Politics 3-1

Politics 3-1...................................................................................................................................... 11nc.................................................................................................................................................. 2PC Key............................................................................................................................................ 5Key to Overall Bill........................................................................................................................... 6A2- McConnell says no................................................................................................................... 8A2- Comparmentalization...............................................................................................................9A2- Bottom of Docket................................................................................................................... 11A2- Winners Win........................................................................................................................... 12A2- Vote No.................................................................................................................................. 15A2- Intrinsicness........................................................................................................................... 16A2- Keystone Thumper................................................................................................................. 17A2- Immigration Thumper............................................................................................................19A2- Military Cuts Thumper...........................................................................................................202nc Heg Scenario......................................................................................................................... 22Heg Extensions............................................................................................................................. 242nc Pharma Scenario................................................................................................................... 25Pharma Extensions....................................................................................................................... 272nc Pharma Impact-Disease.........................................................................................................292nc Disease Scenario................................................................................................................... 312nc Bioterror Scenario.................................................................................................................33Bioterror Extensions..................................................................................................................... 342nc Biotech Scenario.................................................................................................................... 352nc Biotech Scenario—Biodiversity..............................................................................................37Tix Good....................................................................................................................................... 38pc = real....................................................................................................................................... 39

1ncIndependent Payment Advisory Board or IPAB passed the House and is going to pass the Senate- its bipartisan and has several Senators on board. IPAB is key to overall health carePecquet 2/29 (Julian Pecquet, The Hill Political Analyst who has covered the healthcare legislation since it was introduced, “Pressure is On Senate After House Kills Healthcare Law’s ‘Rationing Board’” http://thehill.com/blogs/healthwatch/health-reform-implementation/213513-pressure-is-on-senate-after-house-kills-rationing-board)The Senate is under increasing pressure to bring up legislation repeal ing a key part of President Obama’s

healthcare law. A House subpanel on Wednesday easily approved a measure to repeal a Medicare cost-cutting panel derided by Republicans as a “rationing board.” Two Democrats — including the panel’s ranking member —

crossed the aisle and joined Republicans in voting to nix the Independent Payment Advisory Board (IPAB). The lopsided 17-5 vote underscored the bipartisan support for repealing the board, which Obama has made the centerpiece of his efforts to reduce Medicare spending. It also provided evidence the legislation could have a shot at pass ing the Senate. Sen. John Cornyn (R-Texas) pounced after the House panel’s vote, arguing it’s time for Senate Majority Leader

Harry Reid (D-Nev.) to bring up his version of the repeal bill. “Given the bipartisan support in the House for repealing the IPAB, Sen. Cornyn is hopeful his Democrat colleagues in the Senate will support his bill,” Cornyn spokesman Drew Brandewei said.

No Senate Democrats had signed on as co-sponsors of Cornyn’s bill as of Wednesday, but many in the party would be in a tight spot if it came to the floor. A spokesman for Sen. Claire McCaskill (D-Mo.), who is facing a tough reelection race, said the senator

would take a “hard look” at the proposal if it ever came before the Senate. Calls about the repeal bill to the offices of vulnerable

Democratic Sens. Jon Tester (Mont.), Joe Manchin (W.Va.) and Sherrod Brown (Ohio) were not immediately returned by press time. The Medicare board is central to Obama’s healthcare reform law because it’s one of the few provisions aimed at reining in federal health costs. Far from endorsing its repeal, the president actually proposed strengthening the board’s powers last year. “Former [Congressional Budget Office] Director Robert Reischauer called IPAB a ‘big deal’ that ‘could generate substantial savings,’ ” White House Deputy Chief of Staff Nancy Ann

DeParle wrote in a blog post ahead of Wednesday’s Energy and Commerce Health subcommittee vote. “Hundreds of prominent economists, including three Nobel Laureates, agree that IPAB is an important component of the Affordable Care Act that will slow healthcare cost growth.” The provision in the health law that established the Medicare panel originated with Sen. Jay

Rockefeller (D-W.Va.) and was never popular in the House, where 17 Democrats are among the repeal bill’s 226 co-sponsors. As a result, the bill is expected to sail through the House, where a Republican leadership aide told The Hill the goal is to pass it in conjunction with Supreme Court arguments on the health law’s constitutionality. The House took its first step toward that goal with Wednesday’s vote, in which ranking member Frank Pallone Jr. (D-N.J.) and Rep. Edolphus Towns (D-N.Y.) joined Republicans to vote for repeal. Chairman Joe Pitts (R-Pa.) opened the repeal markup by arguing that the 15-member board would supplant lawmakers’ ability to shape Medicare policy. The board is tasked with recommending provider payment cuts if Medicare costs grow faster than a

targeted rate. Congress could propose its own equivalent savings with a simple majority vote or block the panel’s recommendations with a supermajority. The law prohibits the board from making any recommendations that would ration care, reduce benefits, raise premiums or cost sharing or alter eligibility for Medicare. Pitts, however, pointed out the term “rationing” is not defined anywhere in the law. “For example,” he asked, “is it rationing if IPAB slashes provider reimbursements to the point that doctors decide they can no longer see Medicare patients?” Democrats sought to gloss over their internal divisions by focusing their attacks on Republicans. Pallone suggested Republicans on the panel were hypocrites for framing their vote as an effort to protect Medicare when they all voted for last year’s House budget that would have replaced the program with subsidies for seniors to buy private insurance plans. Critics of the so-called

“premium support” proposal say it would shift costs from the federal government to seniors. “Last year,” Pallone said, “every single one of you

voted to end Medicare as we know it.” He said his vote in favor was aimed not at weakening the healthcare reform law but to “stop ceding legislative power to the executive branch.” Rep. Henry Waxman (Calif.), the top Democrat on the full committee, said the IPAB was nothing more than a useful “backstop” to impose some “discipline” on Congress to stop out-of-

control Medicare health spending. “We all hope the IPAB will be irrelevant. If the act works … it will be,” he said. “Let’s recognize today’s vote for what it is: an attempt to discredit the Affordable Care Act and embarrass the president.”

However, Obama is doubling down on the panel- steady capital and influence are key to block passageTurner 2/28 (Grace, Forbes Analyst of Health Care Policy, president of the Galen Institute, a non-profit research organization that focuses on market-driven health policy, “President Obama’s Dangerous New Medical Board,” http://www.forbes.com/sites/gracemarieturner/2012/02/28/president-obamas-dangerous-new-medical-board/)President Obama is doubling down on one of the most dangerous provisions in his 2010 health overhaul law. In his

proposed budget, he plans to give even greater powers to the I ndependent P ayment A dvisory B oard (IPAB), a panel

created by the new health law to contain Medicare spending. The IPAB is one of the most egregious parts of ObamaCare

because it puts rationing of care on auto pilot. A House subcommittee, chaired by Rep. Joe Pitts (R-PA), is expected to

vote today on a bill that would repeal the IPAB entirely. The Ways and Means Committee also will vote, and then it will go to the full House of Representatives for a vote, likely next month. After that, the legislation faces an uncertain fate in

the Senate, where Sen. John Cornyn (R-TX) just introduced an IPAB repeal bill. Opposition to the IPAB crosses party lines. Rep. Frank Pallone (D-NJ), the top Democrat on the Energy and Commerce Health Subcommittee that will consider the bill today, has said he has no interest in defending the board: “I’ve never supported it, and I would certainly be in favor of abolishing it.” The IPAB is to be composed of 15 appointed officials who will have the authority to make cuts in Medicare payments if per capita spending exceeds defined targeted rates. The U.S. Constitution gives the power of the purse to Congress so that elected representatives can be accountable to the voters for their decisions. The IPAB would turn this principle upside down. In

creating the IPAB, the president and Democrats in Congress wanted to take difficult decisions about cutting spending on Medicare out of the legislative process. In so doing, they gave unprecedented authority to unelected experts to make Medicare payment policy involving hundreds of billions of dollars and impacting tens of millions of seniors. The power is unprecedented because there is to be no judicial, administrative, or realistically, congressional review over its decisions. IPAB is supposed to take decisions outside the political arena so they are made by people less likely to feel the tug of popular opinion. Ironically, the tools available to the IPAB members are limited. The board cannot make structural recommendations to improve how Medicare operates. It is barred from making changes that would modernize the program’s outdated fee-for-service structure or change beneficiary incentives. While the law says the IPAB can try innovative approaches to modernize care, the Congressional Budget Office does not count these programs as achieving any meaningful cost savings. Because the IPAB will be required to make changes that demonstrate actual savings in a one-year time frame, the only tool the board will realistically have will be to cut Medicare payment rates for those providing services and medicines to beneficiaries. And the IPAB is even limited in the kind of spending it can cut. Between 2013 and 2020, the health law directs the IPAB to achieve its targets through payment reductions primarily in the Part D prescription drug program, Medicare Advantage, and skilled nursing facility services. Since the board is forced to reduce overall Medicare spending by focusing only on these relatively smaller segments of Medicare spending,

the cuts would have to be very deep to achieve overall per capita spending reductions. Access to care inevitably will be impacted . President Obama’s 2013 budget describes the IPAB as “ a key contributor to Medicare’s long-term solvency.” Specifically, the White House wants to lower the preset annual spending limit that Medicare has to hit before IPAB can kick in. And the administration calls for the creation of more cost-cutting “tools” for IPAB, including alterations to design benefits.

Expanding space exploration is perceived as controversial new spending -- guarantees backlash.Handberg, 11 - Professor and Chair of the Department of Political Science at the University of Central Florida (Rodger, “Small ball or home runs: the changing ethos of US human spaceflight policy,” The Space Review, 1/17, http://www.thespacereview.com/article/1759/1)The US space program remained focused , not on duplicating Apollo, but on achieving another difficult goal such as going to Mars, a logical extension truly of the Apollo effort. Twice, the presidents Bush provided the presidential

rationale, if not support, for achieving great things. The Space Exploration Initiative (SEI) in 1989 and the Vision for Space

Exploration (VSE) in 2004 were announced with great fanfare but neither survived the realities of congress ional and presidential budgeting . The VSE appeared on paper more realistic about funding, but its choices were draconian: the ISS and space shuttle were both to be sacrificed on

the altar of the new program. The earlier SEI died quickly, so hard choices were not required, while the VSE in the form of the Constellation Program lingers on although its effective demise appears certain. The

Obama Administration prefers another approach while the new Congress is likely more hostile to big ticket discretionary spending. If the Tea Party faction in the Republican House caucus means what it says, the future for Constellation or any other similar program is a dim one . The reality is that the Apollo program, the SEI, and the VSE are examples in space terms of the home run approach. Such efforts

confront the cruel but obvious reality that the human spaceflight program is considered by the public and most of Congress to be a “nice to have,” but not a necessity when compared to other programs or national priorities. Congressional support is narrow and constituency-driven (i.e. protect local jobs), which

means most in Congress only support the space program in the abstract. Big ticket items or programs are not a priority for most, given other priorities. What happens is what can be loosely termed normal

politics: a situation where human spaceflight remains a low priority on the national agenda. Funding for bold new initiatives is going to be hard to come by even when the economy recovers and deficits are under control. The home run approach has run its course at least for a time; now the small ball approach becomes your mantra.

The health care legislation is uniquely key to U.S. readiness in terms of recruitmentSenator Edward Kennedy, US Fed News, January 10, 2007Today's session is the first inquiry into this issue in the new Congress B but it will not be the last. In partnership with Senator Enzi, and with all our colleagues, we'll do our best to develop proposals on how best to see that the promise of this new century of the life

sciences reaches all Americans. Members of the House and Senate have a guaranteed health plan for ourselves and our families. It's time to provide the same guarantee for every man, woman and child in the nation. The stakes

couldn't be higher. Too many trends in health care are going in the wrong direction . Insurance

coverage is down. Costs are up. And America is heading to the bottom of the league of major nations in important measures of the quality of care . Ask people what keeps them awake most at night and many will tell you it's how to afford health care for their families. Ask companies what's high on their list of problems in trying to

compete in the global economy and they'll say it's the cost of health care. Even ask our military leaders how our troubled health care system affects recruitment and therefore our national security . They'll tell you that nearly 1 in 5 men and 2 out of 5 women of recruiting age are ineligible for military service because they’re obese . In family after family, community after community, business after business, citizens see our health care system struggling. They know that good, affordable care is less and less available.

Recruitment shortages destroy deterrence and risk hostile global challengersPERRY AND FLOURNOY, former secretary of defense and senior fellow at CSIS, 06 (William J Perry, Former Secretary of Defense, and Michele A. Flournoy, Senior Fellow at the Center for Strategic and International Studies, National Defense, “The US Military: Under Strain And At Risk,” – National Defense, May, http://www.nationaldefensemagazine.org/issues/2006/may/TheU.S.MilitaryUnder.htm)If recruiting trends do not improve during the next year, the Army, both active and reserve, will experience great difficulties. Few er than needed recruits and first-term re-enlistees could result in a significant “ hollowing ” and imbalance in the Army . There is already a deficit of some 18,000 personnel in the Army’s junior enlisted grades. Even if it meets its recruiting and retention goals, the Army is expected to be short some 30,000 soldiers — not including stop loss — by the end of fiscal 2006. The all-volunteer force is now in historically uncharted waters — fighting a protracted conflict with volunteers rather than draftees. What will happen if the current surge for Iraq becomes the steady state, and the Army and Marines are not resourced with the people, units and equipment they need for a long-term fight? When will the dedication and sacrifice of our troops run up against the needs of families and communities? Will they vote with their

feet? Most of our active duty military has chosen to stay in the force after one or even two tours, but it is reasonable to fear that after a third year-long deployment in a compressed period, many will choose to leave the force.

