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The annual Shangri-La Dialogue took place in Singapore from 30 May to 1 June. Zack Cooper of the American Enterprise Institute attended and returns to the podcast to talk through his impressions with Darren. What did we learn about the Trump administration's strategy in Asia? Should the region fear abandonment or entrapment more? And what should we make of Secretary of Defense Hegseth's call for Australia to spend 3.5% of GDP on defence? Australia in the World is written, hosted, and produced by Darren Lim, with research and editing this episode by Hannah Nelson and theme music composed by Rory Stenning. Relevant links Remarks by Secretary of Defense Pete Hegseth at the 2025 Shangri-La Dialogue in Singapore (As Delivered), 31 May 2025: https://www.defense.gov/News/Speeches/Speech/Article/4202494/remarks-by-secretary-of-defense-pete-hegseth-at-the-2025-shangri-la-dialogue-in/ Huw McKay, “Trump and the art of the (bad faith) deal”, “Lowy Interpreter, 2 June 2025. Stacie E. Goddard, “The Rise and Fall of Great-Power Competition: Trump's New Spheres of Influence”, Foreign Affairs, May/June 2025: https://www.foreignaffairs.com/united-states/rise-and-fall-great-power-competition# Net Assessment (podcast), “Great Power Competition or Collusion?”, 29 May 2025: https://www.stimson.org/2025/great-power-competition-or-collusion/
On this episode of Reaganism, Reagan Institute Director Roger Zakheim is joined by Dr. Zack Cooper, who is a Senior Fellow at the American Enterprise Institute. They discuss Dr. Cooper's book, Tides of Fortune, which explores the rise and decline of great militaries, focusing on China's military buildup and its implications for U.S. defense strategy. The discussion covers the historical context of military power, the dynamics of rising and declining powers, and the need for the U.S. to reassess its military investments in light of China's advancements. Dr. Cooper emphasizes the importance of a balanced military mix and the role of technology in modern warfare, advocating for a strategic shift in U.S. defense policy to address emerging threats effectively.
Zack Cooper joins Robert to talk about strategic competition with China and his new book Tides of Fortune: The Rise and Decline of Great Militaries. They discuss the balance of military power, the kinds of weapon systems the US should invest in, and the Trump administration’s approach to Taiwan. Zack Cooper is a senior fellow […]
This episode has three chapters. Each one answers a key question, and, bottom line, it all adds up to action steps directly and indirectly for many, including plan sponsors probably, community leaders, and also hospital boards of directors. Here's the three chapters in sum. For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. Chapter 1: Are commercial insurance premiums rising faster than the inflation rate? And if so, is the employee portion of those premiums also rising, meaning a double whammy for employees' paychecks (ie, premium costs are getting bigger and bigger in an absolute sense, and also employees' relative share of those bigger costs is also bigger)? Spoiler alert: yes and yes. Chapter 2: What is the biggest reason for these premium increases? Like, if you look at the drivers of cost that underpin those rising premiums, what costs a lot that is making these premiums cost a lot? Spoiler alert: It's hospitals and the price increases at hospitals. And just in case anyone is wondering, this isn't, “Oh, chargemasters went up” or some kind of other tangential factor. We're talking about the revenue that hospitals are taking on services delivered has gone up and gone up way higher than the inflation rate. In fact, hospital costs have gone up over double the amount that premiums have gone up. Wait, what? That's a fact that Dr. Vivian Ho said today that threw my brain for a loop: Hospital costs have gone up over double the amount that premiums have gone up. Chapter 3: Is the reason that hospital prices have rocketed up as they have because the underlying costs these hospitals face are also going up way higher than the inflation rate? Like, for example, are nurses' salaries skyrocketing and doctors are getting paid a lot more than the inflation rate? Stuff like this. Too many eggs in the cafeteria. Way more charity care. Bottom line, is an increase in underlying costs the reason for rising hospital prices? Spoiler alert: no. No to all of the above. And I get into this deeply with Dr. Vivian Ho today. But before I do, I do just want to state with three underlines not all hospitals are the same. But yeah, you have many major consolidated hospitals crying about their, you know, “razor-thin margins” who are, it turns out, incentivizing their C-suites to do things that ultimately wind up raising prices. I saw a PowerPoint flying around—you may have seen it, too—that was apparently presented by a nonprofit hospital at JP Morgan, and it showed this nonprofit hospital with a 15.1% EBITDA (earnings before interest, taxes, depreciation, and amortization) in 2024. Not razor thin in my book. It's a, the boards of directors are structuring C-suite incentives in ways that ultimately will raise prices. If you want to dig in a little deeper on hospital boards and what they may be up to, listen to the show with Suhas Gondi, MD, MBA (EP404). Vivian Ho, PhD, my guest today, is a professor and faculty member at Rice University and Baylor College of Medicine. Her most major role these days is working on health policy at Baker Institute at Rice University. Her work there is at the national, state, and local levels conducting objective research that informs policymakers on how to improve healthcare. Today on the show, Professor Vivian Ho mentions research with Salpy Kanimian and Derek Jenkins, PhD. Alright, so just one quick sidebar before we get into the show. There is a lot going on with hospitals right now. So, before we kick in, let me just make one really important point. A hospital's contribution to medical research, like doing cancer clinical trials, is not the same as how a hospital serves or overcharges their community or makes decisions that increase or reduce their ability to improve the health and well-being of patients and members who wind up in or about the hospital. Huge, consolidated hospital networks can be doing great things that have great value and also, at the exact same time, kind of harmful things clinically and financially that negatively impact lots of Americans and doing all of that simultaneously. This is inarguable. Also mentioned in this episode are Rice University's Baker Institute for Public Policy; Baker Institute Center for Health Policy; Suhas Gondi, MD, MBA; Salpy Kanimian; Derek Jenkins, PhD; Byron Hugley; Michael Strain; Dave Chase; Zack Cooper, PhD; Houston Business Coalition on Health (HBCH); Marilyn Bartlett, CPA, CGMA, CMA, CFM; Cora Opsahl; Claire Brockbank; Shawn Gremminger; Autumn Yongchu; Erik Davis; Ge Bai, PhD, CPA; Community Health Choice; Mark Cuban; and Ferrin Williams, PharmD, MBA. For further reading, check out this LinkedIn post. You can learn more at Rice University's Center for Health Policy (LinkedIn) and Department of Economics and by following Vivian on LinkedIn. Vivian Ho, PhD, is the James A. Baker III Institute Chair in Health Economics, a professor in the Department of Economics at Rice University, a professor in the Department of Medicine at Baylor College of Medicine, and a nonresident senior scholar in the USC Schaeffer Center for Health Policy and Economics. Ho's research examines the effects of economic incentives and regulations on the quality and costs of health care. Her research is widely published in economics, medical, and health services research journals. Ho's research has been funded by the National Institutes of Health (NIH), the Agency for Healthcare Research and Quality, the American Cancer Society, and Arnold Ventures. Ho has served on the Board of Scientific Counselors for the National Center for Health Statistics, as well as on the NIH Health Services, Outcomes, and Delivery study section. She was elected as a member of the National Academy of Medicine in 2020. Ho is also a founding board member of the American Society for Health Economists and a member of the Community Advisory Board at Blue Cross Blue Shield of Texas. Ho received her AB in economics from Harvard University, a graduate diploma in economics from The Australian National University, and a PhD in economics from Stanford University. 05:12 Are insurance premiums going up? 05:59 What is the disparity between cost of insurance and wage increases? 06:21 LinkedIn post by Byron Hugley. 06:25 Article by Michael Strain. 06:46 How much have insurance premiums gone up for employers versus employees? 09:06 Chart showing the cost to insure populations of employees and families. 10:17 What is causing hospital prices and insurance premiums to go up so exponentially? 12:53 Article by (and tribute to) Uwe Reinhardt. 13:49 EP450 with Marilyn Bartlett, CPA, CGMA, CMA, CFM. 14:01 EP452 with Cora Opsahl. 14:03 EP453 with Claire Brockbank. 14:37 EP371 with Erik Davis and Autumn Yongchu. 15:28 Are razor-thin operating margins for hospitals causing these rising hospital prices? 16:56 Collaboration with Marilyn Bartlett and the NASHP Hospital Cost Tool. 19:47 What is the explanation that hospitals give for justifying these profits? 23:16 How do these hospital cost increases actually happen? 27:06 Study by Zack Cooper, PhD. 27:35 EP404 with Suhas Gondi, MD, MBA. 27:50 Who typically makes up a hospital board, and why do these motivations incentivize hospital price increases? 30:12 EP418 with Mark Cuban and Ferrin Williams, PharmD, MBA. 33:17 Why is it vital that change start at the board level? You can learn more at Rice University's Center for Health Policy (LinkedIn) and Department of Economics and by following Vivian on LinkedIn. Vivian Ho discusses #healthinsurance #premiums and #hospitalpricing on our #healthcarepodcast. #healthcare #podcast #changemanagement #healthcareleadership #healthcaretransformation #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Chris Crawford (EP465), Al Lewis, Betsy Seals, Wendell Potter (Encore! EP384), Dr Scott Conard, Stacey Richter (INBW42), Chris Crawford (EP461), Dr Rushika Fernandopulle, Bill Sarraille, Stacey Richter (INBW41)
Zack Cooper joins Robert to talk about strategic competition with China and his new book Tides of Fortune: The Rise and Decline of Great Militaries. They discuss the balance of military power, the kinds of weapon systems the US should invest in, and the Trump administration's approach to Taiwan. Zack Cooper is a senior fellow at AEI where he studies US strategy in Asia, including alliance dynamics and US-China competition. Read more about his new book here.
