CASE

ADV 1
1. Single payer moots quality care.
Michael Cannon 22, Director of Health Policy Studies, Cato Institute, 5/5/22, Cato Institute, “Medicare
for All Would Mean Worse Care for All”, https://www.cato.org/commentary/medicare-all-would-mean-
worse-care-all, kcab

Senate Budget Committee Chairman Bernie Sanders (I-Vt.) has announced that as early as next week, his committee will hold a hearing “on
the need to pass a Medicare for All single‐payer program.”

Sanders gets an “A” for passion, but an “F” in compassion.

The non‐partisan Congressional Budget Office has cautioned that Sanders’ Medicare for All bill would create “a shortage of
providers, longer wait times, and changes in the quality of care.”

Locking in any single set of payment rules—as a single‐payer system by definition must—will always reward low‐
quality care and penalize progress.
Indeed, the non‐partisan Medicare Payment Advisory Commission has warned since at least 2003 that Medicare’s approach to health care
quality “is largely neutral or negative.” Enrolling 330 million people in the program would only make the problem
worse.
Thankfully, there is a (potentially bipartisan) way to reverse Medicare’s negative impact on quality: Apply “public option” principles not to the
private health insurance market but to Medicare, where this traditionally Democratic idea would dramatically increase choice and competition.

Since 1965, Medicare has paid providers more for low‐quality care than for high‐quality care. For example, in
1995, Utah’s Intermountain Health Care reduced mortality by improving how it treated pneumonia. Medicare rewarded those quality
improvements by paying Intermountain less.

In 1999, Duke University developed a better way to treat congestive heart failure. Medication adherence increased. Hospitalizations fell.
Resource use fell by half. Again, Medicare (and private insurers with similar payment rules) responded by reducing payments.
Duke eventually had to shutter the program for lack of funds.

In 2002, Whatcom County, Washington improved glucose management for diabetics and stabilized congestive heart failure patients, saving
$3,000 per patient. The county ended up shuttering the program for the same reason Duke did.

Need more evidence?

In 2009, Medicare reduced payments to Texas’ Baylor Medical Center after the system cut heart‐failure readmissions in half with no
increase in mortality. Hospitals can nearly double net revenues if a Medicare patient develops post‐operative complications. Medicare pays
hospitals nearly $3,000 more per patient when low‐quality care leads to more post‐acute care and readmissions. Medicare
paid a large
urban hospital system more when it allowed urinary‐tract or bloodstream infections than when it
prevented them.

It doesn’t have to be this way.

In the mid‐1990s, Group Health Cooperative of Puget Sound improved diabetes care with an “average cost savings [] of $685-$950 per patient
per year.” Group Health’s different payment rules—which markets developed a century before Congress enacted Medicare—allowed it to
profit from those quality improvements.

What Sen. Sanders doesn’t get is that medicine

is so complex, no single payment system can promote all aspects
of health care quality. Locking in any single set of payment rules—as a single‐payer system by definition must—will always
reward low‐quality care and penalize progress.
Competition drives providers to improve all dimensions of quality—even
those their own payment rules discourage.
Improving care across the board requires letting all varieties of payment rules compete on a level playing
field.

Public‐option principles demand exactly that: a level playing field where consumers are the ultimate arbiters of quality and efficiency. Public‐
option supporters want a new government program to be one of the competitors .

But there’s no need for a new program. Traditional Medicare is a government‐run plan that already competes against private
insurers. Economist Mark Pauly explains that Medicare “is essentially a risk‐adjusted voucher program” that lets enrollees choose between a
public option and private Medicare Advantage plans.

That playing field, however, is anything but level. Congress bars certain plans, encourages excessive coverage, and
penalizes high‐quality coverage. It further violates public‐option principles by offering larger subsidies to healthy enrollees if they choose
Medicare Advantage, and to sicker enrollees if they choose traditional Medicare.

Public‐option principles demand eliminating all such distortions. Most important, they require that each enrollee’s
subsidy neither rise nor fall depending on which health plan, or how much coverage, he or she chooses. Only one type of subsidy can do that:
cash.

Public‐option principles require that Medicare mirror Social Security, which gives enrollees cash and trusts them to
spend it. In 2022, Medicare will spend enough to give each enrollee an average cash subsidy of $12,100. Income‐and risk‐adjustment would
give poorer and sicker enrollees thousands more to ensure they could afford coverage.

Enrollees would spend that money better than government bureaucrats do. Evidence shows that cost‐conscious
patients force
providers to reduce prices and that when seniors control their health decisions , even those with cognitive
limitations make good choices.

While Medicare for All would condemn generations to low‐quality care, applying public‐option principles to Medicare
would improve health care through choice and competition. It’s a Democratic idea even Republicans can love.

2. COVID proves bioterror risk is still low and has actually led to increased prevention
efforts.
Gary Ackerman 22, Associate Professor and Associate Dean for Research in the College of Emergency
Preparedness, Homeland Security and Cybersecurity at the University at Albany, et al., 8/11/22, “Why
COVID probably hasn’t helped bioterrorists, despite fears,” https://thebulletin.org/2022/08/why-covid-
probably-hasnt-helped-bioterrorists-despite-fears/ //sj

Could COVID have changed the equation? Aum and its ilk aside, terrorists haven’t shown a great deal of
interest in bioweapons. But could the pandemic have changed their views? Certainly, many analysts and media organizations have
explored this concern. For example, Vox recently ran a lengthy piece on “ Why experts are terrified of a human-made
pandemic” arguing that COVID is a warning of what’s to come: pathogens enhanced with gain-of-function research and DNA
synthesis improving access to pathogenic material. Axios wrote about how the coronavirus reawakened bioweapons fears. An op-ed in the Los
Angeles Times argued that COVID shows world leaders the harm bioweapons can cause.

The fears are well-justified in at least one regard: Thanks to scientific advances, the technical barriers to bioterrorism are going down. But
COVID isn’t playing a big role there.

As a technical matter, COVID’s bolstering of terrorists’ abilities to acquire biological weapons is likely
modest at best. The main potential concern is the proliferation of medical and public health resources
aimed at combatting COVID and whether any of these can be reappropriated to serve bioterrorism
schemes. In most cases, the answer is no. Nonetheless, new laboratories might create opportunities to
steal equipment or pathogens. Terrorists might also be able to more readily acquire skills related to
handling pathogenic material through the rapid training that occurred to meet pandemic needs. But
these effects are likely minimal.
The pandemic has caused millions of deaths, a lot of illness, and huge economic and societal disruption. It has also shown the limits of
vaccinations: 20 percent of Americans still remain hesitant to get their shots. Pandemic-prompted responses may also be less effective for non-
contagious agents like Bacillus anthracis. For example, masking is unlikely to be effective response absent an unlikely early warning. Yet,
it’s
not at all clear that a terrorist group will see new opportunities for bioweapons based on how society
has responded to COVID.

Contrary to fears, the way some

governments have responded to the pandemic might deter rather than
encourage would-be bioterrorists. For example, the experience of the Operation Warp Speed program in the
United States showed that governments can rapidly develop, disseminate, and update a novel vaccine .
Efforts to bolster early warning systems, like waste-water surveillance programs, may likewise make a bioweapon less effective.

In short, those terrorists who would have pursued bioweapons before COVID will probably still pursue
them, while terrorists who would previously have rejected bioweapons are unlikely to see sufficient new
benefits in the COVID experience to override their concerns.

Well, what now? Though COVID has not changed the threat of bioterrorism much, there might be some
worthwhile policy adjustments to make in light of the pandemic.

Law enforcement and national security agencies concerned with bioterrorism should prioritize groups
with apocalyptic ideologies. These groups may have few viable alternatives to bioterrorism. Likewise, analysts should understand how
ideological subgroups may differ in their response to COVID: For example, many radical environmentalists probably would be turned off from
biological weapons because the groups are generally non-violent. Some sub-groups, however, like RISE, who are more accepting of violence,
might be open to seeing a biological weapon as symbolic of nature’s vengeance on humanity. Aum, famously, recruited scientists to manage its
weapons efforts. Analysts
should be particularly interested in signs such groups are seeking specialized
equipment, recruiting people with specialized bioweapons-related knowledge, or developing that
knowledge themselves.

To the degree COVID

excites policy interest in bioterrorism, those energies should be channeled towards
larger public health preparedness. In practice, many aspects of responding to a bioterrorism incident are not terribly
different than any naturally-occurring outbreak. Measures like epidemiological early warning, building hospital surge capacity,
and exercises on pandemic response are all just as useful in responding to bioterrorism as a natural pandemic. Of course, policymakers need to
consider how bioterrorism may affect the details: Bioterrorists may employ rarer, deadlier diseases; strategic targeting may complicate
modeling and response to early outbreaks; and, in extreme cases, bioterrorists may alter the properties of known biological agents.

Analysts and policymakers also should ensure that the frustrations of COVID do not overly color threat assessments. They need to think
carefully about how the COVID pandemic has actually interacted with the particulars of terrorist ideology and capability. The overall risk
of bioterrorism is probably still quite low, but there are ways to push it even lower.

3. US health care is the best in the world – single-payer removes advantage.

Khaled Dajani 21, assistant professor at Eastern Virginia Medical School in the US; 11-3-2021, “Health
Care in America Is the Best in the World”, Fair Observer,
https://www.fairobserver.com/region/north_america/khaled-dajani-usa-health-care-america-best-
world-quality-health-care-system-world-news-34879/, BEJJP-ATJ [6-28-2023]

Yet overa million people travel to the US every year for their medical care, including heads of state, the
wealthy and elite, who presumably could have received care in their home country or anywhere else in the world. The numbers
cited above do not even include the millions who are cared for by the international satellite campuses of
the Mayo Clinic, Cornell, Harvard and Johns Hopkins systems, to name just a few, that have been established
to bring American health care to the rest of the world.

Around 100,000 Canadians, whose nationalized health system is rated above the United States, are
likely to cross the border each year for medical care. These medical tourists recognize that , on the whole,
health care in the US is the best in the world.
Leading the Way

The United States leads the world as a juggernaut of medical research and innovation. More Americans have
received the Nobel Prize in medicine than Europe, Canada, Japan and Australia combined, which together have double the aggregate
population of the US. Half of the top 10 diagnostic or therapeutic innovations in the past 50 years have come in whole or in part from the US,
along with 75% of the top 30.

When it comes to pharmaceuticals, half of the top 30 blockbusters have come from the United States
alone. The advanced medical milieu that Americans enjoy has led to the world’s best cancer survival
rates, a life expectancy for those over 80 that is actually greater than anywhere else, and lower
mortality rates for heart attacks and strokes than in comparable countries.

There are many reasons that have been put forth to explain this dominance, but the most basic and powerful is very likely money. The free-
market health care economy of the US, along with lower regulatory and tax burdens, strongly
incentivizes corporations to focus their business in America.

At a fundamental level, greater

financial compensation also provides individuals and their families the
potential for a better quality of life, while greater autonomy spurs innovation. This is why the United
States is routinely listed as one of the best countries in the world to practice medicine . One-quarter of all
doctors in America are foreign-trained. Licensure is a daunting process that nearly always requires “starting over” for the immigrant physician.
These physicians are often fully licensed and practicing in their home country, but must now sit for the US Medical Licensing Examination
(USMLE) and spend years redoing all of residency and fellowship.

Despite this challenge, estimates suggest that over

$2 billion is lost annually from physicians leaving sub-Saharan
Africa alone to set up shop in the US. This so-called brain drain is rampant in India, Mexico and Central
America and is not limited to physicians. In 2014, about 14,000 nurses left the Philippines, while only 5,000 graduated nursing
school. The United States represents 5% of the world’s population, accounts for around 5% of the world’s
disease burden, but employs 20% of the global health workforce.
The UK and Canada

Contrast this environment with the nationalized health systems of the United Kingdom and Canada,
which each year rank higher than the US. When resources are controlled by a single-payer system, the
waiting time for care invariably lengthens.

In 2019, the National Health Service (NHS) in

England reported that one-quarter of all cancer patients did not start
treatment on time despite an urgent referral from their physician. Even before the COVID-19 pandemic, wait times
for medically necessary treatments in Canada averaged three months, which the treating physicians documented as
one month longer than clinically reasonable.

Universal health care also leads to an increased tax burden. The tax-to-GDP ratio in the United States is
26%, which is among the lowest of 34 advanced nations. In Canada, that number sits at 32%, in the UK at 34% and in
France at 45%. Some estimate that a single-payer conversion in America would potentially increase taxes by up to
20%.
For those with the means to pay, there is a booming secondary private insurance industry in most socialized health care economies, which has
essentially created a two-tier system of “haves” and everyone else. Self-pay for health care in the UK rises annually by 10%,
leading to a 50% increase over the last half decade, and this excludes cosmetics or costs paid by the NHS. One result is that
nearly all general practices are private now in the UK, contracting their services out to the government while providing direct-pay services for
the affluent.

4. Healthcare modernization solves now – COVID kick-started private investment and

slashed costs.
Shubham Singhal 22, leader of McKinsey’s healthcare, public sector and social sector work; Neha
Patel, leader of the Healthcare Practice’s hospital-scale group; 7-19-2022, “The future of US healthcare:
What’s next for the industry post-COVID-19”, McKinsey & Company,
https://www.mckinsey.com/industries/healthcare/our-insights/the-future-of-us-healthcare-whats-next-
for-the-industry-post-covid-19, BEJJP-ATJ [6-28-2023]

Healthcare services and technology: Long-term growth supported by software and platforms

The HST segment has been a long-term growth story. HST continued its growth trajectory during the
pandemic, with profit pools rising from $45 billion in 2019 to $50 billion in 2021. The outlook continues to be positive. We estimate that the
segment will grow at an 8.2 percent CAGR between 2021 and 2025, to about $70 billion by 2025. That would likely make it bigger than the
payer profits pool by 2025.

HST has had broad overall growth but software and platforms and data and analytics have performed
especially well, with CAGRs of 10 percent and 17 percent, respectively. Business model shifts for payers and providers account for much
of that growth.

The rapid adoption of data and advanced analytics and software is spurring innovation in areas such as
population health management, revenue cycle management, and patient engagement. Furthermore,
virtual health—take-up of which increased substantially during the pandemic but since stabilized— is
accelerating care-model innovation and technology solutions.
Pharma services: More spending, led by the specialty drugs

Pharmacy services have undergone major changes in recent years, including new models of patient
engagement, establishment of partnerships across stakeholders, and the entrance of new digital
pharmacy models. Drug spending has increased, with dispensing revenue growing from $450 billion in 2019 to $500 billion in 2021. The
growth was primarily driven by specialty drugs, which now account for 40 percent of dispensing revenue.6 Continued innovation in drug
development could expand specialty profit pools further; these are expected to increase at an 8 percent CAGR from 2021 to 2025.