Many senior military officers who lived through the Vietnam era and its aftermath believe that if significant numbers of senior non-commissioned officers and field grade commanders begin to leave the force, this could set off a mass exodus and lead to a “hollowing out” of the Army. Meanwhile, the United States has only limited

ground forces ready to respond to contingencies outside the Afghan and Iraqi theaters. As a global power with global interests, the U nited

S t ates must be able to deal with challenges in multiple regions of the world simultaneously. If the Army were ordered to send significant forces to another crisis today, its only option would be to deploy units at readiness levels far below what operational plans would require. As stated rather blandly in one Defense Department presentation, the Army “continues to accept risk” in its ability to respond to crises on the Korean Peninsula

and elsewhere. The absence of a credible, sizable strategic reserve increases the risk that potential adversaries will be tempted to challenge the U nited States. Although the United States can still

deploy air, naval, and other more specialized assets to deter or respond to aggression, the visible overextension of our ground forces could weaken our ability to deter aggression .

Readiness is critical to prevent global warSpencer, 2000 (Jack, Research Fellow at Thomas A. Roe Institute for Economic Policy Studies, “The Facts About Military Readiness”, Heritage Foundation, September 15th, http://www.heritage.org/Research/Reports/2000/09/BG1394-The-Facts-About-Military-Readiness)

America's national security requirements dictate that the armed forces must be prepared to defeat groups of adversaries in a given war. America, as the sole remaining superpower, has many enemies. Because attacking America or its interests alone would surely end in defeat for a single nation, these enemies are likely to form alliances . Therefore , basing readiness on American military superiority over any single nation has little saliency. The evidence indicates that the U.S. armed forces are not ready to support America's national security requirements. Moreover, regarding the broader capability to defeat groups of enemies, military readiness has been declining. The National Security Strategy, the U.S. official statement of national security objectives,3 concludes that the United States "must have the capability to deter and, if deterrence fails, defeat large-scale, cross-border aggression in two distant theaters in overlapping time frames."4According to some of the military's highest-ranking officials, however, the United States cannot achieve this goal. Commandant of the Marine Corps General James Jones, former Chief of Naval Operations Admiral Jay Johnson, and Air Force Chief of Staff General Michael Ryan have all expressed serious concerns about their respective services' ability to carry out a two major theater war strategy.5 Recently retired Generals Anthony Zinni of the U.S. Marine Corps and George Joulwan of the U.S. Army have even questioned America's ability to conduct

one major theater war the size of the 1991 Gulf War.6 Military readiness is vital because declines in America's military readiness signal to the rest of the world that the U nited S tates is not prepared to defend its interests . Therefore, potentially hostile nations will be more likely to lash out against American allies and interests, inevitably leading to U.S. involvement in combat. A high state of

military readiness is more likely to deter potentially hostile nations from acting aggressively in regions of vital national interest, thereby preserving peace.

Repeal Imminent

Conservatives hold the upper hand in health care- funding and physician supportCantlupe 3/1 (Joe Cantlupe, Healthleaders Media, http://www.healthleadersmedia.com/content/PHY-277222/Healthcare-PACs-Tilt-Toward-GOP)Physicians and others in healthcare are flooding GOP coffers with money for congressional and senate campaigns. And individual healthcare contributors are giving more money to President Obama than each of the Republican candidates. Confusing? How about this? Some of the heavyweight physician political action committees (PACs) obviously are interested in the outcome of the presidential race. But they don't funnel a dime into the presidential campaigns. Yes, it's political season, and contradictions litter the landscape. The political spending this time around comes while physicians' diagnoses of the healthcare business in America isn't great. That's reflected in the HealthLeaders Media Industry 2012 survey (PDF) which shows that at least 53% of physician leaders say that healthcare is on the wrong track. And 36% say that government is to blame for the healthcare industry mess, with 26% saying government laws and mandates are among the top three drivers of healthcare costs. That's a lot of dissatisfaction in the wake of the healthcare reform initiated by President Obama. Those complaints are reflected in funding choices revealed in healthcare campaign financing reports—particularly among physician PACs—filed with the Federal Election Commission. Some 97 healthcare professional PACS, which include physician organizations, have contributed $8.9 million to federal campaigns, with $5.2 million (59%) directed to Republicans and $3.6 million (41%) to Democrats, according to FEC figures released this month and compiled by the Center for Responsive Politics, and reviewed by HealthLeaders Media. The center is a non-partisan, non-profit group based in Washington D.C. that tracks campaign spending.

PC KeyObama and White House capital is being used but steady influence is neededGellner 2/29 (Raymond Gellner, Examiner Political Analyst, “GOP will weaken Medicare if they kill Affordable Care Act’s IPAB” http://www.examiner.com/liberal-in-national/gop-will-weaken-medicare-if-they-kill-affordable-care-act-s-ipab#ixzz1ntWrXTUa)In her White House blog on Wednesday, Deputy White House Chief of Staff Nancy-Ann DeParle reinforced the need to stop Republican lawmakers in their attempts to disband the A ffordable C are A ct ’s Independent Payment Advisor Board (IPAB), stating that the GOP alternative will significantly weaken Medicare and make insurance companies the health care deciders for millions of senior citizens. According to DeParle’s blog the IPAB will consist of a panel of doctors, consumers and patient advocates who will give recommendations to Congress on ways to keep costs in check while protecting and strengthening benefits for patients. Backward steps the GOP would implement, should their Medicare initiatives pass, include: a rationing of health care, an increase in premiums (according to an analysis by the Congressional Budget Office), a lack of control in health care costs, and insurance company control of medical care to seniors based upon corporate P&L statements. In comparison measures being set in place by enactment of the Affordable Care Act’s IPAB will: ensure patient control of their medical plan and procedures with guidance from their personal physicians, lower Medicare costs over the long term according to Nobel prize-winning economists and the CBO, and make sure that patient care is

not rationed. DeParle wrote, “Rather than revisiting the past and trying to repeal the Affordable Care Act , Congress should work on strengthening Medicare and creating jobs .” The IPA B is a critical part of the Patient Protection and Affordable Care Act which passed Congress and signed into law by President

Barack Obama in March 2010. During the fight for passage of the health care reform law, Nancy-Ann DeParle was the White House Office of Health Reform Director.

Even with the veto pen Obama still needs capital- massive amounts of support will rise up against himGlass 2/29 (Kevin Glass, Political analyst and managing editor of townhall.com, “House Subcommittee Votes to Repeal IPAB” http://townhall.com/tipsheet/kevinglass/2012/02/29/house_subcommittee_votes_to_repeal_ipab)A bipartisan vote in the House of Representatives moved to repeal a controversial Medicare- cutting provisio n contained in Obamacare . The 17-5 vote means that the legislation will move on to the House floor and sets up a showdown with the Senate over the legislation. The Independent Payment Advisory Board, which would become a panel of bureaucrats tasked with holding down Medicare costs, has been a lightning rod of controversy ever since Obamacare was first proposed. It has been derided by both Republicans and Democrats and even fueled part of Obamacare's "death panel" controversies. One of the primary complaints about IPAB is its unaccountable nature - the bureaucrats would be appointed by the President and its recommendations about health care cuts would be nearly impossible to override by Congress. Even hard-Left Democrats like Barney Frank, Loretta Sanchez and Pete Stark have derided IPAB. IPAB's mission in cutting Medicare might be nigh-impossible. The board was tasked with cutting costs without touching some very big-spending parts of Medicare, and the savings are going towards big spending in other parts of Obamacare. It's politically toxic (see the number of Democrats supporting its repeal) and would likely fail even in the event it was kept in its current form. It's no wonder it's been targeted for attack. Even in the event that both the House and Senate pass an IPAB repeal bill, it would have to be with massive amounts of support , because Obama would surely wield his veto pen . Nonetheless , it'd be a minor hit to Obama's popularity, as he'd be forced to support, in a high profile way, one of the most controversial parts of his landmark health care legislation. And one gets the feeling that's what Republicans are going for no matter what.

Capital was key to the healthcare bill- its key to saving it tooWashington Times 09 (http://washingtontimes.com/news/2009/jun/12/obama-takes-plan-on-the-road/)As lawmakers on Capitol Hill move closer to hammering out the make-or-break details, Mr. Obama used his own formidable political capital to push the reform effort forward, after taking a side last week on one of the debate's two most controversial issues.

All of Obama’s capital is needed- health care isn’t a joke

Washington Post 09 (http://www.washingtonpost.com/wp-dyn/content/article/2009/02/04/AR2009020403047.html)But I honestly don't think this change in personnel will have much of an effect on Obama's strategy for passing health care reform. Doing so was always going to be difficult , requiring all of Obama's political skills, a big investment of political capital and a willingness to mobilize the public behind the proposed plan. Switching Daschle for, say, Sebelius, changes none of that. If anything, the Daschle episode should underscore that the battle for health care reform will be a political fight played out in the public arena, not a backroom deal made among old Washington hands.

Key to Overall BillIPAB is key to the entire health care bill- Nobel Prize winners and health care policymakers guarantee itDeparle 2/29 (Nancy, Deputy White House Chief of Staff, “Making Medicare Stronger” http://www.whitehouse.gov/blog/2012/02/29/making-medicare-stronger)Over the past few years, health care cost increases have been slowing – both for Medicare and private health care.

And both CBO and Medicare estimate that cost increases are slowing. Despite these encouraging trends, there is much more we need to do – both to reduce costs and strengthen the Medicare program for future generations and to

improve health care quality so patients get the best care possible. Achieving these goals takes serious work. That’s why the Affordable Care Act is designed to learn from the best health systems and experts in the country to find better ways to improve health care. Under health reform, we will reward doctors and hospitals that focus on spending time with patients, that better coordinate care, and that improve the quality of care patients are receiving while

lowering costs. Health reform also establishes the Independent Payment Advisory Board (IPAB). IPAB will be composed of fifteen experts including doctors, consumers and patient advocates who will be recommended by Congressional leaders, nominated

by the President, and confirmed by the Senate. It will recommend policies to Congress to help Medicare provide better care at lower costs. Congress could pass these or other changes to strengthen Medicare. Starting in 2015, if Medicare cost growth per beneficiary exceeds a growth rate target, IPAB recommendations would take effect only if Congress fails to act. Today, Congressional Republicans are working to repeal and dismantle the Independent Advisory Board

before it even gets started even though experts like former Bush Administration Medicare Officia l Mark McClellan called for “[strengthening] and [clarifying] the authority and capacity of the Independent Payment Advisory Board

(IPAB).” And a coalition of economists including Nobel Prize Winners said “…the Affordable Care Act contains essentially every cost-containment provision policy analysts have considered effective in reducing the rate of medical spending. These provisions include …An I ndependent Payment Advisory Board with

authority to make recommendations t o reduce cost growth and improve quality withi n both Medicare and the health system as a whole” At the same time, House Republicans passed a plan for Medicare last year that does nothing to reduce overall health care costs. Instead, the Republican plan shifts costs to seniors and empowers insurance companies. Below is a table on how the Republican plan and IPAB compare. Rather than revisiting the past and trying to repeal the Affordable Care Act,

Congress should work on strengthening Medicare and creating jobs.

IPAB is the only way to guarantee health care funding- other mechanism don’t workBeutler 2011 (Brian Beutler, TPM's senior congressional reporter. Since 2009, he's led coverage of health care reform, Wall Street reform, taxes, the GOP budget, the government shutdown fight, and the debt limit fight. “GOP Sens Threaten to Block Key Element of Health Care Law” May 24,2011, http://tpmdc.talkingpointsmemo.com/2011/05/republicans-threaten-to-squash-democrats-most-promising-debt-reduction-tool.php)Senate Republicans are preparing to foreclose on the Democrats’ single best hope for addressing the country’s structural deficit without shifting a huge cost burden on to seniors and other Medicare beneficiaries. It’s a testament to the deep division between the parties on the key driver of future U.S. debt — which might not matter if debt wasn’t the high-stakes issue du jour in Washington. Broadly speaking, there are two competing schools of thought about how best to reduce federal Medicare spending. One version works much like the House GOP budget’s Medicare privatization plan — it involves capping overall Medicare spending, and outsourcing the financing of seniors’ health care to private insurers. This shifts a significant cost on to seniors themselves, but Republicans like the idea for two reasons: (1) It reduces federal spending by fiat; and (2) It rations health care via the private sector — based on what services seniors think they’ll need, and what services insurers will agree to pay for. The

Obama administration’s alternative is a gentle twist on government rationing. It preserves Medicare as a single-payer system but shaves off waste -creating incentives so that over time the provision of care to beneficiaries is more affordable, more efficient, more research-based than it is now

without explicitly “rationing” by declining more services over time. Or at least that’s the goal. And that’s where the Independent Payment Advisory Board comes in. It’s the most promising of the many new cost-cutting initiatives created by President Obama’s health care law. IPAB will be tasked with implementing new ways to reduce Medicare spending, and, though its powers are limited in several key ways — for instance, it’s explicitly forbidden to “ration” health care —

its recommendations take effect almost automatically.

