ACA contains billions of dollars to incentivize the
creation of “accountable care organizations.” Just what are they? It’s hard to say, since the language of the bill on this subject is so vague. An essential
feature, though, is that an ACO is an institution that contracts with Medicare to serve a specific population and promises to
deliver specific quality metrics, such as keeping infection rates down or offering primary care services to patients. In return, it receives
the right to retain a large share of any resulting savings.¶ So far, ACO pilot programs have proved disappointing,

producing little if any savings. And there are good reasons to believe that most ACOs will never
deliver the quality and cost-effectiveness of truly integrated nonprofit health care
systems like the Mayo Clinic or the VA. Under newly minted regulations, there is nothing to prevent ACOs from being just loose
networks of colluding, profit-driven, fee-for-service providers who go through the
motions of pursuing quality. Even stalwart defenders of ACOs now acknowledge their large potential for abuse. As Donald Berwick,
administrator for the Centers of Medicare and Medicaid Services, recently told a forum at the Brookings Institution, “There will be parties out there
who want to repackage what they do and call it an ACO.” ¶ Berwick went on to warn, as have many others, that many ACOs are
likely to be
effective monopolies in their local markets, given the massive consolidation already going on in
the health care industry. This means they will be tempted to abuse their market power by, for
example, raising their rates for non-Medicare patients. This “would ultimately undermine any short-term savings
achieved by Medicare,” notes Merrill Goozner of the Fiscal Times, “since increases in a region’s top line health care tab would eventually force Medicare
to raise its own rates.”

Performance incentives crowd out intrinsic motivation---crushes overall quality

Erik A. Berg 16, MD, LAC+USC Medical Center, and Jesse Schafer, MD, Beth Israel Deaconess
Medical Center/Harvard Medical School, “Reforming Fee-for-Service — Pay-for-Performance,”
Chapter 8 in Emergency Medicine Advocacy Handbook, 4th Edition, p. 44,
https://www.emra.org/globalassets/emra/publications/books/2016advocacyhandbook-
online.pdf
• Motivation¶ Assuming there were better metrics, it seems like paying physicians based on their
performance on these measures should be able change their behavior to produce better clinical results.
However, behavioral science literature challenges the notion that financial incentives can
improve performance on cognitively complex tasks (eg, clinical medicine).10 Tackling
complex tasks seems to require sources of intrinsic motivation — such as purpose, mastery, or altruism
— that are common among physicians .11 When financial rewards are applied to complex tasks ,
however, these financial incentives can actually undermine, or “crowd out,” intrinsic
motivation .12 So rewarding physicians based on particular performance measures risks
sapping their intrinsic motivation to provide high-quality care in general rather than on
just a few activities being measured .
 ABR
ABR is gradual, slow, and will be addressed---reject scary-sounding headlines and
assertions that ‘this time is different’
Drew Smith 16, former R&D director at MicroPhage and SomaLogic, 6/14/16, “The Myth Of
The Post-Antibiotic Era,” https://www.forbes.com/sites/quora/2016/06/14/the-myth-of-the-
post-antibiotic-era/#db027696fa83
Right now, drug resistant infections are mainly a threat to those that are already sick and/or in medical
facilities. But, if we continue down this path, mundane infections in the otherwise healthy could someday
morph into life-threatening ordeals, and simple medical procedures and surgeries may be skipped to avoid risk of
infection.
However, while this threat is real, it’s important to keep in mind that this is an ongoing, gradual challenge ;
it’s extremely unlikely that a single event will herald with complete certainty the abrupt end of
modern medicine as we know it. In this context, those scary headlines are inappropriate , if not numbing
and counterproductive.
In May, Ars wrote about some alarmist and inaccurate news stories dealing with a newly identified type of
drug resistance—one that makes bacteria resistant to a last-resort antibiotic called colistin and can spread between bacteria
easily. The headlines blared that it was the “first” time such a dastardly microbe had seeped into the
US—which is not true. And they suggested that it would certainly mark the end of antibiotics—
also not true.
This week, scientists provided updates on tracking that type of resistance, and of course some
alarmist headlines followed . Yet, the new data actually suggests that a tempering of concerns
about this particular resistance may be in order. It turns out that this “dreaded,” "scary," “nightmare” of a drug-resistant microbe
has been in the US for more than a year and elsewhere in the world since as far back as 2005—it’s just that nobody noticed it. And
nobody noticed it because so far it hasn’t been the dreaded, scary nightmare some have feared.
“ It’s not a huge cause for concern ,” Mariana Castanheira, lead author of one of this week's resistance updates,
told Ars. Castanheira is the director for Molecular and Microbiology at JMI Laboratories, a private company that monitors drug
resistance microbes in hospitals and medical settings. They and others are finding this new type of resistance now simply because
they’re looking for it, she said.
Castanheira explains that people initially started digging for this new type of drug resistance —a gene called
mcr-1—out of concern that it makes bacteria resistant to the antibiotic colistin, which is a relatively toxic drug
used only when nearly all others have failed against a multi-drug resistant infection. Bacteria
have shown up with
colistin resistance before—in fact, many times in the US and elsewhere around the world. But in those cases, the genes were
embedded in the bacteria’s chromosomes and generally passed down through generations. The mcr-1 resistance gene, on the other
hand, seems to always sit on a plasmid, a small loop of DNA that bacteria can readily pass around to neighbors. If colistin-
resistant bacteria shared their mcr-1 plasmid with others that are already resistant to lots of
antibiotics, they could create a long-feared invincible germ—a “pan-resistant” bacteria.
"Doesn't scare me"
So far that doesn’t seem to be happening , though, Castanheira said. In more than a decade of
skulking around, mcr-1 has made its way into bacteria in animals, people, and soil all over the world. Yet, all of the mcr-1
carrying microbes examined have been susceptible to at least one antibiotic—and often
several .

Dragon blood solves ABR now

Chris Tognotti 17, writer for The Daily Dot, 2/26/17, “Study finds Komodo dragon blood could
hold a key to combating human antibiotic resistance,”
https://www.dailydot.com/parsec/komodo-dragon-blood-antibiotic-resistance/
New research into Komodo dragons published earlier this month shows that elements in their blood
might be hugely consequential for the health and wellness of human beings.
Komodo dragons are impressive and somewhat intimidating creatures, and people should be wary if they ever get to see one up
close. But, according to new research published in the Journal of Proteome Research, there may be a vital secret hidden in the giant
lizards’ blood that could be of enormous benefit to humankind, if science manages to fully harness it.
According to the study’s abstract, Komodo dragons (scientific name Varanus komodoensis) are the “largest living lizards and
are the apex predators in their environs,” and they and possess
innate advantages when it comes to staving off
infection. Whether contending with the various infectious bacteria that exist in their saliva or from bite wounds inflicted by other
dragons, they’re extremely resistant to bacteria.
Researchers are intrigued by this, because improved resistance to bacterial infection is a quality that would
benefit countless people

around the world. Especially considering that years of antibiotics overuse has begun to lessen their
efficacy, a looming public health crisis that medical researchers have been warning about for decades.
In 2014, in fact, President Obama signed an executive order specifically geared toward combating the
rise of antibiotic- resistant disease. The stakes are high, given just how much of modern medicine is dependent on
snuffing out potentially debilitating infections through the use of antibiotics.
According to this latest research, Komodo dragon blood might help in that effort. That’s because it contains many
different cationic antimicrobial peptides, chains of amino acids that help the giant lizards stave
off infection, some of which have never previously been studied before. And, as George Mason University professor Barney
Bishop (the lead author of the study) told Motherboard’s Farnia Fekri, this could have implications for future drug
development. Said Bishop:
The peptides may themselves become drugs down the pipe. Or they could provide models and
templates for the development of drugs. This has many potential medical applications .