The structure of the U.S. health care system, particularly employer-sponsored insurance, is significantly impacting the economic well-being of most Americans. In this episode, Zack Cooper, Associate Professor of Public Health and Economics for Yale University, examines the drivers of rising health care costs and their impact on individuals and the economy. He highlights the disconnect between Medicare and private insurance spending, the role of provider market power in driving up prices, and the surprising link between health care costs and job losses for lower and middle-income workers. Zack explains that rising health care premiums lead companies to reduce payroll, disproportionately affecting workers earning between $20,000 and $100,000 annually. He argues that employer-sponsored insurance contributes to income inequality and suggests potential policy solutions such as broader insurance markets, eliminating employer-sponsored insurance, and stronger antitrust enforcement in the health care sector. Zack also touches on the debate between single-payer systems and market-based approaches, emphasizing the need for greater efficiency and value in health care spending. Tune in and learn how health care costs are affecting your wallet and the broader economy! About CareQuest: CareQuest Institute for Oral Health is a national nonprofit dedicated to creating an oral health care system that is accessible, equitable, and integrated. Learn more about how their advocacy, philanthropy, research, and education are creating a better oral health system at carequest.org/turnonthelights Learn more about your ad choices. Visit megaphone.fm/adchoices
We're still only days into Donald Trump's second term, but there is already a wealth of data to draw upon to update our models and expectations for how to think about his impact on the United States, US foreign policy, and the world. Joining Darren to talk through these early days is frequent guest Zack Cooper of the American Enterprise Institute. Australia in the World is written, hosted, and produced by Darren Lim, with research and editing this episode by Walter Colnaghi and theme music composed by Rory Stenning. Relevant links Euan Graham, “The Quad foreign ministers joint statement: short and sweet”, ASPI Strategist, 22 Jan 2025: https://www.aspistrategist.org.au/the-quad-foreign-ministers-joint-statement-short-and-sweet/ Yuval Levin, Trump Redux Begins, National Review, 21 Jan 2025: https://www.aei.org/op-eds/trump-redux-begins/ Ezra Klein Show, “MAGA's big tech divide” (interview with James Pogue), 28 Jan 2025: https://www.nytimes.com/2025/01/28/opinion/ezra-klein-podcast-james-pogue.html James Pogue, “Steve Bannon Has Called His “Army” to Do Battle—No Matter Who Wins in November”, Vanity Fair, 9 Oct 2024: https://www.vanityfair.com/news/story/steve-bannon-nato-world-order James Pogue, “How Long Can the Alliance Between Tech Titans and the MAGA Faithful Last?”, New York Times, 18 Jan 2025: https://www.nytimes.com/2025/01/18/opinion/donald-trump-tech-musk-bannon.html?unlocked_article_code=1.rE4.j9zE.VS5n0pOxgHg_&smid=url-share
In this Relentless Health Value episode, Dr. Rushika Fernandopulle discusses with Stacey Richter his four-prong theory of change for transforming the American healthcare system. Key topics include the necessity of new payment models, process innovation, employing a relational technology infrastructure, shifting the cultural mindset towards team-based care, and emphasizing the importance of long-term partnerships. The conversation underscores the urgent need to move away from the current status quo to ensure better health outcomes and affordable care for all Americans. This is one of those episodes where we consider top-line strategic imperatives and key drivers. There was no better person to do this with than Rushika Fernandopulle, MD, who, in case you were unaware, was the founder of Iora Health, an advanced primary care group that was sold to One Medical and then to Amazon. They discusses his four-prong theory and as Stacey says, "I can't leave well enough alone, so I plucked one more prong from our conversation and stuck it on the end." For a summary of this 5 prong approach, visit the show notes page where we also list all of the links mentioned in the episode. === LINKS ===
This week, Zack Cooper joins us to chat about triathlon! Zack is a professional triathlete and a member of the TTL Devo team. With the Indian Wells race just a week away, we thought it would be the perfect time to have him on the podcast.Here's what we covered:Wireless earphones for cycling and runningThe Orca Flew wetsuit: Is it suitable for cold-water races?Weekend routines for professional triathletesSpectating tips for IM 70.3 Indian WellsCanicross and canitriathlonPacking a bike for international travelA big thank you to our podcast supporters who keep the podcast alive! To submit a question for the podcast and to become a podcast supporter, head over to ThatTriathlonLife.com/podcast
Late Tuesday night South Korean President Yoon Suk Yeol declared martial law, accusing the opposition party of “legislative dictatorship” and vowing to eradicate “pro-North Korean anti-state forces.” Almost as suddenly as martial law was declared, the legislature voted unanimously for it to end – sending the very military forces that attempted to lock down the […]
Late Tuesday night South Korean President Yoon Suk Yeol declared martial law, accusing the opposition party of “legislative dictatorship” and vowing to eradicate “pro-North Korean anti-state forces.” Almost as suddenly as martial law was declared, the legislature voted unanimously for it to end – sending the very military forces that attempted to lock down the National Assembly packing. What do Yoon's actions mean for the future of South Korean politics? How might a collapse of South Korea's conservative party affect U.S.-Korean relations? And what are the broader implications for American allies and partners in Asia? Zack Cooper is a senior fellow at the American Enterprise Institute, where he studies US strategy in Asia, including alliance dynamics and U.S.-China competition. He also teaches at Princeton University and serves as chair of the board of the Open Technology Fund. Zack previously served as the assistant to the deputy national security adviser for combating terrorism at the National Security Council and as a special assistant to the principal deputy undersecretary of defense for policy at the Department of Defense. His upcoming book is Tides of Fortune: The Rise and Decline of Great Militaries (Yale University Press, 2025).Read the transcript here. Subscribe to our Substack here.