Even if IPAB is bad policy it’s still key to the bill- no fall back mechanism existsMorrisey 2/29 (Ed, HotAir Political Analyst, “Bipartisan vote in the subcommittee to kill IPAB” http://hotair.com/archives/2012/02/29/bipartisan-vote-in-house-subcommittee-to-kill-ipab/)While efforts continue at the Supreme Court to get the individual mandate in ObamaCare declared unconstitutional and the entire law thrown out, a House committee voted on a bipartisan basis to kill its so-called “death panel.” On a 17-5 vote that included two of the senior Democrats on the Health subcommittee of Energy and Commerce, the motion to repeal the

Independent Payment Advisory Board will move to the full committee and almost certainly to the House floor: Bipartisan legislation to repeal the healthcare law’s cost-control board sailed through a House panel on Wednesday, raising pressure on the Senate to take up the bill and dealing President Obama a political blow. The Energy and Commerce Health subcommittee vote was 17-5, with ranking member Frank Pallone Jr. (D-N.J.) and Rep. Edolphus Towns (D-N.Y.) crossing the aisle to vote for repeal of the Independent Payment Advisory Board. There were no amendments. They weren’t the only Democrats favoring a repeal, either: Rep. Lois Capps (D-Calif.) said she favors getting rid of the board but wouldn’t because the repeal bill offered no alternative for controlling Medicare costs and wasn’t paid for. Capps’ argument cuts to the heart of the issue. The IPAB is a critical component in ObamaCare’s claims of cost control, one that we have discussed here at Hot Air on a number of occasions over the last two years. The panel of fifteen unelected and unaccountable bureaucrats would essentially ration Medicare funds, deciding on which care to approve or reject. Congress would have to overturn IPAB decisions by a supermajority vote to keep them from going into effect rather than having a panel present recommendations for Congressional action.

A2- McConnell says noMcConnell’s lack of backbone doesn’t matter- conservatives won’t let him off the hook and his past rhetoric guarantees he will go after itPecquet 2/29 (Julian Pecquet, The Hill Political Analyst who has covered the healthcare legislation since it was introduced, “Conservative Group to McConnell: Press Health Law Repeal or Resign as Leader” http://thehill.com/blogs/healthwatch/politics-elections/213665-conservative-group-ready-to-call-on-mcconnell-to-resign-leadership-position-over-healthcare-repeal-comments)Sen. McConnell said GOP lawmakers were all on record opposing the healthcare law and a new vote would accomplish nothing. A conservative group dedicated to the repeal of President Obama's healthcare reform law said Thursday that Senate Minority Mitch McConell (R-Ky.) should resign his leadership post if he's not willing to press for a repeal vote in the Senate. The Hill reported Thursday that McConnell told his conference this week that he does not want to vote again on repealing the law until after the November elections. In response, the conservative Restore America's Voice Foundation said it would "unleash" its 2.3 million activists to call for McConnell's resignation if he doesn't retract his comments. "Senator McConnell must disavow the statement attributed to him today in The Hill, suggesting that he does not have the will or the backbone to force a floor vote by the United States Senate to repeal ObamaCare," foundation Chairman Ken Hoagland said in a statement. "If this alleged statement is true and Senator McConnell refuses to retract it, he is going against the will of the American people and the repeal they have demanded since the day this monstrous law was rammed through Congress." Hoagland is also chairman of the foundation's RepealItNow.org project, which delivered 1.6 million petitions to Congress last October demanding further votes to repeal the law. Former Arkansas Gov. Mike Huckabee is a spokesman for RepealItNow.org. The Hill has reached out to Huckabee to see if he also thinks McConnell should resign but has not yet heard back. All 47 Republican senators voted to repeal the law last February. At the time, McConnell said "this fight isn't over" and vowed to seek additional votes for repeal. This week, however, he told his conference that lawmakers were all on record on where they stood and that a new vote wouldn't accomplish anything. Instead, he said Republicans should focus their efforts on gas prices and the economy.

A 2- Comparmentalization At the top- issue’s are compartmentalizes assumes politicians have already made up their mind- our uniqueness proves certain senators are on the fence which means political capital key-

Yes vote switching—even due to unrelated legislationSimes and Saunders ‘10 – *publisher of the National Interest, **Executive Director of The Nixon Center and Associate Publisher of The National Interest, served in the State Department from 2003 to 2005 (12/23, Dimitri and Paul, National Interest, “START of a Pyrrhic Victory?”, http://nationalinterest.org/commentary/start-pyrrhic-victory-4626, WEA) Had the lame-duck session not already been so contentious, this need not have beena particular

problem. Several Senate Republicans indicated openness to supporting the treaty earlier in the session, including Senator Lindsey Graham and Senator John McCain. Senator Jon Kyl—seen by many as leading Republican opposition to the agreement—was actually quite careful to avoid saying that he opposed New START until almost immediately prior to the vote. Our own

conversations with Republican Senate sources during the lame duck session suggested that

several additional Republicans could have voted to ratify New START under other circumstances; Senator Lamar Alexander is quoted in the press as saying that Republican anger over unrelated legislation cost five to ten votes. By the time the Senate reached New START, earlier conduct by Senate Democrats and the White House hadalienated many Republicans who could have voted for the treaty.That the administration secured thirteen Republican votes (including some from retiring Senators) for the treaty now—and had many more potentially within its grasp—makes clear what many had believed all along: it would not have been so difficult for President Obama to win the fourteen Republican votes needed for ratification in the new Senate, if he had been prepared to wait and to work more cooperatively with Senate Republicans. Senator Kerry’s comment that “70 votes is yesterday’s 95” ignores the reality that he and the White House could have secured many more than 70 votes had they handled the process differently and attempts to shift the blame for the low vote count onto Republicans.

And START proves political capital true- Republicans even switched sidesAnnen ’11 (NielsAnnen, “Ratification of New START a Great Success for Obama”, http://www.social-europe.eu/2011/01/ratification-of-new-start-a-great-success-for-obama/, April 1, 2011, LEQ)

There were a variety of reasons for Republicans to oppose the ratification of New START. For minority leader Mitch McConnell, for whom the majority for START symbolised the first blow to his leadership, it was all about withholding any success from the President and essentially continuing the strategy that added 63 new members to the Republican caucus in the midterm elections. Others like Kyl simply seemed to have overplayed their cards in assuring more federal money for their districts. However, the only political argument against New START should not be ignored, as the right wing critique of the treaty is not that much about the details, but about the very idea to sign a treaty at all. Because of Russia’s fading weight, Moscow is increasingly seen as a neglectable factor that does not deserves that much attention. ‘They’re looking at the Cold War, but the Cold War is over. They’re failing to look at the future’, Republican Senator Shelby said and advised the President to deal with Iran and North Korea

instead of negotiating with Russia. Obviously these arguments did not resonate with everybody within the Republican caucus. In a remarkable maneuver, the White House added 13 Republicans to a unanimous Democratic caucus, surpassing the necessary number of 67 votes that are needed to ratify the treaty. ‘When it’s all going to be said and done, Harry Reid has eaten our lunch,’ Alabama Senator Lindsay Graham said after the vote, referring

to the reelected Democratic majority leader. Indeed, Obama‘s success is remarkable, especially given the fact that the GOP over the course of the last two years has been blocking almost every initiative that came out of Pennsylvania Avenue 1600, effectively destroying Obama‘s message as a unifying political force that so well resonated with independent voters in 2008. However important this political victory may be, what’s really noteworthy about this vote is the President‘s dedication to a crucial foreign policy initiative like New START, knowing that this is not resonating well with a constituency preoccupied with high

unemployment. In putting his shrinking political capital behind New START, Obama showed a remarkable example of leadership. When in 2009, the Nobel Committee in Oslo awarded him with the Peace Prize, its chairman ThorbjornJagland defended his decision with the argument that he wanted to encourage Obama to keep course after his Prague speech: ‘It was because we would like to support what he is trying to achieve’. It seems that Mr. Jagland has not been disappointed.

Spillover is real – Obama is intimately involved in dealmakingSchier 10 – Congdon professor of political science at Carleton College and author of the award-winning "Panorama of a Presidency: How George W. Bush Acquired and Spent His Political Capital" (Steven E, 2/11. “Obama can learn from predecessors,” Politico.com, Lexis.)

Unlike Bush, Obama pushes a vast agenda, reflecting his campaign pledge to do a lot at once, and unlike Bush, Obama's tactical approach to Congress is remarkably nondirective. The signal example of this is the health care bill, in which he spent months giving mere suggestions about its content as congressional sausage-making proceeded.

The public distrusts Congress and rejects the tawdry deal making that accompanies its work. Presidents do well to "hover above" such matters . The best way to do that is by laying down clear

substantive preferences and avoiding a public reputation as just one of the several deal makers. Obama failed to do this in his first year, and his popularity suffered as a result.

Obama’s style guarantees spillover – party lines don’t stay strictReardon 9– Professor, USC Marshall School of Business (Kathleen, 3/24. “What to Do Before the Hope Bubble Bursts.” http://www.huffingtonpost.com/kathleen-reardon/what-to-do-before-the-hop_b_178737.html)

Barack Obama, despite the massive problems he faces, is a popular president. Some of it may be the honeymoon of the first one hundred days, though these weeks have hardly deserved the term. It may be his infectious smile and determination and his tendency to come to us rather than to stay within the

beltway hunkering down as many Republicans want him to do. A good part of it may be that hope still lingers. On 60 Minutes Obama himself mentioned

"flickers" of it appearing lately in the economy, and that was before the Dow soared 500 points. But it may also be a phenomenon in persuasion,

which is that when people publicly commit to an action, they find it uncomfortably dissonant to change their minds. In short, many people who supported Barack Obama did so in very visible ways, often going against their political party, and they simply don't want to now believe or admit that they might have been wrong.

Third – limited political capital means spillover between issuesEdwards & Wood, 99 (George C. Edwards and B. Dan Wood – Professors of Political Science at Texas A&M, American Political Science Review, "Who Influences Whom? The President, Congress, and the Media," June, vol. 93, no.2, JStor, JMP) Examinations of presidential influence on the media's agenda have focused on the State of the Union message. Gilberg and his colleagues (1980) found that the president was not able to influence media stories in the month following the 1978 address. Nearly a decade later, Wanta and his colleagues (1989) reviewed four studies and found mixed results. In two instances the president influenced the media's agenda, but in two instances he did not. Even two studies of the same president, Ronald Reagan, produced different results. Although he did not focus on the media, Cohen (1995) found that the president was able to influence the public's agenda through State of the Union messages. An important aspect of a president's legislative strategy can be to influence

Congress's agenda. If the president is not able to focus congressional attention on his priority programs, these will become lost in the complex and overloaded legislative process . Gaining congressional attention is also important because presidents and their staff can lobby effectively for only a few bills at a time . Moreover, the president's political capital is inevitably limited , and it is sensible to spend it on the issues he cares about most . Thus, presidents try hard to set Congress's agenda. The conventional wisdom of the president's success is captured in Neustadt's observation (1991, 8): "Congressmen need an agenda from outside, something with high status to respond

to or react against. What provides it better than the program of the president?" Kingdon (1995,23) adds that "the president can single handedly set the agendas, not only of people in the executive branch, but also of people in Congress and outside the government."

A2- Bottom of Docket

The affirmative must defend immediate unconditional implementation of the plan:

-key to negative ground- every disad relies on a temporally sensitive uniqueness argument- delaying plan implementation kills all negative ground-No logical limit- every alternative to immediacy is arbitrary, allowing this choice to occur in the 2AC compounds the abuse- the affirmative gets infinite prep time to write the most strategic plan- allowing revisions after they have heard our strategy unlimits-Non topical- should is the present tense-Takes out solvency- the bottom of the docket is not guaranteed to ever get addressed, vote negative on presumption

A 2- Winners Win

Winners win not true for Obama – must be large, popular and on economic issueKuttner, 11 (Robert, co-founder and co-editor of The American Prospect, as well as a distinguished senior fellow of the think tank Demos, 5/16, http://prospect.org/cs/articles?article=barack_obamas_theory_of_power)

Obama won more legislative trophies during his first two years than Clinton did, but in many respects, they were poisoned chalices . Health reform proved broadly unpopular because of political missteps —a net

negative for Democrats in the 2010 midterm. The stimulus, though valuable, was too small to be a major political plus . Obama hailed it as a great victory rather than pledging to come back for more until recovery was assured. He prematurely abandoned the fight for jobs as his administration’s central theme, though the recession still wracked the nation. And because of the administration’s alliance with Wall Street, Obama suffered both the appearance and reality of being too close to the bankers, despite a partial success on financial reform. Obama’s mortgage-rescue program was the worst of both worlds—it failed to deliver enough relief to make an economic difference yet still signaled politically disabling sympathy for both “deadbeat” homeowners and for bankers. (See this month’s special report on page A1.)