Hospital-owned specialty pharmacies have expanded their participation, with nearly 40 percent of provider-owned pharmacies attaining
accreditation.7 In infusion-related value pools, COVID-19
accelerated site-of-care shifts, enabling growth in home
infusion as patients reduced in-person visits to hospitals. Additionally, payers are becoming more directive in shifting
infusion therapies from hospital outpatient settings to lower-cost sites of care such as the home and ambulatory infusion centers, further
accelerating volume shifts.

Traditional drug dispensers such as retail and mail pharmacies continue to face margin pressure, leading to a contraction of profit pools. New
technology-enabled pharmacies have emerged, featuring direct-to-consumer models with digital
prescription management, automated workflows, and faster home delivery services. Although these
players have not yet reached substantial market share, they are growing quickly, spurred by substantial private equity
investment. Competition from these players could promote innovation around convenience and
experience in the business models of larger retail and mail pharmacies as well, creating potential margin
upside.
The wholesaler segment continues to benefit from increased drug spending. We estimate that drug distribution revenue is likely to increase at a
5 percent CAGR from 2021 to 2025; wholesalers’ profit margins from drug distribution are expected to remain flat over the coming years.

Outside of overall specialty growth, the pharmacy benefit managers (PBMs) segment is under pressure for more transparency into rebates and
network spread pricing from payers and sponsors. Employer
demand for cost containment and predictability has given
rise to a wave of new and innovative pricing models. Specialized players (such as specialty drug managers, therapy
management, benefit optimizers, and pharmacy benefit administrators) are now taking on some PBM functions. In the face of these trends and
commoditization, PBMs have launched group purchasing organizations (for example, Ascent Health Services, Zinc Health Services, and Emisar
Pharma Services) to better negotiate with drug manufacturers. They continue
to invest to improve employer and employee
experience and ramp up efforts to better manage medical benefit specialty drugs.

The growth in drug spending, including the rise of specialty drugs, has focused increasing attention on the role of
pharmacy in coordinating care for patients. Of particular interest is the use of pharmacists and patient services in promoting
greater adherence to medication regimens and providing medication-related counseling. Payers, PBMs, and dispensers
alike are focusing on reducing the total cost of care and pursuing enhanced patient outcomes and
experience.
Evolving business models

These shifts in industry economics are prompting business model change in three areas—diversification,
vertical integration, and new business building.
Diversification

As the industry profit pools diversify, healthcare players are reviewing the scope and scale of their
business lines. They are expanding their scope of services to adjacent segments as well as building
businesses to monetize capabilities.

Hospital systems have been expanding across the care continuum, accumulating assets in ambulatory
sites, virtual and digital health, primary care, and post-acute care. A majority of the net patient service revenues of the
largest 50 hospital systems are now outside inpatient care. In addition to outright acquisitions, hospital systems are pursuing
partnerships with innovators in these spaces, including primary care disrupters, risk-bearing management
services organizations (MSOs), and virtual care companies.

Others in care delivery are moving to diversify as well. For example, home health and hospice companies are expanding into more sophisticated
care delivery like hospital-at-home. Pharmacy players are scaling their primary-care businesses with acquisitions of physician and clinic assets,
including value-based physician players. Announced investments seem to suggest
a substantial expansion into primary
care and value-based care well beyond the retail clinics space they have entered previously.
As players build new capabilities, they are recognizing that these capabilities can become large, profitable businesses in their own right. Many
payers have created HST businesses of their own to both serve their core payer business and sell these services to other healthcare players. For
example, payers are building MSOs to take a much more active role in managing the care of their patients. This kind of diversification
has
two benefits: it addresses new value pools while potentially creating value for the core payer business
by reducing total cost of care through more robust analytics and reporting and improved care
coordination to more effectively look after patients.
Also, several provider systems have launched venture funds aimed at diversifying the core business into attractive revenue pools such as data
and analytics; some have created start-up incubators to build a range of digital health products and services. Other health
systems are
starting and expanding specialty pharmacies. About 20 percent of accredited specialty pharmacies are now owned by health
systems and hospitals. Hospital-owned pharmacy programs have unlocked a new, growing revenue stream
while demonstrating improved patient outcomes and experience through their integrated care
programs, highlighting faster time to therapy and improved adherence rates among its specialty patient
population.
Vertical integration

The continued rapid expansion of value-based care models is leading to realignment across the
healthcare value chain. The realignment is in pursuit of models that can better deliver affordability,
quality, enhanced access, and experience of care but also holds the promise of superior economic
returns. Payers, for example, are innovating their Medicare Advantage business to move beyond providing
just the health plan to ownership and orchestration of care models inclusive of physician practices,
virtual care, home care, and pharmacy as well as care management, medication adherence, and other
enablement services. These models are increasingly powered by data- and analytics-enabled clinical
services such as care coordination and enhanced member engagement. Such an approach may offer superior care to members while
expanding the profit pool available to payers by two to three times (Exhibit 3). To access these capabilities, payers are pursuing
acquisitions, minority investments, and partnerships with private equity firms.
New business building

Private equity and venture capital players are continuing to increase investment in healthcare; in 2021, they
invested over twice as much as they did seven years ago. “Platform creation” is the investment thesis for many of these
healthcare investments—identifying opportunities to create value beyond the immediate asset through M&A and business building (Exhibit 4).
The financial sponsors are building the business, then leveraging a platform to create a more expansive set of offerings. In many instances, this
approach ends up transforming the underlying business.

For example, during COVID-19, a private equity-owned, home-based provider built out a clinical trial within a few months to facilitate
vaccine trials, enrolling five times the number of diverse participants compared to normal approaches, based on our experience. In another
case, a provider of non-emergency medical transportation expanded into nutritional meal-delivery services for high-need and high-risk patients.

This high speed of innovation is upending the incumbent healthcare players’ traditional approach of
transforming or incrementally adding to existing business models. Instead, business reinvention has
become a critical priority. While the approach includes making anchor acquisitions, it must also often rely on high-
speed business building to take advantage of incumbent assets and fast scale-up to make a difference to
their business. Many are pursuing this model. For example, one pharmacy services player created a digital pharmacy from scratch within a
year. In another instance, a large healthcare player built an entire value-based care business in 18 months.
 ADV 2
1. Inequality is decreasing – wages are no longer stagnating and
unemployment rates are declining
Semuels 23 (ALANA SEMUELS - Economic correspondent at TIME. She is a four-time nominee for the
Gerald Loeb Award for Distinguished Business and Financial Journalism, and has won awards from the
Society of Business Editors and Writers and the Los Angeles Press Club. “American Inequality is (Finally)
Lessening.” TIME. 3/31/23. https://time.com/6267552/falling-american-inequality/)
If 2022 was the year the U.S. economy came roaring back like a lion, 2023 is more of a lamb. Modest job growth, consistent inflation, falling
home prices, slowing GDP growth—meh. February was another month of meh, the government reported Friday, with personal incomes
increasing 0.3% in February after growing 0.6% in January. In addition, consumer spending grew 0.2% in February. But there’s some pretty good
news that doesn’t readily appear in the steady stream of government data released each week. After decades in which the gap
between the richest and poorest Americans grew by leaps and bounds, the strange rebound from the
pandemic has led to something different: a slow reduction in inequality across the economy. Incomes
of people in the bottom half of income distribution grew by 4.5% in the last calendar year, much faster
than the 1.2% average income growth of all Americans, according to Realtime Inequality, a tool launched by economists at
the University of California, Berkeley to show a more holistic picture of how the U.S. economy is faring, as compared to GDP. While lower-
income households struggled following the Great Recession, taking more than eight years to reach pre-
crisis income levels, they have done much better in the pandemic’s aftermath. Between February 2020
and September 2022, average income for the lowest-earning 50% of Americans increased by more
than 10%, faster than all groups of population except for the top 1%, according to a paper by the Realtime Inequality
economists, Thomas Blanchet, Emmanuel Saez, and Gabriel Zucman. This reduction in inequality breaks from a long-
running trend in which the rich were getting richer and the poor were stagnating . Since 1980, the top 10% of
earners have seen income grow 144%, while the bottom half of earners saw just 20% growth in income. “ What we’re witnessing
since the late 2010s—significant growth rates for low-wage workers—is a notable break from the trend
that has prevailed since the 1980s,” Zucman says, in an email. The biggest factor driving this reduction in
inequality is a tight labor market that has pushed up wages for workers whose pay had previously been
stagnating. The monthly unemployment rate hovered around 4% in both 2018 and 2019 as well as in 2022 (the massive layoffs at the
beginning of the pandemic spiked unemployment in 2020 leading into 2021); this year it hit a decades-long low at 3.4% in
January. Economists expect the government to report an unemployment rate of 3.6% when it releases March data on April 7.

2. Single-payer is more expensive than private health insurance – it would

require massive broad-based taxation and trillions in additional health care
spending
Moffit 20 [Robert E. Moffit, Ph.D., Senior Research Fellow, Center for Health and Welfare Policy, “Single-Payer is Not the Solution to
America’s Health Care Problems”, Heritage Foundation, 11-17-2020, https://www.heritage.org/health-care-reform/commentary/single-payer-
not-the-solution-americas-health-care-problems] AW

Costs Congressional sponsors, as noted, claim that the substitution of broad-based federal taxation for private health insurance costs would
result in most American families paying less for health care than they do today. Sen.
Sanders concedes that his proposed
program would require broad-based taxation on the general population, not just high taxes on the
economically advantaged few. Examining his initial (2016) proposal, however, Professor Kenneth Thorpe of Emory University, a
former advisor to President Clinton, estimated that the Sanders proposal—if it were fully funded—would require a
14.3 percent payroll tax, as well as a 5.7 percent income-related premium; in other words, a level of
taxation equal to 20 percent of payroll. Thorpe concluded that 71 percent of all working families would pay
more for health care than they do under the current system. A 2020 Heritage Foundation econometric
analysis broadly confirmed Thorpe’s findings, estimating that the program would require a tax of 21.2 percent on earnings, and
73.5 percent of Americans would have less money in their pockets. Over 156 million Americans today have employer-
sponsored coverage—roughly half of the American population—and those households losing job-based
coverage would experience an average income reduction of $10,554, which means about 87 percent of
those households would be worse off. Spending Some academic specialists estimate that a single-payer system can indeed
achieve lower levels of household and national health care spending. It is theoretically possible, of course, to achieve such fiscal objectives if,
and only if, federal officials would enforce either serious caps on national health care spending (global budgets), regardless of the demand for
services, or impose severe reductions in medical reimbursements unlike anything Americans have previously experienced. The prevailing view
among prominent health care economists, liberal and conservative alike, is that such an outcome is highly unlikely. For example, scholars at the
Urban Institute, a prominent liberal-leaning think tank, estimated that a single-payer program would require a federal
spending increase of $34 trillion over ten years, and total American health care spending would
increase by $7 trillion. Dr. Charles Blahous, a former trustee of the Medicare program, initially projected a $32.6 trillion increase in
additional federal spending, and later emphasized that this federal and overall national spending would likely be higher . The Center for
Health and the Economy, a conservative-leaning policy group, focused on the Sanders plan and
estimated that federal spending could range between an additional $35-$45 trillion over ten years,
while generating a deficit of up to $2.1 trillion annually. A Rand Corporation study estimated the combination of
additional federal spending and comprehensive benefits plus the absence of cost-sharing could result in
an overall annual increase in national health care spending ranging, depending on utilization, anywhere from
1.8-9.8%.

3. Medical debt has decreased and Biden will continue---multiple recent studies.
Healthcare Purchasing News HPN 23, “Data shows widespread decrease in medical debt,” 2/17/23,
https://www.hpnonline.com/patient-satisfaction/population-health-care-continuum/article/
21296160/data-shows-widespread-decrease-in-medical-debt, ajs

The Consumer Financial Protection Bureau (CFPB) released a new report that shows that the number of Americans with
medical debt on their credit reports fell by 8.2 million from the first quarter of 2020 to the first quarter of 2022.
This report is consistent with a recent report from the Centers for Disease Control and Prevention (CDC) that found that
the number of Americans who are part of families having trouble paying their medical bills declined by 5.5
million between 2020 and 2021. One driver of these declines is the significant increase in the number of insured Americans over
this period, a result of the President’s strategy of protecting and strengthening the Affordable Care Act (ACA) and
lowering health care costs. The decline also reflects continued actions by the CFPB to highlight problems with inaccurate reporting of debt in collections and put the
industry on notice to correct their behavior.

The new data also underscore the importance of the Biden-Harris Administration’s government-wide initiative to reduce the
burden of medical debt. Following the Vice President’s April 2022 announcement, medical debt was directly relieved for many low-income Americans. And,
informed by research showing that medical debt is not a reliable predictor of financial health, federal agencies are working to eliminate the use of medical debt to
assess creditworthiness for participation in government lending programs. Specifically:

· The Department of Veterans Affairs (VA) implemented a streamlined process to make it easier and faster for lower-
income veterans to get their VA medical debt forgiven. The new process – establishing simple criteria to qualify for debt relief and launching a new online

debt relief portal – has already provided relief to over 10,000 veterans and saved them more than $10 million in copay
debt.