As the world begins to think through the implications of a second Trump presidential term, Darren is joined once again by Zack Cooper of the American Enterprise Institute to talk through what we do know, and what we don't, about the coming storm. What was Trump's basic critique of the Biden administration's foreign policy? What are the competing camps on foreign policy inside Trumpworld? And what should Australia do, about AUKUS, the Quad, and the alliance generally? Does Kevin Rudd's position remain tenable? There's a lot to discuss, albeit with the caveat that we do not know much for certain at this point! Australia in the World is written, hosted, and produced by Darren Lim, with research and editing this episode by Walter Colnaghi and theme music composed by Rory Stenning. Relevant links Zack Cooper (bio): https://www.aei.org/profile/zack-cooper/ Zack Cooper, Tides of Fortune: The Rise and Decline of Great Militaries (2025, Yale University Press): https://yalebooks.yale.edu/book/9780300268676/tides-of-fortune/ Net Assessment (podcast): https://warontherocks.com/category/podcasts/net-assessment/ Tanner Greer, “The Battle to Shape Trump's China policy”, Foreign Policy Research Institute, 29 October 2024: https://www.fpri.org/article/2024/10/the-battle-to-shape-trumps-china-policy/ Ezra Klein Show (podcast), Vivek Ramaswamy Has a Different Vision for Trumpism From JD Vance, 29 October 2024: https://www.nytimes.com/2024/10/29/opinion/ezra-klein-podcast-vivek-ramaswamy.html
Ray and Jim welcome AEI senior fellow Zack Cooper to the podcast to discuss China's increasingly aggressive behavior, and what the U.S. and its allies need to do in response. They focus on the question of how deterrence strategies need to evolve and adapt to the threats, whether they be nuclear, conventional military, or across the spectrum of malign gray-zone activities. They discuss the specific need to deter a military move against Taiwan.The discussion turns to the topic of extended nuclear deterrence, and whether a perceived U.S. inability or unwillingness to back up its security guarantees might lead its allies in the region to pursue their own nuclear weapons programs and lead to a breakdown of the non-proliferation regime.Zack also covers the recent U.S. policy of “integrated deterrence” and whether it can be effective, as well as recent discussion about an “Asian NATO” and whether it has a future.
Zack Cooper is a health economist whose work is focused on producing data-driven scholarship that can inform public policy. He currently serves as an Associate Professor of Public Health and ...
Last time Cora Opsahl was on the show, Michelle Bernabe, RN, KAT, wrote a comment on LinkedIn I thought encapsulated the gist of it all so well. She wrote, “[Cora] first became a mentor/ally through Relentless Health Value episode 372. … It opened a doorway to a whole group of very relentless people.” For a full transcript of this episode, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. I want to start there because it's a nice comment, but it's also a call to action. Think about this and think about it not in the context of being a “stakeholder” and not in the context of being an organization but in the context of humans who work at these various organizations who, combined, comprise the bucket of companies that we lumped together using the old stakeholder word. All of these individuals are making choices every day, and all of these choices, they could be made with integrity and with the patient or member in mind … or not. In real life, right now, the overwhelming majority of members/patients in this country get their clinical care and the pleasure of paying for that care or drugs within the current ecosystem we have here in the USA. For any of us, or all of us who work within that traditional ecosystem, it is up to us to choose our own legacy here. It's probably why you listen to this show in the first place, actually. There are so many RHV (Relentless Health Value) listeners who are pushing for patients against the riptide that is the profit motives of the organization that they work for. It's hard. But yeah, it's all about finding our people and supporting each other. Okay, so let's get to the “between a rock and a hard place” portion of this discussion. Hospitals and ASOs (administrative services organizations)/carriers/TPAs (third-party administrators) often enter into or sometimes enter into what amounts to anticompetitive contracts with each other. Listen to episode 395 with Brennan Bilberry for the rundown on that one. But meanwhile, the CAA, the Consolidated Appropriations Act from 2021, holds employer plan sponsors accountable and responsible to ensure that plan assets are spent prudently, that costs paid are reasonable, and that there's no conflict of interest (COI). This is the definition of what a fiduciary is supposed to do, by the way—prudent, reasonable, and no COI. Anticompetitive contracts between a carrier and a hospital are the very definition of COI. And when that COI results in higher, maybe unreasonable, prices and non-prudent spend, well, plan sponsors are put between a rock and a hard place if they stick with their existing vendors. Rosa Novo from Miami-Dade County Public Schools put this really succinctly on a panel at a 32BJ event recently. She said what amounts to, I have no choice but to actually do the right thing here, for many reasons, but one of them is I do not look good in orange. She said, my personal butt is on the line here. And furthermore, who do class action lawsuits make look bad when their company or CEO or CFO are personally sued over conflicted benefits? See the Wells Fargo lawsuit, J&J lawsuit, etc. It sucks that employers or plan sponsors get put into this pickle by their own vendors. And that's what we're talking about today. This is a conversation that starts out talking about rates (ie, prices), edges into rights (ie, plan sponsor rights), and ends up all about power. And by the way, if you're a plan sponsor, especially in New York City, maybe doing the right thing here means hatching a plan to steer and tier in your benefit design, figuring out how to, for reals, help support the efforts of 32BJ to advantage pretty much every patient near and far. The pushback I often hear to doing something like this often involves the perception that plan members are too rich to care about reasonable prices, prudent plan spending, and COI. And yeah, to state the obvious, these same people are also sophisticated enough to smell a fine opportunity for a class action lawsuit; and also, they probably do care, as more and more studies suggest. Sorry if I just stumbled onto a sacred cow. Cora Opsahl, my guest today, is the director of the 32BJ Health Fund, serving over 200,000 folks. Their ability to kick NewYork-Presbyterian, a big, consolidated, very expensive hospital, out of their network in 2018 enabled them to offer maternity benefits for $40 in total out-of-pocket for members. And also, employees got their biggest raise ever; employers got a premium holiday and a 3% rate increase for a bunch of years after that; and yeah … this is where we start the conversation today. And yeah, it's a freakin' tangled web we weave; and this tale is a perfect case study of it. It makes me even more invested in remembering my own manifesto (that was episode 400) to ensure that I can feel good about what I personally have accomplished and what I have been a part of and the net impact of my own personal actions, since I, too, very often work in the belly of the beast. Furthermore, you will find links to a template health savings calculator for plan sponsors and also a template contract (again for plan sponsors) that 32BJ has made available. More on that in the show that follows. Also mentioned in this episode are 32BJ Benefit Funds; Michelle Bernabe, RN, KAT; Brennan Bilberry; Rosa Novo; Marilyn Bartlett; Cynthia Fisher; Zack Cooper, PhD; Claire Brockbank; Andreas Mang; Chris Deacon; Elizabeth Mitchell; and Purchaser Business Group on Health. You can learn more at health.32bjfunds.org and by following Cora on LinkedIn. Cora Opsahl is the director of the 32BJ Health Fund, a self-insured Taft-Hartley benefit fund that sets comprehensive design parameters to ensure the 200,000 members and families of Service Employees International Union 32BJ have easy and sustained access to affordable, high-quality healthcare. Since becoming director of the Health Fund in 2021, Cora has prioritized a data-driven approach to healthcare, focusing on reducing trend; solving the affordability challenge on behalf of union members; and most important, keeping members at the center of every decision. Under her leadership, the 32BJ Health Fund has saved more than $35 million annually—which it has reinvested in new and better benefits, including the first fertility benefit for members—by removing NewYork-Presbyterian hospitals and physicians from its network, transitioning to a new pharmacy vendor and pharmacy group purchasing coalition, and establishing an expanded Centers of Excellence program. Most recently, Cora conducted an innovative medical request for proposal (RFP), stipulating that all finalists must have a signature-ready contract drafted by the Health Fund prior to award. By including the Health Fund–drafted contract in the RFP process, the Fund was able to negotiate an agreement that brought unprecedented visibility and increased accountability to the 32BJ Health Fund benefit. Cora is regarded as an expert in pharmacy benefit management and previously worked at Express Scripts, where she held a variety of roles, ranging from Medicare Part D to operations to strategy and acquisitions. She earned an MBA from Saint Louis University. 