New breakthrough in protein-based antibiotics will solve ABR now---enables

highly targeted antibiotics that don’t create resistance
Richard James 15, emeritus professor at the school of life sciences, University of Nottingham,
and a former director of the centre for healthcare associated infections, 11/20/15, “I believed we
would face an antibiotics apocalypse - until now,”
https://www.theguardian.com/commentisfree/2015/nov/20/antibiotics-apocalypse-research-
resistance-threat-breakthrough
Official recognition of the scale of the problem at least increases the prospects of
developing workable solutions that may prevent our current direction of travel. To illustrate
what a world without antibiotics would look like, I have a photograph from the pre-antibiotic era in London, in 1932 – it shows
children being treated for tuberculosis in three rows of beds outside a building. In those days whether you lived or died was sheer
luck – the only treatment was fresh air.
The huge importance of antibiotics within healthcare globally cannot be overstated. A US study in 1999 calculated that the
introduction of antibiotics in 1936 caused deaths in the US to fall by 220 per 100,000 within 15 years. All other medical technologies
combined over the next 45 years reduced deaths by only 20 per 100,000 people. The euphoria over the healthcare benefits of
antibiotics was encapsulated in 1960, when the US surgeon general announced that “infectious disease is conquered”.
So why has this optimism given way to the apocalyptic scenarios that are now commonly expressed? About 25,000 patients a year
die in the European Union from an infection caused by a bacterium that is resistant to more than one antibiotic – and on current
trends this is predicted to grow to 390,000 a year by 2050.
The use of antibiotics exerts a Darwinian selection pressure for acquisition of resistance by the target bacteria, and resistance arising
anywhere in the microbial world can ultimately be transferred to disease-causing bacteria. In addition, the antibiotic discovery
process is now in terminal decline. The golden age of antibiotics took place in the 1930s to 1970s, with at least 11 new classes
discovered; since then there have been only two new classes of antibiotics.
Many antibiotics today are “broad spectrum” – they kill a broad range of bacterial species. The
unfortunate side effect is that, alongwith the disease-causing bacteria, many other bacteria in the
patient’s intestines are also killed. This puts the treated patient at risk of acquiring a serious
infection such as C difficile. And there are billions of bacterial cells living in our intestines that have very beneficial effects: killing
them is not a rational thing to do.
Correctly prescribed antibiotic therapy is of obvious value to the health of the patient but this comes at a cost to society, due to the
antibiotic resistance that potentially puts everyone else at higher risk. Because of this antibiotics are a critically needed,
shared societal resource whose true value is not, at present, reflected in their price, especially compared
with, say, anti-cancer drugs.
There is thus a need to improve the economic incentives for the development of antibiotics . The
Infectious Disease Society of America has proposed a fee levied against the wholesale price of all antibiotics that would help to fund
development. This is the equivalent of a toll charge to pay for public roads.
The 2015 Review on Antimicrobial Resistance called for an innovation fund of $2bn over five years, funded by the pharmaceutical
industry. The fund would guarantee a return on private companies’ investment if they produced an antibiotic that filled an unmet
need. This proposal is aimed to achieve the development of 15 new antibiotics in a decade and, unlike the IDSA model, recognises
that antibiotic resistance requires a global solution.
But these both assume resistance is largely an economic problem, and therefore significantly underestimate the scientific difficulty
of developing new antibiotics.
Until last month I was still pessimistic about our chances of avoiding the antibiotics
nightmare. But that changed when I attended a workshop in Beijing on a new approach to antibiotic
development based on bacteriocins – protein antibiotics produced by bacteria to kill closely
related species, and exquisitely narrow-spectrum .
My research over 37 years involved the study of a number of bacteriocins that can kill a range of clinically
important bacteria. I – and many other researchers – did not believe they could be useful clinically because injecting a
“foreign” bacterial protein into a patient is likely to induce a severe immune response that would make the antibiotic inactive. There
were therefore gasps of amazement in Beijing at data presented from several animal studies showing this was not the case.
If you consider a killing domain as a red Lego brick and a targeting domain as a yellow Lego brick, you can make hundreds
of different hybrid proteins consisting of one red and one yellow brick to make what I refer to as a series of novel
bacteriocin-derived antibiotics (BDAs). In fact, several BDAs have already been designed to kill target bacteria,
fungi and even tumour cells.
The ability to use the BDA system to continually make novel antibiotics significantly
de-risks the development of antibiotics process and in my opinion offers a significant ray
of hope in the present gloom. It is now for governments and health organisations to make sure they make the most of
this unexpected breakthrough.
Part E CP
 Costs
The CP solves costs better than the plan---it uses the massive market power of a
large government-run risk pool to negotiate down prices, and creates an incentive
for private plans to negotiate prices even lower---we have empirics on our side
because the most efficient Medicare Advantage private plans already deliver costs
lower than Medicare rates
Jacob S. Hacker 18, the Stanley Resor Professor of Political Science at Yale University, 1/3/18,
“The Road to Medicare for Everyone,” http://prospect.org/article/road-medicare-everyone
In short, opening up Medicare to everyone would deliver what’s most inspiring about
single-payer —health care as a basic right of citizenship. Yet it wouldn’t require replacing
employment-based health insurance in one fell swoop. That’s because a large share of employers
now providing health benefits would likely continue to do so.
After all, the penalty in the ACA is modest compared with the cost of benefits, but most larger employers still offer health insurance.
Some might feel less compunction about paying the fee if it were a contribution rather than a penalty. Some might not want to
upgrade their plans to match Medicare Part E. But previous estimates of play-or-pay plans suggest that at any contribution rate close
to the House plan’s, most employers providing coverage would continue providing coverage.
Medicare Part E would also begin to deliver on Medicare for All’s second promise— lower prices . For one,
more people would be covered by Medicare, which would mean more services financed at
Medicare rates. For another, private plans would face competitive pressure to demand better
prices so their customers wouldn’t switch to Part E.
At the same time, Medicare should be allowed to bargain for lower prescription drug prices as do other
rich nations. Americans pay far higher prices for drugs than do citizens abroad, despite the fact that much of the investment in new
drug development begins in U.S. federal R&D spending. The Medicare Part D benefit enacted in 2003 by President George W. Bush
and a Republican congressional majority explicitly barred Medicare from providing drug coverage directly (it vested this
responsibility in regulated private plans)—precisely because drug manufacturers knew they would be required to bring down their
prices if it did. Drug coverage should be part of the basic Medicare package, for young and old alike.
Private insurance plans that participate in Medicare Advantage should also be required to offer coverage
to both old and young. Medicare patients like these options, and younger Americans will want them, too. No less important,
private insurers are deeply invested in Medicare Advantage. Ensuring they would still have a
role—especially when it is lessened in other parts of the market—would reduce their inevitable opposition.
So too, of course, would ensuring that large employers still have the option and incentive to provide
private coverage. (Most large employers pay medical claims directly—a practice known as “self-insurance”—but they often
contract with large insurers to manage the benefits). Indeed, this system might even be more attractive than the ACA to the largest
insurers, which have not shown much interest in the ACA marketplaces.
Many policy experts are critical of Medicare Advantage, because private plans have tended to skim off the healthiest Medicare
patients. But the program was improved by the ACA, which reduced the payments to health plans to better reflect the actual cost of
providing benefits to enrollees. Moreover, the playing field between Medicare and private plans would be
even more level if Medicare could provide drug coverage directly . Today, only Medicare Advantage plans are
allowed to cover prescription medicine alongside other services, which is one big reason beneficiaries enroll in them. Sweeten
traditional Medicare, and private plans will lose this unfair advantage.
According to recent studies, the most efficient Medicare Advantage plans are already delivering
Medicare’s core benefits for less than Medicare can . This is, in large part, because these plans
operate in a market in which their main competitor is Medicare , with its relatively low rates. Thus,
they can pay rates close to Medicare’s, and still get providers to participate in their networks. (This, by
the way, is one reason why privatizing Medicare would be a disaster; without the bargaining clout of the traditional program, private
plans would be paying the exorbitant prices they pay in the rest of the market.)
Medicare Part E could even give private plans additional leverage over providers. This idea is
counterintuitive—wouldn’t a bigger public program just shift costs onto the private sector?—but it’s borne out in the experience of
Medicare Advantage. And if Medicare covered more Americans younger than 65, this dynamic could
play out in the rest of the market, too. After all, even the most consolidated and costly provider
systems accept Medicare rates for older patients. Once Medicare Part E entered the mix, these
lower rates would be paid on behalf of many younger Americans , too. For providers, the alternative to
private payments would increasingly be Medicare rates for younger as well as older patients . As a
 private plans would be able to lower what they paid for nonelderly patients
result,
and still attract providers .
 Policy Durability---2NC