· Communities across the country – from Cook County, Illinois, to Toledo, Ohio, to New Orleans, Louisiana, to Pittsburgh, Pennsylvania – are using or
have passed legislation to use about $16 million American Rescue Plan (ARP) funding to purchase medical debt from hospitals and other
sources and forgive it, wiping out nearly $1.5 billion in medical debt, a ratio of nearly 100-to-1. Other localities and states have proposed to make similar purchases
using ARP funding.
· The Federal Housing Finance Agency (FHFA) validated and approved the use of VantageScore 4.0, along with FICO 10T, for the underwriting of mortgages
by Fannie Mae and Freddie Mac. The addition of VantageScore 4.0, which excludes medical debt entirely, marks the first time that a credit

score that excludes medical debt has been approved for mortgage underwriting of Enterprise loans.
 SOLVENCY
1. Single-payer healthcare inflates healthcare bills while providing worse
service – wouldn’t boost U.S. public health system
Pipes 22 (Sally C. Pipes, President and chief executive officer of the Pacific Research Institute, “Opinion:
Single-Payer ‘Medicare for All’ Would Inflate Americans’ Healthcare Bills”, Time of San Diego, June 7,
2022, https://timesofsandiego.com/opinion/2022/06/07/single-payer-medicare-for-all-would-inflate-
americans-healthcare-bills/)
Inflation is ripping through every sector of the U.S. economy. But there’s one curious exception: healthcare. The cost of medical care is up 3.5%
in the last year. The overall inflation rate, by contrast, is nearly two-and-a-half times higher — 8.3%. So why are Sen. Bernie Sanders and 14 of
his Democratic colleagues proposing to essentially nationalize the U.S. health insurance system? The Vermont socialist introduced his latest bid
for Medicare for All in May at a hearing of the Senate Budget Committee, which he chairs. Thanks but no thanks, senator. As
other
countries with government-run healthcare systems prove, Medicare for All is no bargain. In fact,
patients trapped in socialized medicine often pay huge sums out of pocket — and for low-quality care.
It’s true that the United States spends more per head on health care than other advanced economies.
But that’s largely a function of wealth. Americans, on average, are much richer than our peers in other
developed nations. For example, per-capita health spending is $6,600 higher in the United States than in the United Kingdom. But
Americans make $22,000 more per year, on a per-capita basis. Similarly, Germany spends about $5,500 less per head on health care. But its per
capita GDP is about $17,000 less than the United States. Our
higher spending levels correlate with better health
outcomes. Cancer prevalence has been rising globally, but survival rates in the United States have been increasing.
Meanwhile, Americans typically do not have to endure the long waits common in the United Kingdom and
Canada. In April, more than 24,000 people in England waited more than 12 hours in emergency departments before a decision was made
about whether to admit them. In a newly released book, former UK Health Secretary Jeremy Hunt said that he was “shocked to his core” by
failures in care, including hundreds of avoidable deaths. In Canada in 2019, 4.6 million people over the age of 12 lacked a family doctor,
according to the country’s national statistics agency. Last year, the median wait to receive treatment from a specialist in Canada following
referral by a general practitioner was 25.6 weeks — roughly six months. Patients
pay dearly for their low-quality
government-sponsored health care. There are the high taxes, of course. A typical family of four in
Canada pays more than $15,000 in taxes just for health care. I

n the United Kingdom, the National Health Service costs each English household around 5,785 pounds — a little over $7,100 — each year. That
per-household cost has increased more than 75% since 2000. Increasingly ,
people abroad are paying for a lot of their own
care out of pocket — despite having government-sponsored health insurance. In the United Kingdom,
out-of-pocket healthcare expenses rose about 5.3% between 2020 and 2021 . By 2019, 17% of the costs of medical
care in the United Kingdom were coming directly out of people’s wallets. The Canadian healthcare system doesn’t cover prescription drugs or
dental, vision, or rehab services. Out-of-pocketpayments accounted for roughly 15% of Canadian healthcare
costs in 2019. In the United States, by comparison, just 11% of healthcare expenses come out of patients’ pockets. A recent event
promoting single payer that Sen. Sanders put on with Norway’s ambassador to the United States, Anniken R. Krutnes, was rife with irony. She
claimed, “I will never pay more than $350 a year for health care or medicines,” referring to her annual deductible. If so, she’ll likely be skipping
dental care and the many prescription drugs the government has decided not to cover. In fact, Norway ranks right behind the United States and
Switzerland in per-capita healthcare expenses. Total out-of-pocket costs accounted for nearly 14% of Norwegian health expenses in 2019.
Almost 15% of Norway’s workforce elects to pay for private supplemental health coverage to avoid government rationing and wait times. Most
private supplemental insurance plans are covered via employment. Sen. Sanders would ban even that kind of modest private coverage under
Medicare for All. Government-provided
health care abroad is not free. People pay for it one way or another
— whether out of pocket, through taxes, or even with their lives.
 OFF
Aff must increase services under OASDI
(1) ‘Expanding’
Holm ’2 [Edward G. Holm and Jeffrey G. Gancher; May 9, 2002; Prosecuting Attorney from Thurston
County; Deputy Prosecuting Attorney from Thurston County; Westlaw, “Supplemental Brief of Petitioner
Thurston County” in Thurston County v. Western Washington Growth Management Hearings Board, 2002
WL 32859639]
Respondents have argued that the 4 inch sewer line is an *2 extension of sewer and not a replacement. This assertion ignores the
plain meaning of RCW 36.70A.110(4) which includes the phrase,“... it is not appropriate that urban governmental services be
The term “extend” applies to placing/constructing new
extended to or expanded in rural areas...” RCW 36.70A.110(4).
urban services in the rural area while the term “expand” applies to existing services in the rural area. This is
the plain meaning of the phrase as used in RCW 36.70A.110(4).

(2) “Social Security”

CFR ’92 [Code of Federal Regulations; effective May 21, 1987, as amended on July 29, 1992; Title 5:
Administrative Personnel, Chapter I: Office of Personnel Management, Subchapter B: Civil Service
Regulations, Part 846: Federal Employees Retirement System—Elections of Coverage, Subpart A:
General Provisions, “Section 846.102 Definitions,” 5 C.F.R. § 846.102]

Social security means coverage under the Old Age, Survivors, and Disability Insurance programs of
the Social Security Act.

Violation – the aff doesn’t expand benefits to pre-existing OASDI programs.

Prefer
1) Limits – OASDI is large topic with cases for age, gender, and disability – exploding
beyond that can cover additional groups up until universal coverage.
2) Education – topic is about expanding benefits to pre-existing recipients, not
increasing number of recipients, else eliminates debate over specific benefits and
taxes.
 OFF
ASPEC.
The plan text should specify the federal branch that carries out the plan---they didn’t.
That’s key to agent counterplans and stable links to tradeoff and politics DAs. Reject
the aff.
 OFF
The 2024 election is Trump v Biden – it’s close and dependent on coalitions.
Goldmacher 9/22 [Shane Goldmacher is a national political reporter and was previously the chief
political correspondent for the Metro desk, New York Times, “Biden, Warning Trump Could ‘Destroy’
Democracy, Moves Past G.O.P. Primary”, https://www.nytimes.com/2023/09/22/us/politics/biden-
trump-2024-election-polls.html] Luke
This spring, as the Republican presidential primary race was just beginning, the Democratic National Committee commissioned polling on how
the leading Republicans — Donald J. Trump and Ron DeSantis — fared against President Biden in battleground states. But now, as Mr.
Trump’s lead in the primary has grown and hardened, the party has dropped Mr. DeSantis from such
hypothetical matchups. And the Biden campaign’s polling on Republican candidates is now directed
squarely at Mr. Trump, according to officials familiar with the surveys. The sharpened focus on Mr. Trump isn’t
happening only behind the scenes. Facing waves of polls showing soft support for his re-election among
Democrats, Mr. Biden and his advisers signaled this week that they were beginning to turn their full attention to his
old rival, seeking to re-energize the party’s base and activate donors ahead of what is expected to be a long and grueling
sequel. On Sunday, after Mr. Trump sought to muddy the waters on his position on abortion, the Biden operation and its surrogates pushed back with uncommon intensity. On Monday, Mr. Biden told donors at a New
York fund-raiser that Mr. Trump was out to “destroy” American democracy, in some of his most forceful language so far about the

implications of a second Trump term. On Wednesday, as the president spoke to donors at a Manhattan hotel, he acknowledged in the
most explicit way yet that he now expected to be running against “the same fella.” And on Friday, Mr. Biden
announced plans to join striking autoworkers on the picket line in Michigan next week — one day before Mr. Trump
visits the state. The mileposts all point to a general election that has, in many ways, already arrived. David
Axelrod, the architect of Barack Obama’s presidential campaigns, said engaging now with Mr. Trump would help Mr. Biden in “getting past this
“The whole predicate of Biden’s
hand-wringing period” about whether the president is the strongest Democratic nominee.
campaign is that he would be running against Trump,” Mr. Axelrod said. “Their operative theory is, once this is focused on the
race between Biden and Trump, that nervousness will fade away into a shared sense of mission. Their
mission is in getting to that place quickly and ending this period of doubt.” Mr. Trump has undertaken a pivot of
his own, skipping the Republican debates and seeking to position himself as the inevitable G.O.P. nominee, with allies urging the party to line
up behind him even before any primary votes are cast. Mr. Biden, in his remarks to donors on Monday on Broadway, issued a blunt warning
about his likely Republican opponent. “Donald Trump and his MAGA Republicans are determined to destroy American democracy,” the
president said. “And I will always defend, protect and fight for our democracy. That’s why I’m running.” Mr. Biden is planning to follow up those
off-camera remarks with what he has billed as a “major speech” about democracy. The White House said the speech, in the Phoenix area the
day after the next Republican debate, would be about “honoring the legacy of Senator John McCain and the work we must do together to
strengthen our democracy.”

Expansion in fiscal redistribution is unpopular.

Stantcheva, 21 – Nathaniel Ropes Professor of Political Economy at Harvard (Stefanie Stantcheva,
“Why People Vote Against Redistributive Policies That Would Benefit Them,” MIT Press Reader, 11-20-
2021, Available Online: https://thereader.mitpress.mit.edu/why-do-we-not-support-redistribution]

Understanding the connection between citizens’ information, beliefs, and political support for policies that can affect
their lives in profound ways is both critical and difficult. Amid rising inequality and political polarization, uncovering citizens’
(mis)perceptions, views on fairness, and economic circumstances is an important first step in addressing problems that currently weaken U.S.
democracy. A central
puzzle is why so many voters seem to vote against redistributive policies that would
benefit them, such as more progressive income taxes, taxes on capital income or estates, or more generous
transfer programs, and why voters have tolerated policies that have contributed to a stark rise in inequality
over the past few decades.
The median voter model predicts that an increase in inequality, as captured by the gap between median and average income, should lead to an
increase in support for redistribution and an increase in actual redistribution as policymakers cater to the median voter’s preferences. Yet, as
shown by economist Ilyana Kuziemko and others (including myself), using the General Social Survey, there has
been no increase at all in stated support for redistribution in the United States since the 1970s, even
among those who say they have below average income

Trump reelection leads to global nuclear war – shatters I-law and ruins foreign policy
Beres 23 [Louis, 3-23-23, Professor of International Law at Purdue. Modern Diplomacy, “If Trump
Returns as President: An Existential Threat to the United
States.”.https://moderndiplomacy.eu/2023/03/03/if-trump-returns-as-president-an-existential-threat-
to-the-united-states/] Recut - Luke

