Principles of Health Care Reform for the Commonwealth of Massachusetts

This post is offered as a brief, cursory set of principles that might logically guide a larger debate on what needs to be done to advance health care reform beyond the health insurance reform measures in the Commonwealth (An Act Providing Access to Affordable, Quality, Accountable Health Care, Chapter 58 of 2006 acts of the General Court) and at the federal level (the Patient Protection and Affordable Care Act (ACA) of 2010).  Critically, the point here is to acknowledge that, on the one hand, establishing a mechanism through which access to health insurance could theoretically become universal was indispensable to the larger task of improving health care for individuals in the Commonwealth, but, on the other hand, steps need to be taken to transform the theoretic nature of health insurance reform into a reality of universal coverage and to arrest the perpetual dynamic of cost increases in health care provision, including the rising cost of pharmaceuticals.  This document represents an initial effort to crystalize a set of problems and logically derived ameliorative measures, without, for the present moment, a significant elaboration on each proposition.

1.  Health insurance reform, intended to theoretically generate universal insurance coverage, seeks to address problems of cost shifting/cross-subsidization from uninsured to insured patients and reduces the actuarial risk to insurance carriers by increasing the weight of premium payments by relatively young and healthy individuals relative to older, less healthy individuals.  Both these theoretic effects of health insurance reform should be expected to control a single source of cost increases in health care provision, to the exclusion of other sources.   
2.  Requiring all individuals to possess health insurance coverage without subsequently undertaking a broader analysis of innate problems arising from the structure of health insurance markets, however supplemented by the institution of health insurance exchanges at the state and/or federal level, is unlikely to address other important problems, contributing to cost increases in health care provision and in the inflation of insurance premiums/deductibles/copayments/co-insurance requirements. 
3.  Employer sponsorship of health insurance coverage, as a default mid-Twentieth century ameliorative against a broader government involvement in health care, is the biggest problem in the American health insurance marketplace and one of the biggest sources of increasing labor expenses impacting the competitive position of American employers in diverse global markets. 
4.  The fact that both the Massachusetts health insurance reform law of 2006 and the federal health insurance reform law of 2010 (ACA) rely on employer sponsorship of health insurance as the default mechanism by which a majority of American individuals and households would obtain health insurance coverage, including penalization of employers above threshold employment levels for failure to provide health insurance sponsorship, is a major fault of both laws that needs to be rectified in order to liberate American businesses from the burden of negotiating health insurance markets.
5.  Underwriting disadvantages for small businesses seeking to provide health insurance coverage for employees represent an important impediment to the affordability of health insurance coverage to employers and their employees, and, as such, contributes to inequalities of access to high quality basic health care between individuals employed at small businesses and individuals at larger private or public sector employers.
6.  In reference to both the imperatives of theoretic economics (i.e. labor market flexibility) and practical concerns about continuity of high quality health care provision, the central problem of employer sponsorship of health insurance arises from the non-portability of coverage.  Any further reform measures with respect to health insurance coverage need to ensure that individuals can maintain continuity of coverage as they transition between employers.  As such, the most reliable way to maximize the portability of health insurance coverage for individuals is to eliminate employer sponsorship as the primary means by which individuals obtain health insurance coverage.  
7.  If Massachusetts is to eliminate the institution of employer sponsorship in health insurance markets, then we need to make suitable amendments to Part I, Title XVI, Chapter 111M and other applicable provisions of the General Laws of the Commonwealth in order to displace health insurance coverage by means of employer sponsorship.  Such steps need to include the elimination all possible penalties to all employers for failure to sponsor health insurance coverage and the elimination of employer sponsorship of health insurance for employees of state, county, and municipal government jurisdictions in the Commonwealth.  
8.  In regard to the statutory requirements of the federal Patient Protection and Affordable Care Act (ACA) of 2010, the Commonwealth's Executive Office of Health and Human Services should seek to negotiate a waiver with the U.S. Department of Health and Human Service (HHS) on all penalties to Massachusetts employers for failure to sponsor coverage for employees under the terms of the ACA.    
9.  In lieu of federal tax charges to employers to penalize failure to sponsor health insurance coverage, the Commonwealth should reinstate and generalize fair-share contribution payments across all private sector employers, with minimal size limitations, at rates determined in reference to the average annual premia on mid-range (Silver tier) Connector insurance policies, to be contributed to a special fund for collective health insurance expenditures, such that employers will be held responsible to supply a partial (not more than fifty-percent of annual premium values) offset to expenses incurred by the Commonwealth for substantial increases of subscribers insured under subsidized Connector insurance policies.  
10.  The point of replacing employer sponsorship with fair-share contributions is to minimize and generalize the responsibility of employers to contribute to universal health insurance coverage without incurring excess labor costs for underwriting of businesses in small employer pools and to make insurance coverage for individuals fully portable, enabling individuals to leave particular employers at will without major disruptions in health insurance coverage or in continuity of care (e.g. forced switching of primary care physicians with change in insurance coverage).  In general, such a reorganization of contributions for health insurance coverage would generalize the principle that financing of health insurance coverage should take on a tripartite structure in which employers (through explicit taxation in fair-share contributions) and state government (through general fund expenditures) collectively bear a portion of the burden and individual subscribers (through exchange/Connector-based purchases) individually bear the remainder, commensurate with their individual needs.  
11.  In principle, the replacement of mandated employer sponsored health insurance can be achieved through one of two systems of universal health insurance coverage: a system of mandates for the individual purchase of health insurance from a marketplace of insurers (private and/or public), or a single-payer system of tax financed collective health insurance coverage.  
12.  Theoretically speaking, a single-payer system of health insurance coverage would be the most efficient means of providing health insurance coverage with regard to minimization of transaction costs from administrative expenses and with regard to the superior bargaining power of a single, monopsony purchaser of health care services relative to diverse health care provider agents in the negotiation of compensatory payments for health care services.  In the latter sense, a single-payer system can more efficiently ration health care in order to control the inflation of health care expenses and prevent substantial cross-subsidization between various categories of health care consumers/patients/health insurance subscribers.    
13.  In practical terms, the establishment of a single-payer system in the Commonwealth of Massachusetts would face prohibitive political opposition, if only because the institution of such a system would immediately displace the entire private health insurance industry.  It would, further, institute particular forms of health care rationing that might diverge from the preferences of particular individuals across the broader public - if all health insurance must practice rationing of health care services, then selection across multiple health insurance plans that practice different manifestations of rationing may enable individuals to find plans more amenable to their individual circumstances (e.g. plans with higher premiums but lower deductibles, plans with better prescription coverage, etc.).  
14.  A system of mandated purchasing of subsidized insurance coverage from a marketplace can approach the cost advantages of a single-payer system if individual insurance carriers are capable of achieving subscriber bases of sufficient scale that they can achieve a degree of bargaining power relative to health care provider organizations (e.g. at the highest level, hospital systems).  In the absence of such offsetting bargaining power, insurers will lack substantial capacity to constrain the inflation of health care costs, driven by the capacity of large scale provider organizations to demand higher compensatory rates for health care services and to cross-subsidize between payers with different degrees of bargaining power.  
15.  If the Commonwealth of Massachusetts seeks to eliminate employer sponsorship of health insurance in favor of a universal system of mandated exchange purchases, then the state should also strive to limit the number of plans on each tier of health insurance coverage in order to maximize the subscriber base of participating private insurance carriers and, thus, maximize their bargaining power relative to health care provider organizations.  It should also consider the provision of competitively priced (i.e. substantially at parity with comparable private plans with respect to premiums) public option plans, at least on lower (Silver, Bronze) tiers of the Connector exchange.