The public is suspicious of government and would hate the transition from paying
premiums which are hidden costs to taxes which are highly visible---that turns the
case because it means single payer shreds the public support necessary for
continued policy improvement
Jacob S. Hacker 18, the Stanley Resor Professor of Political Science at Yale University, 1/3/18,
“The Road to Medicare for Everyone,” http://prospect.org/article/road-medicare-everyone
These are questions I’ve struggled with for a long time. As a health policy expert, I’m one of the many social scientists and historians
who’ve sought to understand why the American framework of health insurance looks so different from the systems found in other
nations. Why do we spend roughly twice as much per person as any other nation while leaving
tens of millions of people without insurance and many times more with inadequate protection—all
with worse health outcomes?
The basic answer is simple: Americans are distrustful of government , and America’s fragmented
political institutions make transformative policies hard to enact, especially when they’re
opposed by powerful interest groups. Even at the height of the Great Depression, with overwhelming Democratic
majorities in Congress, FDR decided not to include health insurance in the Social Security Act of 1935, because he feared the
opposition of physicians would kill the whole bill.
FDR’s decision turned out to be fateful. With America’s entry into World War II, the nation’s agenda shifted away from domestic
affairs. Unions, corporations, and private insurers stepped into the breach—thanks in part to favorable tax laws and federal support
for collective bargaining—and by the 1950s, the majority of working-age Americans got health benefits at
work. By the time advocates of government insurance finally had another bite at the apple after LBJ’s landslide election in 1964,
they had strategically retreated to the goal of covering those left out of the employment-based system: the elderly and the poor. The
result was Medicare and Medicaid—the biggest step toward universal health care until the passage of the Affordable Care Act.
The system was a mess, but it was also a minefield. You had a huge insurance industry, allied with a range of profitable sectors that
benefited from its open checkbook, from drug manufacturers to medical device makers to highly paid specialists. You had excessive
costs that government could finance only with hefty taxes. Most important, for every unfortunate American who fell through the
cracks, you had eight or nine more who had benefits at work or through Medicare or Medicaid. To make matters worse, most of
had no idea how much their health benefits really cost , because the
these eight or nine
expense was hidden in their pay packages or spread across all taxpayers.
It would be hard to design a less welcoming context for single-payer .

Enacting a universal program meant taking on a lobbying juggernaut to impose taxes on

people generally suspicious of government , most of whom were insulated from the true
costs of their care. Our unique health-financing system was a reflection of our unique political hurdles. But increasingly it was
the system itself that posed the biggest hurdle of all.
There’s a lesson in this history: The
struggle over health care has always been about politics as much
as policy . The evidence that the American model is inferior is overwhelming, and many policies
would make it better. The challenge is figuring out how to overcome the political barriers
to pursuing those policies—not only to get them passed, but to ensure that they foster
the political conditions for continuing improvement .
1NR
Econ DA
 Healthcare Costs
Warming causes increases the rate of diseases so fast pharma can’t keep up
Harris Ali et al 16, Professor in the Faculty of Environmental Studies at York University,
2016, “Climate Change and Health Improving Resilience and Reducing Risks,” pg. 157-160
It is increasingly evident that climate change is adversely affecting human health. The health burden of
climate change also includes the emergence and increased incidence of infectious and water borne
diseases. The current Ebola outbreak was a chance encounter between a 2-year old child and a fruit
bat, the reservoir for the virus (Baize et al. 2014; Sae´z et al. 2015; WHO 2015). Some studies cite climate variability as the
cause for fruit bats to migrate long distances and reside near cities and towns (Frumkin et al. 2008; Pinzon et al.
2004). An Action Aid (2006) study on the increasing flood frequency in six African cities reports that “climate change is altering
rainfall patterns and tending to increase storm frequency and intensity”. In Sierra Leone, recent extreme weather observed
includes heavy rains that cause flash floods, mass land movement, injuries and fatalities, and infrastructure damage (Figs.
10.1, 10.2 and 10.3). Heavy rains precipitated the 2012 cholera epidemic that started in Guinea (7350 cases
and 133 fatalities) and eventually spread to Sierra Leone (23,124 cases and 299 fatalities) (WHO 2012)¶ Resource
exploitation and extreme weather displaces farmers who practice mostly subsistence farming in rural
communities. They have to venture deeper into forests in search of land and new livelihoods, bringing them in
closer contact with infected animals (WHO 2015), while human activities cause bats and other animals to venture
closer to human habitats.¶ Women accounted for roughly 60–75 % of deaths in the 2014 Ebola epidemic (Wolfe 2014). Ebola’s
gendered impacts—including greater fatality rates for pregnant women, higher risks for caregivers who are often women, and
dangers from sexual violence due to Ebola-related economic collapse (Thomas 2014)—have implications for social resilience,
survival of caregivers and mothers, economic decline and subsequent recovery in disease-affected areas, and the strength of public
health systems (Perkins 2014). When economic and ecological pressures, exacerbated by climate change,
bring people and animals into closer contact while uprooting communities, depleting health care
systems, undermining social resilience, and degrading infrastructure, this becomes a “perfect
storm” for the emergence and spread of infectious disease . ¶

