The Economy and the New Congress

The 2018 midterm elections are over, and it’s time for Congress to get to work. America faces significant, and in some cases urgent, challenges both at home and abroad.

There is a worrisome possibility that addressing the nation’s pressing needs will take a backseat to politics. Democrats’ fury over losing the 2016 presidential election continues to divert their attention away from issues that are truly essential to the citizenry, and towards partisan tactics, including endless investigations into frequently unfounded allegations.

There is also bipartisan blindness on any number of issues, as Washington’s long-standing and unfortunate inability to grasp Mainstreet concerns continues.

The New York Analysis of Policy and Government reviewed five key issues that Congress should rapidly work on. First up: Health Care, and the Economy.

Healthcare

There will be a great deal of emphasis on fixing healthcare issues, some of which have existed for decades and some of which arose or worsened under the Obamacare legislation. Extensive debate about topics such as affordability, especially coverage for pre-existing conditions, can be expected.

There will be no easy answers to all this, and no viable international examples to follow. Medical care in countries with nationalized health care is even worse.

There are common sense approaches to improving medical care and reducing costs. Major steps would include:

End limitations on allowing insurance companies to compete across state lines. This can dramatically lower costs.
Enact tort reform to limit nonsense law suits and drive down the costs of practicing medicine. A key factor that drives costs up and diminishes the timeliness and quality of care: The battery of unnecessary, costly and repetitive tests patients frequently undergo, not for their own benefit but for the concerns of medical practitioners and institutions’ lawsuit avoidance. Tort reform to address this will be difficult, as lawyers’ organizations are among the most powerful lobbyists.
Mandate more transparency in billing practices, particularly from hospitals. Nebulous and often faulty billing practices add a whole additional layer of consternation. Strict standards of transparency and “plain English” billing should be mandated.
Allow physicians’ assistants and registered nurses to do far more.
Permit greater flexibility and choice in health insurance policies.
End excessive and costly red tape preventing new medications and treatments from gaining approval for use.

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An additional but often ignored challenge is the dismal level of customer service when dealing with medical institutions. In no other endeavor would the long waiting times both to get appointments and in doctor’s offices, particularly specialists, be tolerated. Further, the growing trend of sharply limiting the opportunity for patients to speak to their physicians for more than a few seconds is harmful. As crucial as it is, medicine is a service industry. Developing additional spaces for qualified applicants to medical schools should be a priority in the effort to remedy this.

The Economy

Both Ronald Reagan and John F. Kennedy successfully sparked and significantly improved the economy through tax cuts. President Trump has been the latest example. Not only should attempts to undo his tax cuts be repulsed, but further tax cuts should be enacted.

Middle income families have been downtrodden for far too long, particularly since President Clinton gave China greater access to the American marketplace, resulting in the loss of about 66,000 U.S. manufacturing plants. It’s time that China and other nations treated America fairly.

It is not a violation of the concept of free trade to demand that U.S. companies be afforded the same opportunity to compete overseas as other nations are given in America. Disunity within Congress could threaten progress by emboldening adversaries such as China that opposition to the White House will result in a softening of resolve to confront the issue. A more united stance on the Trump Administration’s attempt to finally address the unfair trade policies that have hampered the American economy for far too long would lead to greater results. Ironically, a key Democrat constituency, blue collar workers, stands to gain the most from Trump trade goals.

Finally, one of the key disincentives to starting or expanding businesses, especially smaller enterprises, is the dead weight of excess regulation. Slash that red tape to the bare minimum necessary for safety, and let the American entrepreneurial spirit take flight.

Our review continues tomorrow.