Suddenly forcing bills doesn’t help. The aff overstretches and even Ornstein agreesOrnstein 9. [Norm, resident scholar at AEI, “Is Obama Too Weak In Dealing with Congress?” American Enterprise Institute -- July 8 -- http://www.aei.org/article/100731]

But even in a wonderfully functional Congress, achieving policy success in an area as difficult as this one would be a tough and uphill battle --no matter how skillful and popular a president may be . The same is true

of health policy. Presidents can and must engage , have to step in at crucial moments and shape outcomes, mediate disputes, and use the bully pulpit to push controversial or difficult policy decisions. But the history of presidents and Congresses shows that trying to do more--to go over the heads of Congressional leaders, to set a series of bottom lines and insist on them from party leaders and committee chairmen who find it easy to resist

White House pressure--rarely works unless we are neck deep, not just waist or chest deep, in a crisis. That has always been true, but is even more so today, when majorities have to be largely one-sided and a majority party (especially when it is the Democrats) has limited cohesion or homogeneity. The approach Obama has taken, cutting Congress a lot of slack and being supportive when necessary, led to a string of early and meaningful successes and enactments. True, the tough ones lie ahead. Finding any majority for any climate change bill in the Senate is even more challenging than it was to get a bill through the House. Finding any compromise between health bills that might make it through the House and Senate, pass fiscal muster, and be enacted into law is a tough slog. But I believe the approach the White House has used so far has actually been smart and tough-minded, not

simply expedient and weak. A successful president looks at the endgame, sees what is possible and maneuvers in the

best way to get to that endgame. If you can't get bills through committee, or you can't find a majority on the floor of either chamber , you get nowhere .

Spending too much corrupts the winYoungman 9. [Sam, White House correspondent, “Analysis: July has been disaster for Obama, Hill Dems” The Hill 7/27]Despite a number of former Democratic members and aides working in the Obama administration, Democrats on Capitol Hill have grown bolder in defying their party leader. Many centrist Democrats are worried that Republicans will have the upper hand in the

2010 elections. Paul Light, an expert on the presidency and a professor at New York University, said the president's problems with Capitol Hill reflect "a miscalculation by the Obama administration on how political capital gets spent in Washington." Light said that capital , even for a president who enjoys immense personal popular support like

Obama, is spent a bit at a time on each initiative or piece of legislation . "I think the Obama administration has been spending political capital at roughly the same rate the federal government spends money," Light said. "Eventually, it runs out." Light quoted President Lyndon Johnson, who said that "if you don't get it done in six months, you're not going to get it done." One of the reasons Obama has spent so much capital, aside from his ambitious agenda, has been his willingness to cede so much control to Congress, Light said. While lawmakers like Senate Majority Leader Harry Reid (D-Nev.) and House Speaker Nancy Pelosi

(D-Calif.) are allies of the president, his political capital is not necessarily a priority of theirs. To that end, Light says, Obama has made a mistake in making Pelosi his "broker," spending his political capital but not always to his benefit .

Obama can’t get a win in this contextDickinson 11. [Matthew, professor of political science – Middlebury, “Egypt, Iraq and the Limits of Presidential Power,” Presidential Power Middlebury Blog -- 2/10 -- http://blogs.middlebury.edu/presidentialpower/2011/02/10/egypt-iraq-and-the-limits-of-presidential-power/]

My point is not to defend Bush for acting on faulty intelligence, or to criticize the divisions within the Obama administration

regarding how best to respond to the Egyptian crisis. It is instead to point out something that is abundantly clear to anyone who spends even a modicum of time reviewing presidential archives pertaining to foreign policy decisions (as I have spent a good portion of the last decade doing): presidents may feel greater pressure to lead in foreign affairs, but their actual capacity to shape events in this sphere is distinctly limited – often more so than it is at home. And, as Bush’s memoir reminds, presidents certainly don’t feel any more powerful in the international arena compared to the domestic one. Indeed, the frustration is often greater in foreign affairs. This is in large part because, in contrast to the Wildavsky thesis, presidents are often acting on incomplete or even inaccurate information, and the foreign affairs (or national security) bureaucracy is no more monolithic or responsive to presidential direction than is its domestic counterpart. Indeed, the notion that the president is “in charge” of the national security bureaucracy and can use that authority to act

unilaterally in foreign affairs is, in my view, a dangerous perspective, in no small part because presidents quite naturally feel pressured to act on that misperception. The end result of such unilateral efforts is often a weakening of their power base . Already we are beginning to see an undercurrent of restlessness,

especially among progressives, wondering why Obama hasn’t acted more forcefully to push Mubarak out. (Presumably they believe there is a happy medium located somewhere between toppling a ruler through invasion versus watching and waiting – but this leaves a very very large grey area for U.S. intervention). We can’t be sure what behind-the-scenes steps

Obama is taking, of course, but the complaints are a reminder that even in foreign affairs, presidents are not as powerful as we think they are or that they might wish to be.

Obama thinks that pol cap is finite – he’ll back off controversial issues even if he’s winningKuttner 9. [Robert, co-editor of The American Prospect and a senior fellow at Demos, author of "Obama's Challenge: America's Economic Crisis and the Power of a Transformative Presidency, “Obama Has Amassed Enormous Political Capital, But He Doesn't Know What to Do with It,” 4/28 -- http://www.alternet.org/economy/138641/obama_has_amassed_enormous_political_capital,_but_he_doesn%27t_know_what_to_do_with_it/?page=entire]

We got a small taste of what a more radical break might feel like when Obama briefly signaled with the release of Bush's torture memos that he might be open to further investigation of the Bush's torture policy, but then backtracked and quickly asked the Democratic leadership to shut the idea down. Evidently, Obama's political self wrestled with his constitutional conscience, and won . Civil libertarians felt a huge letdown, but protest was surprisingly muted. Thus

the most important obstacle for seizing the moment to achieve enduring change: Barack Obama's conception of what it means to promote national unity . Obama repeatedly declared during the campaign that he would govern as a consensus builder. He wasn't lying. However, there are two ways of achieving consensus. One is to split the difference with your political enemies and the forces obstructing reform. The other is to use presidential leadership to transform the political center and

alter the political dynamics. In his first hundred days, Obama has done a little of both, but he defaults to the politics of accommodation.

Wins only build long-term capitalPurdum 10. [Todd, Columnist for Vanity Fair, “Obama Is Suffering Because of His Achievements, Not Despite Them,” 12-20 www.vanityfair.com/online/daily/2010/12/obama-is-suffering-because-of-his-achievements-not-despite-them.html]With this weekend’s decisive Senate repeal of the military’s “Don’t Ask, Don’t Tell” policy for gay service members, can anyone seriously doubt Barack Obama’s patient willingness to play the long game? Or his remarkable success in

doing so? In less than two years in office—often against the odds and the smart money’s predictions at any given moment—Obama has managed to achieve a landmark overhaul of the nation’s health insurance system ; the most sweeping change in the financial regulatory system since the Great Depression; the stabilization of the domestic auto industry; and the

repeal of a once well-intended policy that even the military itself had come to see as unnecessary and unfair. So why isn’t his political standing higher? Precisely because of the raft of legislative victories he’s achieved. Obama has

pushed through large and complicated new government initiatives at a time of record-low public trust in

government (and in institutions of any sort, for that matter), and he has suffered not because he hasn’t “done” anything but

because he’s done so much—way, way too much in the eyes of his most conservative critics. With each victory, Obama’s opponents grow more frustrated, filling the airwaves and what passes for political discourse with fulminations about some supposed

sin or another. Is it any wonder the guy is bleeding a bit? For his part, Obama resists the pugilistic impulse. To him, the merit of all these programs has been self-evident, and he has been the first to acknowledge that he has not always done all he could to explain them, sensibly and simply, to the American public. But Obama is nowhere near so politically maladroit as his frustrated liberal supporters—or implacable right-wing opponents—like to claim. He proved as much, if nothing else, with his embrace of the one policy choice he surely loathed: his agreement to extend the Bush-era income tax cuts for wealthy people who don’t need and don’t deserve them. That broke one of the president’s signature campaign promises and enraged the Democratic base and many

members of his own party in Congress. But it was a cool-eyed reflection of political reality: The midterm election results guaranteed that negotiations would only get tougher next month, and a delay in resolving the issue would have forced tax increases for virtually everyone on January 1—creating nothing but uncertainty for taxpayers and accountants alike. Obama saw no point in trying to score political debating points in an argument he knew he had no chance of winning. Moreover, as The Washington Post’s conservative columnist Charles Krauthammer bitterly noted, Obama’s agreement to the tax deal amounted to a second economic stimulus measure—one that he could never otherwise have persuaded Congressional Republicans to support. Krauthammer denounced it as the “swindle of the year,” and suggested that only Democrats could possibly be self-defeating enough to reject it. In

the end, of course, they did not. Obama knows better than most people that politics is the art of the possible (it’s

no accident that he became the first black president after less than a single term in the Senate), and an endless cycle of two steps forward, one step back. So he just keeps putting one foot in front of the other, confident that he can get where he wants to go, eventually . The short-term results are often messy and confusing. Just months ago, gay rights advocates were distraught because Obama wasn’t pressing harder to repeal “Don’t Ask, Don’t Tell.” Now he is apparently paying a price for his victory because some Republican Senators who’d promised to support ratification of the START arms-reduction treaty—identified by Obama as a signal priority for this lame-duck session of Congress—are balking because Obama pressed ahead with repealing DADT against their wishes. There is a price for everything in politics, and Obama knows that, too.

A2- Vote No

Our interpretation of fiat is that the judge represents the committee that is deciding whether to put the bill on the floor

That’s good 1. Neg ground- politics DA are uniquely key this year -- The topic has no link uniqueness

2. Causes the Aff to be a moving target kills Neg ground

3. Politics DA are key to education -we learn about current events and how congress functions

4. That’s a voting issue

5. The link proves the DA is intrinsic

A2- Intrinsicness

Intrinsicness is bad and a voting issue:

1. Decrease clash in rounds- allows the affirmative to get out of every disad or counterplan with the intrinsic permutation; it discourages participation within the activity.

2. The perm makes the aff a moving target- the permutation advocates the plan and other action that the 1AC does not endorse. Stable plans are key to predictable ground and strategy.

3. Infinitely regressive- The permutation could do the plan, the counterplan, and create world peace or feed the hungry in Africa, the negative would never be able to predict which of the thousands of different ways the affirmative could add something to the perm to get around the net benefits

4. Time and strategy skew- allowing intrinsicness perms takes all the time the negative spent developing the net benefit and the affirmative can just test their way out of it, this increases the aff side bias and is akin to doubling the 1AR’s speech time

5. The perms allow for extra topical plans- which are bad for debate, because the aff can always claim to be topical by adding on extra planks to their plan text.

6. It’s a voter for fairness and education.

A2- Keystone Thumper

Keystone won’t affect Obama—no one caresSonmez, 12/17(Wash. Post Columnist, “Keystone pipeline fight will continue even if administration denies permit, GOP says,” http://www.washingtonpost.com/blogs/2chambers/post/keystone-pipeline-fight-will-continue-even-if-administration-denies-permit-gop-says/2011/12/17/gIQAxNTv0O_blog.html)

Portman added that “it seems like it’s an issue that once people understand it, it’d be difficult for the administration to deny without Congress acting again. So I think it comes back up.” President Obama, who had previously said he would reject any effort to tie Keystone to a payroll tax cut extension, made no mention of the pipeline in brief remarks at the White House following Saturday’s votes. Senate Democrats, meanwhile, insisted that the pipeline argument is one in which they believe they have the upper hand.“The point is the average person is not at all focused on the pipeline ,” Sen. Charles Schumer (D-N.Y.) told reporters. “ It’s total inside baseball .” Schumer, who heads Senate Democrats’ messaging shop, added that Congress’ leverage in the pipeline debate is limited since the final say on the matter rests with the administration.

Keystone will get delayedCTV, 12/23(Obama signs bill forcing faster pipeline decision, http://calgary.ctv.ca/servlet/an/local/CTVNews/20111223/obama-signs-60-day-keystone-decision-bill-111223/20111223/?hub=CalgaryHome)

Debate over Keystone XL has become such a "political football" that Ralph Glass, with oil and gas consulting firm AJM Deloitte, said he wouldn't be surprised if Obama found some other way to avoid making a decision before 2012 . The issue put the president in a tough spot; if he approves the pipeline, he risks alienating his environmentally minded Democratic base and if he rejects it, he risks angering Americans eager to see the pipeline's economic benefits.Obama could make his approval contingent on receiving further environmental study, or add some other caveat , Glass said. "I think a decision right now has nothing to do with whether it's economically viable or environmentally too sensitive. I think it's all about votes, and I think somehow they're going to find a way to delay it," he said.