Structural changes and ACA innovations are forcing down costs

John Holahan 17, Institute fellow in the Health Policy Center at the Urban Institute, former
director of the Health Policy Center, “The Evidence on Recent Health Care Spending Growth
and the Impact of the Affordable Care Act,” May 2017,
https://www.urban.org/sites/default/files/publication/90471/2001288-
the_evidence_on_recent_health_care_spending_growth_and_the_impact_of_the_affordable
_care_act.pdf
The ACA, particularly Medicare payment policies and the managed-competition
structure of the marketplaces, likely contributed to the slowdown in spending growth, and these
provisions probably will continue to place pressure on providers. Though average marketplace premium
increases were higher in 2017 than in 2015 and 2016, marketplace competition in large urban markets has generally been intense,
leading to narrower networks of providers who are willing to accept lower payment rates in private insurance plans.11 It is not
necessary to attribute any cost savings to ACA innovations such as accountable care organizations, medical homes, or other delivery
system reforms. The Medicare payment reductions, slow income growth, increased cost-sharing in
private plans, and pressure to establish narrow networks in the private nongroup market have
together reduced the flow of revenues to providers . This in turn may have caused providers
to make substantial structural changes to adapt to the new environment. To the extent that such
structural changes are maintained, they could contribute to slower spending growth in the
future .

Health care cost growth is decreasing

John Holahan 17, Institute fellow in the Health Policy Center at the Urban Institute, former
director of the Health Policy Center, “The Evidence on Recent Health Care Spending Growth
and the Impact of the Affordable Care Act,” May 2017,
https://www.urban.org/sites/default/files/publication/90471/2001288-
the_evidence_on_recent_health_care_spending_growth_and_the_impact_of_the_affordable
_care_act.pdf
National health expenditures grew at historically low rates in recent years (3.6 percent per year on
average in between 2009 and 2013),7 and projections for future growth rates are significantly below
those experienced over recent decades. Average annual growth rates between 1970 and 2010 were equal to growth in
GDP plus 2.5 percent.13 Current estimates from the Centers for Medicare & Medicaid Services (CMS) indicate that the average
annual growth in NHE between 2010 and 2020 will be GDP growth plus 0.8 percent ; for 2020 to
2025, CMS projects the increase in NHE to be GDP growth plus 1.2 percent. The slow growth in recent years was at least partly
related to the recession and slow economic recovery,14,15 but other factors, including changes associated with the ACA,
seem to have contributed as well; evidence indicates and analysts predict that these and other factors are likely to cause
these slower growth rates to persist into the future.
CMS routinely revises its spending forecasts as new data become available. The most recent forecast, released in February 2017,
includes actual spending estimates for 2010 to 2015, and projections for 2016 to 2025.7 Table 1 compares the current (2017)
estimates of actual spending growth to the forecast for 2010 to 2015 spending that was made shortly after the ACA passed in 2010.10
The most recent estimates suggest NHE grew 4.3 percent annually from 2010 to 2015 compared with the original forecast of 6.5
percent. Current estimates of growth in each component of NHE spending for the 2010 to 2015 period are lower than the original
forecast, from 5.8 percent to 4.5 percent for Medicare, from 9.9 percent to 6.5 percent for Medicaid, and from 6.6 percent to 4.4
percent for private insurance. “Other” health spending, which includes spending on the Children’s Health Insurance Program, the
US Department of Defense and Veterans Affairs health programs, public health activity, and investments, including new
construction and capital equipment, was originally projected to increase 5.8 percent; the spending for that category actually grew 3.1
percent.
Actual NHE growth from 2010 to 2015 was lower than projected in 2010 for several reasons. Those reasons include the 2007
to 2009 economic recession and slow recovery, unexpectedly low inflation, increased employer offerings of high-deductible
cost-containment efforts within
insurance plans (higher cost-sharing requirements lead to lower use of care),
state Medicaid programs, and Medicare policies unrelated to the ACA, including cuts as a result of
sequestration. But the ACA , too, probably contributed to low NHE growth in several ways.10
Many of the cost-containment provisions of the ACA were reflected in the 2010 forecast, including the Medicare payment reductions
to hospitals and other providers; the reduction in Medicare Advantage payments; and the managed competition structure in
marketplaces that limited subsidies to the second-lowest-cost silver plan, in turn forcing insurers to price aggressively. Thus, any
contribution of the ACA to reductions in projected spending not already in the baseline would have come from larger-than-
anticipated effects of these provisions or from other factors. Many ACA-related factors that were not included in
the original projections may have helped slow spending growth. First, starting in 2011, adjustments to
ACA Medicare payments seem to have played a role in reducing the number of Medicare
hospital days , outpatient visits , skilled nursing facility days , and advanced imaging
procedures between 2010 and 2014.16 Second, lower Medicare payment rates may have had
spillover effects on other payers; commercial insurers often use Medicare as a benchmark for their negotiations
with hospitals and physicians.17–19 Finally, Medicare policies such as financial penalties for hospital
readmissions may have changed provider practice patterns for patients of other payers as well.
The lower-than-expected spending from 2010 to 2015 has also contributed to lower projected spending through 2019. We compare
the estimates for the 2014 to 2019 period (the current forecast), which reflect actual data for 2014 and 2016 and projections for 2016
to 2019, to the projections made for the same period in 2010. We find that the most recent 2017 CMS forecast estimated that
national health expenditures for 2014 to 2019 would total $20.8 trillion;7 this is $2.9 trillion, or 12 percent, below the CMS forecast
of $23.7 trillion for the same period made in late 2010, shortly after the ACA was passed (Figure 1).10
The 2017 forecast also estimated lower spending for Medicare, Medicaid and private
insurance , compared with the 2010 forecast of spending after enactment of the ACA (data not shown). Medicare
expenditures for 2014 to 2019 were projected to be $4.3 trillion in the 2017 forecast, down from $4.7 trillion in the original 2010
ACA baseline forecast. In the 2017 projections, Medicaid spending for 2014 to 2019 was projected to be $3.5 trillion, compared with
$4.6 trillion in the ACA baseline forecast. Some, but not all, of this decline stemmed from the Supreme Court decision that made
Medicaid expansion a state option.20 Private health insurance expenditures for the 2014 to 2019 period were projected to be $7.7
trillion in the ACA baseline forecast but fell to $7.0 trillion in the updated 2017 forecast.
 Wages Link
The global economy is kicking ass now---fears of slow growth or recession should
be conclusively discounted and current inflation is manageable---the only thing
that can collapse global recovery is fast wage growth in the U.S. prompting
aggressive monetary policy
Tim Wallace 3-14, the Telegraph's Senior Economics Correspondent, 3/14/18, “Boom is back:
world economy to put on strongest spurt since before the financial crisis,”
https://www.telegraph.co.uk/business/2018/03/14/boom-back-world-economy-put-strongest-
spurt-since-financial/
Edited to change the weird way British people express percentages
Global economic growth will rise by more than 3pc[ 3% ] in three consecutive years, in a
performance not seen since the years leading up to the financial crisis.
Fears of permanently lower growth will be swept away by the prediction from analysts at Fitch Ratings.
And the economists do not think this will lead to a surge in inflation which would require