16.  To the extent that the federal Patient Protection and Affordable Care Act (ACA) has established conditions for minimum acceptable coverage of health insurance policies, including provision of female reproductive/family planning services, in exchange-based plans, as well as the conditions for individual exemptions, the crafting of conditions limiting sets of insurance plans on the Massachusetts Connector must be based on variations in coverage levels above and beyond minimums (e.g. discounts for health club membership, enhanced discounts for generic prescription medications, etc.).  
17.  Health care reform, transcending the limitations of health insurance reform, has to address the myriad conditions driving increases in the costs of health care services, including, but not excluded to, capital expenditures in various specialized diagnostic, therapeutic, and surgical instruments and equipment, pharmaceutical research expenditures, medical malpractice insurance/medical torts, and, more fundamentally, personal health and living practices, including exercise, diet, work routine, and stress management for all residents of the Commonwealth.  
18.  Inflation of the cost of medical services at the point of consumption is shaped by a long series of interconnected processes constituting the medical industrial supply chain.  If the Commonwealth  is to come to terms with rising medical expenditures and cost structures and, thus, mitigate growth in the subsidization of health insurance policies through the Connector, then we must be cognizant of how cost increases arise and are transmitted through the course of the supply chain. 
19.  The Commonwealth needs to work with hospital systems and other large provider units to identify supply rigidities in procurement and contracting that might be susceptible to comprehensive cost control.  
20.  Large scale provider units, like hospital systems, seek to maximize returns on investment in infrastructures and equipment by directing capital toward investments that promise reliable, long term cost reimbursement streams from insurers (e.g. treatment of cancers and other chronic conditions, requiring or otherwise benefiting from proprietary therapeutic methods, advanced pharmaceutical products, and/or high technology equipment).
21.  The Commonwealth needs to study the availability of a range of high technology care options across medical facilities across Massachusetts in order to create a registry of advanced care investments, as a possible prelude to developing statutory/regulatory restrictions/controls on new capital investments (especially in infrastructures) in areas of the state over-served for particular care options in relation to regional needs.  Such a registry would have to be periodically (every four or five years) revised to account for changes in medical technologies and, thus, enable the Commonwealth to maintain a vigorous private health care technology sector without simultaneously allowing spillovers on increasing capital costs to compromise the capacity of Massachusetts residents to enjoy high quality basic health care.
22.  Investments in medical research represent one of the great success stories of free market enterprise and the harnessing of charitable impulses.  Capital in medical research is invested on a model of theoretically-informed trial and error, with extreme levels of risk that particular projects will ever realize potential marketability.  As such, successful research projects, capable of being integrated into therapeutic methodologies or pharmaceutical regimens, command high potential returns, generating spillover costs as providers seek to cross-subsidize by demanding higher compensatory payments from insurers for other, lower cost services. 
23.  The idea of restricting or otherwise controlling medical research expenditures in the Commonwealth would generate an enormous loss to both economic growth, in a knowledge-based economy, and the satisfaction of human needs arising from the continued prevalence of a wide range of acute and chronic ailments.  In our regulation of rising medical costs, the Commonwealth needs to separate expenditures on basic research and the wider development of globally marketable medical research products (e.g. pharmaceuticals) from the integration of such products for regular utilization by health care providers in the Commonwealth.  
24.  With regard to the integration of proprietary pharmaceutical products into treatment regimens for patients in the Commonwealth, the Commonwealth needs to give serious attention to both retail direct purchasing of prescription medications by patients from drug manufacturers via online intermediaries (in lieu of retail purchases through pharmacy chains reimbursed by insurers) and the potential for direct intervention into the pharmaceutical supply in order to establish a public clearinghouse for wholesale pharmaceutical purchasing and distribution under contract to pharmacy chains.  Assuming either of these methods holds the best potential for controlling costs in the purchase of pharmaceutical products, especially advanced, proprietary patented medications, not benefiting from generic replication, we need to evaluate where one methodology holds the greatest potential benefit for patients for each pharmaceutical product.  In general, the Massachusetts Executive Office of Health and Human Services should be commissioned by statute to investigate how best to manage cost structures in the purchase and distribution of prescription medications.  
25.  The scale of provider units in relation to the larger marketplace for health care services constitutes a problem to the extent that the bargaining power of large providers undermines cost control at the retail end of the medical industrial supply chain.  The formation of hospital systems, as such, is only a problem to the extent that the bargaining power of each hospital system, in relation to its larger regional market, overwhelms the capacity of health insurers to exercise meaningful cost control in negotiating reimbursement rates for specific services.  On the other hand, the presence of hospital systems on the retail end of the supply chain certainly bolsters the bargaining power of providers against upstream suppliers of medical equipment and other medical industrial services, holding the potential for certain cost savings on the retail end.  In general, the scale of provider units can be a two-edged sword for cost control.    
26.  The best way to deal with the degree of bargaining power of hospital systems relative to insurers on the retail end is to generalize individual mandates for purchases from Connector plans and to truncate the number of available plans per cost tier in order to bolster the size of subscriber pools in particular regions, effectively increasing the bargaining power of insurance carriers relative to providers without undermining the capacity of providers to negotiate cost savings from upstream medical product/service suppliers. 
27.  Reform of legal criteria for recovery of damages in civil suits for medical negligence remains a key component of health care reform agendas among political conservatives, for whom any measure undermining the capacity of trial lawyers to profit from cases of alleged medical malpractice is a positive benefit.  The capacity of tort reform to control cost inflation in health care services is undoubtedly overestimated, but, to the extent that certain, sensible reforms of rules limiting compensatory damages on non-economic (i.e. pain and suffering, rather than lost wages/supplemental medical costs) grounds could minimally impact the rights of patients to legal recourse for malpractice while reducing premiums to physicians for liability insurance, it would be worthwhile for the Commonwealth to consider enacting such reforms.  
28.  In conjunction with statutory reform of rules for recovery of damages in medical torts, health care provider units in the Commonwealth should consider serious, sensible, and easily implemented procedural reforms to reduce the prevalence of secondary injury or infections from medical procedures or other sources commonly resulting in malpractice litigation.  Such reforms might be as straightforward as disciplined utilization of checklist practices in surgical procedures or improvements to communication between nursing shifts at intensive care units.  To the extent that reductions in the cost of malpractice for health care providers must be a two-sided cooperative endeavor between providers/provider organizations and the legal community, a palpable effort by health care providers to reduce the probability that particular health care procedures will result in grounds for litigation will similarly motivate a reduction in insurance costs while improving patient safety.    
29.  In the end, the most significant and meaningful possible measures to achieve health care reform, as opposed to health insurance reform, in the Commonwealth of Massachusetts are located within the behaviors of individual households.  Health insurers are doing their best, through the development of policy provisions, to motivate subscribers to join health clubs and to adopt healthier lifestyle choices in diet (lower consumption of saturated fats from red meat, fried foods, and other sources; reduced consumption of added sugars in processed foods) and everyday routines (further reductions in tobacco use and moderation of alcohol consumption).  However, the development and sustaining of such lifestyle choices requires a commitment by individuals that transcends the capacity of health insurers to motivate or, certainly, for the Commonwealth to enforce by statute or regulation.  Emphatically, true health care reform, in this manner, is not a subject for legislation but for movement building! 
30.  Two thoughts for health care movement building:  
a.  Weekly neighborhood or workplace workout sessions/gym days/nights.
b.  Backyard "victory garden" agriculture and neighborhood growing and distributing cooperatives for neighborhood grown fruits and vegetables (a healthier diet can be bolstered by locally grown produce).
       
