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1. U.S. Health Care from a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes

Author:
Munira Z. Gunja, Evan D. Gumas, and Reginald D. Williams II
Publication Date:
01-2023
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
In the previous edition of U.S. Health Care from a Global Perspective, we reported that people in the United States experience the worst health outcomes overall of any high-income nation.1 Americans are more likely to die younger, and from avoidable causes, than residents of peer countries. Between January 2020 and December 2021, life expectancy dropped in the U.S. and other countries.2 With the pandemic a continuing threat to global health and well-being, we have updated our 2019 cross-national comparison of health care systems to assess U.S. health spending, outcomes, status, and service use relative to Australia, Canada, France, Germany, Japan, the Netherlands, New Zealand, Norway, South Korea, Sweden, Switzerland, and the United Kingdom. We also compare U.S. health system performance to the OECD average for the 38 high-income countries for which data are available. The data for our analysis come from the Organisation for Economic Co-operation and Development (OECD) and other international sources (see “How We Conducted This Study” for details). For every metric we examine, we used the latest data available. This means that results for certain countries may reflect the height of the COVID-19 pandemic, when mental health conditions were surging, essential health services were disrupted, and patients may not have received the same level of care
Topic:
Health, Health Care Policy, Inequality, and Finance
Political Geography:
North America and United States of America

2. Authoritarian kleptocrats are thriving on the West’s failures. Can they be stopped?

Author:
Francis Shin and Ben Judah
Publication Date:
01-2023
Content Type:
Special Report
Institution:
Atlantic Council
Abstract:
A hidden web of power revealed itself to Internet users in early 2022. Following a brutal government crackdown in Kazakhstan in January, anyone using open-source flight-tracking websites could watch kleptocratic elites flee the country on private jets. A little more than a month later, Russia’s invasion of Ukraine brought a new spectacle: social media users were able to track various oligarchs’ superyachts as they jumped from port to port to evade Western sanctions. These feeds captured a national security problem in near real time: In Eurasia and beyond, kleptocratic elites with deep ties to the West were able to move themselves and their assets freely despite a host of speeches by senior officials, sanctions, and structures designed to stop them. Kleptocratic regimes—kleptocracy means “rule by thieves”—have exploited the lax and uneven regulatory environments of the global financial system to hide their ill-gotten gains and interfere in politics abroad, especially in the United States, the United Kingdom, and the European Union. They are aided in this task by a large cast of professional enablers within these jurisdictions. The stronger these forces get, the more they erode the principles of democracy and the rule of law. Furthermore, the international sanctions regime imposed on Russia in response to its invasion of Ukraine has little hope of long-term success if the global financial system itself continues to weaken. The West still has a long way to go to rein in the authoritarian kleptocrats who have thrived on the institutional dysfunction, regulatory failure, and bureaucratic weakness of the transatlantic community for far too long. We need to rethink not just how we combat kleptocracy, but also how we define it. Policy makers need to understand that authoritarian regimes that threaten transatlantic security are closely linked to illicit financial systems. As it stands, our thinking about how foreign corruption spreads is too constrained by stereotypes about kleptocratic goals and actions.
Topic:
Corruption, Diplomacy, Intelligence, Politics, Sanctions, Authoritarianism, Reform, European Union, Regulation, Finance, Economy, Rule of Law, and Russia-Ukraine War
Political Geography:
Russia, United Kingdom, Europe, Ukraine, Canada, and United States of America

3. Central Bank Digital Currency: The Risks and the Myths

Author:
Nicholas Anthony and Norbert Michel
Publication Date:
01-2023
Content Type:
Policy Brief
Institution:
The Cato Institute
Abstract:
Central bank digital currencies (CBDCs) have the potential to radically transform the American financial system—ultimately usurping the private sector and endangering Americans’ core freedoms. Although CBDCs have gained the attention of politicians, central bankers, and the tech industry, this experiment should be left on the drawing board. This paper provides a summary of why Congress should explicitly prohibit the Federal Reserve and the Department of the Treasury from issuing a CBDC.
Topic:
Finance, Economy, Fiscal Policy, Banking, and Digital Currency
Political Geography:
North America and United States of America