sharply higher interest rates, potentially casting the world into recession – suggesting the
world economy is in a sweet spot and can sustain the healthy performance .
“World growth forecasts have been upgraded again as the eurozone recovery powers ahead, US
fiscal policy is eased by more than anticipated and higher commodity prices underpin the emerging-
market recovery,” said Fitch.
Confident companies in advanced economies are investing more, strong jobs markets are
boosting consumer spending and even choppier financial markets do “not look like a signal of
rising recession risk”.
“The balance of inflation risks has clearly shifted – cementing the move towards normalisation by the world’s
major central banks – but Fitch does not foresee a disruptive outburst of inflation that would
prompt sharp, growth-negative monetary policy adjustments in 2018,” the analysts said.
Fitch now estimates GDP growth hit 3.2pc last year and will come in at 3.3pc for 2018 and 3.2pc for 2019, up from 2.5pc in 2016 and
an average of 2.8pc over the past four years.
Britain’s growth is predicted to slow from 1.7pc in 2017 to 1.4pc this year before bouncing back to 1.7pc in 2019.
This is expected to result in one interest rate hike this year and two next year, as the economy is deemed to be close to full capacity.
Globally, Fitch said “central banks are becoming less cautious in their approach to normalising monetary policy as labour markets
tighten and spare capacity disappears.”
The economists predict four interest rate hikes in the US this year as growth stays strong , while the
European Central Bank is gradually moving towards tightening – which could mean a rate rise in late 2019.
Although Fitch does not expect a sharp rise in rates it does acknowledge this is a
key risk to world growth .
One threat is “a sharp pick-up in US core inflation, prompting Fed tightening on a much more
aggressive scale than assumed in the forecast, and a major global interest rate shock ,”
the report said.
“A rapid pick-up in wage growth in the context of increasing labour shortages would be the most
likely catalyst for this . This would be growth negative .”

Powell’s a hardline wage inflation hawk and signals of wage increases spook the
market
Robert L. Borosage 18, president of the Institute for America's Future, 2/9/18, “The Real
Reason Workers Can’t Get A Raise,” https://www.thenation.com/article/the-real-reason-
workers-cant-get-a-raise/
Yet the mere hint of rising wages creates warning flags at the Federal Reserve, America’s central bank.
Corporations could pass on rising wages to consumers by raising prices, and rising prices could feed inflation. The Federal
Reserve has the dual mandate of fostering the highest levels of employment and stable prices . The
Fed governors have decided—arbitrarily—that steady 2 percent inflation is the target they hope to
sustain. They maintain, despite little evidence, that once inflation starts it can spiral out of control, so they assume that they
must act preemptively to slow the economy by raising interest rates. In turn, the economy slows,
workers lose jobs, their ability to demand wage hikes is reduced , and inflation is slowed.
Last week, the country got what appeared to be good economic news—a decent jobs report, top-line unemployment
remaining at 4.1 percent, and average hourly wages inching up 2.9 percent over the 12 months ending in January, which
was the highest increase in the nine years of the recovery. Yet the stock market tanked . The fear that rising
wages could lead the Fed to hike interest rates faster, and slow the economy, helped trigger the
stock selloff.
That panic is testament to how much the game is rigged against workers. Inflation—at 1.5 percent in 2017—remains below the Fed’s
target. Prices aren’t rising too fast; they are rising too slowly. The economy has grown slowly in each of the past three years. Rising
wages are more of a dream than a reality. In real terms, wages rose a nearly invisible 0.6 percent in 2017. In previous expansions,
they’ve gone up over 4 percent without America turning into Weimar. Unit labor costs are up all of 0.2 percent in 2017—the lowest
gains ever at this point in an expansion.
The 2.9 percent wage hike reported by the Bureau of Labor Statistics in January measures the increase over the year of annual
hourly earnings of all workers. But as Doug Henwood writes in Jacobin, workers didn’t pocket most of the increases; managers did.
The BLS also reports on the earnings of workers who are not supervisors. Those rose only 2.4 percent in January over the previous
year—that is about the same that they rose in January 2016 over the previous year. Workers’ wages are barely keeping ahead of the
cost of living. Supervisors are doing better—and will do even better when the regressive tax cuts kick in.
Meanwhile, workers’ bargaining power has been decimated. Unions represent about 6.5 percent of the private workforce. Union
contracts no longer have built-in cost-of-living hikes. Workers capture a dramatically smaller percentage of corporate earnings than
they did in the 50 years between 1950 and 2000. One analyst estimates that if the worker share of earnings had stayed the same in
this century, employees would have pocketed a staggering $10 trillion more in wages over the last 17 years.
That’s the reality. Despite Trump’s boasts, the economy isn’t taking off. The growth of real wages is near zero. The wage share of the
economy is near record lows. Profit margins are near record highs. And as Paul Krugman notes, demand has been sustained not by
rising business investment but by consumers’ drawing down their savings. Consumer debt reached record heights in 2017.
Obviously, for workers to recover, wages have to be allowed to grow. With the Fed poised to pump the economic brakes whenever
wages begin to stir, stagnant wages will remain a feature—not a bug—of the current economic consensus.
These shackles on workers’ wages have little to do with who is in the White House. Obama’s Fed Chair, Janet Yellen, at times wisely
ignored right-wing Cassandras who were rending their garments about imaginary inflation while the economy was barely breathing
after the worst financial collapse since the Great Depression. But under Yellen the Fed did begin to preemptively raise interest rates,
even though the economy hadn’t come close to the Fed’s supposed target of 2 percent inflation.
Donald Trump foolishly replaced Yellin, and his nominee, Jerome Powell,
is likely to be much more receptive
to the arguments of inflation scaremongers . In any case, the wage increases that workers
desperately need are virtually ruled out by the doctrine that the Federal Reserve’s governors
follow.
 AT: Full Employment
The fed believes we are at full employment---that’s what matters for the DA, not
their economists quibbling about the numbers
Jeff Cox 18, Finance editor for CNBC, 2/23/18, “Fed sees economy past full employment, but
with only 'moderate' wage gains” https://www.cnbc.com/2018/02/23/fed-sees-economy-past-
full-employment-but-with-only-moderate-wage-gains.html
Fed eral Reserve policymakers see an economy that may be past full employment, financial market
prices that are high and overall growth that continues to gather steam .
Those conditions remain appropriate for further interest rate increases, though inflation pressures remain
fairly muted for now, according to a key report to Congress the central bank released Friday.
The monetary policy report provided a wide-ranging view of conditions for new Chairman Jerome Powell, who took the Fed's reins
earlier this month. Powell will present the report along with remarks during congressional testimony Tuesday.
"The FOMC expects that, with further gradual adjustments in the stance of monetary policy, economic activity will expand at
a moderate pace and labor market conditions will remain strong," the report said, echoing language from prior
Federal Open Market Committee meetings.
The report comes after a year when the Fed hiked its benchmark interest rate three times and at a time of market unease over policy.
sparks of inflation will prompt the FOMC to move more quickly than
Investors worry that
anticipated with rate increases.