Obama can sidestep it on a technicality – no PC loss. Restuccia 1-2. [Andrew, energy and environment reporter, “White House, GOP battle for supremacy on Keystone pipeline” The Hill -- http://thehill.com/blogs/e2-wire/e2-wire/201917-white-house-gop-battle-for-supremacy-on-keystone]

Both sides are mobilizing to win the messaging war. White House and Obama administration officials have said they will have little choice but to reject the pipeline under the 60-day timeline that was outlined in the payroll tax package that passed in December. By arguing that the GOP-backed measure will force the administration to reject Keystone on a technicality, the White House can avoid having to weigh in on the substantive issues raised by the pipeline — including whether it will boost the economy or harm the environment.

Obama will just delay the decision.CTV 12-23-11 http://calgary.ctv.ca/servlet/an/local/CTVNews/20111223/obama-signs-60-day-keystone-decision-bill-111223/20111223/?hub=CalgaryHome

Debate over Keystone XL has become such a "political football" that Ralph Glass, with oil and gas

consulting firm AJM Deloitte, said he wouldn't be surprised if Obama found some other way to avoid making a decision before 2012. The issue put the president in a tough spot; if he approves the pipeline, he risks alienating his environmentally minded Democratic base and if he rejects it, he risks angering Americans eager to see the

pipeline's economic benefits. Obama could make his approval contingent on receiving further environmental study, or add some other caveat, Glass said. "I think a decision right now has nothing to do

with whether it's economically viable or environmentally too sensitive. I think it's all about votes, and I think somehow they're going to find a way to delay it," he said.

Forcing the issue gives Obama an out. Inside Climate News, 12-22-11 http://insideclimatenews.org/news/20111222/congress-john-boehner-payroll-tax-keystone-xl-pipeline-obama-jobs

Parenteau doesn't totally agree with Boxer's assessment. But he notes that Obama isn't necessarily boxed in by the 60-day deadline . "At first, I thought the Republicans were constructing a rope-a-dope strategy, where either way he would alienate a part of his base," he said. Obama would

lose union support by killing the pipeline and lose hard-core environmentalists by approving it. " But now I think he has a trump card to play," Parenteau added. All Obama would have to do, Parenteau said, is tell Congress that as of today, Keystone XL isn't in the national interest because too many questions about it are still unanswered. The rider gives the president some leeway. Though it forbids further review under the National Environmental Policy Act (NEPA), it doesn't restrict the Obama administration from executing a comprehensive review of the project via some sort of NEPA equivalent. "Could somebody go to court and

challenge him? "Parenteau asked. "Maybe, but I don't think it would go anywhere. "Basically, Obama would be saying, 'I'm telling you no today but that doesn't mean I'm telling you no forever.'"

The GOP is going to come out the losersInside Climate News, 12-22-11 http://insideclimatenews.org/news/20111222/congress-john-boehner-payroll-tax-keystone-xl-pipeline-obama-jobs

House Republicans keep trying to give President Obama a political black eye by wielding the

36-inch diameter Keystone XL pipeline as a cudgel just before Christmas. Instead, they could end up severely maiming only themselves if they persist with end-of-year legislative theatrics at what some are referring to as the "Capitol Hill Playhouse" this week. "It's quite a sandbox, isn't it?" Pat Parenteau, a Vermont Law School

professor who specializes in Congress and environmental issues, told InsideClimate News. "I think their strategy has backfired and that they've roped themselves with this political gambit . This idea that you have to keep introducing ideology into every issue, that will be their undoing." Parenteau is referring to House Republicans' insistence on gumming up a straightforward bill to extend a payroll tax break for 160 million Americans with language that would force Obama to fast-track approval or denial of the $7 billion, hotly contested pipeline.

A2- Immigration ThumperImmigration’s a winNicholas 1-8 (Peter, Washington Bureau political analyst, LA Times, 1/8/2012, http://www.latimes.com/news/nationworld/nation/la-na-obama-immigration-20120107,0,59623586.story)

Reporting from Washington— President Obama moved to repair relations with a crucial voting bloc and opened another battle with Republican lawmakers by easing rules on the politically volatile issue of illegal immigration. His proposal will probably affect tens of thousands — perhaps more than 100,000 — illegal residents. It would end a requirement that undocumented immigrants with parents or spouses in the United States leave the country first if they wish to file paperwork that would forestall deportation on the grounds of family hardship. Under the new rule, which does not require congressional approval, immigrants would be allowed to stay in the U.S. and apply for a waiver, which can be granted if deporting an immigrant would cause undue hardship to his or her U.S. family. The move left Republicans irritated. Rep. Lamar Smith (R-Texas), chairman of the House Judiciary Committee, said the new rule along with other moves by the president had "granted back-door amnesty to potentially millions of illegal immigrants without a vote of Congress." Latino groups, many of which have been highly critical of Obama for failing to move aggressively on immigration issues, were delighted. The administration's move is a "sensible and compassionate proposal [that] helps bring much-needed sanity to an often senseless process," said Janet Murguia, president and chief executive of the National Council of La Raza, which describes itself as the nation's largest Latino civil rights and advocacy group. Both reactions were welcomed at the White House. Obama's aides have been eager to highlight the difference between the president and Republicans on immigration issues , knowing he has little to lose — the conservative voters who are most deeply concerned about illegal immigration have little likelihood of voting for him — and much to gain. Asserting himself in opposition to Republicans, particularly on controversial issues, Obama won two-thirds of the Latino vote in the 2008 presidential race, according to exit polls, and he needs a similar margin in November to win reelection. Campaign strategists have identified several paths to capturing the 270 electoral votes he needs: All require(s) a strong showing among Latino voters to win swing states including Nevada, New Mexico, Colorado and Florida. Disquiet over Obama's immigration policies has jeopardized his support among Latino voters. Under Obama, the government has deported record numbers of illegal immigrants. And he has failed to persuade Congress to overhaul the immigration system and provide a path to legal status for the estimated 11 million living in the U.S. illegally, despite a promise that he would address the issue in his first year in office. A poll by the Pew Hispanic Center last month showed that 59% of Latinos disapproved of Obama's handling of deportations although it also showed the president running far ahead of the Republican presidential candidates. The Republicans have been competing for the toughest rhetoric against illegal immigration as they jockey for the support of the conservative voters who dominate the party's primaries. The move on immigration followed a pattern the administration has relied on recently of aggressively using executive action to achieve goals that have been stuck in Congress. Earlier this week, Obama used his power to fill job vacancies during congressional recesses to name a chief for the government's Consumer Financial Protection Bureau and to fill three slots on the National Labor Relations Board. Such assertion of executive power has boosted Obama’s clout, especially in dealings with Congress. "If 2011 was the White House's attempt to win back the center, 2012 is about mobilizing the base," said Frank Sharry, executive director of America's Voice, a group that advocatesan immigration overhaul. "They are realizing that they need a huge turnout of Latino votes in Florida and in the West."

A2- Military Cuts Thumper

Obama will push the Panetta planNYT, 1/2/’12(“Panetta to Offer Strategy for Cutting Military Budget”)

Mr. Panetta will outline the strategy guiding his spending plans at a news conference this week, and the specific cuts — for now, the Pentagon has prepared about $260 billion in cuts for the next five years —  will be detailed in the president’s annual budget submission to Congress, where they will be debated and almost certainly amended before approval. Although the proposals look to budget cuts over a decade, any future president can decide to propose an alternative spending plan to Congress.

Avoids controversyNYT, 1/2/’12(“Panetta to Offer Strategy for Cutting Military Budget”)

In a shift of doctrine driven by fiscal reality and a deal last summer that kept the United States from defaulting on its debts, Mr. Panetta is expected to outline plans for carefully shrinking the military — and in so doing make it clear that the Pentagon will not maintain the ability to fight two sustained ground wars at once.Instead, he will say that the military will be large enough to fight and win one major conflict, while also being able to “spoil” a second adversary’s ambitions in another part of the world while conducting a number of other smaller operations, like providing disaster relief or enforcing a no-flight zone.Pentagon officials, in the meantime, are in final deliberations about potential cuts to virtually every important area of military spending: the nuclear arsenal, warships, combat aircraft, salaries, and retirement and health benefits. With the war in Iraq over and the one in Afghanistan winding down, Mr. Panetta is weighing how significantly to shrink America’s ground forces.There is broad agreement on the left, right and center that $450 billion in cuts over a decade — the amount that the White House and Pentagon agreed to last summer — is acceptable . That is about 8 percent of the Pentagon’s base budget. But there is intense debate about an additional $500 billion in cuts that may have to be made if Congress follows through with deeper reductions.

Super long termCSM 1-5, “Obama military strategy: Is it bipartisan enough?”,http://www.csmonitor.com/Commentary/the-monitors-view/2012/0105/Obama-military-strategy-Is-it-bipartisan-enough

Fortunately, the administration has kept key lawmakers in the loop as the Pentagon drew up the strategy. For more than a century, a once-isolationist America has struggled to define its role in the world with each new challenge, such as 9/11. A national consensus on security is essential to budget decisions as big and consequential as this one. The bitter political fight over the Iraq war, for instance, only eroded the past bipartisan cohesion on defense. When Obama become president, he first had to clear the decks on that war and set a closing date for the US role in Afghanistan. Only then could he initiate a new vision. The nation’s budget crisis only adds to the need for a new strategy. Advanced technologies now allow for leaner forces with quicker results. The types of threats shift even faster these days, requiring security agencies to be ever learning, ever nimble. In fact, Pentagon officials say the new strategy is not set in stone. Take for example their call for no longer keeping a large Army for long land wars or for stabilizing another nation. The Pentagon wants to maintain

the know-how and capability to still do that – just not with active troops and equipment at the ready. The Army will thus be downsized. Similar reductions occurred after the Vietnam War and cold war. Both efforts led to some mistakes, but also a few needed shifts, such as a volunteer force. Not every president gets it right on security strategy. Congress will need to find the holes in this one. The basic debate is one over values and interests, such as defending oil routes, preventing wholesale massacres, advancing democracy, and protecting trade partners in Asia. Obama and Congress must set military spending based on a bipartisan strategy , not on what the national budget will allow. The federal government’s primary role is defense of the country. This president promises not to let the military be “ill prepared.” He puts a plan on paper. But the long march to make it real still runs through Congress .

Readiness ExtensionsFlashpoints exist across the globe. Only U.S. military readiness prevents escalation to full-blown warDennis Duggan, Assistant Director, National Sec.-Foreign Relations Commission, The American Legion, FNS, April 17, 1997

Mr. Chairman, The American Legion is pleased to appear before this Subcommittee to express its concerns about FY 1998 defense appropriations. The American Legion knows only too well what can happen when diplomacy and deterrence fail. As history has demonstrated, it is important for the President and Congress to continue to uphold their constitutional responsibilities to provide

for the "common defense" of the American people in a highly uncertain world. The world is still a dangerous place. There is unrest in the Middle East, in Bosnia and eastern Europe, and on the Korean peninsula. A

revitalized Red China is exercising its military and maritime prowess by reaching into the Pacific and to our very

shores and cities. Russia is still armed with at least 7,000 intercontinental missiles and opposes the concept of an

expanded NATO. The continuous proliferation of weapons of mass destruction and the increase in ethnic and nationalistic wars are prompting more U.S. contingency operations continue to demand attention. Additionally, the United States faces the challenges posed by international terrorism, fundamentalist religious movements and drug cartels, none of which operate within the basic rules of international law. The American Legion has always adhered to the principle

that our nation's armed forces must be well-manned and equipped, not to pursue war, but to preserve and

protect the hard-earned peace. The American Legion strongly believes the current military downsizing is based more on budget targets and budget deficit reduction than on current and foreseeable threats to the national security well-being of the American people and America's vital interests. Mr. Chairman, The American Legion is convinced that the United States is returning to the days of the "hollow forces." Once Army divisions, Navy aircraft carrier battle groups, and Air Force fighter wings are cut from the

force structure, they cannot be rapidly reconstituted without the costly expenditures of time, money, and human lives. History has demonstrated that it has been safer to err on the side of preserving robust forces to protect America's interests.

