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April 2017

The Pitfalls of Single-Payer Health Care: Canada’s Cautionary Tale Before America resigning themselves to socialized medicine, flummoxed legislators should consider the experience of our neighbors to the North. By Candice Malcolm

In the Netflix series House of Cards, President Frank Underwood campaigned for the White House by telling Americans, “You are entitled to nothing.” The fictional president — a Democrat, no less — was forthright with American voters about the unaffordable and unsustainable structure of America’s entitlement programs, and he was rewarded at the polls.

In real-life America, unfortunately, there is no such courageous honesty from the political class. Even many in the Republican party, once the stalwart force fighting against the growth of big government, are now resigned to contemplating a government takeover of the health-care industry in the wake of their failure to repeal and replace Obamacare. Charles Krauthammer, for example, woefully predicts that President Trump will opt for single-payer health care. F. H. Buckley, meanwhile, optimistically calls for Trump to look to the Canadian model of universal coverage.

There’s just one problem: The Canadian model of universal coverage is failing.

Assessing Canada’s Single-Payer System

The Canada Health Act (CHA), introduced in 1984, governs the complicated fiscal agreement between the provinces, who administer health services, and the feds, who manage their health-insurance monopoly and transfer funds to the local governments. Unlike in the United Kingdom, where health care is socialized and hospitals are run by the National Health Service, in Canada health care is technically delivered privately, although given the Kafkaesque regulations and restrictions that govern it, the system is by no means market-based. In fact, Canada’s government-controlled health-care system has become more restrictive than communist China’s.

Debates about health-care policy typically revolve around three key metrics: universality, affordability, and quality.

Canada passes the first test with flying colors: Every resident of the country is insured under the CHA, with covered procedures free at the point of delivery. While medical providers are independent from the federal government, they are compelled to accept CHA insurance —and nothing else — by a prohibition on accepting payments outside the national-insurance scheme so long as they wish to continue accepting federal health-transfer funds. The spigot of money from Ottawa thus ensures a de facto government monopoly in the health-insurance market.

The CHA provides and ensures universal coverage from the top down. In Canada, the government determines what procedures are medically necessary. Bureaucrats, not doctors, decide which procedures and treatments are covered under the CHA — based on data and statistics rather than on the needs of patients. While private insurance does exist — an OECD report found that 75 percent of Canadians have supplementary insurance — it applies only to procedures and services that fall outside the CHA — including dental work, optometric care, and pharmaceutical drugs.

When it comes to affordability, the Canadian system also passes, if just barely. Canadians pay for health insurance through their taxes; most never see a medical bill. But that doesn’t mean the system is affordable. Au contraire, it relies almost entirely on current taxpayers to subsidize the disproportionately large health-care needs of elderly Canadians in their final few years of life. Rather than pre-funding the system to deal with the coming tsunami of aging Baby Boomers, Canada’s provincial governments pay and borrow as they go — and rank among the most indebted sub-sovereign borrowers in the world. According to Don Drummond, an economist appointed by Ontario’s Liberal government to help fix its finances, Canada’s largest province is projected to see health-care costs soar to the point where they will consume 80 percent of the entire provincial budget by 2030, up from 46 percent in 2010.

Trump’s Syria Strike Was Constitutional The Framers gave presidents broad powers to take the lead in matters of national security, and they gave Congress the power to cut off funding. By John Yoo

In ordering Friday’s strike on a Syrian airbase, President Donald J. Trump sent the U.S. military into combat without Congress’s blessing. He has punished the Assad regime for its use of sarin nerve gas on its own people and only begun to correct the mistakes the Obama administration made when it allowed the Syrian civil war to metastasize into a conflict that is destabilizing the Middle East.

For its troubles, however, the Trump administration has come under fire from his conservative flank. Libertarian senator Rand Paul demands that Trump seek congressional authorization, while distinguished conservative law professor Mike Paulsen and National Review editor Kevin Williamson argue in these pages that the strikes violate the Constitution. Their arguments add to the outrage of Trump supporters, such as Ann Coulter, who tweeted: “Those who wanted us meddling in the Middle East voted for other candidates.”

This time, President Trump has the Constitution about right. His exercise of war powers rests firmly in the tradition of American foreign policy. Throughout our history, neither presidents nor Congresses have acted under the belief that the Constitution requires a declaration of war before the U.S. can conduct military hostilities abroad. We have used force abroad more than 100 times but declared war in only five cases: the War of 1812, the Mexican-American and Spanish-American wars, and World Wars I and II.