The Economy is near full employment---consensus of economists

Clive Crook 3/9, editor at Bloomberg View, 3/9/18, “Full Employment,”
https://www.bloomberg.com/quicktake/full-employment
The U.S. expansion has put millions of people back to work and economists agree that the
economy is now at or close to full employment . But what does that mean exactly? When economists talk
about full employment, they don’t mean everybody has a job. And they don’t mean that even the rosiest economic health can cut
unemployment to zero. If unemployment falls too much, inflation will rise as employers compete to hire workers and push up wages
too fast. To economists, full
employment means that unemployment has fallen to the lowest
possible level that won’t cause inflation . In the U.S., that was thought to be a jobless rate of about 5 percent
— above the February rate of 4.1 percent. Is higher inflation therefore on the way? Or is full employment a smaller number than
economists supposed?

Full employment now---the U-6 metric proves

Gillian B. White 17, senior associate editor at The Atlantic, “Full Employment: Are We There
Yet?” 5/27/17, https://www.theatlantic.com/business/archive/2017/05/full-
employment/528339/
That caveat helps illustrate the trickiness of judging whether or not the labor market has reached its full potential. Economists
generally agree that, by historical standards, today’s unemployment statistics look good . Holtz-Eakin believes that
full employment has been reached in part because of the U-6 , a measurement of
unemployment that takes into account discouraged workers—a group made famous for its growing population
during the last recession and recovery. These are people who don’t have jobs but have stopped looking for
them because they believe their efforts are futile. The number of workers who this applies to has
been diminishing , both because workers who were only loosely attached to work have become
more substantially tethered , and because fewer Americans who work part-time are reporting that they’re doing so
because they simply can’t find full-time work. Between the declining unemployment rate and there being
fewer workers stuck in the forgotten parts of the labor market , Holtz-Eakin says that’s enough to suggest that
full-employment terms have been met .
 AT: Thumpers
No overheating now---the squo is goldilocks---the Fed doesn’t think overheating is
happening which is the only relevant factor
Howard Schneider 3/1, Reuters Fed correspondent, 3/1/18, “Fed chief Powell says no
evidence U.S. economy overheating,” https://www.reuters.com/article/us-usa-fed-powell/fed-
chief-powell-says-no-evidence-u-s-economy-overheating-idUSKCN1GD5F8
WASHINGTON (Reuters) - Federal Reserve Chairman Jerome Powell said on Thursday the U.S.
economy does not appear to be running hot , even as the influential head of the New York Fed suggested a
faster pace of interest rate increases may still be in the offing for 2018.
“There is no evidence the economy is overheating,” Powell told the Senate Banking
Committee in his second appearance in Congress this week, saying he expects the Fed to stick with a
“gradual” pace of monetary policy tightening.