  

On Analyses of Sanders' Economic Plan, Friedman, and the Democratic Party Witchhunt(!)

As an initial point in this commentary, it is really difficult to predict the future.  This point applies as much to meteorologists as it does to economists (Nobel prize winners as well as us indiscriminate schmucks, whether we graduated from Harvard or missed out on graduating from UMASS-Amherst because key members of our  dissertation committees passed away).  It might always be worthwhile to listen to a Nobel prize winner like Paul Krugman, except when he's on a partisan tirade to expose an errant defector who happened to piece together some statistical data to evaluate, in reference to (I'm guessing) simplistic macroeconomic models, the economic policy proposals of a democratic socialist in the Democratic Party primaries (see Krugman, "Varieties of Voodoo," New York Times (19 Feb 2016), at: .http://www.nytimes.com/2016/02/19/opinion/varieties-of-voodoo.html?_r=0)  For the record, I haven't seen Gerald Friedman's analysis of Bernie Sanders' economic policy proposals, but I would err on the side of caution before dismissing their validity, if only because it is really difficult to make detailed predictions on the future of the U.S. economy, when the range of endogenous variables that have to find their way into macroeconomic models, expressing growth projections in relation to the elasticity of macroeconomic capital investments relative to changes in marginal tax rates, can be really nebulous!  That said, my larger point in this post does not concern Gerald Friedman's analysis.
              For the record, Jerry Friedman was the first person I encountered, as an undergrad handing in a final paper for an upper-level economics class on labor economics in the spring 1997, who suggested to me that I should embark on a graduate career in economics!  Acknowledging that Jerry has a long history in economic analysis, grounded in his own graduate work studying economic history with, among other instructors, Robert Fogel, during the developing stages of the Cliometric revolution in historical research at Harvard, I'm fairly confident that Jerry's research on Senator Sanders' proposals produced a valid analysis, acknowledging further that such proposals are unlikely to ever enjoy statutory enactment in the Congress that Sanders would face!  That said, I am less concerned with Sanders' economic proposals or Jerry Friedman's analyses thereof than I am concerned with the state of discursive contestation of economic policy over the course Democratic primaries and the idea that someone with Jerry Friedman's credentials could advance analyses and be thoroughly derided as some sort of leftist traitor to the project of getting a Democratic candidate elected to the Presidency!  On the academic end of the American electorate, I have to question what the hell is going on with the democratic process, especially within the Democratic Party, that we cannot honestly debate the potential benefits and costs of nominally progressive economic proposals without bringing down the wrath of party insiders for insinuating that Sanders might actually be serious and that it might be worth devoting at least some attention to his ideas before we race to anoint Hillary Clinton as the Democratic Party nominee.  In these respects, I can fathom why such committed progressive economic thinkers as Alan Krueger and Christina Romer would justifiably fear that evaluating and debating the economic proposals of a political figure who labels himself a democratic socialist, even in academic circles, much less in the mainstream media, cannot play well to moderate electoral constituencies (see "An Open Letter from Past CEA Chairs to Senator Sanders and Professor Gerald Friedman," at: https://lettertosanders.wordpress.com/2016/02/17/open-letter-to-senator-sanders-and-professor-gerald-friedman-from-past-cea-chairs/).  It is, however, condescending to publicly disparage the credibility of one set of analyses without a serious effort to identify its faults and posit an alternative analysis, assuming that under a different set of assumptions, the merits of Senator Sanders' proposals might prove substantially less robust.  As such, notwithstanding Jerry's apparently expressed support for Hillary Clinton's candidacy, I will continue to find obstructions to my support for Clinton, if only because of the witch hunt that has seemingly been waged against someone who I consider a sincere and committed economic historian and one of my personal influences in moving forward as a student of economics.

