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Henry Kissinger in 2008

Henry Kissinger, former secretary of state, took part in a foreign policy panel Thursday at a University conference on election year politics and policies.

Presidential politics: take three

Panelists tackle exporting democracy, tax policy, and health care

By Deane Morrison

September 5, 2008

Back when both were active on the national scene, Henry Kissinger would occasionally let Hubert Humphrey introduce him. But only occasionally. "If he introduced you, you didn't get to speak," the former secretary of state quipped to a packed house Thursday at the University's Humphrey Institute. Kissinger's appearance was the marquee event on the last day of "America's Future: Conversations about Politics and Policy during the 2008 Republican National Convention," a University conference held September 1-4. This is the last of three reports on the conference, whose sessions can be viewed on a Web archive. Kissinger was part of a panel that examined the prospects for exporting democracy around the world. J. Brian Atwood, dean of the Humphrey Institute, saw an erosion of support for promoting democracy abroad, especially in the wake of U.S. actions and practices in Iraq and Guantanamo Bay. Later, he asked Kissinger how the United States can influence the behavior of powers like Russia and China. Drawing examples from his own experience, Kissinger urged caution and discretion. "We told Russia, 'We don't question your right to determine the emigration from your country,'" he said. "'But if you increase it, we will notice, and we won't say we asked you to do it." Emigration from the Soviet Union soon increased from 900 to 40,000 a year, Kissinger said. On China, he said it would be a mistake to tell the evolving, 4,000-year-old country, which will have hefty political, cultural, and economic impacts on the world, what sorts of "structures" it should have. It would not do to produce a generation of Chinese nationalists who substitute nationalism and anti-Westernism for Communism. Kissinger counseled patience in the face of China's long evolutionary path. But not even he had all the answers. Saudi Arabia, Kissinger said, is an issue that has defeated every administration he has seen. "No one is willing to face the consequences of overthrowing that system," he said. "Whatever follows would certainly be worse." It would include an inrush of other parties--unnamed, but clearly unsavory--to help fill the vacuum. Another speaker, Lorne Craner, remarked that his organization's work is hard enough without "Guantanamo and torture being thrown in our face." Craner is president of the International Republican Institute, a nonpartisan organization that tries to spread democracy abroad by means of volunteer trainers. Revelations about recent U.S. treatment of prisoners has also alienated Europeans whose help in these efforts the institute has sought.

Cutting remarks

A session on the two major party candidates' tax policies brought a lot of arguing by advisers to Barack Obama and John McCain. Overall, both would cut taxes. But an analysis provided by the Tax Policy Center showed that both candidates' policies "would substantially increase the national debt over the next 10 years," and "[n]either candidate's plan would significantly increase economic growth unless offset by spending cuts or tax increases" as yet unspecified by the campaigns.

"No one is willing to face the consequences of overthrowing [the Saudi regime]. Whatever follows would certainly be worse."

The center also handed out a chart of how after-tax income would change for people in each quintile of income under the McCain and Obama proposals. It showed those in the lowest quintile gaining about 6 percent under Obama and almost one percent under McCain, while in the highest quintile the gains were about 2 percent under Obama and 6.5 percent under McCain. The biggest difference was for those in the top 1 or 0.1 percent of income. Under Obama, their after-tax income would drop about 1.5 percent and 2.7 percent, respectively; under McCain, it would rise about 9.5 percent and 11.5 percent, respectively. The center's Leonard Burman admonished both campaigns to simplify the tax code and broaden the tax base. He said that frustration with the code's complexity undermines support for progressive taxes and breeds support for a flat tax.

Getting health care off life support

The conference ended with a discussion of health care and the need for reform before Medicare, as Utah Sen. Bob Bennett put it, bankrupts the country. The session centered on a bill sponsored by Bennett and Oregon Sen. Ron Wyden, which Bennett said would allow employees to receive their health care dollars directly and tax-free, instead of having them paid by an employer as a pre-tax benefit, and would let employees take those dollars with them if they change jobs. The bill has picked up 16 co-sponsors, eight from each side of the aisle. Bennett said he and Wyden take a "Noah's Ark" approach: They always add co-sponsors in pairs, one from each party, to keep the roster evenly bipartisan. The key to containing costs is top-quality care, Bennett said. He cited the waste that ensues when poor-quality care--or none--leads to patients showing up at emergency rooms with problems made severe by neglect. Medtronic's Stephen Mahle echoed that concern. "The largest expense in business is correcting quality problems," he said, adding that the system today has "perverse economic incentives" that reward poorer quality care and wasted effort. For example, said Mahle, suppose a doctor could choose between a pacemaker that lasts five years and one that lasts 10 years. A doctor who consistently implanted the five-year model would get to do--and be compensated for--more procedures. Another way to lower costs while improving care is to make sure practitioners hear about the latest research in their field. "We need a good process for evidence-based medicine, because a lot of research isn't translated into practice," said Jeff Korsmo of the Mayo Clinic Health Policy Center. As an example of how evidence-based medicine can slash costs, Bennett told of a study in Salt Lake City by Intermountain Healthcare that showed that post-surgical infection rates dropped from 2 to 0.2 percent when antibiotics were administered in the first hour after surgery. Starting antibiotics later would thus lead to higher costs associated with fighting infections that had already gained a foothold.
Read the first and second articles in this series.