06:16 Why is it imperative for employers to do something differently when it comes to being plan sponsors? 09:22 How analyzing claims data allowed 32BJ Health Fund to reshape their benefit design. 12:09 What anticompetitive rights did 32BJ run into that limited 32BJ Health Fund from managing their benefit design? 14:12 How do these anticompetitive rights have quality implications as well as cost implications? 18:43 How did 32BJ Health Fund remove NewYork-Presbyterian from their network, and how much did it save 32BJ Health Fund per year? 19:46 What did the healthcare savings allow the unions and employers to do? 20:46 Study by Zack Cooper, PhD. 21:26 Why rising healthcare costs has pushed 32BJ Health Fund to move beyond benefit design to manage healthcare spend. 24:15 Why 32BJ Health Fund wants to control the contracting process. 26:00 EP419 with Andreas Mang. 27:18 What are 32BJ Health Fund's four non-negotiables? 33:17 Wall Street Journal article on health insurance contract. 35:30 Upcoming episode with Claire Brockbank. 36:14 What is the challenge that exists in our current healthcare environment? 37:43 Cora's advice on how to get high-quality healthcare at an affordable price. You can learn more at health.32bjfunds.org and by following Cora on LinkedIn. @CoraOpsahl discusses #fiduciaryresponsibility in #healthcare on our #healthcarepodcast. #podcast #financialhealth #primarycare #patientoutcomes #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Dan Nardi, Dr Spencer Dorn (EP451), Marilyn Bartlett, Dr Marty Makary, Shawn Gremminger (Part 2), Shawn Gremminger (Part 1), Elizabeth Mitchell (Summer Shorts 9), Dr Will Shrank (Encore! EP413), Dr Amy Scanlan (Encore! EP402), Ashleigh Gunter, Dr Spencer Dorn (EP446)
Maybe you've already caught Part 1 of my conversation with Shawn Gremminger, and if so, you're ahead of the game. But if not, no worries—here's the deal: I decided to split this deep dive into the 340B program with Shawn into two parts. So, feel free to jump into one or both—it's totally up to you. To Read The Full Article Including Links Mentioned, click here. If you enjoy this podcast, be sure to subscribe to the free weekly newsletter to be a member of the Relentless Tribe. These episodes don't have to be listened to in order, so you're good to start here with Part 2. Let's get into it!" Right now, we are going to talk about how 340B impacts employers and commercial plans and other plan sponsors. So, if all you want to hear about is the why—as in, Why do employers care about what amounts to a program that is or was supposed to be for low-income Americans and Medicaid?—you are in the right place. As just one example of the why should employers care if you are teetering on the edge of proceeding, did you know that if an employee or a member of a commercial plan gets a drug at a contract pharmacy participating in 340B, the employer does not get the rebate? The employer is gonna pay the list price for that med. Wait, what? Yeah, details follow because Shawn Gremminger is gonna get into this and many other reasons why employers or anyone in the commercial market (or taxpayers, really) should care about this, as some may call it, Medicaid program. The fact is, 340B is currently so gargantuan that it creates market distortions that bleed into the prices and possibly the quality of healthcare for everybody, all Americans. And that could really matter to employer or Taft-Hartley plan sponsors. After you listen to this show, if you want to drill in a little deeper on the “what the what” and the history of 340B, head back and take in Part 1 of this episode 448. Shawn Gremminger gives the skinny on how the program morphed over the years into a $53 billion juggernaut and is credited (or blamed) for all kinds of healthcare market consolidation and many other weird and unusual consequences that make me admire some of the folks who are truly gold medal winners in the sport of financial engineering. If you want a summary of the points Shawn makes for why employers should care, it is your lucky day, because here you go. Here's the four distortions in the market that Shawn talks about which impact employers: To continue reading, please view our show notes/full article. 09:11 Why do employers care about 340B, which is a Medicaid program? 11:30 Why do I care as an employer, even if I'm not Pharma? 12:44 Why is 340B causing employers to pay significantly more for healthcare? 14:36 Study by Zack Cooper, PhD. 15:06 Why are there distorted pricing models at 340B hospitals? 21:22 Why do employers need to stop playing the blame game?
For a full transcript of this episode, click here. Unintended consequences is a thing. ERCowboy wrote on Twitter a while back, “In any complex system, the likelihood of unintended consequences vastly outweighs the predictability of intended ones.” In this healthcare podcast, we're talking about two state laws where this is apropos: CON (Certificates of Need) laws and then COPA (Certificates of Public Advantage). Turns out, states actually have pretty much power to impact the competitive landscape in their state. They have a lot of levers they can pull. States really can make a difference in terms of improving real competition on value and on cost and quality. So, these two laws are, in a way, their attempt to do so. Before we kick into what's going on here, I think it is important to point out that these laws on their face aren't an obviously and overtly terrible mistake. This isn't like equivalent to accidentally putting ChapStick in the dryer. There were good people who spied a problem and had an idea for how to fix it. I'm reminded of something I read by Nicholas Kristof on a totally different topic, but he wrote, “The central problem is not so much that the effort was unserious as it's more focused on intentions than on oversight and outcomes.” And that pretty much sums up, I think, the gist of what's going on here. And I can say that because here we are in a position to Monday morning quarterback. So, I've invited Ann Kempski on the pod to point out what hindsight may reveal about these well-intentioned efforts, the CON and COPA laws. First up, let's talk about Certificate of Need laws, or the CONs. Currently, we have 35 states and Washington, DC, that operate CON programs with wide variations by state. The National Conference of State Legislatures has a good overview of each state's laws. Why did these laws originally get put into effect? They got put into effect to cut down on supply-driven demand that was considered to potentially raise total cost of care—because in healthcare, unlike Econ 101, more supply doesn't mean lower prices. In the real world, if you have more supply, volume goes up and total cost of care goes up, too. So, it could be considered good thinking to limit the amount of supply. Except there's four problems that wind up happening often enough, which is why some states are busy repealing these CON laws. We cover these four problems in the show that follows. Spoiler alert: What happens a lot of times is that the big get bigger. Consolidated entities have an upper hand, and we all know consolidated entities are generally not known for their competitive prices or their desire to rationalize volume. So, yeah … we dig into this and parse it out into, as I said, four main problems; but this is most commonly where it all winds up (ie, total cost of care does not go down). I have included links that Ann Kempski shared with me, including a statement from the Federal Trade Commission (FTC) and Department of Justice detailing the anticompetitive effects of state CON laws. There's also a document written by a former FTC commissioner that highlights how state CON laws can inhibit competition. And then lastly, a systemic review of 90 studies that find the costs of CON laws exceed their benefits. Okay, so let's move on to our number two state law that often does not go as planned; and this is the Certificate of Public Advantage, or the COPA, laws. Approximately 19 states have them, and these laws attempt to immunize hospital mergers from antitrust laws by replacing competition with state oversight. The idea here is that a state tells the FTC to stand down and gives their seal of approval to a merger to stop it from getting scrutinized for antitrust