Credo quia absurdum, “I believe because it is absurd”-Tertullian There

are many reasons to fear Donald J. Trump’s return to
the White House, but one remains especially worrisome. It stems from the former president’s
conspicuous ignorance of international law and US foreign policy. Among assorted particulars of this debility, a
previously failed Trump posture – “America First” – would likely prove more injurious the second-time around .[1]
Prima facie, its restoration, thoughtless in the most literal sense, would dignify a numbingly vacant US president’s indifference to science, logic,
Following escalating
history and law.[2] Could it get any worse? Could anything be more absurd? Here is a basic answer:
aggressions by Russia in Ukraine and potentially destabilizing aggressions by China and North Korea in Asia,[3] America
needs a leader who can read and think meaningfully. The American White House is not a proper place for foreign policy
pretenders, especially a former president who already displayed a pernicious fusion of historical indifference and intellectual incompetence.
There are also relevant specifics. Any future presidential retrogressions to “America First” would stem from misapplied US cultural
underpinnings. These backward steps, absurd steps, would reflect variously intersecting declensions of “mass-man.”[4] Though Donald Trump
remains a celebrated leader of the American “mass,” not just a member, he has never actually risen above the capacities of his chorus. Rather,
amid the constant rancor and noisy defilement, he has remained one of mass man’s most fervid exponents. From time immemorial,
international relations have been rooted in Realpolitik[5] or power politics.[6] Though such traditional patterns of thinking are normally
accepted as “realistic,” they actually undermine world law and global order. It follows that any sitting US president should
finally acknowledge the lethal limitations of our planet’s global threat system,[7] and recognize, as inevitable corollary, that US power
ought never be founded upon delusions of national primacy. “America First” has a pleasing resonance with the Many,
with those who like to chant in crowds. But this narrow political resonance does not extend to the Few, to those who would prefer to think as
conscious individuals.[8] About the “Few,” German-Swiss philosopher Thomas Mann attributes the downfall of civilizations to gradual
absorptions of the educated classes by the Mass, to the “simplification of all functions of political, social, economic and spiritual life.”[9] If
nothing else, America’s Trump era was a humiliating period of deliberate and falsifying simplifications. Is it anything less than preposterous to
actually seek its return? Americans require intellect-based answers, not an endless barrage of silly clichés and partisan rancor. In turn, such
answers will call for dialectical (mind challenging) thinking.[10] Analytically, in these calculations, the United States should always be considered
as one significant part of the larger world system, the world system configuration created by the Peace of Westphalia in 1648.[11] Though more
or less ignored by global leaders, the “Westphalian” system of international law[12] (a system of institutionalized global anarchy) is destined to
fail. Moreover, together with the accelerating spread of nuclear weapons technologies and infrastructures, any such failure would prove
remorseless, unprecedented (sui generis would say the logicians) and irremediable.[13] At another level, it would signal the potentially
insufferable triumph of anti-reason.[14] There are also relevant nuances. Grievous world system failure could take place in hard to fathom
increments, or with great suddenness, as an unanticipated nuclear “bolt from the blue.” On such bewilderingly
unpredictable matters, any US policy resurrection of Donald Trump’s “America First” would prove starkly
injurious. Conceptually, it’s not complicated. In these indispensable calculations, history deserves a much more manifest pride of place.
False bravado and belligerent nationalism have never succeeded in any decipherable ways or for longer than brief intervals. Indeed, from an
historical standpoint, no observation could be more obvious. Plausibly, in a Trump-resurrected future, unsteady
expressions of national security policy would be exacerbated by multiple system failures. At times, these
failures could be mutually reinforcing or “synergistic.”[15] At other times, they could involve “force-multiplying” weapons of
mass destruction. In any case, they could be brought about by the defiling restoration of an absurd presidency. Rejecting the banalities
of “America First” and its derivative foreign policy deformations, a capable US president should think along clarifying lines of subject-matter
interrelatedness. It is preposterous to deny that “America First” would fail US national security obligations. Moreover, any such failure, even
one that did not produce catastrophic war or terror, would be degrading to United States. “The visionary,” teases Italian film director Federico
Fellini, “is the only realist.” But there can be nothing “visionary” about “America First.” Whether in its previous Trump-defined iteration or in a
future modified version, this stitched together amalgam of a former president’s clichés would be absurd. Should such a lack of vision find its
way back into the American White House in 2024, its multiple and recycled harms could fatally undermine whatever might still remain of
if strengthened and expanded by manipulative resurrections of
American Reason.[16] At some point, especially
“America First,” world system failures could become both tangibly dire and irreversible. In the final analysis, it
will not help the United States or any other country to tinker “thoughtlessly”[17] at the ragged edges of our “Westphalian” world legal order. At
any US presidential reaffirmations of “America First” could significantly hasten the
that decisive turning point,
onset of a regional or worldwide nuclear war. It’s not complicated. “America First” is just mass-defined shorthand for
“America Last.” In the longer term, the only sort of foreign policy realism that could make any sense for the United States is a posture that
pointed toward much “higher” awareness of global “oneness.”[18] Whether or not we like the sound of such “intellectual” cosmopolitanism,
world system interdependence is not a matter of policy volition. It is an incontrovertible fact.[19] In its fully optimized expression, such an
indispensable awareness – the literal opposite of former US President Donald Trump’s “America First” – would resemble what the ancients
called the “city of man.” For the moment, the insightful prophets of any more consciously collaborative world civilization will remain few and
far between.[20] But this lamentable absence, one unimproved even by active intellectual interventions by our “great universities,”[21] does
not owe to any witting analytic forfeiture. Above all, it reflects an imperiled species’ stubborn unwillingness to take itself seriously. This means
an unwillingness to recognize that the only sort of patriotic loyalty still able to rescue a self-destroying planet is one finally willing to embrace
humankind as a whole. Any such embrace would represent a new and re-directed focus of patriotic loyalty. Almost by definition, therefore, it
would not be discoverable by American mass. There is more. Intellectually and historically, “America First” remains misconceived and irrational.
[22] Now, more desperately than ever before, we require a logic-based universalization and centralization of international relations. Though
challenging, this complex requirement need not express a bewildering or incomprehensible rationale. But there will still be demanding
intellectual prerequisites. In the United States especially, such expectations will almost certainly be unrealizable. Nonetheless, it is hardly a
medical or biological secret that core factors and behaviors common to all human beings greatly outnumber those that differentiate one person
from another. Unless the leaders of all major states on Planet Earth can finally understand that the survival of any one state must be contingent
upon the survival of all, true national security will continue to elude everyone. This includes the “most powerful” states and individuals, even if
their explicit policy mantras call foolishly for the subject to be “first.” What cannot benefit the entire “hive,” warns Marcus Aurelius in his
Meditations, can never help the individual “bee.” The most immediate security tasks in our Westphalian condition of global anarchy remain
narrowly self-centered. Simultaneously, national leaders must finally learn to understand that our planet represents a recognizably organic
whole, a fragile but intersecting “unity” that exhibits diminishing options for genocide avoidance[23] and war avoidance.[24] This is the
indispensable unity of human “oneness.” It’s finally time for candor. Though clichéd, America is “running out of time.” Quickly, to seize rapidly
disappearing opportunities for longer-term survival, our leaders must learn to build upon the critical foundational insights of Francis Bacon,
Galileo and Isaac Newton,[25] and on the more contemporarily summarizing observation of philosopher Lewis Mumford: “Civilization is the
never ending process of creating one world and one humanity.”[26] Whenever we speak of civilization we must also speak of law.
Jurisprudentially, no particular national leadership can claim any special or primary obligation in this regard. Nor could any such leadership
cadre ever afford to build comprehensive security policies upon the vaguely distant hopes of mass. But the United States remains a key part of
the community of nations and must do whatever it can to detach an already collapsing “state of nations” from our time-dishonored “state of
nature.”[27] There is more. Any such willful detachment should be expressed as part of a wider vision for a more durable and justice-centered
world politics. Over the longer term, an American president will have to do his or her part to safeguard the global system as a whole. Then,
“America Together,” not “America First,” would express a markedly more rational and intellect-based security mantra.[28] However impractical
or fanciful this may all sound, nothing could be more perilous than continuing on a long-discredited “Westphalian” course. “What is the good of
passing from one untenable position to another,” inquires Samuel Beckett in Endgame, “of seeking justification always on the same plane?” It’s
a critical question, one that should now be asked of any sitting or aspiring US president, especially an aspirant who has already demonstrated
his consummate unfitness. For the moment, there is no need for detailing any further analytic or intellectual particulars. There are, of course,
bound to be many. Always, these will need to be held together by coherent and comprehensive (science-based) theory.[29] In The Plague,
Albert Camus instructs: “At the beginning of the pestilence and when it ends, there’s always a propensity for rhetoric…It is in the thick of a
calamity that one gets hardened to the truth – in other words – to silence.” As long as the nation-states in world politics continue to operate as
glib archeologists of ruins-in-the-making – that is, as “political prisoners” of a vastly-corrupted philosophic thought – they will be unable to stop
the next series of catastrophic wars.[30] Credo quia absurdum, said the ancient philosopher Tertullian. “I believe because it is absurd.” Until
now, certain traditional expectations of balance-of-power world politics may have been more-or-less defensible. Nevertheless, soon, from the
essential standpoint of longer-term options and global security survival prospects, an American president should open up this nation’s latent
security imagination to more visionary and intellect-based forms of foreign policy understanding. Resurrecting the “everyone for himself”
extremity of former president Donald J. Trump’s “America First” would represent a US policy move in the wrong direction. No move could
conceivably be more wrong. It could never make sense for the United States to construct security justifications along the incessantly brittle lines
“America First” remains a self-defiling national mantra, nothing more. Recently championed
of belligerent nationalism.[31]
it ought never be allowed to
by an American president who was proudly detached from historical or analytic understanding,
reappear in United States foreign policy. To be sure, there is nothing inherently wrong with any sensible manifestations of
American patriotism, but these primacy-oriented (zero-sum) manifestations could never be reconciled with any
dignified human survival.
 OFF
Social security perpetuates capitalism
Brents 84 [Barbara, Prof of Sociology at UNLV, “Capitalism, Corporate
Liberalism and Social Policy: The Origins of the Social Security Act of
1935,” Mid-American Review of Sociology, p.25-7]
Social insurance as we know it had its earliest intellectual roots in the late 19th century transformation of liberal
thought from an individualist laissez faire ideology to the social responsibility, interventionist ideology of the 20th century. It was the
view of this new corporate liberalism that provided justifications and methods for social insurance in America, along a course
that was entirely consistent with the continuance of a capitalist system. Twentieth century
corporate "liberalism, as James Weinstein (1968) defines it, involves an ideology which holds that social
engineering, social efficiency and social responsibility are the means to stabilize, rationalize and expand the
existing capitalist political economy, and avoid dangerous alternate forms of social organization,
especially socialism. In the attempt to succeed in this endeavor, the economist arose as the technical expert
who would develop government policy that could create and maintain a stable social order. As
corporate liberalism developed, it succeeded in co-opting a potentially radical and often violent working
class by incorporating labor representatives as junior partners in a business/government
association designed to work out "rational" and "efficient" solutions to conflicts and maintain
industrial peace'. Terms such as efficiency and stabilization replaced justice as the main expressed
goal. However, corporate liberalism, as it shall be discussed throughout this paper, cannot be viewed as a static, autonomous
concept. It was a dynamic set of ideas that originated in the minds of humans and was both shaped by and shaped interaction in a
social environment. This
ideology laid the intellectual groundwork, set the ideological boundaries, and
devised the methods used in the formulation of the Social Security Act as "the" solution to the problems of
old age and unemployment. Corporate liberal ideas originated in Germany in the late 187Os and were first brought to the United
States by a group of prominent American economists trained in the German Historical School of Economics centered at the
University of Heidelberg. Contrary to classical economics and its abstract reasoning and individualistic emphasis on natural rights
and natural law, this group believed economic phenomena could best be understood by using statistical investigations and inductive
methods to shape economic institutions to meet social goals through active state intervention. The members of this school formed
the Union for Social Politics (Verein fiir Sozialpolitik) in Germany to gather economic information to meet "the acknowledged need ...
of social reform in -opposition to social revolution on the one hand, and to rigid laissez faire on the other" (Dorfman, 1955 :21).
These attempts to "meet the challenge of socialism resulted in an advanced program of social insurance, culminating in Bismark's
American economists from this
program of sickness, accident, invalidity and old age insurance" (Dorfman, 1955 :21). The
school returned to the United States with these ideas during the late 1880s and 90s, years fraught with long
and severe depressions and widespread labor unrest. Many, including some businessmen, were losing
confidence in the ability of an unregulated economy to maintain social order, and these
economists did much to change the scope of American economics. The work of Richard Ely in particular
helped define and institutionalize emerging corporate 'liberal 'thought and subsequent notions of social insurance. Ely, impressed
with the efficiency of the German government, believed the United States government could likewise efficiently shape economic life
for the good of the public. He outlined programs of social reform that resembled those of the New Deal over 40 years later public
housing, public work for the unemployed, child and female labor restrictions, and government insurance for protection against death,
reforms had the expressed goals of avoiding
old age, sickness and accidents (Fine, 1956; Ely, 1894). His
socialist- violence and revolution, and maintaining the existing class structure by eliminating the
waste and inefficiency of the present system (Fine, 1956; Ely, 1894). Ely published 25 books and 280 pamphlets and
articles before his death in 1937. His students included a long list of New Dealers, reformists, economists, sociologists and others
who became important in forming American social policy during the first half of the twentieth century.

Capitalism makes extinction inevitable and “vote neg to build the ICFI as the world
party for socialist revolution”
Kishore 23 [Joseph Kishore, David North "2023: The global capitalist crisis and the growing offensive of
the international working class" World Socialist Web Site. International Committee of the Fourth
International (ICFI) January 3, 2023] [thiele] [Kishore = 40, is the national secretary of the Socialist
Equality Party in the United Stats; North = leading role in the international socialist movement for 45
years. He is presently the chairperson of the International Editorial Board of the World Socialist Web Site
and the national chairperson of the Socialist Equality Party (United States)]
The ICFI in the decade of socialist revolution 73. The development of the global class struggle represents
a major historical inflection point. The downward slope in the graphic timeline of the class struggle that
dates back to the late 1970s has clearly shifted direction and is curving upward. 74. Within this new
objective situation, the role and practice of the revolutionary party is decisive. At its Summer School in
2019, the Socialist Equality Party (US), based on an analysis of the objective crisis of capitalism and the
history of the Fourth International, identified the qualitative change in the political situation. The present
period, it noted, would be characterized by “the intersection of a new revolutionary upsurge of the
international working class with the political activity of the International Committee.” The International
Committee of the Fourth International has begun the fifth stage of the history of the Trotskyist movement.
This is the stage that will witness a vast growth of the ICFI as the World Party of Socialist Revolution. The
objective processes of economic globalization, identified by the International Committee more than 30
years ago, have undergone a further colossal development. Combined with the emergence of new
technologies that have revolutionized communications, these processes have internationalized the class
struggle to a degree that would have been hard to imagine even 25 years ago. The revolutionary struggle
of the working class will develop as an interconnected and unified world movement. The International
Committee of the Fourth International will be built as the conscious political leadership of this objective
socio-economic process. It will counterpose to the capitalist politics of imperialist war the class-based
strategy of world socialist revolution. This is the essential historical task of the new stage in the history of
the Fourth International. 75. Building on this analysis, the WSWS wrote, in its New Year statement posted
on January 3, 2020, that the coming decade would be the “decade of socialist revolution.” We wrote, “The
growth of the working class and the emergence of class struggle on an international scale are the
objective basis for revolution. However, the spontaneous struggles of workers and their instinctive striving
for socialism are, by themselves, inadequate. The transformation of the class struggle into a conscious
movement for socialism is a question of political leadership.” 76. The challenge of political leadership is to
analyze the objective logic of the capitalist crisis and, on this basis, to develop initiatives that raise the
consciousness of the working class, increase its self-confidence and undermine the political influence of
the capitalist parties. 77. In November 2021, as the Omicron variant was just beginning its global spread,
the ICFI launched the Global Workers Inquest into the COVID-19 Pandemic. In its first year, the Inquest
has gathered statements from dozens of scientists and workers documenting the criminal response of the
ruling class and elaborating a scientific and, above all, political strategy for ending the pandemic once and
for all. 78. On December 10, 2022, the International Youth and Students for Social Equality, the student
and youth movement of the ICFI, held a global online rally to initiate a global movement of young people
against war. In November, the Sozialistische Gleichheitspartei, the German section of the ICFI, initiated
an aggressive campaign in the Berlin elections, which will be held in January and February, 2023. The
SGP is the only party that is fighting to mobilize the working class against the US-NATO war against
Russia. 79. In Sri Lanka, the Socialist Equality Party launched an initiative in July calling for a Democratic
and Socialist Congress of Workers and Rural Masses, in opposition to the conspiracies within the political
establishment to replace the hated Rajapakse government with a new government equally committed to
implementing austerity measures demanded by the IMF. 80. A principal block to the working class
struggle in every country is the corporatist trade unions, which have played a critical role in enforcing
decades of growing social inequality, supporting the ruling class’s war policy, and implementing the back-
to-work campaign during the pandemic. The ICFI’s call for the International Workers Alliance of Rank-
and-File Committees is the means through which the struggles of workers throughout the world can be
unified. In opposition to all those who insist on the inviolability of the existing corporatist trade union
apparatus, the IC advocates the building of organizations comprised of and controlled by the workers
themselves. 81. Over the past year, the fight to break workers free of the union bureaucracy was
powerfully expressed in the campaign of Will Lehman for president of the United Auto Workers in the
United States, which began in June. The campaign won broad support from rank-and-file workers, who
responded to his call for the complete abolition of the trade union apparatus and the transfer of power to
workers on the shop floor. 82. The campaign exposed the vast social gulf that exists between rank-and-
file workers and the UAW apparatus, which is staffed with thousands of individuals whose income places
them in the top 5 percent and even top 1 percent of the population. Forced to hold a direct election due to
the massive corruption scandal that engulfed the UAW, the apparatus responded with a deliberate
campaign of voter suppression. 83. The extremely low turnout of only 9 percent was a product of this
campaign, combined with the alienation of rank-and-file workers from the apparatus. Despite the relatively
small number of ballots cast, the 5,000 votes cast for Lehman reveal the existence of a very large
constituency in the working class for socialist policies. The campaign has established the basis for the
development of a network of committees in auto plants and other workplaces throughout the country. 84.
The building of rank-and-file committees, in every sector and in every country, is necessary for the
development of the class struggle, which in turn is the necessary foundation for a movement not only
against exploitation and inequality, but also against war, the ruling classes’ pandemic policy, and the drive
to fascism and dictatorship. The World Socialist Web Site and the centenary of Trotskyism 85. In the
founding program of the Fourth International, Trotsky wrote that outside of this party “there does not exist
a single revolutionary current on this planet really meriting the name.” The same evaluation can be made
of the role of the International Committee of the Fourth International in the global class struggle and the
preparation of the working class for the world socialist revolution. The International Committee of the
Fourth International is not one of many “factions” that claims to be Trotskyist. The ICFI is the only political
party that works in the Marxist tradition and upholds the historical continuity of the Fourth International as
the World Party of Socialist Revolution. This is not an idle boast. It is substantiated in the theory, program
and practice of the ICFI. 86. On February 14, 2023, the World Socialist Web Site will mark the 25th
anniversary of its founding in 1998. Utilizing the new communications technology of the internet, the ICFI
created the WSWS as the first genuinely global publication of the international socialist movement. The
revolutionary technology provided the possibility and the means for the development of such a
publication. But the essential foundation of the WSWS—what made possible its daily publication over a
period of 25 years—was its grounding in the entire theoretical and political heritage of the Fourth
International. The scope of the World Socialist Web Site’s coverage of political, social, cultural and
intellectual events and processes has testified to the power of the Marxist method of analysis and the
historical perspective of Trotskyism. 87. Drawing on the lessons of the central revolutionary and
counterrevolutionary experiences of the 20th century, the WSWS has reported and analyzed all the
central political events of the 21st century. Counteracting the mind-numbing and deceitful propaganda of
the capitalist media, it has provided an intellectually liberating and revolutionary orientation for an entire
generation of workers, students and youth. While providing the most politically advanced analysis of
events, the WSWS has relentlessly combated the environment of cultural backwardness and intellectual
deceit and charlatanry. 88. There is yet another anniversary whose celebration will begin in the autumn of
this year. October 2023 will mark the centenary of the founding of the Left Opposition, under the
leadership of Leon Trotsky. This marked the beginning of the Trotskyist opposition to the Stalinist
bureaucracy and the regime whose betrayals of the principles of the October Revolution resulted in
historic defeats of the international working class and, ultimately, in the destruction of the Soviet Union
and the restoration of capitalism. 89. One hundred years after the founding of the Left Opposition, the
perspective and program of the Trotskyist movement have been vindicated by history. The role of Stalin
and Stalinism as the “gravedigger of revolution” is recorded in their countless crimes against the socialist
movement and the working class. 90. The International Committee of the Fourth International, the world
Trotskyist movement, is the only representative of revolutionary Marxism in the 21st century. All the
various Pabloite, state capitalist and other pseudo-left organizations have been exposed as agents of
imperialism, defenders of the trade union apparatus and opponents of the working class. 91. Marxism is
based on a historical materialist understanding of the objective laws and processes that give rise to mass
revolutionary movements. The theory of permanent revolution, developed by Trotsky, remains the
essential strategic foundation of the world socialist revolution. The perspective of the ICFI is imbued with
a political optimism that is based on a scientifically grounded understanding of the revolutionary capacity
of the working class to put an end to capitalism. But this optimism is not that of a passive observer who
derives comfort from the idea that “history is on our side.” It is true that the crisis of capitalism leads to
revolution. But the revolution must be prepared and fought for. The socialist resolution of the crisis of
capitalism requires the resolution of the crisis of working class leadership. 92. As we begin the new year,
we call on workers and youth to draw on the lessons of the past year, as well as the lessons of history,
and recognize that capitalism has reached a dead end. The future of humanity depends on the triumph of
socialism. We call on you to join this fight, to build the International Workers Alliance of Rank-and-File
Committees, to participate in the Global Workers’ Inquest into the COVID-19 pandemic, to increase the
circulation of the World Socialist Web Site, and above all, to make the decision to join the Socialist
Equality Party in your country and work to build the International Committee of the Fourth International as
the world party of socialist revolution.
 OFF
The United States federal government should expand Social Security by removing the
requirements on Medicare funded from deficit spending.