Without any congressional approval, presidents have sent forces to battle Indians, Barbary pirates, and Russian revolutionaries; to fight North Korean and Chinese Communists in Korea; to engineer regime changes in South and Central America; and to prevent human-rights disasters in the Balkans. Other conflicts, such as the 1991 Persian Gulf war, the 2001 invasion of Afghanistan, and the 2003 Iraq War, received legislative “authorization” but not declarations of war. The practice of presidential initiative, followed by congressional acquiescence, has spanned both Democratic and Republican administrations and reaches back from President Trump to Presidents Abraham Lincoln, Thomas Jefferson, and George Washington.

Common sense does not support replacing the way our Constitution has worked in wartime with a radically different system that mimics the peacetime balance of powers between president and Congress. If the issue were the environment or Social Security, Congress would enact policy first and the president would faithfully implement it second. But the Constitution does not duplicate this system in war. Instead, our Framers decided that the president would play the leading role in matters of national security.

If the issue were the environment or Social Security, Congress would enact policy first and the president would faithfully implement it second.

Obama Is America’s Version of Stanley Baldwin Both leaders put their successors in a dangerous geopolitical position. By Victor Davis Hanson

Last year, President Obama assured the world that “we are living in the most peaceful, prosperous, and progressive era in human history,” and that “the world has never been less violent.”

Translated, those statements meant that active foreign-policy volcanoes in China, Iran, North Korea, Russia, and the Middle East would probably not blow up on what little was left of Obama’s watch.

Obama is the U.S. version of Stanley Baldwin, the suave, three-time British prime minister of the 1920s and 1930s. Baldwin’s last tenure (1935–1937) coincided with the rapid rise of aggressive German, Italian, and Japanese Fascism.

Baldwin was a passionate spokesman for disarmament. He helped organize peace conferences. He tirelessly lectured on the need for pacifism. He basked in the praise of his good intentions.

Baldwin assured Fascists that he was not rearming Britain. Instead, he preached that the deadly new weapons of the 20th century made war so unthinkable that it would be almost impossible for it to break out.

Baldwin left office when the world was still relatively quiet. But his appeasement and pacifism had sown the seeds for a global conflagration soon to come.

Obama, the Nobel peace laureate and former president, resembles Baldwin. Both seemed to believe that war breaks out only because of misunderstandings that reflect honest differences. Therefore, tensions between aggressors and their targets can be remedied by more talk, international agreements, goodwill, and concessions.

Ideas such as strategic deterrence were apparently considered by both Baldwin and Obama to be Neanderthal, judging from Baldwin’s naÏve efforts to ask Hitler not to rearm or annex territory, and Obama’s “lead from behind” foreign policy and his pledge never to “do stupid sh**” abroad.

Obama issued various empty deadlines to Iran to cease enriching uranium before concluding a 2015 deal that allowed the Iranians to continue working their centrifuges.

Aggressors clearly assumed that Obama’s assurances were green lights to further their own agendas without consequences.

Iran routinely threatened U.S. Navy ships, even taking ten American sailors into custody early last year. Obama issued various empty deadlines to Iran to cease enriching uranium before concluding a 2015 deal that allowed the Iranians to continue working their centrifuges. Iran was freed from crippling economic sanctions. And Iran quietly received $400 million in cash (in the dead of night) for the release of American hostages.

Durbin: ‘Praise the Lord’ That Mattis is ‘That Close to the President’ By Bridget Johnson see note please

PRAISE FROM DICK DURBIN IS WORRISOME….DURBIN RANKS A + 5 ON THE ARAB AMERICAN INSTITUTE’S SCORECARD FOR LEGISLATORS INDICATING A VERY PRO-ARAB VOTING RECORD. HE RECENTLY GRATIFIED HIS SUPPORTERS BY ATTENDING A CAIR 10TH ANNIVERSARY GALA.

CAIR has been designated by the FBI and several in Congress as a supporter of U.S.-designated terrorist groups. This is what Durbin said about the organization:
“For more than 10 years, CAIR-Chicago has enhanced the understanding of Islam within our communities by facilitating dialogue, protecting civil liberties, empowering American Muslims, and building coalitions which promote justice and mutual understanding. I applaud your commitment to guaranteeing that our country’s ideals are fully respected and realized for all.” – Dick Durbin U.S. Senator, State of Illinois

Senate Minority Whip Dick Durbin (D-Ill.) said he sees movement in the Trump administration toward the “center stripe” on foreign policy, and “praise the Lord” that Defense Secretary James Mattis is in charge at the Pentagon.