violations. So, like, a big dominant health system gets an okay to buy a rural hospital. Meanwhile, everybody realizes this will lead to a situation where there is a dominant health system and that dominant health system will reduce competition. But the state may choose to do this because … public advantage, as in the “PA” in COPA, Certificate of Public Advantage. But they'll do this because the state has decided that the public advantage of allowing the possibly problematic anticompetitive merger to move forward, the public advantage is a bigger advantage than having competition. Hmmm … what could go wrong here? Well, several things that Ann Kempski discusses in the show that follows. The Federal Trade Commission strongly advised the states against enacting these laws. Here is a link to this article that was on the FTC Web site. I was so thrilled to get the chance to chat with Ann Kempski, who knows so much about these topics. Ann Kempski is an independent healthcare consultant with a background in the labor movement, advocating for healthcare workers and purchasers for many years. Ann Kempski collaborates with clients to strengthen primary care, enhance union health funds, and reduce commercial prices. She often partners with academics from Johns Hopkins to analyze hospital transparency data for insights into market trends. Before we jump into the episode, we've had a loss in our community. We've had actually several, one of them being Marshall Allen, another one being Suzanne Delbanco. I know our guest today worked alongside of and really admired Suzanne. Ann Kempski says: “Suzanne was a kindred spirit and a real inspiration for me and many others. She founded two very influential nonprofit organizations: first, The Leapfrog Group and then, second, Catalyst for Payment Reform, which is dedicated to empowering purchasers to be more effective purchasers in the healthcare marketplace.” Additional Resources on State Laws and Policies That Promote Hospital Consolidation, Inhibit Competition Certificate of Public Advantage (COPA) Laws A recent story from Tennessee highlights the weak oversight and observed in COPA-related hospital mergers. Competition and Antitrust in Healthcare “Is There Too Little Antitrust Enforcement in the US Hospital Sector?” by Zarek Brot-Goldberg, Zack Cooper, Stuart Craig, and Lev Klarnet, April 2024 Catalyst for Payment Reform publications and white papers The Great Reversal: How America Gave Up on Free Markets, by Thomas Philippon, 2019 Also mentioned in this episode are Nicholas Kristof; Marshall Allen; Suzanne Delbanco; Brian Klepper, PhD; and Gloria Sachdev, PharmD. You can learn more by following Ann on LinkedIn. Ann Kempski is an independent health policy consultant with 30 years of experience as an analyst, advocate, and strategist advancing health reforms related to coverage, quality, and payment in public programs and commercial insurance. She has served in leadership roles in several organizations, including Kaiser Permanente, SEIU (Service Employees International Union), and the State of Delaware. Ann currently supports organizations and efforts to strengthen primary care payment and transition away from fee for service, promote competition in commercial healthcare prices and coverage, and expand access to evidence-based behavioral health services. Ann is especially grateful to collaborate with and learn from talented graduate students and faculty at Johns Hopkins Bloomberg School of Public Health on research and policy analysis to understand commercial market and price dynamics and provider behavior. She has an undergraduate degree in economics from the College of William & Mary and a master's degree in industrial and labor relations from Cornell University. 06:20 Ann remembers Suzanne Delbanco. 06:55 EP224 with Suzanne Delbanco. 07:40 What are state Certificate of Need laws? 08:44 Why are states getting rid of these CON laws? 13:26 Why CON laws are created. 15:43 EP437 with Brian Klepper, PhD. 16:09 What are the conflicts of interest and problems that arise when CON laws are created? 20:55 What happens when states get rid of these CON laws? 24:10 How are Certificate of Public Advantage laws different from CON laws? 27:58 Why does the research show that COPAs don't usually accomplish their goals? 31:34 What encouraging current events are happening in the realm of COPA laws? 32:08 Gloria Sachdev, PharmD, of Employers' Forum of Indiana. You can learn more by following Ann on LinkedIn. @kempann discusses #COPA and #CON state #healthcarelaws on our #healthcarepodcast. #healthcare #podcast #financialhealth #primarycare #patientoutcomes #healthcareinnovation Recent past interviews: Click a guest's name for their latest RHV episode! Marshall Allen (tribute), Andreas Mang, Abby Burns and Stacey Richter, David Muhlestein, Luke Slindee, Dr John Lee, Brian Klepper, Elizabeth Mitchell, David Scheinker (Encore! EP363), Dan Mendelson
In this special episode of “Diving Deep,” part of the Fixing Healthcare podcast series, cohosts Dr. Robert Pearl and Jeremy Corr dive deep into the economic and societal implications of ... The post FHC #139: The hidden costs of rising healthcare prices with Zack Cooper appeared first on Fixing Healthcare.
Zack Cooper of the American Enterprise Institute joins Darren to discuss the troubling trend of PRC military actions that are endangering Australian personnel and equipment, and those of our partners. Last week, a Chinese fighter aircraft dropped flares into the path of an Australian helicopter that was conducting a patrol in international waters as part of sanctions-enforcement against North Korea. Australia lodged diplomatic protests and PM Albanese called the action ‘completely unacceptable'. Similar incidents have happened before. Last year Australian naval divers suffered minor injuries after a Chinese warship released sonar pulses, and there have been other aerial incidents as well. Why are Chinese forces doing this? Can Australia respond, either unilaterally or with partners? Is an increasingly risky maritime domain now simply part of the price of protecting our interests? Zack talks Darren through his perspective on these issues. Australia in the World is written, hosted, and produced by Darren Lim, with research and editing this episode by Walter Colnaghi and theme music composed by Rory Stenning. Relevant links Andrew Greene, “Australian helicopter forced to take evasive action after Chinese fighter detonates flares”, ABC News, 6 May 2024: https://www.abc.net.au/news/2024-05-06/australian-helicopter-chines-fighter-flares-hmas-hobart/103812042 Euan Graham, “China's latest unsafe interception at sea was no accident”, ASPI Strategist, 8 May 2024:
President Biden hosted the leaders of Japan and the Philippines on Thursday, sending a strong message of unity to Beijing. The administration says the network of alliances and partnerships in Asia is expanding in direct response to actions by China. Nick Schifirin discussed the developments with Zack Cooper, senior fellow at the American Enterprise Institute. PBS NewsHour is supported by - https://www.pbs.org/newshour/about/funders
President Biden hosted the leaders of Japan and the Philippines on Thursday, sending a strong message of unity to Beijing. The administration says the network of alliances and partnerships in Asia is expanding in direct response to actions by China. Nick Schifirin discussed the developments with Zack Cooper, senior fellow at the American Enterprise Institute. PBS NewsHour is supported by - https://www.pbs.org/newshour/about/funders
Howie and Harlan are joined by Yale health economist Zack Cooper to discuss his work on surprise medical bills and the impact of high healthcare costs on households, wages, and the economy. Harlan reports on Hippocratic AI's efforts to develop AI nurses. Howie looks at the global effort to eradicate tuberculosis. Links: “Hippocratic AI banks $53M backed by General Catalyst, a16z, Memorial Hermann, UHS and other health systems” “Polaris: A Safety-focused LLM Constellation Architecture for Healthcare” Yale | Eli Whitney Students Program Touching the Dragon: And Other Techniques for Surviving Life's Wars The Price Ain't Right? Hospital Prices and Health Spending on the Privately Insured “Costs Can Go Up Fast When E.R. Is in Network but the Doctors Are Not” “Bankrupt Envision Healthcare approved to split in two, cut debt” “The Company Behind Many Surprise Emergency Room Bills” Surprise! Out-of-Network Billing for Emergency Care in the United States “Medical LLM developer Hippocratic AI gets $53M at $500 valuation” The Breakthrough of Large Language Models Release for Medical Applications: 1-Year Timeline and Perspectives World Health Organization | World Tuberculosis Day Partners In Health | Tuberculosis “WHO urges investments for the scale up of tuberculosis screening and preventive treatment” “The latest twist in John Green's anti-tuberculosis story: working with governments” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.