Photo: National Park Service

Quick Analysis

Ukraine’s Frozen Conflict

As we approach winter in the northern hemisphere, the war in Ukraine is beginning to resemble a “frozen conflict” from many perspectives. Ukrainian President Volodymyr Zelensky recently told the media he hopes the war will end faster once President-elect Trump takes over in January. Opinions in Moscow, however, differ from that of the Ukrainian leader. Russian President Vladimir Putin argues that the North Atlantic Treaty Organization (NATO) needs to exclude Ukraine from joining in “exchange” for peace. If it does not, he says, then no end to the war is in sight. So far there is no Christmas solution. Several NATO countries, according to Vladimir Socor of the Jamestown Foundation, are tentatively considering “coalitions-of-the-willing” to provide security for Ukraine outside of the formal NATO framework. There is, however, no collective mechanism today under which such an arrangement is viable. According to the NATO Charter, while Ukraine is a NATO partner country, it may not join as a full member since it has not fulfilled the requirements for membership. That has not stopped NATO and allies from continuing “to provide Ukraine with unprecedented levels of support, helping to uphold its fundamental right to self-defence,” according to the organization. Socor says that keeping Ukraine out of NATO will not advance peace with Russia. Waiting for a peace settlement, he suggests, would only serve to encourage Moscow to continue the war indefinitely. Although the Biden Administration officially withdrew its support for Ukrainian membership in 2021, NATO maintains an “open door” policy toward membership-seeking countries. The current White House position led the way for European states to oppose Ukraine’s membership saying that a decision should be delayed until “conditions are met.” Biden pushed for changing “open door” to a “bridge” metaphor. It is not intended as an across-the-board NATO policy and has been implemented in the past on a case-by-case basis, says Socor. “The alliance’s open-door policy was not fully insulated from Russia’s non-statutory blocking power, and NATO-aspirant countries’ path toward membership was not always irreversible.” Russia has successfully blocked states like Georgia from joining, first in 2008 and again after the war in Ukraine began in 2014. Russia recognizes the value add of Ukraine to NATO is enormous and that Kyiv has a better case than some other nations. Putin’s invasion was, in part, intended to foreclose that option. By 2021, Moscow was pushing hard to maximize its war objectives, which included further annexations of Ukrainian territory. A main goal for Putin was, and is, to ensure there is no Ukraine left to join NATO. As President-elect Trump prepares to assume office in January, he is faced with the historical challenges presented by the war. Post-conflict security guarantees were the center of several proposals made during the 2023 military stalemate. The incoming Trump Administration has yet to outline how it intends to handle the Russia-Ukraine war. Analysts in Washington believe that the new Administration will expect its European allies to guarantee the majority of Ukraine’s security needs. As we approach 2025, several European nations have acknowledged that they do not view Ukraine as eligible for NATO membership as it would draw the organization into the middle of the conflict. Others want to wait until the war is over or pending a “peace” settlement before considering Ukrainian membership. Socor reports that some “influential voices” are suggesting that “Kyiv should join NATO after “freezing” the war along a stable armistice line, de facto accepting Ukraine’s partition, with NATO security guarantees applying de jure to the government-controlled territory only.” This would mean starting accession talks soon with the actual talks to commence only after a ceasefire is in place. Trump arrives in Washington at a time when Putin’s hybrid strategies of war in Ukraine have eviscerated commonly-held differences between war and peace. “Absent a political consensus in NATO over Ukrainian membership, certain European allies, including France’s President Emmanuel Macron, are holding informal consultations about post-conflict security guarantees to Kyiv by NATO members outside of NATO’s framework,” according to the Jamestown Foundation. The Biden Administration downplayed the discussions on possible forms of military assistance and defense industry cooperation by sending only an Assistant Secretary of State. For a European peace to hold the Trump Administration would need to formally extend the United States’ nuclear deterrence to Ukraine. Options under discussion in Europe include a “coalition of the resolute” to deploy forces to Ukraine as part of a possible armistice package, deterring further Russian attacks, says Secor. European officials are also debating, without any agreement, whether its military forces could perform non-combat logistical roles to free Ukrainian forces to fight. None of the possible courses of action has moved forward as all eyes are waiting on the incoming Trump Administration for clues about its intended level of support for a NATO framework and other non-NATO proposals. Daria Novak served in the U.S. State Dept.