Brexit, the Scots, Welsh, and Ulster, and England's Grandiose Aspirations to Stand Alone in the Age of Globalization

Earlier on this blog, I significantly advocated Grexit, as the best hope for the Greek economy to achieve a restoration of economic growth and development in the aftermath of its regional monetary mismatch between Greek macroeconomic performance and the strength of the Euro.  I continue to advocate such an exit, notwithstanding the misplaced hopes of various players in the Greek economy to see a reversal on its present economic fortunes through rigorously applied austerity.  The Euro is too strong a currency, in relation to Greek economic activity, to sustain the level of export growth that Greece needs in order to sustain a broader recovery of the Greek economy and realize a sustainable growth path.  Britain, standing outside of the Euro-zone and compliance with the Schengen Agreement, is another story entirely.  Notwithstanding the various exceptions in Britain's relationship to the rest of Europe, the English have exhibited a sustained apprehension and expressive resistance to the idea that free trade with the continent could compel them, over time, to accept a more robust and inclusive connection, with inherent associated costs for English rate payers.  At a time in which Germany, Sweden, and other states are bearing the heavy costs of migration from refugees of the Syrian civil war and the broader virtues of the open state are pointedly coming into question, it stands to reason that broad swaths of the English population, particularly in the Midlands and in economically declining regions of Lancashire, Yorkshire, and other areas (e.g. the region of Birmingham) subject to diverse stresses from economic transformation over the last two decades would look upon the European Union as a latent cause of all ills!!  Acknowledging the stress that has been placed upon wide expanses of the English economy, it is simultaneously worth advancing the argument that progressive economic development in this age of globalization is a double-edged sword for most regions of the global economy, not least for my corner of the U.S., where a range of manufacturing industries (e.g. electrical equipment manufacturing, once a major industry in Western Massachusetts) have left a barren expanse littered with troubled dependents on governmental assistance.  I do not know to what extent the English economy will suffer from departure from the free-trading zone of Europe.  Emphatically, however, it seems clear that the extractive economies of Scotland would benefit significantly from continued inclusion in the wider European economy.  If England, by mere plurality within the broader population of Great Britain, decides to abandon the EU, then it would seem quite likely that the Scots would enthusiastically embark on a new campaign to abandon the UK.  If they succeeded (an extremely likely scenario), moreover, it might only be a matter of time until the Welsh and the Scots-Irish majority of Ulster would proceed in kind to bid mother England fair-thee-well.  In these respects, it would seem that England would be best served by listening to the corporate voices of London City and ignoring the Tory pronunciations of Boris Johnson - England belongs with Scotland, Wales, and Ulster, and all four belong in the EU!

The Abject Absurdity of the Egyptian Justice System in the Aftermath of the Arab Spring

See: http://www.cnn.com/2016/02/23/africa/egypt-toddler-sentenced/

Someone within the Egyptian military/judicial establishment, and within the U.S. government by virtue of our continued financial relationship with Egypt, should be ashamed of them self for trying, convicting, and issuing a life sentence to a three-year old for manslaughter and malicious assault against public property!  

The Ridiculous Twelfth North Carolina Congressional District and the Defense of the Voting Rights Act of 1965

This is the first illustration of why the passing of Justice Scalia (bless his soul!) is big, especially for Chief Justice Roberts, who, apparently, maintains a principled opposition (if not a personal animus!) to the Voting Rights Act of 1965, as thoroughly demonstrated in the Shelby County case.  Sadly, the Chief Justice can no longer muster a majority to run around invalidating the substance of Constitutional protection to the suffrage rights of minorities.  Instead, he has to rely on the honor of lower federal courts to respect his broader vision of a democratic system that will allow state legislatures carte blanche in determining how legislative districts will be constructed to reflect the democratic will of the electorate, on the principle of one person, one vote, with absolute racial and ethnic neutrality.  In this case, a district court judge in North Carolina failed to respect his wishes, invalidating a geographically attenuated Congressional district as an impermissible case of racial gerrymandering, crowding in African-American votes in order to ensure a Republican majority in the state's Congressional delegation.  There will be no Supreme Court injunction invalidating the demand that North Carolina redraw its Congressional district mappings to fairly incorporate racial population distributions without regard to the broader strategic objectives of the state's Republican Party.  In conjunction with a range of other issues (e.g. voter identification procedures) addressing "voter fraud," guaranteed to challenge the suffrage rights of a wide range of emerging populations based on race and income, North Carolina deserved excessive scrutiny from the federal courts, and without Justice Scalia's conservative intervention, existing precedents on voting rights, challenging the actions of the North Carolina legislature will, invariably, stand.  I will not, in this respect, state that I was happy to greet Justice Scalia's passing - he was a proud and principled standard bearer of the conservative stance within the Supreme Court.  On the other hand, I am glad that his passing will ensure that voting rights, which I consider most highly as a fundamental right of human beings in community above every other freedom, get maximum protection at the highest levels of the federal judiciary.

Russian Ownership of the Syrian Civil War: On Syrian Kurds, Turkey, and the Current State of NATO