Howie and Harlan are joined by Yale health economist Zack Cooper to discuss his work on surprise medical bills and the impact of high healthcare costs on households, wages, and the economy. Harlan reports on Hippocratic AI's efforts to develop AI nurses. Howie looks at the global effort to eradicate tuberculosis. Links: “Hippocratic AI banks $53M backed by General Catalyst, a16z, Memorial Hermann, UHS and other health systems” “Polaris: A Safety-focused LLM Constellation Architecture for Healthcare” Yale | Eli Whitney Students Program Touching the Dragon: And Other Techniques for Surviving Life's Wars The Price Ain't Right? Hospital Prices and Health Spending on the Privately Insured “Costs Can Go Up Fast When E.R. Is in Network but the Doctors Are Not” “Bankrupt Envision Healthcare approved to split in two, cut debt” “The Company Behind Many Surprise Emergency Room Bills” Surprise! Out-of-Network Billing for Emergency Care in the United States “Medical LLM developer Hippocratic AI gets $53M at $500 valuation” The Breakthrough of Large Language Models Release for Medical Applications: 1-Year Timeline and Perspectives World Health Organization | World Tuberculosis Day Partners In Health | Tuberculosis “WHO urges investments for the scale up of tuberculosis screening and preventive treatment” “The latest twist in John Green's anti-tuberculosis story: working with governments” Learn more about the MBA for Executives program at Yale SOM. Email Howie and Harlan comments or questions.
Zach Cooper is a senior fellow at the American Enterprise Institute, where he studies US strategy in Asia, including alliance dynamics and US-China competition. He also teaches at Princeton University and is currently writing a book that explains how militaries change during power shifts. Before joining AEI, Dr. Cooper was the senior fellow for Asian security at the Center for Strategic and International Studies (CSIS), and has served on the National Security Council, as well as the Department of Defense. Dr. Cooper joins Nathan Lee from Baylor University to discuss deterrence and security in the Indo-Pacific. To learn more about AEI's Summer Honors Program visit our website here - https://www.aei.org/shp/. To learn more about Zack's course on Indo-Pacific policy visit the course description page here - https://www.aei.org/china-and-competition-in-the-indo-pacific/
The title says it all! If you missed episodes of our show "Net Assessment" over the summer and fall, you aren't alone. Zack Cooper, Melanie Marlow, and Christopher Preble join Ryan for a discussion about the show, about what's happening in the world, and what we can expect from Net when it comes back next month.
Professor Peter Dean, Director, Foreign Policy and Defence at the United States Studies Centre; Dr Zack Cooper, Senior Fellow at the American Enterprise Institute; and Hayley Channer, Director, Economic Security at the United States Studies Centre provided insights from an international strategy simulation that was hosted by the Centre to test how political thresholds, perceptions of risk, and national strategic assumptions might affect collective responses to a multi-faceted contingency in the Indo-Pacific. The Sydney International Strategy Forum brought together prominent thought leaders, policymakers and industry experts to tackle the big issues confronting Australia, the United States and the Indo-Pacific. From bolstering supply chain resilience to turning AUKUS into reality, the forum discussed the enormous opportunities and risks posed by such cross-cutting challenges and what they mean for the future of our region. The forum was held at the Four Seasons Sydney on 1 November 2023.
Moderated by Dr Michael Green, CEO at the United States Studies Centre, this session of the Sydney International Strategy Forum features panellists Professor Peter Dean, Director, Foreign Policy and Defence at the United States Studies Centre; Rep. Akihisa Nagashima, a member of the Japanese House of Representatives; Dr Zack Cooper, Senior Fellow at the American Enterprise Institute; and Dr Gorana Grgić, Senior Lecturer in US Politics and Foreign Policy at the United States Studies Centre. The Sydney International Strategy Forum brought together prominent thought leaders, policymakers and industry experts to tackle the big issues confronting Australia, the United States and the Indo-Pacific. From bolstering supply chain resilience to turning AUKUS into reality, the forum discussed the enormous opportunities and risks posed by such cross-cutting challenges and what they mean for the future of our region.The forum was held at the Four Seasons Sydney on 1 November 2023.
Almost six months have passed since the release of the Defence Strategic Review (DSR), and this episode Darren is joined by Zack Cooper, Senior Fellow at the American Enterprise Institute, for an American perspective on Australia's defence policy. The conversation starts with a basic conceptual model and fundamental tensions with Australia's alliance with the US, before traversing a range of contemporary issues, including AUKUS, the possible re-election of Donald Trump and battlefield lessons from Ukraine. Australia in the World is written, hosted, and produced by Darren Lim, with research and editing by Corbin Duncan and theme music composed by Rory Stenning. Relevant links Zack Cooper, biography: https://www.aei.org/profile/zack-cooper/ Department of Defence, “National Defence: Defence Strategic Review 2023”, April 2023: https://www.defence.gov.au/about/reviews-inquiries/defence-strategic-review Institute for the Study of War: https://www.understandingwar.org/ Binge Mode: Harry Potter (podcast): https://podbay.fm/p/binge-mode-harry-potter
Zack Cooper, senior fellow at the American Enterprise Institute and lecturer at Princeton University, joins this episode to discuss the upcoming Camp David summit between Japan, South Korea, and the U.S. This momentous occasion is a result of leadership from South Korea's President Yoon and Japan's Prime Minister Kishida in hopes of mending ties since Japan's invasion of Manchuria a hundred years ago. Zack also delves into U.S. policy in Southeast Asia and its pivot to the Pacific. He also explores the Communist Party's reliance on economic growth to maintain control, the potential for increased tensions around Taiwan in the future, and the U.S.'s ambiguous commitments to Taiwan due to treaty changes in the 1970s. Tune into this episode for an engaging discussion about geopolitics in East Asia![00:00 - 09:14] Exploring China's Geopolitical and Military AmbitionsJapan and South Korea have never had an independent diplomatic meeting outside of a more significant summitThe U.S. and Japan have had their differences going back to World War II, but Japan and Korea never had the same forcing functionChina is playing a significant role in pushing Japan and Korea together as they trust China less than each otherThe Camp David Summit is about trying to make it more difficult for them to focus on historical issues and force them into the future[09:15 - 17:39] Split Opinions on Responding to Economic Downturn and Taiwan TensionsXi Jinping's thinking is uncertain, and both a weak, inward-looking China and an aggressive, brittle China are possibleRussia's experiment of consolidating national unity by attacking Ukraine has not worked outTaiwan is different from Ukraine, and it is unclear what the U.S. commitments are with TaiwanChinese people have delivered remarkable economic growth in the past decades, but now the growth numbers for this year are lower[17:40 - 24:42] Examining the Challenges of the U.S.-China Conflict Over TaiwanThe Biden team has three pillars of their approach: Invest, Align, and Compete with ChinaTaiwan has strategic value as it is close to U.S. treaty alliances with Japan and the PhilippinesChina trying to invade Taiwan is one of the hardest things militarily in the worldThe U.S. Navy is smaller than China's, and U.S. facilities and people in the region would be under threat if a conflict arises[24:43 - 37:22] Examining Command and Control in Southeast Asia U.S. could strike the Chinese mainland if a decision is made in Oval Office or White House Situation RoomChina hasn't been involved in a major conflict for 50 years, and technology is different nowQuote:"It is a fascinating moment in time, watching Japan and Korea finally try and move past some of their historical differences." - Zack CooperConnect with Zack!Twitter: @ZackCooperConnect with me on LinkedIn!LIKE, SUBSCRIBE, AND LEAVE US A REVIEW on Apple Podcasts, Spotify, Google Podcasts, or whatever platform you listen on. Thank you for tuning in, and Stay Tuned for the Next Episode COMING SOON! Hosted on Acast. See acast.com/privacy for more information.