The Fed’s locked in to three rate hikes this year---the economy’s growing as fast as
it can without overheating---an additional rate hike would spook the market
Paul Davidson 3-21, USA Today economics reporter, 3/21/18, “Fed raises rates, keeps forecast
for 3 hikes in 2018,” https://www.usatoday.com/story/money/2018/03/21/fed-powell-hikes-
interest-rates-consumer-loans/444986002/
Citing a brighter economic outlook, the Federal Reserve raised its key short-term interest rate Wednesday but
maintained its forecast for a total of three hikes this year amid still-modest inflation.
The move is expected to ripple through the economy, nudging consumer and business borrowing costs higher, especially for
variable-rate loans such as adjustable-rate mortgages and credit cards.
Investors cheered the unchanged rate forecast for 2018 , pushing up the Dow Jones industrial average
about 250 points initially before stocks pared their gains.
The Fed’s policymaking committee, as widely anticipated, lifted the federal funds rate — what banks charge each other for overnight
loans — by a quarter percentage point to a range of 1½% to 1¾%.
That’s still low by historical standards but it marks the central bank’s fourth rate increase in the past 12 months
and another vote of confidence in an economy that’s picking up steam nearly nine years after the Great
Recession ended.
"We'retrying to take that middle ground " on rate hikes, boosting rates enough to head off an
eventual spike in inflation without derailing the economic expansion , Fed Chairman Jerome
Powell said at a news conference. The meeting was the first led by Powell, a Republican and Trump appointee, who took the reins
from Democrat Janet Yellen last month.
A breakdown of how the Fed sees:
How fast rates will rise
Wednesday’s rate hike was all but certain. Most of the suspense centered on whether the Fed would bump
up its forecast from a total of three quarter-point increases this year to four. It held steady at
three but raised its projection from two to three hikes next year as inflation picks up.
The Fed expects its key rate to climb to about 2.1% at the end of the year and 2.9% by the end of 2019 and over the longer run. It still
expects “further gradual” rate increases.
With federal tax cuts and increased spending set to juice growth over the next couple of years, some
analysts expected policymakers’ median projection to factor in an additional hike in 2018. That could have
unnerved already volatile markets . But surprisingly tame consumer price increases
likely convinced Fed officials to stand pat, at least for now .
The Fed raises rates to head off excessive inflation and lowers them to spur faster growth.
The economy
The Fed foresees the economy growing faster than it did in December. It expects growth of 2.7% this year, up from its December
forecast of 2.5%, and 2.4% in 2019, up from its prior 2.1% estimate. Both top the tepid 2.2% average during the nearly 9-year-old
recovery.
“The economy is healthier than it's been since before the (2008) financial crisis," Powell said,
The Fed statement said, "The economic outlook has strengthened in recent months,” an apparent nod to the $1.5 trillion
Republican tax cuts and a budget blueprint that increases federal spending by $320 billion over the next
decade.
The stimulus
measures are poised to further jolt an economy that had already gained
momentum , expanding at more than a 3% annual pace in the second half of 2017 on solid job and
income growth and a strong global economy .
But while the Fed said economic activity has been rising “at a moderate rate,” it added that growth in consumer spending and
business investment “have moderated from their strong fourth-quarter readings.”
Some economists worry the tax cuts and additional federal spending eventually could drive up inflation too quickly and add to the
$21 trillion national debt — both of which could push interest rates higher, eventually curtailing borrowing and economic activity.
 AT: Other countries solve
Sustained low interest rates are key to renewables globally ---hikes shift the fuel
balance back towards coal and gas
Angus McCrone 16, Chief Editor at Bloomberg News Energy Finance, 9/26/16, “McCrone: If
interest rates turn, clean energy will find it tougher,” https://about.bnef.com/blog/mccrone-
interest-rates-turn-clean-energy-will-find-tougher/
In the decade since, interest rates globally have plumbed depths never seen before – or even imagined. In the
US, the Fed Funds Rate spent almost seven years at 0.25%. The main European Central Bank refinancing rate was cut to zero in
March this year, and at one point earlier this month, the German 10-year bond yield (the rate at which investors are prepared to lend
to the government in Berlin for 10 years) was minus 0.4 percent. The Bank of Japan benchmark interest rate is currently at -0.1
percent.
Amazingly enough, there is a chance that some central banks could lower rates further still. That was certainly the way the markets
were thinking in the aftermath of the U.K.’s surprise vote on June 23 to leave the European Union. However, there are also
grounds for thinking the trend might be about to turn, and wondering what the implications would be for the clean
energy and transport sectors.
One is that U.S. rates have already been raised once (in December 2015), and may be lifted again after the presidential election in
November, in response to signs of incipient inflation. Where
the U.S. goes on interest rates, other countries
tend to follow . Or at least that is what happened in other cycles.
Even in countries that have not matched the U.S. on economic growth recently, it may be that interest rates will be heading up – for
the simple reason that current policies do not seem to be working. Many developed economies remain weak, and negative interest
rates may be damaging, rather than boosting, the confidence of banks in Europe and Japan, and causing headaches for the pension
system. Perhaps something new should be tried, so the thinking goes, to stimulate growth – maybe a combination of fiscal loosening,
monetary tightening and structural reforms, or ‘helicopter money’ created by the central bank and used to fund new infrastructure
programs.
The other reason interest rates might turn upwards is the Donald Trump factor. The U.S. Republican presidential candidate told the
Economic Club of New York on September 15 that he would renegotiate the North American Free Trade Agreement, brand China as
a currency manipulator, and if necessary impose import duties, in an attempt to “bring vast new jobs and wealth to America.” The
Trump plan – if he wins the presidency on November 8 and if the plan is actually implemented (two big ‘ifs’) – might boost the U.S.
economy in the medium term, or might not – there would be a period of great uncertainty. However, its logical economic
consequence would be to substitute higher-priced, home-made goods for cheap imports, push up prices and wages, and so mean an
end to the rock-bottom-interest-rate era in the U.S.
For the first few years after the financial crisis, while central bank rates dropped to near-zero, the actual interest rates paid by
renewable energy project developers stayed stubbornly high. Banks had rediscovered risk premiums, and were using them to repair
their balance sheets.
Over the past three years, however, those low
rates started to be passed on, and clean energy has grown to
like them . They have served to bolster investment in renewables in several ways. They have
slashed the all-in cost of debt for projects, and the rates at which utilities can borrow from bond
markets, improving the economics of technologies with high upfront costs and low operating-
stage costs, such as wind, solar, hydro-electric and geothermal.
They have also brought new waves of money – from institutions and private investors – into renewables. They
have been attracted partly because wind and solar have matured as an asset class and are no longer seen as high-risk, but also
because those investors have had to look further afield for steady yields of 5-6 percent in the era of super-low interest rates.
Bloomberg New Energy Finance can claim to have glimpsed the low-interest-rate boost coming for renewables. In a VIP Comment
article in August 2010, Watch the Debt Markets for Clues on the Next Twist for Clean Energy, we postulated that “we might be
moving into a new phase of easier credit for project developers”. But we certainly did not foresee just how far it would go – in
Germany, for instance, onshore wind developers in 2015-16 have been enjoying an all-in cost of debt of just 2 percent for new
projects, down from 5 percent in 2010.
Impact on Costs
How would the sector stand if interest rates were to turn and, within a year or two, rise significantly
above current levels? My analyst colleagues will soon be publishing BNEF’s latest Levelized Cost of Electricity estimates for
all the main generating technologies. The results are likely to show electricity from onshore wind and solar photovoltaics falling in
price yet again, with the global central estimates below the $81 and $99 per megawatt-hour shown in our first-half 2016 report,
published in April.[1] Offshore wind’s LCOE is also likely to be down from six months ago, reflecting aggressive pricing in recently
announced projects, such as by Dong Energy A/S for Borssele 1 and 2 in the Netherlands and Vattenfall AB for Vesterhav Sud and
Nord in Denmark.
Falling financing costs have played as much of a part in the long slide in LCOEs for onshore wind and PV as reductions in equipment
costs, more efficient construction and installation, and streamlined operation and maintenance. The switch to tenders and reverse
auctions has also caused all parts of the supply chain to address their overheads and trim margins, in order to enable winning bids to
be tabled.
Let’s look at the impact higher interest rates would make, compared to the H1 2016 LCOE estimates. If all-in costs of debt were
to rise by 200 basis points, this would raise the LCOE of a U.S. solar project by $7, to $94 per megawatt-hour,
assuming it was financed pre-construction with a debt-equity ratio of 70:30 and a 20-year loan; and the LCOE of a Germany PV
project by $9, to $112 per megawatt-hour, assuming an 80:20 debt-equity ratio and a 12-year loan. And by the way, if you think a
200-basis-point rise in debt costs sounds extreme, and therefore very unlikely, I would point out that this would only return all-in
borrowing costs in northern Europe to where they were in 2012.
These estimated increases in LCOE, of 9 percent or so, would not kill renewable energy stone dead –far from it. But they would
tilt the balance back towards coal and gas (and biomass), where the upfront capex is a smaller fraction of
lifetime costs and where operating-stage expenses, notably the purchase of the fossil fuel feedstock, are a far bigger part.