Readiness deters wars, creating a secure international orderIke Skelton, U.S. Rep, Missouri, Congressional Record, 143 Cong Rec H 1897, *H1898, April 29, 1997

So to respond to my colleagues who ask, what is the enemy,'' I say, true; today we cannot define precisely what the enemy is or will

be. We can say, however, that we will fail in our responsibility in this Congress if, once again, we allow the armed forces to be unprepared for the enemies that may emerge. In fact, as I will argue today, a failure to support a strong   military in the present historical circumstances would be even more unfortunate and more

unforgivable than in the past for two reasons. First, today the United States is the only Nation able to protect the peace. In the past we were fortunate that allies were able, often by the narrowest of margins, to hold the line while we belatedly prepared for war. Bismarck once said: God protects fools, and the United States.'' Today, no one else is capable either of preventing conflict from arising in the first place, or of responding decisively if a major threat to the peace does occur. While I trust in God, I believe God has given us the tools we need to keep peace, and it is our task to use them wisely. Second, and

perhaps most importantly, if we fail in our responsibility to maintain U.S. military power, the United States, and, indeed, the world as a whole, may lose an unprecedented opportunity to construct an era of relative peace that could last for many, many years. Today, our military strength is the foundation of a

relatively secure international order in which small conflicts, though endemic and inevitable, will not

decisively erode global stability. As such, our military strength is also a means of preventing the growth of one or more new powers that could, in time, constitute a threat to peace and evolve into the enemy we do not now foresee. Because of this, the very limited investment required to maintain our military strength, though somewhat larger than we are making right now, is disproportionately small compared to the benefits we, and the rest of the world, derive from it. My fellow Missourian, Harry S Truman, stated this clearly: We must be prepared to pay the price for peace, or assuredly we will pay the price of war.'' These two premises, that the United States alone is able to protect the peace, and that adequate, visible U.S. military power may prevent new enemies from arising in the future, are, it seems to me, the cornerstones of a sound strategy for the years to come.

Isolationism results in great power races that will threaten the U.S.Jeremy Black, Professor of History, University of Exeter, UK, “War and strategy in the 21st century,” Orbis, v46 issue 1, Winter, 2002

Such an image might work for an isolationist state with few links to the global economy and international finance, but it is difficult to see the United States adopting this role in coming decades. Were it to do so, Americans would face the same risks that obtained in the 1930s: the consolidation of power blocs that can be threatening no matter how economically inefficient they are in the long run. American disengagement would encourage the alignment among France, Russia, and Germany, an alignment that is already too powerful within Europe, and encourage Japan to accommodate Chinese power, possibly at Taiwan's and even South Korea's

expense. Most threatening would be an accentuation of Russo-Chinese links that have been forged in recent years and are among the most unwelcome legacies of the Clinton era.

Regional security organizations are impractical in most of the world.Barbara Conry (foreign policy analyst at the Cato Institute) 2/5/1997 "U.S. "Global Leadership": A Euphemism for World Policeman" CATO INSTITUTE http://www.cato.org/pub_display.php?pub_id=1126

Unfortunately, regional security organizations require a high degree of cohesion among member states and therefore are not possible in many parts of the world. The WEU is probably the only such organization that is viable in the near future, although effective regional security organizations encompassing some Latin American and Asian countries are not inconceivable. In much of the rest of the world, however, there is little evidence of the cohesion and common interest that would be a precondition for a functioning regional security organization.

Readiness Impact – Terror

Readiness key to prevent terrorJack Spencer, policy analyst at the Heritage Foundation, Heritage Foundation Reports, 8-1-2003, pg. lexis

Whether or not the U.S. military is large enough to perform its assigned missions is being debated once again. Given that American soldiers will not be coming home from Iraq on time, the answer seems to be an emphatic "no." However, before the size of the force is decided, its missions must be defined. The emerging capabilities gap exists because the force is being used too extensively. With the war on terrorism, operations in Afghanistan, fighting in Iraq, and peacekeeping in the Balkans all ongoing, some forces must be held aside in case North Korea starts a war. The United States is now being pressured to deploy peacekeepers to Liberia, and this is in addition to enduring U.S. peacetime responsibilities such as deterring large-scale aggression in vital regions of the world, maintaining alliance commitments, and ensuring access to the high seas. To bridge the capabilities gap, the United States should focus its military resources on missions that are vital to the nation. Specifically, it must field a force

capable of fighting the immediate war on terrorism, fighting with little or no warning in unanticipated places, maintaining adequate capability to deter aggression against America's interests and allies, and contributing to homeland defense. Only to the extent that America's capabilities exceed its ability to fulfill these missions should it consider contributing military resources to other non-vital missions. Moreover, the long delay in rotating troops out of Iraq demonstrates that the United States does not have enough forces for even its primary missions.

A nuclear terror attack causes miscalculation and nuclear warSpeice, 2006 (Patrick, J.D. Candidate 2006, Marshall-Wythe School of Law, College of William and Mary, “NEGLIGENCE AND NUCLEAR NONPROLIFERATION: ELIMINATING THE CURRENT LIABILITY BARRIER TO BILATERAL U.S.-RUSSIAN NONPROLIFERATION ASSISTANCE PROGRAMS,” William & Mary Law Review, Feb, l/n)

The potential consequences of the unchecked spread of nuclear knowledge and material to terrorist groups that seek to cause mass destruction in the United States are truly horrifying. A terrorist attack with a nuclear weapon would be devastating in terms of immediate human and economic losses. 49 Moreover, there would be immense political pressure in the United States to discover the perpetrators and retaliate with nuclear weapons, massively increasing the number of casualties and potentially triggering a full-scale nuclear conflict. 50 In addition to the threat posed by terrorists, leakage of nuclear knowledge and material from Russia will reduce the barriers that states with nuclear ambitions face and may trigger widespread proliferation of nuclear weapons. 51 This proliferation will increase the risk of nuclear attacks against the United States [*1440] or its allies by hostile states, 52 as well as increase the likelihood that regional conflicts will draw in the United States and escalate to the use of nuclear weapons. 53

2nc Heg Scenario

Health care is key to competiveness Mohit, 2k9 (Dr. Behzad Mohit, May 11, 2009, “Universal Health Care Can Save Our Economy and Keep 1.7 million Jobs in the US”, http://www.huffingtonpost.com/dr-behzad-mohit/universal-health-care-can_b_201154.html, Dr. Behzad Mohit is an author, physician, and graduate of the State University of New York medical school with eleven years of postgraduate studies in prestigious universities and research institutes)The first article of this series, I wrote that a universal health care system "can save more in one year than what we spent on the Iraq and Afghanistan wars since 9/11 , i.e. a trillion dollars ." I was wrong. There is more to it than that. Let me explain: The proposed nonprofit, single payer, people-funded and people-managed system described in my

book, Universal Health Care System for the United States of America, has many more economic and social benefits. You may be surprised if I tell you that those benefits would dwarf the importance of one trillion dollars in savings per year. It was just in the news that GM laid off 21,000 workers and plans to close all its U.S. plants this summer for at least 9 weeks. What if GM, Chrysler and Ford moved all their operations to Canada? In 2007 General Motors spent $4.6 billion on health care for its employees. Ford and Chrysler each spent $2.2 billion as well. If those companies moved to Canada they would save all that in health care costs ($9 billion per year), and the United States would lose 240,000 jobs and $156 billion in tax revenue. Of course, that loss doesn't include the ripple effect that the move would have on the 974,000 people in the automotive supply industry, or

the 1.7 million jobs created by the money those people spend. The health care cost is a major factor in the near bankruptcy and competitive disadvantage of our auto industry. Let's look at the example of Toyota. In Japan, Toyota enjoys the economic benefits of universal health care. Because of universal health care, Toyota's production costs are $1,400 lower per vehicle than the cost for American manufacturers. That translates directly into competitive advantage , as Toyota makes $2,400 more per car than its U.S. counterparts. Back in the United States, GM has said that the cost of providing health care for its workers adds between $1,500 and $2,000 to the price tag of every vehicle it sells. Alan S. Blinder, an economist at Princeton, has estimated that between 28 million and 42 million American jobs are at risk of being moved "offshore" in the near future, as technology reduces the friction of moving abroad. What can we do to keep U.S. automakers and other manufacturers in the country? Could instituting

universal health care help? Now let's extrapolate this approach to other sectors of the economy. As of 2008, annual health care spending in the United States reached $2.1 trillion or 16 percent of the GDP. Most of that money -- about 54 percent -- comes from the private sector . That's $1.13 trillion dollars that American companies are spending on health care each and every year. This is

more than the national budgets of France, Canada and the UK combined. If that isn't a drag on our competitiveness, what is? With a universal health care system, companies would keep that money and would have a healthier and more productive work force. If we implement the universal health care system, other economic benefits would also ensue. For example, job lock occurs when people stay at their current job solely for the health care benefits paid by their employers. One study showed that, in California alone, in 2002 job lock affected 179,000 people, with $772 million in foregone productivity. Some objectors to the universal health care plan say: "Wait a minute. What about the job losses in the multiple health care insurance companies? They will all be out of business." O.K. Let's

look at this. The entire health care industry employs 470,000 people. If we gave all the individuals who were laid off by the health insurance industry $100,000 per year for the rest of their lives, it would cost $47 billion dollars per year. That would amount to less than 5% of the one trillion dollar savings per year that would have resulted from instituting a universal health care system. Bear in mind that most of these people would get retrained and obtain other

jobs. However, if they chose to remain unemployed they would have a comfortable life. And our country would save a minimum of $950 billion per year . This is equivalent to one third of our national budget . In summary, the non-profit, single payer, people-funded, people-managed insurance agency proposed in the book, Universal

Health Care System for the United States of America, saves our economy and keeps 1.7 million jobs in the U.S. and results in savings of at least $1.3 trillion per year for our manufacturing and other businesses. This is how we can have an even playing field for our industrial base and provide good jobs for our hard-working work force and keep the US competitive with other nations. At the same time we will have healthier people who are free from anxiety regarding their health care.The non-profit element is essential to this proposal. It will keep the conflict of interest between making money for the providers and the health of the patients out of the system. This conflict of interest is a major contributor to the present

high cost and suboptimal quality of the current health care system in our country. In addition, the universal health care system suggested will once again restore integrity to the delivery of health care and medical research and education in our country . This privately run insurance agency is not "socialized medicine" and it avoids the inefficiencies of government bureaucracy.Now let me ask my readers, does such a non-profit single payer universal health care system make sense to you? If it does, what is holding us back? Let's get moving on it. We should give our leaders the support they need to get it done. We should also clearly tell our business leaders about its benefits. Please read my book at uhc.helpeachother.com -- it's free -- and make your views known. In the next article I will respond to your comments and write on the issue of incentives for doctors and other health care providers to do a good job for the people and be rewarded accordingly. I will also address how the profit motive in medicine has increased the cost and decreased the quality of our health care.

U.S. competitiveness is key to hegemony; a loss of our edge will cause isolationismKhalilzad, 95 – Rand Corporation(Zalmay, “Losing the Moment?” The Washington Quarterly, Vol. 18, No. 2, pg. 84, Spring, Lexis)The United States is unlikely to preserve its military and technological dominance if the U.S. economy declines seriously. In such an environment , the domestic economic and political base for global leadership would diminish and the U nited S tates would probably incrementally withdraw from the world, become inward-looking, and abandon more and more of its external interests . As the U nited S tates weakened, others would try to fill the Vacuum . To

sustain and improve its economic strength, the U nited S tates must maintain its technological lead in the economic realm . Its success will depend on the choices it makes. In the past, developments such as the agricultural and industrial revolutions produced fundamental changes positively affecting the relative position of those who were able to take advantage of them and negatively affecting those who did not. Some argue that the world may be at the

beginning of another such transformation, which will shift the sources of wealth and the relative position of classes and nations. If the U nited S tates fails to recognize the change and adapt its institutions, its relative position will necessarily worsen . To remain the preponderant world power, U.S. economic strength must be enhanced by further improvements in productivity, thus increasing real per capita income; by strengthening education and

training; and by generating and using superior science and technology . In the long run the economic future of the United States will also be affected by two other factors. One is the imbalance between government revenues and government expenditure. As a society the United States has to decide what part of the GNP it wishes the government to control and adjust expenditures and taxation accordingly. The second, which is even more important to U.S. economic wall-being over the long run, may be the overall rate of investment. Although their government cannot endow Americans with a Japanese-style propensity to save, it can use tax policy to raise the savings rate.