Why Can't Biden and the Pentagon Control Elon Musk From Helping His Pal Putin? | Ariel Dorfman on the 50th Anniversary of the Coup Against Allende | On the 22nd Anniversary of 9/11 the Senate Homeland Security Committee Wants an Unredacted Report on Saudi Arabia's Role in the Attack backgroundbriefing.org/donate twitter.com/ianmastersmedia facebook.com/ianmastersmedia
Drug addiction is a mental health problem, and it comes with a lot of social and psychological factors. No one just wakes up one morning and decides that they're going to do drugs. The problem comes from somewhere else, and it's in going to that root cause that most initiatives to tackle the drug problem fall short. This is what Zack Cooper wrestles with every day. In his medical startup, he addresses the need for substance abuse mitigation in South Carolina using a unique approach where patients can come just like they're going to a doctor's clinic. Zack puts a lot of focus on the ongoing (and worsening) opioid crisis that plagues the state and all of the US, and his insight into the topic is one that every health professional can learn from. Tune in and learn a ton from this fascinating conversation! The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/wRCLeJ Love the show? Subscribe, rate, review, and share! Here's How » Join the Medical Sales Podcast Community today: evolveyoursuccess.com
Zack Cooper joins CareTalk to discuss why surprise medical bills might soon become a thing of the past.TOPICS(1:22) Zack's deep dive into surprise billing(3:46) How the No Surprises Act came to be(7:23) The 1% Steps for Healthcare Reform Project(8:56) The Legal Villains(12:01) How can politics actually work for cost reduction?Dive deeper into this episode and read our report, Putting an End to Surprise Medical Bills With The No Surprises Act.ABOUT CARETALKCareTalk is a weekly podcast that provides an incisive, no B.S. view of the US healthcare industry. Join co-hosts John Driscoll (President U.S. Healthcare and EVP, Walgreens Boots Alliance) and David Williams (President, Health Business Group) as they debate the latest in US healthcare news, business and policy. ABOUT ZACK COOPERZack Cooper is an Associate Professor at Yale University, and Director of Health Policy at the school's Social and Policy Studies. As a health economist, his research has provided empirical evidence that informed public policies, including the No Surprises Act.GET IN TOUCHBecome a CareTalk sponsorGuest appearance requestsVisit us on the webFOLLOW CARETALKSpotifyApple PodcastsGoogle PodcastsFollow us on LinkedInSubscribe to the CareTalk Newsletter to access exclusive content and insights covering the biggest topics in healthcare today. Produced by Grippi Media
Zack Cooper is a senior fellow at AEI, where he studies US defense strategy in Asia, including alliance dynamics and US-China competition. He also teaches at Princeton University and cohosts the Net Assessment podcast for War on the Rocks. Zack joins Phoebe and Robert to discuss A New China Playbook, the defense of Taiwan, and the Russia-Ukraine War.
Zack Cooper is a senior fellow at AEI, where he studies US defense strategy in Asia, including alliance dynamics and US-China competition. He also teaches at Princeton University and cohosts the Net Assessment podcast for War on the Rocks.Zack joins Phoebe and Robert to discuss A New China Playbook, the defense of Taiwan, and the Russia-Ukraine War.
In this month's episode of Japan Memo, Robert Ward and Yuka Koshino are joined by Satoru Mori, Professor at Keio University in Tokyo and a Senior Fellow at the Nakasone Peace Institute (NPI) and Zack Cooper, Senior Fellow at the American Enterprise Institute (AEI).Robert, Yuka, Satoru and Zack provide US and Japanese perspectives on Taiwan contingency scenarios; their analyses on Taiwan contingency wargames conducted in the US and Japan between 2021-2022; and offer assessments on what the US and Japan can and should do to better prepare for a contingency scenario in peacetime. Topics discussed include:The outcomes of the wargames conducted between 2021-2022The challenges and limitations for the US, Japan and their alliance in a Taiwan contingencyHow Japan's three new strategic documents will consider a Taiwan contingencyThe peacetime contingency preparations that should be undertaken by the US, Japan, and their allianceThe following literature is recommended by our guests to gain a clearer picture of the topics discussed:‘Self-respect and Independence of Mind: The Challenge of Yukichi Fukuzawa' by Shinichi Kitaoka (translated by James M. Vardaman)‘Japan Prepares for Total War' by Michael Beinart We hope you enjoy the episode and please follow, rate, and subscribe to Japan Memo on the podcast platform of your choice.Date of Recording: 25 November 2022Japan Memo is recorded and produced at the IISS in London. Hosted on Acast. See acast.com/privacy for more information.
Live with Jake WIlliams and Zack Cooper from Element Home Loans, local in Charleston, SC and a little Chubby Fish!