CP solves aff
Santens '21 [Scott; "Why We Need Modern Monetary Theory (MMT) and Why It Needs Universal
Basic Income (UBI);" https://vocal.media/theSwamp/why-we-need-modern-monetary-theory-mmt-and-
why-it-needs-universal-basic-income-ubi]
In the beginning, man said, Let there be money: and there was money. Centuries later , on March
27, 2020, the United States passed into law the Coronavirus Aid, Relief, and Economic Security
Act and with the stroke of a pen, over $2 trillion was spent without first taxing or borrowing from
anyone. It included $1,200 stimulus checks for adults and $500 for kids. Another $900 billion was spent
without first taxing or borrowing from anyone nine months later as the Consolidated Appropriations Act. It
included $600 stimulus checks per adult and kid. Another $1.9 trillion was spent without first taxing or
borrowing from anyone another three months later when a third stimulus check went out thanks to the
American Rescue Plan Act, this one for $1,400 per adult and kid. It was followed in July by the first of six
monthly payments of $250 to $300 more per kid. All told, within one year, $1 trillion in cash was sent
directly to the bank accounts and mailboxes of about 85% of Americans, no strings attached. We didn’t
"pay for" any of this. We just did it. None of it was made possible by taxing or borrowing from anyone
first, and that’s the big lesson I believe everyone needs to take away from the COVID-19 pandemic
besides the effectiveness of direct cash payments and dangers of politicizing science and public health.
Americans needed money, so it was created out of nothing. The thing is, that’s not new. It’s how money
works in any country that issues its own currency. Here’s the now less secret truth: the US government
is not funded by taxes. It creates its own currency out of nothing. It spends it into existence. Taxes then
remove money from the money supply to maintain its value (among other things). For the
cryptocurrency enthusiasts out there, the US dollar utilizes a mint and burn model. The eater address is
the IRS. In other words, yes there is in fact a "magical money tree." All money is a human invention
and there is in fact no limit to the amount of money that can be created. There is however a limit
at any point in time to the goods and services that can be exchanged for money at that point in
time, and that real and always changing limit depends entirely on the amount of natural
resources, human labor, machine labor, knowledge, skills, time, energy, etc. that is available to meet
demand with supply at that point in time. That’s what really matters - what money is meant to
measure - not money itself. Money is only a human construct created to very roughly measure the stuff
it’s traded for, and taxation is important for a multitude of reasons, but making spending possible by a
currency issuing government just isn’t one of them. This is the heart of what’s come to be known as
Modern Monetary Theory (or MMT). Conventional thinking says that the US government first needs to
obtain money from taxes or borrowing in order to spend it. MMT says that the government first spends
money, then it taxes or borrows money to remove it from circulation. That may seem like a somewhat
silly difference, but I’ve come to believe it’s actually an extremely important one, and one that once
adopted, is the most likely path to a better future that includes a truly Universal Basic Income — like
Alaska's annual dividend but monthly and larger — that’s the highest it can be without surpassing inflation
targets. I’ve never been against MMT as a descriptive theory, but for years I’ve just seen it as an
alternative way of looking at federal spending and taxes, but having just lived through the year 2020, and
having read Stephanie Kelton’s book The Deficit Myth, I've come to believe MMT may just be the key
to achieving UBI, and perhaps even the only way.
Plan comparatively wrecks business confidence
Alberto Alesina, et. al, Carlo A. Favero, and Francesco Giavazzi, 3-1-2018, Alberto Alesina is the
Nathaniel Ropes Professor of Political Economy at Harvard University, "Improving Economic Growth: Cut
Spending or Raise Taxes?," IMF,
https://www.imf.org/en/Publications/fandd/issues/2018/03/alesina, //hm-sms
Our second finding is that reductions in entitlement programs and other government transfers were less
harmful to growth than tax increases. Such cuts were accompanied by mild and short-lived economic
downturns, probably because taxpayers perceived them as permanent and so expected that the taxes
needed to fund the programs would be lower in the future. Thus, the data suggest that reforms of social
security rules aimed at reducing government spending are more like normal spending cuts than tax
increases. Because social security reforms tend to be persistent, especially in countries with aging
populations, they entail some of the smallest costs in terms of lost output. Private investment also
responded very differently to the two types of austerity plans—positively to spending-based plans and
negatively to tax-based plans. Business confidence behaved consistently with private investment. On the
other hand, household consumption and net exports (the difference between exports and imports) did not
appear to differ on average during the two types of adjustments. What about recent episodes of austerity
that occurred after the crisis and started during a recession? Although the sheer size of some of these
austerity plans was exceptional—not only in Greece but also in Ireland, Portugal, and Spain and to a
lesser extent in Italy and the United Kingdom—the outcomes did not differ significantly from those of
previous episodes. Countries that chose tax-based austerity suffered deeper recessions than those that
chose to cut spending. Among the latter are Ireland, despite a massive bank bailout program, and the
United Kingdom, whose economic performance was much stronger than the IMF had predicted. The UK
plan consisted almost completely of spending cuts. These included cuts in government consumption and
public investment; reductions in transfers, including more restrictive policies on employers’ pension
contributions; support allowances; and public service pensions. Spending cuts (planned or immediately
implemented) between 2010 and 2014 amounted to 2.9 percent of GDP—about 0.6 percent a year on
average. Of all these measures, 87 percent were implemented within this five-year interval, with the rest
deferred. The result: growth in the United Kingdom was higher than the European average. Investment
growth recovered from the 21 percent drop of 2009 and increased almost 6 percent in 2010. Possible
explanations There are at least three possible explanations for these striking results. One is that the
difference between tax- and spending-based plans is due to a difference in accompanying policies. The
most obvious candidate is monetary policy. Guajardo, Leigh, and Pescatori (2014) argue that differences
in the response of monetary policy are largely responsible for the different effects of the tax- and
spending-based corrections they analyzed. We, however, find only a small fraction of the difference to be
related to monetary policy. A second possibility relates to the behavior of the exchange rate. A fiscal
correction could be less harmful if preceded by a currency devaluation, which would make exports more
competitive and support growth. We find that this was not the case: there was no systematic difference in
the behavior of the exchange rate before the two types of fiscal adjustment. If the exchange rate had
been a significant factor, then the difference between the two cases in terms of GDP growth should have
been associated with higher growth of net exports following a devaluation, independently of the type of
fiscal plan adopted. This was not the case. As mentioned above, the driving force was domestic private
investment. Finally, large fiscal adjustments are often periods of deep structural reforms, which may
include the liberalization of product and/or labor markets. If these were systematically occurring at the
time of spending cuts, they might explain our finding. But in fact, these reforms did not occur
systematically during periods of spending cuts. A more promising explanation points to the role of
confidence and expectations. Imagine an economy on an unsustainable path with exploding public debt.
Rising interest rates in countries with high debt may generate exactly this scenario. Sooner or later fiscal
stabilization must occur. The longer the delay, the more taxes must be raised (or spending cut) in the
future. Stabilization, when it occurs, removes uncertainty about further delays that would have increased
the costs even more. Blanchard (1990) provides a simple model that illustrates this point. Stabilization
that eliminates uncertainty about higher fiscal costs in the future stimulates demand today—especially
from investors, who are more sensitive to uncertainty given the long-term nature of their plans. In their
models, Blanchard (1990) and Alesina and Drazen (1991) do not distinguish between stabilization on the
tax and the spending side. However, it is quite likely that the benefits of removing uncertainty are more
likely to occur with spending-based, rather than tax-based, austerity plans. A tax-based plan that does not
address the automatic growth of entitlements and other programs over time is much less likely to produce
a long-lasting effect on the budget. If the plan doesn’t address automatic spending increases, taxes must
be continually raised to cover the additional outlays. So the confidence effect is likely to be much smaller
for tax-based plans, because of rising expectations of future taxes. Spending-based plans, on the other
hand, produce the opposite effects. Our finding for the response of business confidence to austerity
supports this view. Business confidence increases immediately at the start of a spending-based austerity
plan, in contrast to what happens at the beginning of a tax-based plan.

decreased business confidence causes recession

Barkin 19 Barkin, Tom. “Confidence, Expectations and Implications for Monetary Policy.” Federal
Reserve Bank of Richmond, 11 July 2019,
www.richmondfed.org/press_room/speeches/thomas_i_barkin/2019/barkin_speech_20190711.
In addition, the business reaction function has gotten faster. Short-termism has increased as activism
in the market for corporate control has shifted companies’ focus. Just as with consumers, I think firms’
resilience is down. They start with lower confidence—another “hangover” from the Great Recession. At
the same time, businesspeople tell me the length of the current upturn makes them nervous that another recession
might be right around the corner. The speed of the reaction function may be exacerbated by higher
leverage. Corporate debt as a percentage of GDP is at an all-time high. Levered companies—
and their creditors—have a bias toward taking action on negative news. This can mean cutting costs,
reducing staff or pricing for volume. Taken together, all these factors lead to an asymmetry in which firms
are much more cautious about the downside than they are optimistic about the upside. Perhaps
both consumers and businesses have a higher bar for spending decisions. It’s possible that some of the tepid
recovery from the Great Recession was a self-fulfilling lack of belief in the strength of the economy. Firms’ fear
of
failure could have prevented them from making investments even in the presence of reasonable
returns. This negative tilt, or asymmetry, continues today. Firms are frustrated with political
polarization and uncertainty about trade and regulation. This limits their pricing courage and caps
the upside on their spending and investment decisions. For these reasons, a drop in confidence could
lead to lower investment, lower output and eventually lower employment. If employment is placed at risk,
consumption won’t be far behind. And that would place us in more serious difficulty. Put another way,
I don’t discount the idea that we could talk ourselves into a recession.