Durbin told MSNBC that it was “absolutely essential” that Trump moved forward the expansion of NATO this week, signing off on ratification after the Senate approved Montenegro’s ascension 97-2. Sens. Rand Paul (R-Ky.) and Mike Lee (R-Utah) were the “no” votes.

That’s in advance of Trump’s first foreign trip to the NATO summit in May. The U.S. “will work to further strengthen our already strong relationship with Montenegro and looks forward to formally welcoming the country as the twenty-ninth member of the NATO alliance,” White House press secretary Sean Spicer said in a Tuesday statement. Trump meets with NATO Secretary General Jens Stoltenberg at the White House today.

“Ukraine is the Exhibit A of why it is essential that the countries of Europe, Poland, the Baltics, and Ukraine know that the United States committed to NATO. That is the only way to stop Putin’s adventurism in this situation,” Durbin said. “…What you’re seeing is moderation of the views of Donald Trump, at least in his White House foreign policy that differs from what we heard on the campaign trail. On the campaign trail he didn’t back off an inch.”

“…What a dramatic change in such a short period of time. Think a week ago, about a week ago, here is Secretary of State Tillerson saying let the Syrian people decide if Assad has a future. Within seven days we’re attacking them.”

Durbin opined that “there is a transition taking place,” and pinpointed senior advisor Jared Kushner “as one of the elements of that transition” is “true from what I’ve heard.”

“It’s an indication they are moving toward what used to be the center stripe, mainstream on foreign policy,” he added.

On Mattis, Durbin lauded his Tuesday Pentagon press conference, adding, “Praise the Lord that that sort of person is that close to the president.” CONTINUE AT SITE

Syria and the Fundamentalist Islamic Uprising By Robert Turner

Should the United States have prolonged the Syrian civil war by arming the rebels? Based on recent experience, one wonders if deposing ruling monarchies is in the best interest of either the peoples of the Middle East or of the world at large. Consider the following:

The failure of the Carter administration to support its ally Mohammad Reza Pahlavi, the Shah of Iran, led to establishment of the Islamic Republic of Iran, the region’s greatest threat. The reward to the United States for its implicit support of the Iranian revolution was an attack on its embassy, the ensuing hostage crisis, throngs in the streets screaming “Death to America,” and support of terrorism aimed at the U.S. and its’ allies. The result to Israel is likely to be increasingly dire in months and years to come.

The failure of the Obama administration to support U.S. ally Hosni Mubarak, president of Egypt, and a key supporter of the peace with Israel negotiated by Anwar Sadat, led to a near takeover of Egypt by the Muslim Brotherhood, described as a terrorist organization by a number of allies in the region. Only intervention by the military saved Egypt from Islamic totalitarianism.

While hardly virtuous, Muammar Gaddafi, following a wakeup confrontation with President Reagan’s military followed by the implicit threat of George W. Bush’s anti-terrorism campaign after 9/11, had given up his nuclear ambitions and was actually providing significant assistance in world efforts to defeat Islamic terrorism. Hillary Clinton, Obama’s first-term Secretary of State, decided that Colonel Gaddafi should not be allowed to put down a rebel insurrection within Libya and led an international effort to free Libya from his predilection to violence. Again, our interference resulted in tragedy for America and disaster for the people of Libya.

Saddam Hussein, the counterweight to Iran in the Middle East, was a cruel dictator with the propensity to involve himself in world politics and commit despicable acts. After 9/11, in addition to its war against the Taliban in Afghanistan, the Bush administration opted to invade Iraq due to concerns over Hussein’s weapons of mass destruction. The ensuing government of Iraq was transformed from Sunni Muslim control that kept a firm hand on its Shiite Muslim majority population to Shiite Muslim control that abused its minority Sunni Muslim population. The result has been a continued reign of terror as car bombs and suicide bombers continue attacks on both branches of the Islamic tree.

Our involvement in Iraq was then followed by the disastrous and premature Obama decision to withdraw U.S. forces, thereby creating the opening for creation of a caliphate by the Islamic State in Iraq and Syria (ISIS) that has been on a murderous rampage throughout not only the Middle East but now extends into Europe, Africa, and even the United States.

That brings me back to the question of Syria: if the United States had not encouraged Syrians in their rebellion against the Assad government, if we had not surreptitiously armed Islamist rebels with weapons from Gaddafi’s stockpiles in Libya, if we had not trained and equipped something we called the “Free Syrian Army,” might not the civil war in Syria have ended by now with far fewer casualties than our prolonging of the war effort has allowed? I don’t know the answer to this question, but it seems worthy of serious consideration.