Giselle, Iulia, and Dalibor are joined by Zack Cooper, Senior Fellow at the American Enterprise Institute, to discuss how Russia's invasion of Ukraine might impact China's strategy towards Taiwan. Zack outlines three lessons China should be learning from Russia's invasion of Ukraine: 1) Invasions are tough, and an amphibious landing would be tougher. 2) Don't take bad military advice, and in a personalistic dictatorship, you don't get the best information. 3) Western countries are more willing than expected to unite on sanctions. Yet the lessons China is currently learning are different, experts say, due to the Chinese government's information ecosystem. Zack also delves into the Russian-Chinese relationship, the Chinese nuclear doctrine, among many other topics. Show notes: -Sign up for The Eastern Front's biweekly newsletter https://www.aei.org/the-eastern-front-podcast/ (here) -Enter The Eastern Front's giveaway https://hello.aei.org/Eastern-Front-Giveaway.html (here)
In this episode, we examine the United States’ relationship with Taiwan, the future of its strategic ambiguity policy, and the increasingly aggressive Chinese posture toward Taiwan. Joining us on the podcast is Dr. Zack Cooper, senior fellow at the American Enterprise Institute. Defending Taiwan Episode Credits: Editor: Leo Kamer Hosts: Julia An, Chris H. Park
Taiwan represents possibly the most intractable issue in international affairs, but also one of the most important. Arguably, no theory or opinion on the biggest questions Australian foreign policy can be complete, or maybe even credible, until it grapples with the Taiwan issue. And so on this episode Allan and Darren use the occasion of US Speaker Nancy Pelosi's controversial visit to the island to sort through their views. Be warned, this is a long and wonkish episode! But more so than perhaps anything else discussed on the podcast, Taiwan requires the time and space to lay out one's views and have them challenged. The episode concludes with a quick update on Australia-China relations, given the Chinese Ambassador's recent speech at the National Press Club. We bid farewell Annabel Howard and thank her so much for all her help, and welcome Atikah Mekki and thank her for audio editing today, and thanks also to Rory Stenning for composing our theme music. Relevant links James Fearon, “Rationalist explanations for war”, International Organization, Volume 49 Issue 3 (1995): https://web.stanford.edu/group/fearon-research/cgi-bin/wordpress/wp-content/uploads/2013/10/Rationalist-Explanations-for-War.pdf Hugh White, “Sleepwalk to War: Australia's Unthinking Alliance with America”, Quarterly Essay, 27 June 2022: https://www.blackincbooks.com.au/books/sleepwalk-war Michael Beckley, Zack Cooper, and Allison Schwartz, “Deterring Coercion and Conflict Across the Taiwan Strait”, American Enterprise Institute: https://www.defendingtaiwan.com/deterring-coercion-and-conflict-across-the-taiwan-strait/ James R. Holmes and Toshi Yoshihara, “Taiwan's Navy: Able to Deny Command of the Sea?”, China Brief Volume 10, Issue 8 (2010): https://jamestown.org/program/taiwans-navy-able-to-deny-command-of-the-sea/ Bonnie Glaser and Zack Cooper, “Nancy Pelosi's Trip to Taiwan Is Too Dangerous” New York Times, 28 July 2022: https://www.nytimes.com/2022/07/28/opinion/china-us-taiwan-pelosi.html Ben Herscovitch, “Australia's shifting statements on Taiwan, China's changed tone, and coal exports”, Beijing to Canberra and Back” (newsletter), 4 August 2022: https://beijing2canberra.substack.com/p/australias-shifting-statements-on Ambassador Xiao Qian, Ambassador of the People's Republic of China, Speech to National Press Club (video), 10 August 2022: https://www.youtube.com/watch?v=AXeHRtmWJ68 China's ambassador to Australia addresses National Press Club — as it happened (Live Blog), ABC News, 10 August 2022: https://www.abc.net.au/news/2022-08-10/live-updates-xiao-qian-addresses-national-press-club/101318252 Ben Herscovitch, “Beijing (re)embraces one-China disinformation plus aggregate leader-level meetings”, Beijing to Canberra and Back” (newsletter), 31 August 2022: https://beijing2canberra.substack.com/p/beijing-reembraces-one-china-disinformation Gatra Priyandita, Dirk Van Der Kley and Ben Herscovitch, “Localization and China's Tech Success in Indonesia”, Carnegie Endowment for International Peace, 11 July 2022: https://carnegieendowment.org/2022/07/11/localization-and-china-s-tech-success-in-indonesia-pub-87477 Kevin Rudd, The Avoidable War: The Dangers of a Catastrophic Conflict between the US and Xi Jinping's China (Hachette, 2022): https://www.hachette.com.au/kevin-rudd/the-avoidable-war-the-dangers-of-a-catastrophic-conflict-between-the-us-and-xi-jinpings-china Jessica Chen Weiss, “The China Trap: US foreign policy and the perilous logic of zero-sum competition”, Foreign Affairs, Sep/Oct 2022: https://www.foreignaffairs.com/china/china-trap-us-foreign-policy-zero-sum-competition The Sandman (TV): https://www.netflix.com/au/title/81150303
How does the crisis provoked by Nancy Pelosi's recent trip to Taiwan illustrate the broader state of U.S.-China relations?Jude Blanchette and Zack Cooper join Andrea Kendall-Taylor and Jim Townsend to discuss the likely trajectory of the crisis and its broader implications for the transatlantic community. Jude Blanchette holds the Freeman Chair in China Studies at the Center for Strategic and International Studies. Previously, he was engagement director at The Conference Board's China Center for Economics and Business in Beijing, where he researched China's political environment with a focus on the workings of the Communist Party of China and its impact on foreign companies and investors. Zack Cooper is a senior fellow at the American Enterprise Institute, where he studies U.S. strategy in Asia, including alliance dynamics and U.S.-China competition. He also teaches at Princeton University, co-directs the Alliance for Securing Democracy, and cohosts the “Net Assessment” podcast.
Nancy Pelosi made a visit to Taiwan this week. It wasn't exactly a surprise—we all knew it was happening—but it wasn't announced, and it wasn't quite official either. Beijing has gone a little bit crazy. There are military exercises taking place off the coast of Taiwan in response. There are threats of war. There was even talk of shooting down Pelosi's plane. To talk it all through, Benjamin Wittes sat down with Sophia Yan, Beijing correspondent for the Telegraph; Julian Ku, professor of law at Hofstra University; and Zack Cooper of the Alliance for Protecting Democracy at the German Marshall Fund. They talked about why Pelosi went, about how Beijing reacted, and whether it's all bluster or whether this is the real deal. They also talked about what we can expect to happen over the next few months and how we can deescalate the situation over the next few days. Support this show http://supporter.acast.com/lawfare. See acast.com/privacy for privacy and opt-out information.
Links1. "FACT SHEET: Quad Leaders' Tokyo Summit 2022," May 23, 2022.2. "The Quad Goes to Sea," by Zack Cooper and Gregory Poling, War on the Rocks, May 24, 2022.
Greg and Elina talk with Zack Cooper, senior fellow at the American Enterprise Institute, about the Quad's new maritime domain awareness partnership. Simon is joined by Andreyka Natalegawa, research associate with the Southeast Asia Program at CSIS to cover the fighting in Myanmar, disappointment from Cambodia, and chickens!
The Biden administration maintains that our policy towards Taiwan remains ambiguous, despite his recent gaffe saying we would respond militarily if China attacked. But is this policy sustainable... especially when the President keeps slipping up and saying the opposite? Zack Cooper from the American Enterprise Institute joins the show to talk about the importance of having a policy our leaders will actually follow. See omnystudio.com/listener for privacy information.
This is the national security podcast crossover of the century! Or at least of the year...ok maybe of Spring 2022! For this special episode, Doyle Hodges of TNSR and “Horns of a Dilemma” hosts Zack Cooper, Melanie Marlowe, and Chris Preble of “Net Assessment.” They try to sort through relations between Moscow and Beijing in this time of war, as well as a whole bunch of related issues. And yes, they engage in the airing of grievances, a “Net Assessment” tradition. Make sure you subscribe to their podcasts, which are a part of the War on the Rocks family.
How Far Will Xi Jinping Go in Supporting His Fellow Dictator Putin? | Possible Blowback Against China's Support of Putin | Why is India's Modi Siding With Putin? backgroundbriefing.org/donate twitter.com/ianmastersmedia facebook.com/ianmastersmedia
AUKUS helps build regional deterrence, yet more is needed beyond defence cooperation. Veerle is joined by Dr Zack Cooper, Senior Fellow at the American Enterprise Institute, who offers insights on how AUKUS fits into US strategic thinking on meeting the rising challenges in the Indo-Pacific for the US and its allies. Further cooperation beyond exclusive groupings focused on defence is needed, particularly in the areas of technology, trade and governance, and Zack explains how Europe and Indo-Pacific partners stand to play an important role. Tune in also for a discussion on what is meant by integrated deterrence.
Friends, The focus of this interview is on a solution created by Yale Economists to address the rising & unsustainable costs of healthcare in our country. Most of us are ...
In this episode, Mike sits down with Eric Sayers, adjunct senior fellow for the Asia-Pacific Security Program at the Center for a New American Security, and Zack Cooper, research fellow at the American Enterprise Institute, two rising conservative Asia strategic thinkers. Building on the previous episodes on the Democrats' Asia strategy, the three discuss the nature of the U.S. strategic competition with China, growing isolationism among some Republican thinkers, and the roles of government, values, and principles for future Republican administration's Asia grand strategy. Download full transcript here.