This post is, to a great extent, a response to Joseph Micallef's recent analysis of Russia's evolving Syrian engagement with the Syrian Democratic Forces (SDF), an alliance dominated by Kurds of the Democratic Union Party (PYD)/Kurdish People's Protection Units (YPG) (see Joseph V. Micallef, "The Enemy of My Enemy: Russia and the Kurds Reshape the Syrian Civil War," on the World Post (2/21/16), at: http://www.huffingtonpost.com/joseph-v-micallef/the-enemy-of-my-enemy-rus_b_9282978.html).  The larger point here, that Russian intervention in Syria is transforming the civil war in ways that will ultimately give Moscow a privileged role in determining the fate of the country, is revealing on the course of U.S. engagement with Syrian opposition since the beginnings of the conflict.  Notably, the Obama administration's largely hands-off approach in assisting moderate Sunni Arab opposition/Free Syrian Army contingents and, secondarily, Kurdish forces, with the overall goal of undermining the growth of the Islamic State, has created a leadership vacuum into which Russia has taken a lead role in defining a more comprehensive vision of what Syria should look like.  In this respect, we should probably be grateful that neither the Islamic State nor Jabhat al-Nusra, al Qaeda's Syrian affiliate, has a place at Putin's table!  Furthermore, granting a certain latitude to Micallef's conclusions in this respect, it seems conceivable that Russia is open to the idea of an autonomous Kurdish state in northern Syria, along the Turkish border (i.e. in areas bordering traditional Kurdish areas of Turkey, within which the allied Kurdish Workers' Party (PKK), regarded as a terrorist organization by both Turkey and the U.S., operates).  To the extent that this is the case (and I'm not entirely convinced by Micallef's argument, just hopeful), it appears that Putin is willing to jettison the idea of a wholly unified Syria under control of the Alawite Assad regime in Damascus in the interest of pursuing a pragmatic strategic alliance with the SDF coalition.  If this is true, and if Russia remains willing to back up its vision minimally with tactical air power, then it would, at least, seem possible that the conflict might be brought to some kind of conclusion through a limited federalization of the country, provided IS controlled areas can be retaken by either government forces, SDF, or a combination of the two, supported by Russian air power.
           To the extent that IS is our primary target of interest in Syria and the continued existence of the Assad regime, however mitigated by a partial political division of the country, remains, at most, a secondary issue of American engagement with the Syrian civil war, such a situation might not be unambiguously contrary to American interests.  The problem here is, however, that our NATO ally, Turkey has interests, in its long run conflict against Kurdish nationalism in its eastern regions, that are not wholly congruent with our own, in our efforts to deny radical Sunni Salafism, either represented by al Qaeda/Jabhat al-Nusra or IS, a base in Syria and/or western Iraq.  The Turkish AKP government is not only engaged in military operations against PKK  in its eastern regions, but Turkish forces have also engaged in bombardment of YPG/SDF forces around the town of Azaz.  Moreover, according to Micallef, Turkey may be contemplating outright invasion of Syrian territory in the vicinity of Azaz and IS controlled Manbij, with the expressed intent of denying SDF forces of the opportunity to establish a link between Kurdish controlled territories on the eastern bank of the Euphrates River and the Afrin region in Syria's northwest.  Emphatically, Turkey's conflict with the PKK in its own territory and against the SDF/YPG/PYD in Syrian territory represents a complication to American involvement in the struggle against IS.  For his part, Micallef suggests that Turkish forces have been complicit in allowing the growth of IS as an unfortunate but innocuous and mildly beneficial occurrence in its struggle to suppress Kurdish nationalism on both sides of the frontier.
             Acknowledging the utility of maintaining a forward air base at Incirlik in Turkey for tactical air support of anti-IS forces, including SDF, the current status of our relationship with Turkey represents a defined problem for U.S. policy in relation to Syria if, on the one hand, our primary goal is to contain and/or destroy IS and, on the other hand, SDF constitutes the most successful ground entity in the war against IS in Syria.  Furthermore, with Russian air power being actively deployed in support of SDF and the probability of eventual Turkish ground intervention against SDF, we may have to contend with the consequences of a direct military confrontation between forces of the Russian Federation and a NATO state!  In this respect, given article 5 of the North Atlantic Treaty, we would, conceivably, be committed to engage in military operations against the Russian Federation in defense of offensive military operations by Turkey against military forces whose objectives are fully consistent with our own, relative to the struggle against militant Salafism/IS in Syria.
            In this respect, as in many others, I have serious concerns about the current organizational structure of NATO, continued U.S. involvement in the alliance, and the consequences of NATO's present geographic reach relative to the evolution of Russian nationalism, bolstering Putin's ideological appeal.  Expressly, at some point in the immediate future, it seems imperative that the Obama administration or its successor reconsider the American role in NATO, specifically in relation to the problem of Turkish domestic politics (i.e. the lingering conflict against Kurdish nationalists).  These problems clearly transcend the limited circumstances of the Syrian civil war, but the impending conflict between Turkey and Russia over the SDF, whatever its origins, are bringing them front and center.  It makes no sense for the U.S. to be drawn into a conflict between Turkey and Russia over the legitimate national aspirations of Turkish and Syrian Kurds, especially when those legitimate national aspirations are being nominally defended by an anti-democratic, anti-liberal autocratic like Putin!
            As Micallef's article suggests,, the broader problems between Kurdish populations and the post-Ottoman state of Turkey have their origins in the Lausanne Treaty (1924) and its apportionment of geographic space between post-Ottoman Turkey, Britain, and France.  Insofar as these apportionments are, similarly, pertinent to a discussion of the conflict between Sunni and Shi'a populations in Iraq, to say nothing of the Iraqi Kurds, they are critical to a discussion of the conflict between Syria's Kurds, Sunnis, and Alawites and they, likewise, substantially shape the evolution of the modern state of Turkey.  It is not the responsibility of the U.S. to dictate a political resolution in the conflict between the government of Turkey and its Kurdish population, but, if this ongoing conflict holds the potential for expenditures of American lives and American tax dollars, then, to whatever extent Putin has assumed ownership of Syria's civil war and accepted the potential expenses of military involvement and domestic terrorism by militant Salafists of various nationalities, we hold a palpable stake in the peaceful resolution of conflict between Turkey and its Kurds, at least in the interest of preventing the commitment of American troops into an unnecessary conflict to defend a country committed to denying political autonomy to one of its disparaged ethnic minorities.  We should be ashamed of ourselves if we allow even one American soldier to die in defense of Recep Erdoǧan's vision for domination of Turkey's Kurdish citizens!  