US recession causes global war

Dr. Mathew Maavak 21, PhD in Risk Foresight from the Universiti Teknologi Malaysia, External
Researcher (PLATBIDAFO) at the Kazimieras Simonavicius University, Expert and Regular Commentator
on Risk-Related Geostrategic Issues at the Russian International Affairs Council, “Horizon 2030: Will
Emerging Risks Unravel Our Global Systems?”, Salus Journal – The Australian Journal for Law
Enforcement, Security and Intelligence Professionals, Volume 9, Number 1, p. 2-8

Various scholars and institutions regard global social instability as the greatest threat facing this
decade. The catalyst has been postulated to be a Second Great Depression which, in turn, will
have profound implications for global security and national integrity. This paper, written from a broad
systems perspective, illustrates how emerging risks are getting more complex and intertwined; blurring
boundaries between the economic, environmental, geopolitical, societal and technological taxonomy used
by the World Economic Forum for its annual global risk forecasts. Tight couplings in our global systems
have also enabled risks accrued in one area to snowball into a full-blown crisis elsewhere. The
COVID-19 pandemic and its socioeconomic fallouts exemplify this systemic chain-reaction.
Onceinexorable forces of globalization are rupturing as the current global system can no longer be
sustained due to poor governance and runaway wealth fractionation. The coronavirus pandemic is also
enabling Big Tech to expropriate the levers of governments and mass communications worldwide. This
paper concludes by highlighting how this development poses a dilemma for security professionals. Key
Words: Global Systems, Emergence, VUCA, COVID-9, Social Instability, Big Tech, Great Reset
INTRODUCTION The new decade is witnessing rising volatility across global systems. Pick any random
“system” today and chart out its trajectory: Are our education systems becoming more robust and
affordable? What about food security? Are our healthcare systems improving? Are our pension systems
sound? Wherever one looks, there are dark clouds gathering on a global horizon marked by volatility,
uncertainty, complexity and ambiguity (VUCA). But what exactly is a global system? Our planet itself is an
autonomous and selfsustaining mega-system, marked by periodic cycles and elemental vagaries. Human
activities within however are not system isolates as our banking, utility, farming, healthcare and retail
sectors etc. are increasingly entwined. Risks accrued in one system may cascade into an unforeseen
crisis within and/or without (Choo, Smith & McCusker, 2007). Scholars call this phenomenon
“emergence”; one where the behaviour of intersecting systems is determined by complex and largely
invisible interactions at the substratum (Goldstein, 1999; Holland, 1998). The ongoing COVID-19
pandemic is a case in point. While experts remain divided over the source and morphology of the virus,
the contagion has ramified into a global health crisis and supply chain nightmare. It is also tilting the
geopolitical balance. China is the largest exporter of intermediate products, and had generated nearly
20% of global imports in 2015 alone (Cousin, 2020). The pharmaceutical sector is particularly vulnerable.
Nearly “85% of medicines in the U.S. strategic national stockpile” sources components from China
(Owens, 2020). An initial run on respiratory masks has now been eclipsed by rowdy queues at
supermarkets and the bankruptcy of small businesses. The entire global population – save for major
pockets such as Sweden, Belarus, Taiwan and Japan – have been subjected to cyclical lockdowns and
quarantines. Never before in history have humans faced such a systemic, borderless calamity. COVID-19
represents a classic emergent crisis that necessitates real-time response and adaptivity in a real-time
world, particularly since the global Just-in-Time (JIT) production and delivery system serves as both an
enabler and vector for transboundary risks. From a systems thinking perspective, emerging risk
management should therefore address a whole spectrum of activity across the economic, environmental,
geopolitical, societal and technological (EEGST) taxonomy. Every emerging threat can be slotted into this
taxonomy – a reason why it is used by the World Economic Forum (WEF) for its annual global risk
exercises (Maavak, 2019a). As traditional forces of globalization unravel, security professionals should
take cognizance of emerging threats through a systems thinking approach. METHODOLOGY An EEGST
sectional breakdown was adopted to illustrate a sampling of extreme risks facing the world for the 2020-
2030 decade. The transcendental quality of emerging risks, as outlined on Figure 1, below, was primarily
informed by the following pillars of systems thinking (Rickards, 2020): • Diminishing diversity (or
increasing homogeneity) of actors in the global system (Boli & Thomas, 1997; Meyer, 2000; Young et al,
2006); • Interconnections in the global system (Homer-Dixon et al, 2015; Lee & Preston, 2012); •
Interactions of actors, events and components in the global system (Buldyrev et al, 2010; Bashan et al,
2013; Homer-Dixon et al, 2015); and • Adaptive qualities in particular systems (Bodin & Norberg, 2005;
Scheffer et al, 2012) Since scholastic material on this topic remains somewhat inchoate, this paper
buttresses many of its contentions through secondary (i.e. news/institutional) sources. ECONOMY
According to Professor Stanislaw Drozdz (2018) of the Polish Academy of Sciences, “a global financial
crash of a previously unprecedented scale is highly probable” by the mid- 2020s. This will lead to a trickle-
down meltdown, impacting all areas of human activity. The economist John Mauldin (2018) similarly
warns that the “2020s might be the worst decade in US history” and may lead to a Second Great
Depression. Other forecasts are equally alarming. According to the International Institute of Finance,
global debt may have surpassed $255 trillion by 2020 (IIF, 2019). Yet another study revealed that global
debts and liabilities amounted to a staggering $2.5 quadrillion (Ausman, 2018). The reader should note
that these figures were tabulated before the COVID-19 outbreak. The IMF singles out widening income
inequality as the trigger for the next Great Depression (Georgieva, 2020). The wealthiest 1% now own
more than twice as much wealth as 6.9 billion people (Coffey et al, 2020) and this chasm is widening with
each passing month. COVID-19 had, in fact, boosted global billionaire wealth to an unprecedented $10.2
trillion by July 2020 (UBS-PWC, 2020). Global GDP, worth $88 trillion in 2019, may have contracted by
5.2% in 2020 (World Bank, 2020). As the Greek historian Plutarch warned in the 1st century AD: “An
imbalance between rich and poor is the oldest and most fatal ailment of all republics” (Mauldin, 2014).
The stability of a society, as Aristotle argued even earlier, depends on a robust middle element or middle
class. At the rate the global middle class is facing catastrophic debt and unemployment levels,
widespread social disaffection may morph into outright anarchy (Maavak, 2012; DCDC, 2007). Economic
stressors, in transcendent VUCA fashion, may also induce radical geopolitical realignments. Bullions
now carry more weight than NATO’s security guarantees in Eastern Europe. After Poland repatriated
100 tons of gold from the Bank of England in 2019, Slovakia, Serbia and Hungary quickly followed suit.
According to former Slovak Premier Robert Fico, this erosion in regional trust was based on historical
precedents – in particular the 1938 Munich Agreement which ceded Czechoslovakia’s Sudetenland to
Nazi Germany. As Fico reiterated (Dudik & Tomek, 2019): “You can hardly trust even the closest allies
after the Munich Agreement… I guarantee that if something happens, we won’t see a single gram of this
(offshore-held) gold. Let’s do it (repatriation) as quickly as possible.” (Parenthesis added by author).
President Aleksandar Vucic of Serbia (a non-NATO nation) justified his central bank’s gold-repatriation
program by hinting at economic headwinds ahead: “We see in which direction the crisis in the world is
moving” (Dudik & Tomek, 2019). Indeed, with two global Titanics – the United States and China – set
on a collision course with a quadrillions-denominated iceberg in the middle, and a viral outbreak on its
tip, the seismic ripples will be felt far, wide and for a considerable period. A reality check is
nonetheless needed here: Can additional bullions realistically circumvallate the economies of 80 million
plus peoples in these Eastern European nations, worth a collective $1.8 trillion by purchasing power
parity? Gold however is a potent psychological symbol as it represents national sovereignty and
economic reassurance in a potentially hyperinflationary world. The portents are clear: The current global
economic system will be weakened by rising nationalism and autarkic demands. Much uncertainty
remains ahead. Mauldin (2018) proposes the introduction of Old Testament-style debt jubilees to facilitate
gradual national recoveries. The World Economic Forum, on the other hand, has long proposed a “Great
Reset” by 2030; a socialist utopia where “you’ll own nothing and you’ll be happy” (WEF, 2016). In the final
analysis, COVID-19 is not the root cause of the current global economic turmoil; it is merely an accelerant
to a burning house of cards that was left smouldering since the 2008 Great Recession (Maavak, 2020a).
We also see how the four main pillars of systems thinking (diversity, interconnectivity, interactivity and
“adaptivity”) form the mise en scene in a VUCA decade. ENVIRONMENTAL What happens to the
environment when our economies implode? Think of a debt-laden workforce at sensitive nuclear and
chemical plants, along with a concomitant surge in industrial accidents? Economic stressors, workforce
demoralization and rampant profiteering – rather than manmade climate change – arguably pose the
biggest threats to the environment. In a WEF report, Buehler et al (2017) made the following pre-
COVID-19 observation: The ILO estimates that the annual cost to the global economy from accidents and
work-related diseases alone is a staggering $3 trillion. Moreover, a recent report suggests the world’s 3.2
billion workers are increasingly unwell, with the vast majority facing significant economic insecurity: 77%
work in part-time, temporary, “vulnerable” or unpaid jobs. Shouldn’t this phenomenon be better
categorized as a societal or economic risk rather than an environmental one? In line with the systems
thinking approach, however, global risks can no longer be boxed into a taxonomical silo. Frazzled
workforces may precipitate another Bhopal (1984), Chernobyl (1986), Deepwater Horizon (2010) or Flint
water crisis (2014). These disasters were notably not the result of manmade climate change. Neither was
the Fukushima nuclear disaster (2011) nor the Indian Ocean tsunami (2004). Indeed, the combustion of a
long-overlooked cargo of 2,750 tonnes of ammonium nitrate had nearly levelled the city of Beirut,
Lebanon, on Aug 4 2020. The explosion left 204 dead; 7,500 injured; US$15 billion in property damages;
and an estimated 300,000 people homeless (Urbina, 2020). The environmental costs have yet to be
adequately tabulated. Environmental disasters are more attributable to Black Swan events, systems
breakdowns and corporate greed rather than to mundane human activity. Our JIT world aggravates the
cascading potential of risks (Korowicz, 2012). Production and delivery delays, caused by the COVID-19
outbreak, will eventually require industrial overcompensation. This will further stress senior executives,
workers, machines and a variety of computerized systems. The trickle-down effects will likely include
substandard products, contaminated food and a general lowering in health and safety standards (Maavak,
2019a). Unpaid or demoralized sanitation workers may also resort to indiscriminate waste dumping. Many
cities across the United States (and elsewhere in the world) are no longer recycling wastes due to
prohibitive costs in the global corona-economy (Liacko, 2021). Even in good times, strict protocols on
waste disposals were routinely ignored. While Sweden championed the global climate change narrative,
its clothing flagship H&M was busy covering up toxic effluences disgorged by vendors along the Citarum
River in Java, Indonesia. As a result, countless children among 14 million Indonesians straddling the
“world’s most polluted river” began to suffer from dermatitis, intestinal problems, developmental disorders,
renal failure, chronic bronchitis and cancer (DW, 2020). It is also in cauldrons like the Citarum River
where pathogens may mutate with emergent ramifications. On an equally alarming note, depressed
economic conditions have traditionally provided a waste disposal boon for organized crime elements.
Throughout 1980s, the Calabriabased ‘Ndrangheta mafia – in collusion with governments in Europe and
North America – began to dump radioactive wastes along the coast of Somalia. Reeling from pollution
and revenue loss, Somali fisherman eventually resorted to mass piracy (Knaup, 2008). The coast of
Somalia is now a maritime hotspot, and exemplifies an entwined form of economic-environmental-
geopolitical-societal emergence. In a VUCA world, indiscriminate waste dumping can unexpectedly morph
into a Black Hawk Down incident. The laws of unintended consequences are governed by actors,
interconnections, interactions and adaptations in a system under study – as outlined in the methodology
section. Environmentally-devastating industrial sabotages – whether by disgruntled workers, industrial
competitors, ideological maniacs or terrorist groups – cannot be discounted in a VUCA world.
Immiserated societies, in stark defiance of climate change diktats, may resort to dirty coal plants and
wood stoves for survival. Interlinked ecosystems, particularly water resources, may be hijacked by
nationalist sentiments. The environmental fallouts of critical infrastructure (CI) breakdowns loom like a
Sword of Damocles over this decade. GEOPOLITICAL The primary catalyst behind WWII was the
Great Depression. Since history often repeats itself, expect familiar bogeymen to reappear in
societies roiling with impoverishment and ideological

clefts. Anti-Semitism – a societal risk on its own – may reach alarming proportions in the West
(Reuters, 2019), possibly forcing Israel to undertake reprisal operations inside allied nations. If that
happens, how will affected nations react? Will security resources be reallocated to protect certain
minorities (or the Top 1%) while larger segments of society are exposed to restive forces? Balloon effects
like these present a classic VUCA problematic. Contemporary geopolitical risks include a possible
Iran-Israel war; US-China military confrontation over Taiwan or the South China Sea; North Korean
proliferation of nuclear and missile technologies; an India-Pakistan nuclear war; an Iranian closure of
the Straits of Hormuz; fundamentalist-driven implosion in the Islamic world; or a nuclear
confrontation between NATO and Russia. Fears that the Jan 3 2020 assassination of Iranian Maj. Gen.
Qasem Soleimani might lead to WWIII were grossly overblown. From a systems perspective, the killing of
Soleimani did not fundamentally change the actor-interconnection-interaction adaptivity equation in the
Middle East. Soleimani was simply a cog who got replaced.
 OFF
The United States federal government should shift funding and operational authority
for social security and Medicare to state governments and United States territories,
and impel expand Social Security by removing the requirements on Medicare

Federal programs fail, States solve poverty better by tailoring to state needs
Tanner ’22 [(Michael D Tanner; 12-15-2022; Former Senior Fellow at the CATO Institute,
headed research on domestic policy regarding poverty and social welfare "Welfare Reform,"
Cato Institute, https://www.cato.org/publications/welfare-reform#)//IshMonkey]

Consolidate and decentralize federal welfare programs; move to cash transfers; emphasize individual control
Given the failure of more than 50 years of federal welfare policy to significantly reduce poverty or
increase economic mobility, it should be apparent that the federal government does not know best. Nor have we
demonstrated that we know enough about how to reduce poverty to impose a one‐size‐fits‐all policy throughout the
country. Five decades of failure should have taught us to be modest.

Wherever possible, Congress should shift both the funding and operational authority for welfare and other
anti‐poverty programs to the states. The “laboratories of democracy,” as Justice Louis Brandeis described
them, should be the primary focus of anti‐poverty efforts, not an afterthought. That means more than simply giving
states the authority to tinker with programs as they exist today. It means federal funding, even in block grant form,
should not be accompanied by federal strings. Instead, states should be given control over broad
categories of funding, with the ability to shift funds freely between programs at their discretion, but within
a framework in which their efforts are rigorously evaluated and held accountable for achieving results . Some states may wish to
emphasize job training or public service jobs. Others may feel that education provides the biggest bang
for the buck. In some states, housing may be a priority; in others, the need for nutrition assistance may
be greater. Some may wish to impose strict eligibility requirements, while others may choose to
experiment with unconditional benefits, even a universal basic income.

Moreover, states that have successfully reduced poverty while also reducing the number of people on the welfare rolls
should be allowed to shift funds to other priorities entirely. Success should be rewarded. States that fail to achieve results,
after accounting for factors beyond their control, should have their funding reduced, with any shortfall made up from state
funds. Failure should not be subsidized.

While shifting funds from the

federal government to the states represents a good first step, the states should
go even further by moving away from in‐kind benefits and to direct cash payments. While it is reasonable for
taxpayers to seek accountability for how their funds are used, this paternalism may be both unnecessary and self ‐defeating. For starters,
arguments that the poor can’t be trusted with cash are too often based on erroneous and racially biased stereotypes rather than on sound
evidence. In fact, studies from states that drug‐test welfare recipients suggest that the use of drugs is no higher among welfare recipients
than among the general population. 14 And numerous studies have shown that even when welfare recipients are given totally unrestricted
cash, they do not increase their expenditure on “temptation goods” like tobacco or alcohol. 15

Furthermore, cash benefits can allow the poor to decide for themselves how much of their income should be allocated to
rent, food, education, or transportation. They might also choose to save more or invest in learning new skills that will help
them earn more in the future. A 2015 Financial Industry Regulatory Authority report found that 53 percent of American
households with incomes less than $25,000 had no investment accounts, compared to just 1 percent of households making
over $150,000 a year without investment accounts. We can’t expect people to behave responsibly if they are never given
16

any responsibility.