Heg ExtensionsObama’s universal health care system is key to US competitivenessJohnson, 2k9 (Toni Johnson is a Staff Writer for the Council on Foreign Relations, 1/7/2009, “Healing US Healthcare”, http://www.cfr.org/publication/18052/healing_us_healthcare.html?breadcrumb=%2Fissue%2F129%2F)Health care reform discussions focus largely on improving access and lowering costs. Obama's health care plan would create a public-sponsored insurance plan similar to the one provided by the government to members of Congress. It targets individual buyers and small businesses, two segments that have had trouble affording private insurance. Nearly 16 percent of the U.S. population has no health coverage. Insurance companies have balked at the public insurance plan, saying it would underpay doctors like other government health plans and shift costs to private insurers (NYT). Instead, the insurance industry wants the government to mandate that everyone must have health insurance in exchange for a pledge not to refuse coverage regardless of health status. Obama's plan would mandate the industry cover

everyone without requiring that everyone obtain insurance. That could allow some people to wait until they are sick before buying, the industry argues. The value of rationalizing the U.S. health care sector has been accepted for some time as an important step in keeping the U.S. industry competitive , as this Backgrounder explains. C. Fred Bergsten, director of the Peterson Institute for International Economics, and Raymond C. Offenheiser, president of the charity Oxfam America, say universal health care can provide U.S. workers with a safety net against the impact of trade deals (Miami Herald). Princeton

economist Ewe Rheinhardt says the health care sector will soon be the largest in the U.S. economy, making it a good taxpayer investment (NPR). He and others say that past efforts to pump federal stimulus money into public works projects - dams, roads,

bridges - often wound up missing the crisis, as the projects (and stimulus) get caught up in local planning and bidding battles. But shifting to health care investment, writes BusinessWeek columnist Chris Farrell, feeds a sector of the economy already growing, and would relieve a major source of economic insecurity "for anyone handed a pink slip during the recession."A November 2008 Kaiser Foundation report notes that access to employer-sponsored health insurance has been on the decline (PDF) among low-income workers. Meanwhile, the fiscal crisis is reducing the number of people who can pay (BusinessWeek) their doctor's bills and insurance premiums. Even if the widely acknowledged systemic problems are left aside, these problems will worsen during a recession. The situation could push more people into government health care programs such as Medicaid. President-elect Obama's economic stimulus proposal would allow laid-off workers without insurance to apply for Medicad for the first time. The Democratic victory in November has

ignited a debate to what extent U.S. health care will become a government-run program. This has been a major step in the right direction. A universal health care system would allow the US to maintain its competitive edge . Pete DuPont, a billionaire former Republican presidential hopeful, warns of a coming "Europeanizing" of American health care (WSJ). But analysts suggest

the European-style "single-payer" system is now virtually off the table (LAT).Obama's health plan hopes to tackle rising costs by allowing importation of cheap medicines from developed countries and increase access to new generic drugs as a means to lower costs. This would cut into drug company profits, however, and will be certain to meet opposition. And as this CFR Backgrounder points out, some experts also worry importing more drugs from other countries will challenge the already taxed Food and Drug Administration, the agency charged with drug safety. Expanding the number of people covered also presents another challenge: The United States has a shortage of doctors (NYT) and other medical professionals.

2nc Pharma Scenario

Health care reform benefits the pharmaceutical industry – FDA revitalization outweighs drops in prices.Business Week 1/26/2009 (Aaron Pressman, “HEALTH REFORM STUMBLING BLOCKS STILL REMAIN,” SECTION: Personal Business -- HOW TO PLAY IT: DRUGMAKERS; Pg. 87 Vol. 4117, Lexis)As Barack Obama closed in on the Presidency last year, investors got increasingly skittish about drug stocks. Johnson & Johnson fell 18% in the two months before the election, Schering-Plough dropped 23%, and Eli Lilly tumbled 28%. Investors had good reason to be worried. Obama 's health-care reform plan is likely to include letting Medicare negotiate lower drug prices, overturning a ban on government-driven discounts that was in the original 2003 "Part D" program. But Medicare pricing is only part of the story for drugmakers, several health-care fund managers argue. Investors may be overlooking substantial benefits to pharmaceutical companies because Obama is also likely to get the Food & Drug Administration moving again, says Sam Isaly, co-manager of Eaton

Vance Worldwide Health Sciences Fund. "In the end, pricing may or may not come out negative, but change at the FDA will be very positive," he says. The FDA has been widely criticized for weak oversight and inefficiency, and its

congressional overseers have had a testy relationship with the agency. Isaly says few drugs of "consequence" have been approved in the past few years as the agency shied away from anything controversial. "There's an opportunity for a major shift there ." Add the stocks' low valuations and high dividend yields, and many drug stocks look appealing. Isaly favors Novartis and Bristol-Myers Squibb among major pharma companies. Novartis faces the loss of patent protection for Diovan, its blood pressure medication, in September 2012. But the company is moving ahead quickly with several other promising drugs in development to treat kidney cancer, meningitis, and multiple sclerosis. Bristol-Myers' patent on best-seller Plavix, which is used to prevent blood clots,

expires in 2011. So the company is slashing expenses by $2.5 billion while it scouts for promising smaller drugmakers to acquire. Heath-care reform is also likely to improve prospects for generic drugmakers. With patents on drugs representing $25

billion in annual sales set to expire by 2012, the generic industry is already sitting pretty. The new Congress is planning to revisit the question of allowing generic versions of biologic drugs (those developed from living cells rather than chemical components, which is currently illegal). Rosanne Ott, co-manager of Alger Health Sciences Fund, says Teva Pharmaceutical Industries and Mylan are best-positioned to benefit for the next two years. Ott says Teva is moving ahead in integrating Barr Pharmaceuticals, which it bought last year. And Mylan is likely to beat investors' expectations in 2009 after digesting Merck's generic lines, which it acquired in 2007 and '08.

Pharma industry is the only way to stop biowarfare Shorett, Research Fellow at the Council for Responsible Genetics, 2004, (Peter, “THE CRACK IN BIOSHIELD'S ARMOR”, September-December, http://www.gene-watch.org/genewatch/articles/17-56Shorett.html)Congress will face an uphill battle in passing what is sure to be viewed as a giveaway to the pharmaceutical industry. A few of its provisions may significantly delay the introduction of generic drugs to treat illnesses

that affect millions of U.S. voters. Large drug companie s, however, may be the only players with the necessary expertise, resources and experience to develop effective vaccines, antibiotics, and other countermeasures against biological weapons .

Pharma Extensions

Drug innovation key to pharma and they won’t stop producing new drugs even if profits tankTaggart, Professor of International Business Strategy at the University of Glasgow, 1993 (James H., “The world pharmaceutical industry”, Google Books)The pharmaceutical industry is critically reliant on continuing flows of new products , which are the fruits of research and development. The profitability, and ultimately the survival , of the major firms in the industry depends on the maintenance of a competitive position; in turn, the competitive position is determined by the rate of innovation . Thus, among the major firms in the industry, there are few recorded cases where a company has cut back on research and development expenditure, even during periods of falling profits.

Generics boost pharma by forcing innovationBalto, Senior Fellow at the Center for American Progress, 6/23/09, (Robert, “Removing Obstacles to Generic Drug Competition”, http://www.americanprogress.org/issues/2009/06/generic_drug_competition.html)Innovation is the lifeblood of the pharmaceutical industry and advancements in drug technology mean that a growing number of medical conditions can be treated more effectively and safely. Moreover, advancements in drug technology can often improve the mechanism of delivery, dosage forms, and the method of interaction. These types of product- line extensions are common in almost every industry, as we can tell from the numerous products advertised as “new and

improved.” However, in some cases, brand-name pharmaceutical companies make trivial changes to a drug to secure an additional patent and a longer period of exclusivity. Since this typically occurs close to the end of patent life, and tends to involve the brand inducing a switch of all or part of the demand for the drug from the old version to the new in advance of generic entry for the old, it is often

called “product hopping.” This can have anticompetitive effects , especially when it is coupled with other conduct to delay generic entry.

2nc Pharma Impact-Disease

Pharma key to solve pandemics and other emerging disease – cost controls will kill itBandow, senior fellow at the Cato Institute, 3/27/05 (Doug, “A strong pharmaceutical industry is the best defense against pandemics”, http://wwww.signonsandiego.com/uniontrib/20050327/news_lz1e27bandow.html)Yet at a time when the world may have narrowly escaped a potential viral epidemic in the form of SARS – and faces the prospect of biological terrorism – the drugmakers are under siege in America. Rhetorically, they have been lumped with the tobacco companies by demagogic politicians, as if firms which make products that heal are the same as those which make products that kill. The explosion of liability lawsuits is another problem. Henry Miller of the Hoover Institution points out that the number of vaccine makers has fallen by almost three-fourths since 1967. The basic problem, he notes, is that "compared to therapeutic drugs, vaccines traditionally offer low return on investment but high exposure to legal liability." This is the major reason we were left so vulnerable to the failure of Chiron, the British firm that was producing flu vaccine. Underlying the widespread political assault is a panoply of distorted and even false claims . The industry is not uniquely profitable and its returns are broadly commensurate with the cost of raising capital . Complaints about rising drug expenditures are common , even though

people routinely spend more for a dinner out than on a typical prescription. Moreover, the primary reasons total drug outlays are rising is not because of price hikes on existing medicines, but because Americans are buying new products and using more old ones. Other myths abound. The drugmakers actually spend more on R&D than marketing. They devote far more money to finding drugs

than does the National Institutes of Health. What makes the concerted assault against pharmaceutical concerns so perverse is that Washington claims it understands the importance of pharmaceutical research. Dianne Murphy, director of the FDA's Office of Counterterrorism &

Pediatric Drug Development, said of drugmakers working on bioterrorism: "we want them to come in and talk to us when the drug is barely a glimmer in a scientist's eye." Yet Washington's threat to void the patent for Cipro in the midst of the 2001 anthrax scare was a warning to firms that no good deed is likely to go unpunished. Indeed, the better the deed (more effectively dealing

with a deadlier disease), the greater the likely punishment (losing the hard-won return on the underlying research). The United States is essentially the last pharmaceutical free market among leading industrialized states. Price and

use controls pervade Europe and other industrialized states, including Canada and Japan. In Europe, observed Wall Street

Journal reporter Stephen D. Moore, "Innovative cancer drugs have gotten bogged down even earlier in the system." He adds: "Many European countries also attempt to restrict demand after new medicines reach pharmacy shelves. Drugs can be saddled with tight prescribing rules to limit consumption. Patients across Europe are fighting for improved access

to older drugs such as Taxol, the world's top-selling anticancer drug." Thus, the vast majority of drug innovation derives from the American market. That will end, however, if government arbitrarily seizes – directly, through domestic restrictions, or indirectly, through "reimportation" of American drugs from countries with price controls – the fruit of industry R&D, thereby cutting industry prices and profits. Investment will fall. Which will mean less research and development. And fewer life-saving products. Life is uncertain and arbitrary; SARS demonstrated that flying on the wrong plane and sitting next to the wrong person could become a death sentence. And potentially many more people will die if new, even deadlier infectious diseases emerge, whether avian flu or something else. Yet the resources are available to prevent or ameliorate any such outbreak. Writes Dr. Joseph DiMasi of Tufts University: "a rapid expansion of scientific discoveries and technologic advances has given the pharmaceutical industry unprecedented opportunities to innovate . Combinatorial chemistry, high-throughput screening and genomics have provided a technologic platform that is highly conducive to growth in innovation. However, given typical lengths for the drug discovery and development processes,

most of the fruits of these efforts will likely not be realized for years to come." Reaping those long-term benefits to protect people worldwide will require the aid of America's much-vilified pharmaceutical industry. If critics succeed in disabling the drugmakers , we will all be at risk . It's time those who benefit from industry research stopped treating drugmakers as the enemy.

Pharma key to solve pandemicsBandow, senior fellow at the Cato Institute, 3/27/05 (Doug, “A strong pharmaceutical industry is the best defense against pandemics”, http://wwww.signonsandiego.com/uniontrib/20050327/news_lz1e27bandow.html)Diseases like SARS and avian flu, which have proved resistant to drugs commonly used to fight influenza viruses, demonstrate how we all benefit from profitable drugmakers and

abundant pharmaceutical research. Although governments have an important role to play in fighting any disease pandemic, necessary for developing any effective treatment and putting into mass production any vaccine or other medicine is private industry . Indeed, the initial fight against SARS focused on finding an existing medicine that worked. Laboratories screened some 2,000 federally approved and experimental drugs

to see if they were useful in fighting SARS. Gurinder Shahi, a doctor in Singapore, explained: "Given how little we know about SARS and the reality that it is killing people, it is justified for us to be daring and innovative in coming up with solutions ." Daring innovation is most likely in a competitive , profit-driven market . For instance, Pfizer worked with the U.S. National Institute of Allergy and Infectious Diseases to test 350 compounds

developed as part of an earlier project to cure the common cold. NIAID also collaborated with the California biotech company Vical Inc. to test a new, experimental vaccine that has protected mice from the disease. Adventis

and Merck as well as laboratories around the world began working to develop vaccines. Indeed, most of today's medicines exist only because there is a bevy of sophisticated pharmaceutical companies devoted to finding drugs to heal the sick . Progress has been particularly dramatic in recent years.

For instance, two decades ago not one drug was available to fight AIDS. Today 74 have been approved and another 83 are in development.