Northampton City Council Vote Against the Trans-Pacific Partnership

By a 5 to 1 majority, the city council of Northampton, Massachusetts, my home city, approved a resolution sponsored by Council President Bill Dwight, Ward 1 Councilor Maureen Carney, and Ward 7 Councilor Alisa Klein denouncing the Trans-Pacific Partnership (TPP).  This trade agreement, concluded between the U.S. and eleven other trading partners on the Pacific rim in October of 2015, eliminates a wide range of multilateral trade restrictions for the signatories while seeking to enforce International Labor Organization (ILO) standards on the organizational rights of workers and on prohibitions trade of commodities produced by child labor and forced labor and to enforce a range of provisions on preservation of endangered species and comprehensive management of fisheries as conditions for full enforcement of trade liberalization provisions (see Office of the United States Trade Representative, "The Trans-Pacific Partnership," at: https://ustr.gov/tpp/).  In these regards, if the trade agreement fulfills the promises conveyed by the Obama administration and its trade representatives in its negotiation, then it should broadly benefit a range of industries in the U.S., most notably agricultural and extractive sectors, while simultaneously benefiting workers in countries like Vietnam and Malaysia with poor records of enforcement in the protection of independent organizational rights and credible institutions of collective bargaining.  Assuming this is the case, and especially to the extent that the Obama administration has gone out of its way to tout American benefits from such an agreement, it is worth considering why both Hillary Clinton and Bernie Sanders, as Democratic Party Presidential candidates, and numerous Congressional Democrats including Senator Elizabeth Warren and Congressman Jim McGovern of the Second Congressional district of Massachusetts, my congressman, have opposed the agreement.  Likewise, one of the statutory cleared advisers to the trade delegation negotiating the TPP has argued that the secrecy with which U.S. negotiators operated made it impossible for a thorough evaluation of trade provisions, including important topics like country of origin provisions governing the extent to which products, manufactured with materials originated from countries outside the TPP zone, will be conferred duty-free status (see Michael Wessel, "I've read Obama's trade deal. Elizabeth Warren is right to be concerned," on Politico, Primary Source, at: http://www.politico.com/magazine/story/2015/05/tpp-elizabeth-warren-labor-118068).  Acknowledging the necessity to maintain the secrecy of certain provisions in order to avoid misrepresentation of particular details by the media in ways that might derail the broader negotiations process, if the administration cannot share its bargaining positions and counter-proposals by negotiating partners openly with personnel tasked and cleared to view confidential materials by legislative statute to perform an advisory role, then how can advisers be expected to do the job Congress has tasked them to do in guarding the interests of various segments of the American public and the American business community.
                  In these respects, I think I can offer a few observations regarding both the TPP and Democratic opposition to the agreement, inclusive of Northampton's city council resolution.  First, in line with Michael Wessel's arguments concerning the negotiations process, it is unclear whether the Obama administration as a whole and the Office of the U.S. Trade Representative in particular are being disingenuous about the benefits and latent costs of the TPP.  In general, as someone who has spent classroom time explaining the Ricardian theory of comparative advantage to undergraduate economics students and, notwithstanding possible dynamic criticisms, largely accepts its logic, I think the U.S. federal government should play an active role in shaping the transition of the U.S. economy in order to achieve a broader conformity with patterns of comparative advantage internationally, if only for the potential benefit that such a realignment might have for American consumers.  In the long run, this certainly means a declining share of manufacturing employment in the U.S., a pattern that has been evident for several decades.  On the other hand, to the extent that we may be moving in a direction detrimental to a range of manufacturing industries, including, especially, automobile manufacturing, we need to be able to openly debate long term changes to the composition of aggregate American employment and supporters of increased trade liberalization in manufactured goods should have to expressly articulate the expected gains and losses from trade to enable Congress and, by virtue of the broader democratic process and pressure from constituents, the larger electorate to evaluate the impact of a trade deal like TPP.  For this process to occur with this level of secrecy amounts to a perversion of the democratic process to serve interests undisclosed to the American public.
               Moreover, if the claims of the Obama administration and the Office of the U.S. Trade Representative can be taken at face value, then we can assume that workers in places like Vietnam, and, for that matter, Mexico will be guaranteed legitimate rights to organize and collectively bargain for better wages and working conditions, under threat of trade sanctions/initiation of bilateral trade restrictions and punitive tariffs relative to trade with the U.S.  The same apparently can be said with respect to enforcement of agreements on trade in endangered species and regulation of maritime commerce to reduce over fishing.  On the other hand, the thresholds for enforcement of punitive sanctions for breach of labor standards and environmental rules are unclear in the administration's documentation on TPP.  If we do not know the conditions under which trade partners will be held to account on important matters of economic and environmental policy, then how can we be sure that the trade agreement will meet broader policy goals with regard to these countries?  Specifically, with regard to our TPP partners in Southeast Asia, the enforcement of collective bargaining rights for workers to a degree consistent with ILO standards would be apt to raise manufacturing costs, hampering capital investment in manufacturing at privileged export processing zones.  How can we be sure that governments in this region will faithfully allow a larger share of gains from trade to be enjoyed by labor, thus, enabling a balanced increase in living standards rather than unmitigated financial bonanza for owners and financiers of sweatshops?  
               In regard to Northampton's resolution, I am doubtful that the city council's actions will have much effect on Congress' eventual evaluation of TPP.  Our congressman already agrees that TPP is a bad idea.  For my part, I'm with At-large Councilman Jesse Adams, the lone "no" vote on the council.  Being at least somewhat predisposed toward the potential benefits from trade liberalization, I just do not have enough information to say, one way or another, whether TPP is, in fact, a bad deal, and the information supplied to the American electorate, to Congress, and even to privileged, cleared advisory staff by the administration appears inadequate to make any informed decision.  In this sense, I think it is fair to say that I simply have no idea what to think about TPP, and I hope that Congress will demand a more thorough examination of its provisions before any decision is made on the agreement.

Attacking Pope Francis I Probably Bad Strategic Decision for Trump

It stands to reason that the Republican primary contests, especially South Carolina and the Super Tuesday Southern primaries, would be an arena for posturing by candidates as exemplars of Christian values.  In this respect, it is worth conceding that there is no universal set of characteristics that definitively exemplify Christianity, an evident fact whether we accept the definitions of particular contemporary Christian religious figures or we dig through the Christian gospels or the Pauline epistles for an unequivocal statement on what makes a person a true Christian.  A textual analysis of the Acts of the Apostles, the Letter to the Hebrews, and various Pauline epistles (e.g. Romans, Galatians, etc.) testify to the reality that the first generations of the Judaic/Messianic cult of Christianity weren't even sure what it meant to be Christian or whether someone could legitimately call himself a Christian if he wasn't ritually circumcised in accordance with Mosaic law!  That said, I think it suffices to say that Donald Trump is perfectly at liberty to define the terms that constitute a good Christian, even if those terms appear to bear little resemblance to the various gospel renderings of the Beatitudes.  Moreover, millions of evangelical Christian Republican voters, in the Southern and Midwestern states will invariably decide whether Trump is credible in suggesting that true Christian love and brotherhood demands the construction of a wall, at Mexico's expense no less, to keep Latin American migrants, especially from drug related violence in Guatemala, Honduras, and El Salvador, out of the U.S.  On the other hand, Trump is probably outmatched in defining the virtues of Christianity against Francis I, if only in view of the Pontiff's relative strength in speaking for 1,900+ years of generally continuous ecclesiastical tradition on the behalf of Christianity's largest sectarian body.  What seems critical to me, in this regard, is the degree to which this Pontiff, for all of his apparent leftist political slant in advocating openness toward migrants fleeing poverty and violence, criticizing the global distribution of wealth in advanced industrial/post-industrial economies and the reproduction of abject poverty in developing economies, and calling for a serious global response to climate change, can command the moral reprobation of Trump by American Christians, particularly evangelicals, as an innate transgressor of true Christian love.  If, on the one hand, a fair number of Trump's faithful supporters will simply disregard any detractors, no matter what ecclesiastical authority they muster, then, on the other hand, who else do Christian voters in the Republican primaries get to turn to?  Ted Cruz, an evangelical who wants to carpet bomb Syria and also wants to build a border wall, supplemented by "bio-metric tracking?"  Ben Carson, an evangelical who believes that the Founding Fathers never intended to enable a Muslim to serve as President and argues that the Jewish Holocaust could have been prevented if only German Jews had armed themselves?  What about Marco Rubio, a Catholic who also apparently attends evangelical Baptist services and rejects Francis' Papal indictments of the evils of rampant economic inequality as statements external to the Pontiff's authority to speak on matters of moral and spiritual significance?  In the end, Republican Christian voters will, in a spirit befitting of the individualistic overtones of the Reformation, have to decide for themselves whether any of these candidates adequately reflects their own understandings of what Christianity stands for, regardless of what a Catholic Pontiff has to say on the subject, and, for that matter, whether authentic Christian values constitute an important criterion in deciding who should represent their party in the general election.