4. A Wall of Separation Between Money and State: Policy and Philosophy for the Era of Cryptocurrency

Author:
Max Raskin and Richard A. Epstein
Publication Date:
03-2023
Content Type:
Journal Article
Journal:
Brown Journal of World Affairs
Institution:
Brown Journal of World Affairs
Abstract:
Throughout history, there have been two fundamental and interrelated debates over the creation and use of money.1 The first debate is whether money should be created by the market or the state.2 When money is created by private markets, individual currencies oper- ate in competition with each other, such that the value of any given currency is measured by its relative strength against the others. In contrast, under a system where the government has a monopoly over the supply of money, the sound- ness of the currency is ensured, if at all, by a set of institutional constraints to prevent its debasement. A second debate arises between those who believe that money should be a tool used by policymakers to achieve certain political, economic, and social ends and those who believe that money should be a neutral unit of measurement, like inches or kilograms.3 Today, central banks are tasked with mandates to achieve full employment, plug budget deficits, and spur real economic growth. The institutional challenge for governments is to decide how to balance these goals with the need for price stability. Discretion by central bankers with respect to these tradeoffs is intended to allow public officials to operate the system for the public benefit. By the same token, government discretion in the management of money creates the possibility of major failures—such as runaway inflation—if that discretion is misused.
Topic:
Finance, Economy, Central Bank, Currency, Cryptocurrencies, and Bitcoin
Political Geography:
Global Focus and United States of America

5. La política exterior argentina: Equilibrios y continuidades entre China y Estados Unidos

Author:
Florencia Rubiolo and Diego Telias
Publication Date:
01-2023
Content Type:
Journal Article
Journal:
Revista UNISCI/UNISCI Journal
Institution:
Unidad de investigación sobre seguridad y cooperación (UNISCI)
Abstract:
La competencia entre Estados Unidos y China en el ámbito comercial, tecnológico y geopolítico tiene repercusiones globales. América Latina, a pesar de una creciente irrelevancia, también es una arena donde estas potencias están compitiendo. Argentina no ha quedado fuera de esta disyuntiva y, al igual que otros países de la región, ha intentado mantener un equilibrio entre ambas potencias, por la importancia que cada una reviste: Estados Unidos en lo financiero y China tanto en lo comercial como en materia de inversiones. En este artículo, a través de un repaso teórico, análisis de documentos oficiales y entrevistas, se analiza la política exterior de Alberto Fernández hacia China en el contexto de las divergencias entre ambos Estados. Concluimos que Argentina ha intentado de manera continua un equilibrio, aunque no implica equidistancia, ante una situación en donde los gobiernos aún no han sido presionados a optar.
Topic:
Foreign Policy, Finance, Investment, Trade, Competition, and Equilibrium
Political Geography:
China, Argentina, South America, and United States of America

6. Are Financial Barriers Affecting the Health Care Habits of American Men?

Author:
Munira Z. Gunja, Evan D. Gumas, and Reginald D. Williams II
Publication Date:
07-2022
Content Type:
Policy Brief
Institution:
Commonwealth Fund
Abstract:
Whether it’s stubbornness, an aversion to appearing weak or vulnerable, or other reasons, men go to the doctor far less than women do.1 While behavioral and cultural norms may have a lot to do with the care-seeking habits of American men, the fact remains that the United States is the only high-income country that does not ensure all its residents have access to affordable health care. Roughly 16 million U.S. men are without health insurance, and affordability is the reason that people most often cite for why they do not enroll in a health plan.2 Do income level and financial stress help explain why men do not get needed care and experience worse health outcomes? Using data from the Commonwealth Fund’s 2020 International Health Policy Survey and the Organisation for Economic Co-operation and Development (OECD), we compare health care accessibility, affordability, and health status for adult men in 11 high-income countries. We also examine measures of income and income-related stress, where the data allow, to understand the role income insecurity might play in American men’s relatively low use of health care.
Topic:
Health, Finance, Medicine, and Gender
Political Geography:
North America and United States of America

7. Greening the US Sovereign Bond Guarantee Program: A Proposal to Boost Climate-Directed Sovereign Finance in Developing Countries

Author:
Scott Morris, Rowan Rockafellow, and Alan Cameron
Publication Date:
02-2022
Content Type:
Working Paper
Institution:
Center for Global Development
Abstract:
Sovereign bond guarantees (SBGs) are an effective but underutilized instrument available to the US government in support of developing country partners. By protecting bond purchasers in the event of a foreign issuer country’s default, SBGs substantially reduce borrowing costs for developing country governments. In this CGD policy paper, we estimate the costs and benefits of historical US sovereign bond guarantees in order to model the use of SBGs for climate finance purposes. We demonstrate that the US government-provided SBG has the effect of conferring the US government’s cost of borrowing on the partner government. On that basis, it represents substantial savings for these countries. Based on this analysis, we propose a $20 billion “Green” SBG program aimed at financing climate change mitigation efforts in 28 emerging market economies. We estimate that the US government could support $20 billion in bond issuances through a subsidy outlay of $2 billion, resulting in a 22 percent reduction in borrowing cost of the target countries, which represents $4 billion in budgetary saving for their governments. We propose that the subsidy appropriations in support of the guarantees be retained and recycled within the Green SBG program, which would substantially improve the financial leverage of the program over time. We also suggest that the program could be used for climate adaptation purposes by targeting a different group of developing countries
Topic:
Climate Change, Development, Finance, Sustainability, and Green Transition
Political Geography:
North America and United States of America