US emissions reductions are key to solve warming

Stefan Rahmstorf 17, Professor of Ocean Physics at Potsdam University, Head of Earth System
Analysis at the Potsdam Institute for Climate Impact Research, 6/2/2017, “The world needs the
US in fight against climate change”, http://thehill.com/blogs/pundits-blog/energy-
environment/336066-the-world-needs-the-us-in-fight-against-climate-change
The incontrovertible physics of the greenhouse effect means that global temperatures are rising.
They have risen exactly as was predicted in the 1970s, by 1 degree Celsius above pre-industrial
temperatures until now. Incontrovertible physics also means that warming causes sea-levels
to rise. They are rising faster now than they have for several millennia, and the rise has accelerated threefold
during the 20th century. Global warming also brings us more extreme weather events, like
crippling heat waves and droughts already affecting millions of people. ¶ The world must work
together to stop global warming. It is a threat to all of us , to our children and to our children’s children. It
cannot be reversed, only stopped in time.¶ The Paris accord is not perfect, but it is the best we could hope for. The
deal’s main fault is that, due to decades of dithering, it came so late. It aspires to limit global warming to 1.5 degrees Celsius, but that
is practically unachievable by now. Some critical tipping points may have already been triggered. ¶ The West Antarctic Ice Sheet looks
doomed, a fatal instability that will lead to its irreversible decay and raise global sea levels by three meters. Coral reefs are already
dying on a massive scale due to heat stress. Even holding global temperatures well below 2 degrees Celsius,
which should help to prevent even worse tipping points from happening, will require global
emissions to fall to zero by 2040 or 2050 at the latest .¶ That is why fighting climate change is a race against the
clock now. That is why with any delay, even by a few years, the last chance to halt global warming within manageable bounds is
slipping through our fingers.¶ President Trump appears unaware of basic scientific knowledge, preferring to believe a false
propaganda narrative from a group of fossil-fuel fans among his advisers. He even reportedly fell for a well-known fake Time
magazine cover — supposedly from the 1970s but in reality a modern Photoshop job — warning of an Ice Age. It’s a favorite myth
promoted by climate deniers that most climate scientists predicted an Ice Age in the 1970s. ¶ And Trump has clearly fallen for the
false “Climategate” narrative, referring to “those horrible emails that were sent between the scientists” in a New York Times
interview. This kind of doubt over climate science is a “product with an industry behind it.” Someone with a lot of money is trying to
fool you with this — and, by the way, with bizarre economic studies that paint a grim picture of the economic consequences of the
Paris accord. The organizations that make up the U.S. climate change counter-movement have an annual income of over $900
million.¶ In the scientific community, there has long been an overwhelming consensus about
the basic facts of human-caused global warming. Apart from the studies that demonstrate this, I can vouch for this
fact from my personal experience of working in climate science for the past thirty years. ¶ The U nited S tates is currently
the second-largest emitter of greenhouse gases after China; in terms of the accumulated
historical emissions it is the largest. And, of course, U.S. emissions per person are about twice as
large as those of China or of Europe. That means that the U.S. has a large responsibility for
the worldwide consequences of these emissions that it cannot just walk away from.¶ Leaving the Paris Agreement
and withdrawing from its emissions reduction commitment is a reckless and irresponsible act. The Trump
administration will not be able to derail the global effort to halt global warming, since almost every
country on the planet by now understands — at least partly — how serious the threat of further global
warming is.¶ But the U.S. can delay progress enough to push the Paris goals out of reach. If the U.S.
does not reduce its emissions in the coming years along with the rest of the world, we will
altogether fail in keeping global warming below a highly dangerous level .
 AT: No Impact
We’re on track for 4 degrees now --- that makes adaptation impossible
Naomi Klein 14, award-winning journalist, syndicated columnist, former Miliband Fellow at
the London School of Economics, member of the board of directors of 350.org, This Changes
Everything: Capitalism vs. the Climate, pp. 12-14
But the bigger problem—and the reason Copenhagen caused such great despair—is that because governments did not agree to
binding targets, they are free to pretty much ignore their commitments. Which is precisely what is happening. Indeed, emissions are
rising so rapidly that unless something radical changes within our economic structure , 2 degrees now looks like a
utopian dream. And it’s not just environmentalists who are raising the alarm. The World Bank also warned when it
released its report that “we’re on track to a 4-C warmer world [by century’s end] marked by extreme
heat waves , declining global food stocks , loss of ecosystems and biodiversity, and
life-threatening sea level rise .” And the report cautioned that, “there is also no certainty that
adaptation to a 4-C world is possible .” Kevin Anderson, former director (now deputy director) of
the Tyndall Centre for Climate Change, which has quickly established itself as one of the U.K’s premier
climate research institutions, is even blunter; he says 4 degrees Celsius warming—7.2 degrees
Fahrenheit—is “incompatible with an organized, equitable, and civilized global community .”¶ We don’t
know exactly what a 4 degree Celsius world would look like, but even the best-case scenario is likely to be calamitous. Four
degrees of warming could raise global sea levels by 1 or possibly even 2 meters by 2100 (and would
lock in at least a few additional meters over future centuries). This would drown some island nations such as the Maldives and
Tuvalu, and inundate many coastal areas from Ecuador and Brazil to the Netherlands to much of California and the northeastern
United States as well as huge swaths of South and Southeast Asia. Major cities likely in jeopardy include Boston, New York, greater
Los Angeles, Vancouver, London, Mumbai, Hong Kong, and Shanghai. ¶ Meanwhile, brutal heat waves that can kill tens
of thousands of people, even in wealthy countries, would become entirely unremarkable summer events
on every continent but Antarctica. The heat would also cause staple crops to suffer dramatic
yield losses across the globe (it is possible that Indian wheat and U.S. could plummet by as much as 60 percent), this
at a time when demand will be surging due to population growth and a growing demand for meat .
And since crops will be facing not just heat stress but also extreme events such as wide-ranging droughts, flooding, or pest
outbreaks, the losses could easily turn out to be more severe than the models have predicted . When
you add ruinous hurricanes, raging wildfires, fisheries collapses, widespread disruptions to
water supplies, extinctions, and globe-trotting diseases to the mix, it indeed becomes difficult to
imagine that a peaceful, ordered society could be sustained (that is, where such a thing exists in the first
place).¶ And keep in mind that these are the optimistic scenarios in which warming is more or less
stabilized at 4 degrees Celsius and does not trigger tipping points beyond which runaway
warming would occur. Based on the latest modeling, it is becoming safer to assume that 4 degrees could bring
about a number of extremely dangerous feedback loops—an Arctic that is regularly ice-free in September, for
instance, or, according to one recent study, global vegetation that is too saturated to act as a reliable “sink ”,
leading to more carbon being emitted rather than stored. Once this happens, any hope of predicting impacts
pretty much goes out the window. And this process may be starting sooner than anyone predicted. In May 2014,
NASA and the U niversity of C alifornia, Irvine scientists revealed that glacier melt in a section of West
Antarctica roughly the size of France now “appears unstoppable.” This likely spells down for the entire West Antarctic ice
sheet, which according to lead study author Eric Rignot “comes with a sea level rise between three and five metres. Such an event
will displace millions of people worldwide.” The disintegration, however, could unfold over centuries and
there is still time for emission reductions to slow down the process and prevent the
worst . ¶

Turns nuke war and magnifies every impact

Jürgen Scheffran 16, Professor at the Institute for Geography at the University of Hamburg
and head of the Research Group Climate Change and Security in the CliSAP Cluster of
Excellence and the Center for Earth System Research and Sustainability, et al., April 2016, “The
Climate-Nuclear Nexus: Exploring the linkages between climate change and nuclear threats,”
http://www.worldfuturecouncil.org/file/2016/01/WFC_2015_The_Climate-
Nuclear_Nexus.pdf
Climate change and nuclear weapons represent two key threats of our time. Climate change endangers ecosystems
and social systems all over the world . The degradation of natural resources, the decline of water
and food supplies, forced migration, and more frequent and intense disasters will greatly affect population
clusters, big and small. Climate-related shocks will add stress to the world’s existing conflicts
and act as a “threat multiplier ” in already fragile regions. This could contribute to a
decline of international stability and trigger hostility between people and nations .
Meanwhile, the 15,500 nuclear weapons that remain in the arsenals of only a few states possess the destructive force
to destroy life on Earth as we know multiple times over. With nuclear deterrence strategies still in place, and
hundreds of weapons on ‘hair trigger alert’, the risks of nuclear war caused by accident,
miscalculation or intent remain plentiful and imminent .
Despite growing recognition that climate change and nuclear weapons pose critical security risks, the linkages between both threats
are largely ignored. However, nuclear and climate risks interfere with each other in a mutually enforcing way.
Conflicts induced by climate change could contribute to global insecurity , which, in turn, could
enhance the chance of a nuclear weapon being used , could create more fertile breeding
grounds for terrorism, including nuclear terrorism , and could feed the ambitions among some
states to acquire nuclear arms . Furthermore, as evidenced by a series of incidents in recent years, extreme weather
events, environmental degradation and major seismic events can directly impact the safety and security of nuclear installations.
Moreover, a nuclear war could lead to a rapid and prolonged drop in average global temperatures
and significantly disrupt the global climate for years to come, which would have disastrous implications for
agriculture, threatening the food supply for most of the world . Finally, climate change, nuclear
weapons and nuclear energy pose threats of intergenerational harm, as evidenced by the transgenerational effects of nuclear testing
and nuclear power accidents and the lasting impacts on the climate, environment and public health by carbon emissions.