The Coming Battle over the Supreme Court in the Wake of Scalia's Passing

To be brief on an issue that is certainly going to degenerate into a national political obsession in a Presidential election year when both the leftist fringe of the Democratic Party and the rightist fringe of the Republican Party are gaining traction in early primaries and polling, the sudden passing of Justice Scalia, the most principled constitutional conservative on the present Supreme Court and one of the Court's most influential conservative voices in its history, throws a definitive wrench into the Court's present session.  Emphatically, the Roberts Court's ongoing assault on the Voting Rights Act of 1965 and progressive enfranchisement of marginalized electoral blocs, more generally, beginning with the Shelby County case and represented in this session with the case of Evenwel v. Abbott, challenging the definition of "one person, one vote" in drawing legislative districts in Texas, may be over, provided any incoming jurist to the Court cannot be counted as an opponent of liberal voting rights.  Likewise, it seems improbable that the Court can now overthrow the mandatory payment agency fees in lieu of union dues charged to non-union public school teachers in California for the service of contract negotiation by teachers' unions, the case in Friedrichs v. California Teachers Association.  Public sector unions and agency shops with agency fees as an alternative to union membership are likely to both be spared a major defeat at the hands of the Court.  Finally, it seems likely that Zubik v. Burwell, a case involving an accommodation for non-profit religious affiliated employers by the U.S. Department of Health and Human Services (HHS) in the administration of the Patient Protection and Affordable Care Act's (ACA) requirement of women's reproduction service provisions within minimum acceptable insurance coverage, in which the Third Circuit held that HHS' accommodation did not violate the religious freedom of non-profit Catholic charitable organizations, will result in no change to administration of the ACA to non-profit religious affiliated employers.  All of the above cases are apt to result in ties between the Court's four liberal justices (Breyer, Ginsburg, Sotomayor, and Kagan) and three remaining conservative jurists (Chief Justice Roberts, Alito, and Thomas) plus the swing libertarian (Kennedy).  As a consequence, lower court decisions that were likely to be overturned within the Supreme Court will remain in effect.
           On the contrary, Scalia's passing is unlikely to affect the Court's decision in its rehearing of Fisher v. University of Texas at Austin, a case involving racial preferences in college admissions, because Justice Kagan is recusing herself from this case, with which she was actively involved as U.S. Solicitor General prior to nomination to the Court.  It would seem probable to me that any decision made by the Court in this case, with a four to three conservative/libertarian majority, would be limited in effect to the particular racial admissions preference in question rather than issuing a broader decision to strike down affirmative action policies in college admissions on a nationwide scale.  The latter alternative in a period that has seen the development of the Black Lives Matter movement and an accentuation of African-American activism in the name of racial equality, per se, would be an unqualified partisan bombshell, and Chief Justice Roberts is too politically savvy to allow such a majority opinion to be issued.  Likewise, the Fifth Circuit Court's injunction against the Obama administration's Deferred Action for Parents of Americans (DAPA) program, allowing certain categories of undocumented immigrants to obtain legal alien status, in the case of United States v. Texas, is likely to stand if, as expected, the Court ties four to four.  Lastly, it seems at least possible that the Court, by a four to four tie, will allow a Fifth Circuit Court decision to stand in Whole Woman's Health v. Hellerstedt, a case in which a women's health clinic performing abortion procedures contrary to newly established statutory limitations by the state of Texas filed suit claiming that requirements mandating that doctors performing abortions must have admitting privileges at a nearby (within 30 miles) hospital and that clinics performing abortions must meet standards for an ambulatory surgical facility effectively operate to reduce the availability of facilities capable of performing abortions without palpably advancing the health of women as the stated intention of the law.  However, Justice Kennedy remains a potential swing vote in the case favoring stricter scrutiny of statutory enactments limiting access to abortion procedures and otherwise contravening the established precedence of Roe v. Wade, linking the decision to abort a pregnancy to an implicit right to privacy on reproductive decisions in the U.S. Constitution and limiting the authority of state legislatures to prohibit abortion before the point of fetal viability.  Assuming Justice Kennedy sides with the liberals on the Court, the Fifth Circuit's decision that the Texas statute in question effectively satisfies a rationality standard in advancing the interests of women's health would be vacated.  Justice Scalia's presence on the Court would have been insufficient to prevent such an outcome.
               Acknowledging the potential impacts from Justice Scalia's absence from the Court for the remainder of this term, it remains possible that a vacant seat will remain for the October 2016 term if President Obama either avoids nominating a replacement or is blocked from doing so through the Senate's approval process.  In this respect, Obama has made it clear that, with eleven months remaining in his second term, he has no intention of leaving the Court to function with eight justices.  On the other hand, both Senate Majority Leader Mitch McConnell (R-Kentucky) and Judiciary Committee Chairman Charles Grassley (R-Iowa) have no intention of allowing President Obama to appoint a replacement justice.  As such, the field of battle over the fate of the U.S. Supreme Court is forming around the Constitutional responsibilities of the President to appoint federal jurists, including Supreme Court justices, and those of the Senate to approve Presidential appointments.  Insofar as the continuity of a conservative majority and the broader policy issues likely to emerge as judicial questions over the next decade are at stake, it stands to reason that Senate Republicans and Republican Presidential candidates would want to insist that Scalia be replaced by the next Presidential administration.  Such a demand amounts to a complete abdication of the Constitutional responsibilities of the executive and legislative branches of the federal government regarding their roles in determining the composition of the federal judiciary, as a whole, and of the Supreme Court, in particular.  The American polity has a right to demand that its elected President and its elected Senators follow their prescribed Constitutional duties in order to ensure that federal judiciary can do its job.
             If, as expected, Obama nominates D.C. Circuit Court judge Sri Srinivasan, a moderate jurist of South Asian origin educated at Stanford University, to fill Scalia's seat, then, especially in a Presidential election year in which the Republican Party's slate of Presidential candidates appears to be sliding unremittingly to the right (with the possible exception of John Kasich who is liable to depart after Super Tuesday), it may be in the best interest of Senate Republican leaders just to swallow the appointment as a bitter pill under circumstances where they could have fared much worse.  If they attempt to block Srinivasan, then they will be forced to confront the criticism of blatant obstructionism from Senate Democrats and from the eventual Democratic Presidential candidate.  Moreover, it will become an issue in numerous contested Senate races that could threaten the Republican Senate majority.  With all this in mind, the idea that Obama might go out in left field, nominating a distinguished and vigorously partisan liberal Constitutional scholar, amounts to lunacy.  Obama, himself, is too politically savvy not to recognize that he has an ideal opportunity to either decisively change the character of Constitutional jurisprudence in the high court with the appointment of an effective centrist or to hammer home the last nails in the Republican coffin for the 2016 elections.        
           