Cash benefits also could encourage mobility, helping to break up geographic concentrations of poverty that can isolate the
poor from the rest of society and reinforce the worst aspects of the poverty culture, especially if those benefits are received
early in life. Armed with money instead of vouchers redeemable only at certain locations, the poor could escape bad
neighborhoods the same way vouchers and tax credits allow children to escape bad schools. Doing so can produce
tremendous results: Chetty et al. (2016), for example, found that families that moved into low ‐poverty areas before their
children entered their teen years saw the children go on to earn 31 percent more later in life than did comparable children
who remained in high‐poverty areas. Beyond higher earnings, children from families that moved saw a wide range of other
positive outcomes. They were more likely to attend college, less likely to be single parents, and more likely to live in better
neighborhoods when they grew up and left home. 17

Any cash payment system should be designed to help low‐income Americans solve their immediate problems without becoming ensconced
in the welfare system. Thus, Congress could encourage states to expand existing cash‐ diversion programs,
which provide lump‐sum cash payments in lieu of traditional welfare benefits. 18 Currently in use in 32 states and DC, these programs
are designed to assist families facing an immediate financial crisis or short‐ term need. The family is given
a single cash payment in the hope that if the immediate problem is resolved, there will be no need for going on welfare. In exchange for
receiving the lump‐sum payment, welfare applicants in most states—but not all—give up their eligibility for TANF for a period ranging from
a couple of months to a year.19 Several studies indicate that for individuals who had not previously been on welfare, diversion programs
significantly reduced their likelihood of ending up there .
Studies also suggest that diversion participants are
subsequently more likely to work than become traditional recipients of welfare .20

Finally, Congress should reform the EITC to turn it into a pure wage supplement. Benefits should be available to childless adults and should
not rise with the number of children in a family. Payments should arrive monthly rather than in an annual lump sum. Any additional cost
due to expansion should be paid for by reductions in other welfare programs.

Reforms to federal, state, and local policy will ensure that workers have the compensation, flexibility, and benefits that meet their diverse
needs.

Provision of public welfare to at least some people may be justified, according to certain ethical viewpoints, but is insufficient and
We should not judge the success of our efforts to end
counterproductive to effectively deliver human flourishing.
poverty by how much charity the state redistributes to the poor , but by how few people need such charity in the
first place.

Truly improving the lives of the poor is not a question of spending slightly more or less money, tinkering
with the number of hours mandated under work requirements, or rooting out fraud, waste, and abuse.
We need a new debate, one that moves beyond our current approach to fighting poverty to focus on
what works rather than noble sentiments or good intentions—a system built on work, individual
empowerment, and Americans’ philanthropic impulse.

Congress should therefore

-consolidate all current welfare and anti‐poverty programs;
-shift remaining welfare programs to the states with as few strings as possible;
-encourage states to transition from in‐kind benefits to cash grants;
-encourage states to make greater use of welfare diversion (lump‐sum cash) programs; and
-transform the EITC into a pure wage supplement linked to work rather than family size/composition.
State governments should—
-transition from in‐kind benefits to cash grants;
-review benefit levels; phaseout ranges and asset and income tests to reduce “welfare cliffs” and disincentives to work, savings,
and family formation;
-avoid arbitrary and punitive restrictions on the use of benefits;
-expand the use of diversion programs and lump‐sum payments in lieu of traditional benefits; and
-make greater use of federal waivers to experiment with different ways to deliver benefits, combine
programs, and change program incentives.
 OFF
Text: The United States federal government should create a voluntary personal
retirement account option with automatic enrollment funded by Social Security
payroll contributions.

Solves and avoids politics.

Andrew G. Biggs 11-22-2021, senior fellow at the American Enterprise Institute who studies Social
Security, former principal deputy commissioner of the Social Security Administration, PhD from the
London School of Economics. "Progressive Social Security Reform Meets Reality." American Enterprise
Institute. https://www.aei.org/articles/progressive-social-security-reform-meets-reality/. DL

Now, however, a
revised version of the most popular progressive Social Security-reform plan has belatedly
recognized a political reality: While ordinary Americans are happy for others to pay more tax dollars
into Social Security, they would generally rather not do so themselves.

Before Bush’s failed reform push, conservatives, myself included, were very big on the idea of voluntary personal
retirement
accounts. The sales pitch was compelling: To fix Social Security’s multi-trillion-dollar funding shortfall, we could
raise taxes or reduce benefits — but why take those steps when it would be much less painful to raise the
rate of return on contributions by investing part or all of a worker’s payroll taxes in personal accounts?
 OFF
The United States federal government should substantially increase fiscal
redistribution in the United States by expanding Social Security by removing the
requirements on Medicare with the exception of the Knights of the Ku Klux Klan.

Solves the aff---PICs out of the KKK---you have an ethical obligation to reject white
supremacy.
Harvard Law 2K (December 2000, Harvard Law Review, “Constitutional Law. First Amendment.
Viewpoint Discrimination. Eighth Circuit Holds That Missouri May Not Exclude Knights of the Ku Klux
Klan from Public Program. Cuffley v. Mickes, 208 F.3d 702 (8th Cir. 2000), Petition for Cert. Filed, 69 U. S.
L. W. 3166 (U. S. Aug. 21, 2000) (No. 00-289)”, pg 660-665)//aleks

Government viewpoint discrimination achieved by conditioning public benefits on silence or conformist

speech has long been deemed unconstitutional.' However, the Supreme Court's doctrine of
nonsubsidization has created confusion in the already notoriously knotty area of First Amendment law.2 Born into this
muddle - and highlighting the doctrinal tension - was Cuffley v. Mickes,3 a recent Eighth Circuit case in which the court held that Missouri
could not exclude the Knights of the Ku Klux Klan (Klan) from its Adopt-A-Highway Program solely on the
basis of the Klan's viewpoint.4 Unfortunately, in reaching this decision, the appellate court acknowledged only the
involvement of the Klan's expressive conduct in the case, and no speech by the state of Missouri. This misstep
permitted the court to avoid engaging the doctrinal tension implicit in deciding whether the government's interest in
controlling its own speech may limit the rights of citizens to partake of government benefits . The court should have recognized
the distinction between the government's speech and the Klan's expressive conduct and held that the
government's speech interest indeed limits the unconstitutional conditions doctrine.

Otherwise, the KKK pushes minorities out and creates an unsafe work environment.
LeRoy 18 (March 1, 2018. Michael H. LeRoy is the LER Alumni Professor of Labor and Employment
Relations, and an affiliated member of the College of Law faculty. His current research program
examines updated uses of the Ku Klux Klan Act of 1871 as a legal tool to combat racial extremism in the
workplace. “TARGETING WHITE SUPREMACY IN THE WORKPLACE”, https://law.stanford.edu/wp-
content/uploads/2018/03/29.1-LeRoy_107-158.pdf)//aleks

As hate incidents increase in the workplace, individuals and employers face legal action—but not hate
groups who incite and orchestrate attacks against minorities. Extreme attacks by white supremacists
recreate conditions of racial segregation at work and in specific labor markets. When Congress passed the Ku Klux Klan Act
in 1871, they aimed to uproot white supremacist intimidation that forced blacks to work in a racial caste. Today, a growing number of
extreme incidents show the U.S. is returning to work segregation. This study suggests a new way to apply the Ku Klux
Klan Act to work-related racial conspiracies.

American workers have a dark history of insecurity over their livelihood. In the aftermath of the Civil War and decades later, some claimed
racial superiority over freed slaves; reviled Chinese coolies for their customs and hard work; demonized Japanese who were imported for their
labor; subjected Mexicans to peonage; slandered Jews; and shunned Catholics. Their hatred of otherness fueled the politics behind the Chinese
Exclusion Act, Japanese exclusion provisions of the Immigration Act of 1924,9 and National Origins Formula.10 For nearly a century, many
workers warped the beneficent purposes of their labor unions, turning fraternal work organizations into monopolies for whites. By
institutionalizing racial segregation, they limited labor market competition to their advantage.
Courts curbed racial segregation in unions in the 1940s. Since then, most unions have accepted racial equality. However, organized labor’s
connection to American workers has withered with declines in union membership. More
voiceless and adrift than any time
since the National Labor Relations Act was passed in 1935, some workers have returned to their nativist
roots. Racial demagogues have inflamed their grievances against immigrants, blacks, and other non-
whites.
 OFF
The United States federal judiciary ought to hold that Constitutional guarantees
compels enforcement of Social Security 2100: A Sacred Trust.

Constitutionalizing economic rights spills over to narrow judicial deferral AND avoids
politics---breaks down the political question doctrine.
Rotem Litinski, 11-30-2019, BA in PoliSci from Berkeley, "Economic Rights: Are They Justiciable, and
Should They Be?," American Bar Association,
https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/

economic-justice/economic-rights--are-they-justiciable--and-should-they-be-/, b

Many have questioned whether it is constitutionally acceptable for a court to assess the progressive realization
of economic rights,
which would require the actions of several mechanisms in concert. Because the responsibility of constructing and
enforcing laws belongs to the legislative and the executive branches, respectively, judicial enforcement of
economic rights might be misconstrued as a denigration of the checks and balances system. On the other hand, judicial
review necessitates that courts evaluate the consistency of legislation and government action with constitutional ideals, aspirations, and
obligations. Ensuring the human rights of individuals to shelter, food, and basic economic stability, foundational to the realization of their
human dignity, is well within those constitutional bounds. Regardless, U.S. courts often gag themselves by denying their
power to constitutionalize socioeconomic rights.

Due to their unelected status, the role and expanse of the courts is constantly in question. But it is this status that
insulates judges from the public, enabling them to protect individuals and groups while exercising
objectivity. There is an institutional bias toward preserving the public good over individual rights because the latter creates a risk that may
conflict with a public interest, a risk that public officials want to minimize. Whereas public officials may base decisions off
public approval, insulated judges are distanced from public sentiments and can remain consistent in their values and
decisions. These factors establish the credibility needed to exercise powerful judicial review.

Economic Rights as Derivatives of Constitutional Provisions

In practice, democratic constitutions often compel

the court to gag itself to counteract judicial overextension and
relegate jurisdiction to the State. The court has an obligation—similar to the positive duties imposed on the State—to
intervene if unconstitutional legislation unreasonably infringes on the basic rights and liberties of individuals to functionally engage
in society. This obligation is as rooted in human rights and economic justice as it is in the Constitution.

PQD blocks norm development for drone warfare.

Hafetz ’17 [Jonathan; January 6; Professor of Law at Seton Hall University, J.D. from Yale University, M.
Phil. From Oxford University, B.A. from Amherst College; Just Security, “The Troubling Application of the
Political Question Doctrine to Congressional Force Authorizations,”
https://www.justsecurity.org/36021/troubling-application-political-question-doctrine-congressional-
force-authorizations/]

The U.S. District Court for the District of Columbia on Nov. 21 dismissed the suit brought by U.S. Army Captain Nathan Michael Smith
challenging the legality of the military campaign against ISIS under Operation Inherent Resolve. The opinion by Judge
Colleen Kollar-Kotelly rejecting the suit on political question grounds is troubling. (Judge Kollar-Kotelly also denied Smith had
standing based on his claim that continuing to fight in an unauthorized military action against ISIS would violate his oath to support and defend
the Constitution). The Obama administration’s release last month of its Report on the Legal and Policy Frameworks Guiding and Limiting the
United States’ Use of Military Force and Related National Security Considerations (“Framework Report”), while admirable in several respects
(see Marty Lederman’s comprehensive summary), crystalizes concerns about the potential ramifications of the political question ruling in Smith
v Obama.

In Smith, the plaintiff maintained that neither the 2001 nor 2002 Authorization for Use of Military Force (AUMF)—the former enacted for al
Qaeda and the Taliban, the latter for Iraq—constituted authorization for military action against ISIS. Such action, the plaintiff therefore argued,
was unlawful under the 60-day time limit imposed by the War Powers Resolution. The district court held that the suit presented a
nonjusticiable political question because the issues raised were primarily ones committed to the political branches of government
and because the court lacked judicially manageable standards. This holding, as Michael Glennon has argued here, and Marty has argued here,
here, and here, misconstrues and misapplies the political question doctrine. In short, a suit asking a court to interpret the scope and meaning of
a congressional force statute—and, particularly, what entities it applies to—presents a legal question squarely within the province and ability of
the judiciary to decide.

Smith’s suit, in the court’s view, would have failed anyway for lack of standing. But the
court’s political question ruling sweeps
more widely and if followed, would bar suit by future plaintiffs raising similar merits claims even where
they unquestionably had standing. Those future plaintiffs could include, for example, individuals detained
by the United States or harmed by U.S. drone strikes (including family members of individuals killed in such strikes). The ruling would
foreclose those persons from claiming that the U.S. action was illegal if it were predicated on their connection to ISIS or to another group that
fell outside current force authorizations.

The Obama administration’s Framework Report underscores these concerns, particularly as executive power is handed to a Trump
administration that could jettison existing policy constraints while further enlarging America’s forever war against terrorist groups.

The Framework Report highlights several broader trends. First, itreinforces that the U.S. armed conflict against al Qaeda
and the Taliban seems only to expand, not contract, with time. Since 2001, it has extended to other groups,
whether because they fall under the al Qaeda umbrella (like ISIS) or are deemed associated forces (as al-Shabaab recently was).

Second, the Report underscores that, under the current framework, the president generally has authority—even if he does not exercise it—to
detain and target individuals based solely on their purported membership in a military group covered by the 2001 AUMF. That authority thus
permits status-based detention or targeting, without resort to claims of self-defense.

Third, the Report reinforces that additional restrictions on this broad legal authority exist only as a matter of policy. As such, they may be
discarded by the next administration. Further, the policies themselves—which apply heightened requirements for using lethal force outside
areas of active hostilities—have proven susceptible to workarounds in practice (See the valuable New York Times reporting by Charlie Savage,
Eric Schmitt, and Mark Mazzetti on how in Somalia the U.S. military has avoided limitations in the May 2013 Presidential Policy Guidance
through assertions of an independent power of collective self-defense, which includes assistance to U.S. partners on the ground).

Courts remain an important check on elastic counterterrorism powers. This check will become even
more important in a Trump administration that expansively interprets existing—or future—force
authorizations while disregarding restraints. In the past, suits challenging particular drone strikes—both ex-ante and
ex-post—have been dismissed on threshold justiciability grounds. Smith, however, is the first decision to hold that the central
underlying question—the meaning and scope of executive power under a congressional force authorization—is itself a political
question. As Smith explained “Plaintiff asks the Court to second-guess the Executive’s application of these statutes to specific facts on the
ground in an ongoing combat mission halfway around the world” (emphasis in original). Smith’s rationale would prevent other challenges to the
application of force authorizations not only to ISIS, but also to other, yet unidentified, groups.

Extinction – miscalculated AND intentional nuclear war.