Is it a curious coincidence that this revolutionary wave engulfing one Islamic nation after another from Tunisia in 2010, to Libya, Egypt, Yemen, Syria and Iraq occurred within mere months of one another? Is it a coincidence that demonstrations, protest and riots over this same period of time occurred in Morocco, Bahrain, Algeria, Lebanon, Jordan, Kuwait, Oman and Sudan with lesser protests in half a dozen other nations?

Taiwan Needs Submarines As China increases its threats, the U.S. can help the island’s self-defense.

Taiwan’s recent announcement that it will build its own diesel-electric submarines has provoked skepticism across the defense industry. The island’s shipyards lack experience constructing pressure hulls, and the local defense industry will struggle to provide the high-tech innards of a modern submarine, such as fire control and propulsion systems. So what is Taipei up to?

Taiwan certainly needs the subs to deter an invasion from mainland China, and the best option would be to buy them from a country with an existing production line. But Beijing has pressured the viable candidates not to sell to Taiwan.

In 2001 George W. Bush’s Administration promised to develop and build conventional submarines for Taiwan. But the U.S. Navy and its backers were opposed because it only deploys nuclear-powered subs and it fears that if a U.S. company began to build diesel subs, then it might lobby Congress to acquire them. The Bush proposal also foundered on political opposition within Taiwan to spending the large sums to buy and operate the boats. The U.S. dropped the idea in 2008.

Since then Taiwan’s defense situation has grown more dire. In 2009 a RAND study concluded that in the event of a mainland attack, the island would lose air superiority over its territory within a few days. China’s armed forces have continued to advance in quality and quantity, while many of Taiwan’s weapons are aging or obsolete.

China has also stepped up its bullying. After President Tsai Ing-wen was elected in January 2016, Beijing downgraded economic ties and again threatened to use military force if Taiwan refuses indefinitely to hold talks on reunification. The country’s first aircraft carrier conducted a cruise around Taiwan in December and January, sending a pointed message to the island’s population.

These moves seem to have shaken Taiwanese politicians out of their complacency. The government recently announced plans to increase military spending by up to 50% in 2018, bringing the island’s defense budget up to the goal of around 3% of GDP that the U.S. has been urging for years.

Authorities Detain Islamist After Blast on Team Bus in Germany’s Dortmund Style of attack leaves investigators hesitant to attribute responsibility By Ruth Bender

BERLIN—Authorities detained a suspected Islamist on Wednesday and were investigating another after a bomb blast hit a German soccer team’s bus, leaving one player injured.

The arrest came after investigators found three identical letters near the scene that indicated an Islamist motive, said Frauke Köhler, spokeswoman of the federal prosecutor. Yet the Tuesday night attack in Dortmund bore few of the hallmarks of past Islamist attacks in the country, leaving investigators hesitant to attribute responsibility.

Terror experts said the unusual sophistication of the attack, the preparation it would have required, and the force of the explosives used would mark a significant step up for Islamist militants if they were indeed responsible.

Ms. Köhler didn’t publicly identify the detained suspect or say why the second person hadn’t been arrested. But a person close to the investigation said both were from North-Rhine Westphalia, the western state where Dortmund is located, and that investigators were lacking evidence to arrest the second one.

The attack hit a bus that was ferrying Borussia Dortmund’s soccer players to their stadium for a quarterfinal game in the most prestigious tournament in club soccer.

“It almost looks like a classical improvised explosive device as we see it in Iraq,” said Stefan Hansen, managing director of the Center of Research on Terrorism and Radicalization at the University of Kiel. CONTINUE AT SITE

U.N. Vote on Syria Fails as Russia Blocks Measure Veto in Security Council comes amid growing polarization over the country’s conflict By Farnaz Fassihi

UNITED NATIONS—The U.N. Security Council failed to bring about a resolution condemning the latest chemical attacks in Syria after Russia vetoed the measure, its eighth veto of proposed moves against Damascus since the conflict began six years ago.

The deadlock on Wednesday didn’t come as a surprise, as the Security Council has grown increasingly polarized over the conflict, leaving it unable to offer a feasible solution for ending it.

For the past eight days, since news of another chemical attack in Syria surfaced on April 4, the Council has struggled over a seemingly simple diplomatic task: to issue a resolution that condemns the general use of chemical weapons in Syria; call for U.N. investigations; and call on Damascus to offer full access to investigators.

The resolution went through three rewrites. At one point, three competing texts—one from U.S. and its allies, another from Russia and a third from the other 10 nonpermanent members of the Council—were circulated in a last-minute attempt to restore unity.