The Fatal Non-existence of Sanders' Foreign Policy

Following from my previous post as well as from Hillary Clinton's well-grounded criticisms, Bernie Sanders is a single-issue economistic candidate.  His candidacy is dogmatically oriented toward a renewal of the promises of the New Deal without an apparent corresponding realization that, as the most powerful nation on earth, both economically and militarily, we have a responsibility to defend common humanity and project an ethical commitment to create a more democratic world through engaged and aggressive diplomatic action and, if necessary and imperative, the muscular utilization of American military might to achieve changes that diplomacy cannot otherwise achieve.  A Sanders administration would have to both rigorously define the meaning of a principled and engaged progressive foreign policy, grounded in secular democracy, economic integration on fair and equitable terms for all participating parties, common concern for the maintenance of ecological sustainability by all nations, and respect for the basic dignity of human life and human freedom, and demonstrate its commitment to act in the name of realizing a world corresponding the terms of such a policy.  That is not to say that a Sanders administration should establish a new, more humanitarian American imperium, but, on the contrary, we need to engage as one voice among many in a broader transnational conversation about how human civilization is to evolve and transform itself around common needs and concerns in the Twenty-first century, and we can be a critical participant in assuring that such a conversation happens.
           Climate change is a very large and pressing issue to the global human community and will so remain into the future.  A Sanders administration might attempt to lead on this ground, but, fundamentally, the capacity of the U.S. to leverage a convincing perspective on global ecology is presently undermined by the incapacity of progressives to achieve meaningful changes in the U.S. economy, oriented toward sustainability.  Changes to carbon emission thresholds attempted by the Obama administration pursuant to the Clean Air Act are currently being challenge in the federal judiciary and, notwithstanding the passing of Justice Scalia and the absence of his conservative voice in the Supreme Court, it seems unlikely that the administration will be able to effect permanent changes without legislative enactments.  Such enactments will not make it through a Republican controlled Congress.  In this sense, it is hard to lead globally on the issue of climate change when the U.S. federal government has one hand tied behind its back!
              Pointedly, at the present, Syria, the rise of the Islamic State, and the role of sectarian politics across the Middle East (most notably the proxy war being waged between Iran and Saudi Arabia in Syria, Iraq, and Yemen) remains the most pressing issue in foreign security policy and Sanders appears utterly clueless about it!  This point is not shocking - Sanders' prominent base of support really doesn't want to spend any time thinking or discussing foreign policy toward the Muslim world.  Circumstances that truly and emphatically demand a muscular American response tend to leave a bitter taste in the mouths of most American progressives.  The idea, expressed by Sanders at the last Democratic debate in Wisconsin, that there might be room in the Department of Defense budget to facilitate some cutting, however true in certain ways, is most unhelpful to this conversation.  Rather, if a Sanders administration is to have a meaningful impact on the world in which it is situated, then it will have to consider how the U.S. military is currently organized and institute changes in order to deal with divergent, heterogeneous threats to domestic security and deal better with punctuated regional threats to allies and to world peace, generally.  Some programs, vigorously defended as cash cows for local arms contractors in certain Congressional districts will have to be challenged.  Certain ideas, unpopular across the broader expanse of the American electoral, will have to be defended.  A Sanders administration, elected on economic grounds, would have to decide how many carrier groups and how many ballistic missile submarines the Navy needs in order to extend naval air power and leverage an undersea nuclear deterrent globally, how many nuclear capable bomber wings and how many heavy air mobility wings the Air Force needs, and how many active combat divisions and expeditionary forces the Army and Marine Corps need.  It would also have to jointly determine the cost effectiveness and the tactical necessity of particular military technological initiatives.  These are heady demands to be made of an administration elected to wage economic warfare against Wall Street and to deliver a single-payer health insurance system!
              On the specifics of Syria and Iraq, a Sanders administration would have to exercise a greater degree of diplomatic savvy to balance the divergent interests of nominal American allies (Saudi Arabia and Turkey), countenance the legitimate interests of rivals (Russia and Iran), and seriously engage with the needs of populations on the ground (Iraqi and Syrian Kurds, Sunnis, the Shi'a-dominated government of Iraq, the Alawites of western Syria, the Yazidis of northern Iraq).  Pointedly, at some point in the forthcoming administration, the U.S. may have to come to some definitive position regarding the sovereignty of Iraqi Kurdistan relative to the Shi'a dominated government in Baghdad.  How would a Sanders administration act in this regard?  Would defending the best interests of democratic sovereignty for the Iraqi Kurds fatally undermine our effort to defeat the Islamic State by crippling our relations with our NATO ally, Turkey, to say nothing of our relations with the Iraqi central government?  How do we deal meaningfully with the Syrian conflict as Russia becomes progressively engaged militarily in the Assad government's behalf and the flood of refugees from the country continues to destabilize the European Union and undermine the premises of the Schengen agreement on free movement within the EU?  These are issues that Senator Sanders needs to thoughtfully address on his road to the Democratic nomination if he seriously intends to be an American President.  At this point, Secretary Clinton is quite correct in her criticism that Sanders is not ready to engage in foreign policy and, therefore, not ready for the office that he seeks to win.