8. Strategic Competition in the Financial Gray Zone

Author:
Heather A Conley, James Andrew Lewis, Eugenia Lostri, and Donatienne Ruy
Publication Date:
04-2022
Content Type:
Special Report
Institution:
Center for Strategic and International Studies
Abstract:
Over the past 10 years, the U.S. government has slowly reoriented its foreign and security policy from the fight against global terrorism toward strategic competition with Russia and China. This reorientation has been accompanied by a new examination of how strategic competition will impact the integrity and future stability of the U.S. economy and financial system. One of the most important elements of strategic competition is sub-threshold warfare (also called asymmetric, hybrid, or gray zone warfare), wherein strategic competitors seek to shape the geostrategic environment in their favor, from information operations to economic warfare—which includes such tools as illicit finance and strategic corruption. Strategic competitors present a clear economic and financial threat to the United States when they operate in the emerging financial gray zone, in which malign actors can take advantage of the U.S. financial system to further their aims and disarm the country internally. The U.S. government, along with its allies, has only begun to acknowledge the sweeping nature of the financial gray zone and to reposition itself to compete within it. Because adversaries exploit the seams between the internal and external policies and authorities, Washington must have greater insights into a complex operating system and better integrate data across the many relevant agencies—in a way, connecting the financial dots. As it develops this comprehensive picture, the U.S. government should develop stronger defensive and offensive policy tools to counter this emerging threat.
Topic:
Economics, Finance, Strategic Competition, and Rivalry
Political Geography:
China, Asia, North America, and United States of America

9. South Korea's Critical Moment in Digital Currency Policymaking: Between Regulating Cryptocurrencies and Launching a Central Bank Digital Currency (CBDC)

Author:
June Park
Publication Date:
03-2022
Content Type:
Working Paper
Institution:
Korea Economic Institute of America (KEI)
Abstract:
Why is South Korea pilot-testing its Central Bank Digital Currency (CBDC), and what made it shift from non-issuance to consideration? This paper investigates the Bank of Korea (BOK)’s CBDC-related developments amid the geopolitical contest between the U.S. and China. It examines the Moon Jae-in administration’s defiance of decentralized finance (DeFi) and the BOK’s sudden shift from non-issuance to potential issuance, which led to expedited research, development, and pilot-testing of CBDCs. As in the case of the digital yuan, the BOK envisions a hybrid architecture for the digital won, wherein central banks and associated partner institutions are CBDC distributors, though they are distinguished by placing the digital won on distributed ledger technology rather than by centrally controlling it. However, South Korea’s previously rash decision to forego DeFi under an undemocratic process has deprived the country of the time and opportunity to develop new innovations as a leading country in the digital frontier. By sticking only to digitalizing centralized finance, the country now aims to be in “standby” mode for its CBDC launch if and when required, so as not to fall behind in digital financial architecture. This paper scrutinizes the South Korean government’s moves on crypto and CBDCs and argues that 1) the Moon administration has shown incapability in addressing DeFi amid the crypto boom and bust, and 2) the BOK’s shift from non-issuance to potential issuance of the digital won is driven by its interest to uphold central bank independence amid swaying geopolitics between the U.S. and China and an unpredictable upcoming presidential election in South Korea.
Topic:
Economics, Elections, Finance, Cryptocurrencies, and Digital Currency
Political Geography:
China, Asia, South Korea, North America, and United States of America

10. Taxless fiscal states: Lessons from 19th-century America and 21st-century China

Author:
Yuen Yuen Ang
Publication Date:
03-2022
Content Type:
Working Paper
Institution:
United Nations University
Abstract:
How do modern fiscal states arise? Perhaps the most dominant explanation, based on the European experience, is that democratic institutions that limited the extractive power of states—exemplified by the 1688 Glorious Revolution in England—paved the way for the rise of fiscal capacity and subsequent prosperity. Revisionist accounts, however, reveal that this dominant narrative is flawed. In fact, numerous factors converged to enable the rise of European fiscal states, and in England, debt and land were particularly salient factors. Building off this literature, I bring attention to the role of ‘taxless public financing’ (i.e. financing public infrastructure through means other than taxation) in the making of fiscal states in two seldom compared cases: 19th-century America and 21st-century China. Both countries relied heavily on taxless financing to launch an infrastructure boom that spurred rapid growth along with massive corruption and financial risks.
Topic:
History, Finance, Tax Systems, and Land
Political Geography:
China, Asia, North America, and United States of America