China abstained, declining to join Russia’s veto in a stand that drew praise in Washington from President Donald Trump. The U.S., together with France and the United Kingdom, and seven of their allies voted in favor. CONTINUE AT SITE

Notable & Quotable: Angry Clintons ‘Hillary’s talented and accomplished team of professionals and loyalists simply took it.’

From “Shattered: Inside Hillary Clinton’s Doomed Campaign,” a forthcoming book by Jonathan Allen and Amie Parnes, excerpted at TheHill.com, April 12:

Hillary Clinton turned her fury on her consultants and campaign aides, blaming them for a failure to focus the media on her platform.

In her ear the whole time, spurring her on to cast blame on others and never admit to anything, was her husband. Neither Clinton could accept the simple fact that Hillary had hamstrung her own campaign and dealt the most serious blow to her own presidential aspirations.

That state of denial would become more obvious than ever to her top aides and consultants during one conference call in the thick of the public discussion of her server. Joel Benenson, Mandy Grunwald, Jim Margolis, John Anzalone, John Podesta, [Robby] Mook, Huma Abedin and Dan Schwerin were among the small coterie who huddled in Abedin’s mostly bare corner office overlooking the East River at the campaign’s Brooklyn headquarters. Hillary and Bill, who rarely visited, joined them by phone.

Hillary’s severe, controlled voice crackled through the line first. It carried the sound of a disappointed teacher or mother delivering a lecture before a whipping. That back end was left to Bill, who lashed out with abandon. Eyes cast downward, stomachs turning—both from the scare tactics and from their own revulsion at being chastised for Hillary’s failures—Hillary’s talented and accomplished team of professionals and loyalists simply took it. There was no arguing with Bill Clinton.

The Trump Presidency Begins A presidency that was almost too much fun has taken a clear turn to the serious. Dan Henninger

Instead of “The Trump Presidency Begins,” an alternative headline for this column might have been “Trump’s Presidency Begins.” Each describes a different reality.

Until recently, “Trump’s presidency” has been about one thing—Donald Trump. It’s been Trump 24/7. Mr. Trump owned the presidency the way Mr. Trump owns a tower on Fifth Avenue. For better and for worse, Trump’s presidency was all about him.

In the past few weeks—the Gorsuch appointment, the Syrian strike, the meeting with China’s Xi Jinping —we are finally seeing the beginning of the real Trump presidency.

Like all the others dating back to George Washington, the presidency is not an object captured by one person; it is an office held in trust for the people of the United States.

The Trump-centric phenomenon of these early days is the product of our celebrity-centric times, not least the presidency. He drove it with social media, and the media torrents washed back over him.

There are some realities, though, that the media torrents haven’t washed away yet. America’s institutions, its politics and the distant world are still too large for anyone to hold and command alone. That is the lesson of recent days.

Neil Gorsuch was nominated by Mr. Trump to fill the ninth seat on the Supreme Court. What followed was a mighty political struggle. The opposition to Judge Gorsuch, led by Senate Minority Leader Chuck Schumer, revealed that the legal philosophies of progressives and conservatives have arrived at incompatibility.

Confirming Judge Gorsuch required the Trump presidency to recede so its political allies could rise and execute. The legislative branch eliminated the filibuster for Supreme Court nominees, thereby preserving the president’s prerogatives.

While the Gorsuch drama played out on the Senate floor, Mr. Trump met at Mar-a-Lago with China’s Xi Jinping, who traveled nearly 8,000 miles to meet the American president. Possibly, the Chinese thought that Muhammad going to the mountain would flatter the flatterable Mr. Trump. Instead, the strikingly low-key meeting acknowledged the high stakes for the two nations and the world.

On Wednesday, Mr. Xi called the president to discuss North Korea again. That no doubt had something to do with Mr. Trump’s soufflé surprise over dinner with Mr. Xi—a missile strike against an Assad airfield and chemical-weapons depot in Syria.

Unlike the assassination of Osama bin Laden, when the mission details leaked out overnight, there was no self-congratulatory media dump out of the White House of this presumably ultra-media-conscious president. Just a blow to the Middle East status quo.

For our purposes, the important thing isn’t the strike but what came before. It requires little imagination to guess the import of the conversations about operational and political details between the president and Defense Secretary Jim Mattis —former head of the U.S.’s Middle Eastern Central Command—and his national security adviser, Gen. H.R. McMaster. As Dorothy said to Toto, I don’t think we’re in Kansas anymore. CONTINUE AT SITE