Boyle ’13 [Michael; 2013; Professor of Political Science at La Salle University, former Lecture in
International Relations and Research Fellow in the Centre for the Study of Terrorism and Political
Violence; International Affairs, “The Costs and Consequences of Drone Warfare,” vol. 89]
The race for drones
An important, but overlooked, strategic consequence of the Obama administration’s embrace of drones is that it has generated a
new and dangerous arms race for this technology. At present, the use of lethal drones is seen as acceptable to US policy-
makers because no other state possesses the ability to make highly sophisticated drones with the range, surveillance capability and lethality of
those currently manufactured by the United States. Yet therest of the world is not far behind. At least 76 countries
have acquired UAV technology, including Russia, China, Pakistan and India.120 China is reported to have at least 25
separate drone systems currently in development.121 At present, there are 680 drone programmes in the world, an
increase of over 400 since 2005.122 Many states and non-state actors hostile to the United States have begun to
dabble in drone technology. Iran has created its own drone, dubbed the ‘Ambassador of Death’, which has a range of up to 600
miles.123 Iran has also allegedly supplied the Assad regime in Syria with drone technology.124 Hezbollah launched an Iranian-made drone into
Israeli territory, where it was shot down by the Israeli air force in October 2012.125

A global arms race for drone technology is already under way. According to one estimate, global spending on
drones is likely to be more than US$94 billion by 2021.126 One factor that is facilitating the spread of drones (particularly
non-lethal drones) is their cost relative to other military purchases. The top-of-the line Predator or Reaper model costs approximately US$10.5
million each, compared to the US$150 million price tag of a single F-22 fighter jet.127 At that price, drone technology is already within the
reach of most developed militaries, many of which will seek to buy drones from the US or another supplier. With
demand growing, a
number of states, including China and Israel, have begun the aggressive selling of drones, including attack drones, and
Russia may also be moving into this market.128 Because of concerns that export restrictions are harming US competitiveness in the drones
market, the Pentagon has granted approval for drone exports to 66 governments and is currently being lobbied to authorize sales to even
more.129 The Obama administration has already authorized the sale of drones to the UK and Italy, but Pakistan, the UAE and Saudi Arabia have
been refused drone technology by congressional restrictions.130 It is only a matter of time before another supplier steps in to offer the drone
technology to countries prohibited by export controls from buying US drones. According to a study by the Teal Group, the US will account for 62
per cent of research and development spending and 55 per cent of procurement spending on drones by 2022.131 As the market expands, with
new buyers and sellers, America’s ability to control the sale of drone technology will be diminished. It is likely that the US will retain a
substantial qualitative advantage in drone technology for some time, but even that will fade as more suppliers offer drones that can match US
capabilities.

The emergence of this arms race for drones raises at least five long-term strategic consequences, not all of which
are favourable to the United States over the long term. First, it is now obvious that other states will use drones in ways that are inconsistent
with US interests. One reason why the US has been so keen to use drone technology in Pakistan and Yemen is that at present it retains a
substantial advantage in high-quality attack drones. Many of the other states now capable of employing drones of near-equivalent technology
—for example, the UK and Israel—are considered allies. But this situation is quickly changing as other leading geopolitical players, such as
Russia and China, are beginning rapidly to develop and deploy drones for their own purposes. While its own technology still lags behind that of
the US, Russia has spent huge sums on purchasing drones and has recently sought to buy the Israeli-made Eitan drone capable of surveillance
and firing air-to-surface missiles.132 China has begun to develop UAVs for reconnaissance and combat and has several new drones capable of
long-range surveillance and attack under development.133 China is also planning to use unmanned surveillance drones to allow it to monitor
the disputed East China Sea Islands, which are currently under dispute with Japan and Taiwan.134 Both Russia and China will pursue this
technology and develop their own drone suppliers which will sell to the highest bidder, presumably with fewer export controls than those
imposed by the US Congress. Once both governments have equivalent or near-equivalent levels of drone technology to the United States, they
will be similarly tempted to use it for surveillance or attack in the way the US has done. Thus, through its own over-reliance on drones in places
such as Pakistan and Yemen, the US may be hastening the arrival of a world where its qualitative advantages in drone technology are eclipsed
and where this technology will be used and sold by rival Great Powers whose interests do not mirror its own.

A second consequence of the spread of drones is that many

of the traditional concepts which have underwritten
stability in the international system will be radically reshaped by drone technology. For example, much of
the stability among the Great Powers in the international system is driven by deterrence, specifically nuclear
deterrence.135 Deterrence operates with informal rules of the game and tacit bargains that govern what states, particularly those holding
nuclear weapons, may and may not do to one another.136 While it is widely understood that nuclear-capable states will conduct aerial
surveillance and spy on one another, overt
military confrontations between nuclear powers are rare because they
are assumed to be costly and prone to escalation. One open question is whether these states will exercise
the same level of restraint with drone surveillance, which is unmanned, low cost, and possibly deniable.
States may be more willing to engage in drone overflights which test the resolve of their rivals, or engage in ‘salami tactics’ to see
what kind of drone-led incursion, if any, will motivate a response.137 This may have been Hezbollah’s logic in sending a drone into Israeli
airspace in October 2012, possibly to relay information on Israel’s nuclear capabilities.138 After the incursion, both Hezbollah and Iran boasted
that the drone incident demonstrated their military capabilities.139 One could imagine two rival states—for example, India and Pakistan—
deploying drones to test each other’s capability and resolve, with untold consequences if such a probe were misinterpreted by the other as an
attack. As drones get physically smaller and more precise, and as they develop a greater flying range, the temptation to use them to spy on a
rival’s nuclear programme or military installations might prove too strong to resist. If this were to happen, drones might gradually erode
the deterrent relationships that exist between nuclear powers, thus magnifying the risks of a spiral of conflict
between them.

Another dimension of this problem has to do with the risk of accident. Drones are prone to accidents and
crashes. By July 2010, the US Air Force had identified approximately 79 drone accidents.140 Recently released documents have revealed that
there have been a number of drone accidents and crashes in the Seychelles and Djibouti, some of which happened in close proximity to civilian
airports.141 The rapid proliferation of drones worldwide will involve a risk of accident to civilian aircraft, possibly producing an international
incident if such an accident were to involve an aircraft affiliated to a state hostile to the owner of the drone. Most of the drone accidents may
be innocuous, but some will carry strategic risks. In December 2011, a CIA drone designed for nuclear surveillance crashed in Iran,
revealing the existence of the spying programme and leaving sensitive technology in the hands of the Iranian government.142 The expansion of
drone technology raises the possibility that some of these surveillance drones will be interpreted as attack drones, or that an accident or
crash will spiral out of control and lead to an armed confrontation.143 An accident would be even more dangerous if
the US were to pursue its plans for nuclear-powered drones, which can spread radioactive material like a dirty bomb if they crash.144

Third, lethal drones

create the possibility that the norms on the use of force will erode, creating a much
more dangerous world and pushing the international system back towards the rule of the jungle. To some
extent, this world is already being ushered in by the United States, which has set a dangerous precedent that a state may simply kill foreign
citizens considered a threat without a declaration of war. Even John Brennan has recognized that the US is ‘establishing a precedent that other
nations may follow’.145 Given this precedent, there is nothing to stop other states from following the American lead and using drone strikes to
eliminate potential threats. Those ‘threats’ need not be terrorists, but could be others— dissidents, spies, even journalists—whose behaviour
threatens a government.

One danger is that drone use might undermine the normative prohibition on the assassination of leaders and government officials that most
(but not all) states currently respect. A greater danger, however, is that the US will have normalized murder as a tool of statecraft and created a
world where states can increasingly take vengeance on individuals outside their borders without the niceties of extradition, due process or
trial.146 As some of its critics have noted, the Obama administration may have created a world where states will find it easier to kill terrorists
rather than capture them and deal with all of the legal and evidentiary difficulties associated with giving them a fair trial.147

Fourth, there is a distinct danger that the world will divide into two camps: developed states in possession of drone technology, and weak
states and rebel movements that lack them. States with recurring separatist or insurgent problems may begin to police their restive territories
through drone strikes, essentially containing the problem in a fixed geographical region and engaging in a largely punitive policy against them.
One could easily imagine that China, for example, might resort to drone strikes in Uighur provinces in order
to keep potential threats from emerging, or that Russia could use drones to strike at separatist
movements in Chechnya or elsewhere. Such behaviour would not necessarily be confined to authoritarian governments; it is equally
possible that Israel might use drones to police Gaza and the West Bank, thus reducing the vulnerability of
Israeli soldiers to Palestinian attacks on the ground. The extent to which Israel might be willing to use drones in combat and surveillance
was revealed in its November 2012 attack on Gaza. Israel allegedly used a drone to assassinate the Hamas leader Ahmed Jabari and employed a
number of armed drones for strikes in a way that was described as ‘unprecedented’ by senior Israeli officials.148 It is not hard to imagine Israel
concluding that drones over Gaza were the best way to deal with the problem of Hamas, even if their use left the Palestinian population subject
to constant, unnerving surveillance. All of the consequences of such a sharp division between the haves and have-nots with drone technology is
hard to assess, but one possibility is that governments
with secessionist movements might be less willing to
negotiate and grant concessions if drones allowed them to police their internal enemies with ruthless
efficiency and ‘manage’ the problem at low cost. The result might be a situation where such conflicts are contained but not
resolved, while citizens in developed states grow increasingly indifferent to the suffering of those making secessionist or even national
liberation claims, including just ones, upon them.

Finally, drones have the capacity to strengthen the surveillance capacity of both democracies and authoritarian regimes, with significant
consequences for civil liberties. In the UK, BAE Systems is adapting military-designed drones for a range of civilian policing tasks including
‘monitoring antisocial motorists, protesters, agricultural thieves and fly-tippers’.149 Such drones are also envisioned as monitoring Britain’s
shores for illegal immigration and drug smuggling. In the United States, the Federal Aviation Administration (FAA) issued 61 permits for
domestic drone use between November 2006 and June 2011, mainly to local and state police, but also to federal agencies and even
universities.150 According to one FAA estimate, the US will have 30,000 drones patrolling the skies by 2022.151 Similarly, the European
Commission will spend US$260 million on Eurosur, a new programme that will use drones to patrol the Mediterranean coast.152 The risk that
drones will turn democracies into ‘surveillance states’ is well known, but the risks for authoritarian regimes may be even more severe.
Authoritarian states, particularly those that face serious internal opposition, may tap into drone technology now available to monitor and
ruthlessly punish their opponents. In semi-authoritarian Russia, for example, drones have already been employed to monitor pro-democracy
protesters.153 One could only imagine what a truly murderous authoritarian regime—such as Bashar al-Assad’s Syria—would do with its own
fleet of drones. The expansion of drone technology may make the strong even stronger, thus tilting the balance of power in authoritarian
regimes even more decisively towards those who wield the coercive instruments of power and against those who dare to challenge them.

Conclusion

Even though it has now been confronted with blowback from drones in the failed Times Square bombing, the United States has yet to engage in
a serious analysis of the strategic costs and consequences of its use of drones, both for its own security and for the rest of the world. Much
of the debate over drones to date has focused on measuring body counts and carries the unspoken assumption that if drone strikes
are efficient—that is, low cost and low risk for US personnel relative to the terrorists killed—then they must also be effective. This article has
argued that such analyses are operating with an attenuated notion of effectiveness that discounts some of the other key dynamics—such as
growing anti-
the corrosion of the perceived competence and legitimacy of governments where drone strikes take place,
Americanism and fresh recruitment to militant networks—that reveal the costs of drone warfare. In other
words, the analysis of the effectiveness of drones takes into account only the ‘loss’ side of the ledger for the ‘bad
guys’, without asking what America’s enemies gain by being subjected to a policy of constant surveillance and attack.
In his second term, President Obama has an opportunity to reverse course and establish a new drones policy which mitigates these costs and
avoids some of the long-term consequences that flow from them. A more sensible US approach would impose some limits
on drone use in order to minimize the political costs and long-term strategic consequences. One step might be to limit the use of drones to
HVTs, such as leading political and operational figures for terrorist networks, while reducing or eliminating the strikes against the ‘foot soldiers’
or other Islamist networks not related to Al-Qaeda. This approach would reduce the number of strikes and civilian deaths associated with
drones while reserving their use for those targets that pose a direct or imminent threat to the security of the United States.

Such a self-limiting approach to drones might also minimize the degree of political opposition that US drone strikes generate in states such as
Pakistan and Yemen, as their leaders, and even the civilian population, often tolerate or even approve of strikes against HVTs. Another step
might be to improve the levels of transparency of the drone programme. At present, there are no publicly articulated guidelines stipulating who
can be killed by a drone and who cannot, and no data on drone strikes are released to the public.154 Even a Department of Justice
memorandum which authorized the Obama administration to kill Anwar al-Awlaki, an American citizen, remains classified.155 Such non-
transparency fuels suspicions that the US is indifferent to the civilian casualties caused by drone strikes, a perception which in turn magnifies
the deleterious political consequences of the strikes. Letting some sunlight in on the drones programme would not eliminate all of the
opposition to it, but it would go some way towards undercutting the worst conspiracy theories about drone use in these countries while also
signalling that the US government holds itself legally and morally accountable for its behaviour.156

A final, and crucial, step towards mitigating the strategic consequences of drones would be to develop internationally
recognized standards and norms for their use and sale. It is not realistic to suggest that the US stop using its
drones altogether, or to assume that other countries will accept a moratorium on buying and using
drones. The genie is out of the bottle: drones will be a fact of life for years to come. What remains to be
done is to ensure that their use and sale are transparent, regulated and consistent with internationally recognized human
rights standards. The Obama administration has already begun to show some awareness that drones are dangerous if placed in the wrong
hands. A recent New York Times report revealed that the Obama administration began to develop a secret drones ‘rulebook’ to govern their
use if Mitt Romney were to be elected president.157

The same logic operates on the international level. Lethal drones will eventually be in the hands of those who will use them with fewer scruples
than President Obama has. Without a set of internationally recognized standards or norms governing their sale and use, drones will proliferate
without control, be misused by governments and non-state actors, and become an instrument of repression for the strong. One remedy might
be an international convention on the sale and use of drones which could establish guidelines and norms for their use, perhaps along the lines
of the Convention on Certain Conventional Weapons (CCW) treaty, which attempted to spell out rules on the use of incendiary devices and
fragment-based weapons.158 While enforcement of these guidelines and adherence to rules on their use will be imperfect and marked by
derogations, exceptions and violations, the presence of a convention may reinforce norms against the flagrant misuse of drones and induce
more restraint in their use than might otherwise be seen. Similarly, a UN investigatory body on drones would help to hold states accountable
for their use of drones and begin to build a gradual consensus on the types of activities for which drones can, and cannot, be used.159 As the
progenitor and leading user of drone technology, the
US now has an opportunity to show leadership in developing an
international legal architecture which might avert some of the worst consequences of their use.