2nc Disease Scenario

Health care solves diseaseReuters, 2k8 (Reuters, August 28th, 2008, “Independent WHO Study Backs Universal Health Care”, http://www.medscape.com/viewarticle/579788_print)GENEVA (Reuters) Aug 28 - Major inequalities in health and life expectancy persist worldwide, according to an independent World Health Organization

commission which on Thursday called for all countries to offer universal health care. Huge discrepancies also exist within countries, including Scotland where a boy born in the deprived Glasgow suburb of Calton can expect to live 28 years less than one born in affluent Lenzie, just 13 km (8 miles) across town, it

said. "The health inequities we see in the world are absolutely dramatic in their scale ," said Michael Marmot, a WHO health researcher, who chaired the commission, told reporters."Between countries we have life expectancy differences of more than 40 years. A woman in Botswana can expect to live 43 years, in Japan 86 years." The Commission on Social Determinants of Health, composed of 19 independent experts, handed over its findings

to the World Health Organisation (WHO). The United Nations agency ordered the report three years ago. "One of the recommendations in the Commission's report is that there should be universal health care systems that are available to people regardless of ability to pay," said Marmot, head of the epidemiology and public health department at University College London. "Virtually all advanced countries have universal health care systems but we don't think that should be limited to high-income countries. We think that could be much more broadly available," he added. The sustainability of health care systems is a concern for all countries, amid growing "commercialisation" of services, according to the commission. It favoured financing health care through general taxation and/or mandatory universal insurance. Systems must be based on access to primary health care, which in poor areas could target the most disadvantaged groups first. Brazil and Venezuela offered examples of how large-scale targeted health care programmes can work

towards universalism INABILITY TO PAY "We are distressed by the reports we see of health care simply being unavailable to people because of inability to pay. We see that throughout low- and middle-income countries," Marmot said. Health care is also a key issue in the U.S. presidential campaign, with both Democrat Barack Obama and Republican John McCain proposing to fix what they call a broken system. Some 15.3 percent of Americans had no public or private health insurance in 2007, down from 15.8 percent in 2006, according to the latest U.S. figures released on Monday. A total of 45.7 million people were uninsured, down from 47 million. "It's not perhaps the best use of the money that is being spent. And there are a lot people who feel that and would actually like to see coming out of the current campaign in the U.S. proposals for a universal health insurance," Marmot said. Margaret Chan, WHO director-general, said WHO's Executive Board would examine the report at its January meeting and submit proposals to the annual meeting of its 193 member states in

May. Chan said that focusing on the "upstream" or universal systems should lead to better disease prevention programmes. "The importance of prevention continues to grow, partly because of escalating health care costs. Disease prevention is the key step into stopping the next virus. . We simply cannot afford the way we go about doing health care nowadays without tackling and doing more prevention”

ExtinctionFrank Ryan, M.D., 1997, virus X, p. 366How might the human race appear to such an aggressively emerging virus? That teeming, globally intrusive species, with its transcontinental air travel, massively congested cities, sexual promiscuity, and in the less affluent regions — where the virus is most likely to first emerge — a vulnerable lack of hygiene with regard to food and water supplies and hospitality to biting insects' The virus is best seen, in John Hollands excellent analogy, as a swarm of competing mutations, with each individual strain subjected to furious forces of natural selection for the strain, or strains, most likely to amplify and evolve in the new ecological habitat.3 With such a promising new opportunity in the invaded species, natural selection must eventually come to dominate viral behavior. In time the dynamics of infection will select for a more resistant human population. Such a coevolution takes rather longer in "human" time — too long, given the ease of spread within the global village. A rapidly lethal and quickly spreading virus simply would not have time to switch from aggression to coevolution. And there lies the danger. Joshua Lederbergs prediction can now be seen to be an altogether logical one. Pandemics are inevitable. Our incredibly rapid human evolution , our overwhelming global needs, the advances of our complex industrial society, all have moved the natural goalposts. The advance of society, the very science of change, has greatly augmented the potential for the emergence of a pandemic strain. It is hardly surprising that Avrion Mitchison, scientific director of Deutsches Rheuma Forschungszentrum in Berlin, asks the question: "Will we survive!” We have invaded every biome on earth and we continue to destroy other species so very rapidly that one eminent scientist foresees the day when no life exists on earth apart from the human monoculture and the small volume of species useful to it. An increasing multitude of disturbed viral-host symbiotic cycles are provoked into self-protective counterattacks. This is a dangerous situation. And we have seen in the previous chapter how ill-prepared the world is to cope with it. It begs the most frightening question of all: could such a pandemic virus cause the extinction of the human species?

2nc Bioterror Scenario

Healthcare reform key to prevent bioterror and smallpox outbreakSklar, director of the Business for a Fair Minimum Wage project of Business for Shared Prosperity, 12/19/2002, (Holly, Rolling the Dice on Our Nation's Health, p. http://www.commondreams.org/views02/1219-07.htm)Imagine if the first people infected in a smallpox attack had no health insurance and delayed

seeking care for their flu-like symptoms. The odds are high. Pick a number from one to six. Would you bet your life on a

roll of the dice? Would you play Russian Roulette with one bullet in a six-chamber gun? One in six Americans under age 65 has no health insurance . The uninsured are more likely to delay seeking medical care , go to work sick for fear of losing their jobs, seek care at overcrowded emergency rooms and clinics, and be poorly diagnosed and treated. The longer smallpox--or another contagious disease -- goes undiagnosed, the more it will spread , with the insured and uninsured infecting each other. Healthcare is literally a matter of life and death. Yet, more than 41 million Americans have no health insurance of any kind, public or private. The uninsured rate was 14.6 percent in 2001--up 13 percent since 1987. The rate is on the rise with increased healthcare costs, unemployment and cutbacks in Medicaid and the State Children's Health Insurance Program (SCHIP). One in four people with household incomes less than $25,000 is uninsured. One in six full-time workers is uninsured, including half the full-time workers with incomes below the official poverty line. The share of workers covered by employment health plans drops from 81 percent in the top fifth of wage earners to 68 percent in the middle fifth to 33 percent in

the lowest fifth, according to the Economic Policy Institute. As reports by the American College of Physicians, Kaiser Family Foundation and many others have shown, lack of health insurance is associated with lack of preventive care and substandard treatment inside and outside the hospital. The uninsured are at much higher risk for chronic disease and disability, and have a 25

percent greater chance of dying (adjusting for physical, economic and behavioral factors). To make matters worse, a health crisis is often an economic crisis. "Medical bills are a factor in nearly half of all personal bankruptcy filings," reports the National Academy of Sciences Institute of Medicine. The U.S. is No. 1 in healthcare spending per capita, but No. 34--tied with Malaysia--when it comes to child mortality rates under age five. The U.S. is No. 1 in

healthcare spending, but the only major industrialized nation not to provide some form of universal coverage. We squander billions of dollars in the red tape of myriad healthcare eligibility regulations , forms and procedures, and second-guessing of doctors by insurance gatekeepers trained in cost cutting, not medicine. Americans go to Canada for cheaper prices on prescription drugs made by U.S. pharmaceutical companies with U.S. taxpayer subsidies. While millions go without healthcare, top health company executives rake in the dough. A report by Families USA found that the highest-paid health plan executives in ten companies received average compensation of $11.7 million in 2000, not counting unexercised stock options worth tens of millions more. The saying, "An ounce of prevention is worth a pound of cure," couldn't be truer when it comes to healthcare. Yet, we provide universal coverage for seniors through Medicare, but not for children. We have economic disincentives for timely diagnosis and treatment of diseases. Universal healthcare is a humane and cost-effective solution to the growing healthcare crisis. Universal coverage won't come easy, but neither did Social Security or Medicare, which now serves one in seven Americans. Many proposals for universal healthcare build on the foundation of "Medicare for All," albeit an improved Medicare adequately serving seniors and younger people alike. Healthcare is as essential to equal opportunity as public education and as essential to public safety as police and fire protection. If your neighbor's house were burning, would you

want 911 operators to ask for their fire insurance card number before sending--or not sending--fire trucks? Healthcare ranked second behind terrorism and national security as the most critical issue for the nation in the 2002 Health Confidence Survey released by the Employee Benefit Research Institute. The government thinks the smallpox threat is serious enough to start inoculating military and medical personnel with a highly risky vaccine. It's time to stop delaying universal healthcare, which will save lives everyday while boost ing our readiness for any bioterror attack.

Biological terrorism threatens extinctionClifford E. Singer, Spring 2001, Swords and Ploughshares, http://www.acdis.uiuc.edu/homepage_docs/pubs_docs/S&P_docs/S&P_XIII/Singer.htmThere are , however, two technologies currently under development that may pose a more serious threat to human survival . The first and most immediate is biological warfare combined with genetic engineering. Smallpox is the most fearsome of natural biological warfare agents in existence. By the end of the next decade, global immunity to smallpox will likely be at a low unprecedented since the emergence of this disease in the distant past, while the opportunity for it to spread rapidly across the globe will be at an all time high. In the absence of other complications such as nuclear war near the peak of an epidemic, developed countries may respond with quarantine and vaccination to limit the damage. Otherwise mortality there may match the rate of 30 percent or more expected in unprepared developing countries.. With

development of new biological technology, however, there is a possibility that a variety of infectious agents may be engineered for combinations of greater than natural virulence and mortality, rather than just to overwhelm currently available antibiotics or vaccines.

Bioterror Extensions

Healthcare reform key to track and control bioterror attacksGreen, PhD, Director, Outreach and Lead GE3LS Advisor at the Ontario Genomics Institute, May 2004 (Shane K., “Bioterrorism and Health Care Reform: No Preparedness Without Access”, American Medical Association Journal of Ethics, Virtual Mentor, Volume 6, Number 5, http://virtualmentor.ama-assn.org/2004/05/pfor2-0405.html)Using infectious diseases as weapons, bioterrorism threatens to weaken the civilian workforce and , hence, a nation's ability to go about its daily business. Moreover, in the case of diseases that are transmissible person to person , each infected individual becomes a human weapon , infecting others, who then infect others, and so on, tying up medical responders and overwhelming medical resources. A nation's greatest defense against bioterrorism, both in preparation for and in response to an attack, is a population in which an introduced biological agent cannot get a foothold, ie, healthy people with easy access to health care. Yet, in spite of spending significantly more per capita on health care than any other developed nation, the US is peppered with communities in which many people have little or no access to health care . This may be due to a lack of adequate health insurance—a fact of life for over 43 million demographically diverse Americans—or to

cultural barriers that inhibit proper utilization of available services, or to inadequate distribution of health professionals and services . These communities are more vulnerable to infectious diseases [4] and therefore might be considered the nation's Achilles' heel in a bioterrorism attack. Take, for example, vaccination. A lack of access to health care among US citizens, particularly immigrant populations and those living in poverty, is associated with a failure to be vaccinated. This can have a serious impact on the spread of contagion, as evidenced by a rubella outbreak in 1997 in Westchester County, New York, in which a readily containable virus managed to infect a community composed largely of immigrants who had not been immunized [5].Granted, US federal law permits all persons, including immigrants living here illegally, to receive emergency health care, immunizations and treatment of communicable diseases; those who are unable to pay can receive these services through Medicaid. Studies have shown, however, that immigrants are often disinclined to apply for Medicaid for fear that doing so will compromise their residency status or citizenship applications [6]. Still others avoid the health care system altogether due to mistrust or language barriers [7].Yet, the stockpiling of "prophylactic countermeasures" remains the focus of many current preparedness initiatives, including Project BioShield [8]. The national stockpile of smallpox vaccine, for example, has been expanded in the wake of the 2001 terrorist attacks to a point where it now contains sufficient quantities to vaccinate the entire US

population, in the event that the threat of smallpox is deemed imminent [9]. If effectively disseminated —through mass vaccination programs, for example—the vaccines would indeed constitute a significant line of defense against smallpox; however, it would be a line unwittingly breached by persons unable to be vaccinated. Since this is true of any and all such stockpiles, barriers to access must be addressed if these initiatives are to effectively mitigate the harmful effects of any bioterrorist attack . Immunization, however, is not the whole story; though comprehensive vaccination programs may help to defend against select agents like smallpox, it is simply impractical to suggest that all Americans could, in anticipation of such an attack, be given vaccines and subsequent boosters, if necessary, for each and every pathogen that could be used as a weapon—especially since a bioweapon would

quite possibly contain an engineered strain of a pathogen for which no satisfactory vaccine exists. If such an attack were to take place, it would be imperative for infected individuals to seek immediate medical attention. This is especially true for index cases, the identification and isolation of which is essential to limit the spread of contagion (if the agent used is transmissible person to person). Early identification of index cases enables health officials to trace contacts and swiftly report potential cases, thereby allowing early measures—such as isolation or quarantine—to halt, or at least slow, an emerging potential epidemic [10].A lack of access would greatly impede such an early and effective response, turning vulnerable citizens into unwitting facilitators for the spread of infectious disease. Indeed, it has been shown that people without health insurance report up to 47 percent fewer visits to physicians [11], and often wait longer to seek medical attention even when doing so would be prudent, eventually presenting in advanced stages of infection. Almost certainly, once an incident of bioterrorism has been identified and news of it has permeated the media, all potentially exposed persons, insured and uninsured alike, would report to health care

facilities for assessment. But by then it might be too late to prevent the outbreak from devastating entire communities—especially since recent data suggest that to prevent new viral epidemics, infected patients must be identified and isolated at the earliest possible stages of an outbreak to avoid the virus reaching peak infectivity [12]. What Can Be Done? In their recent report, "Insuring America's Health," the Institute of Medicine recommended that Congress and the White House immediately begin working towards universal health insurance coverage for all Americans by 2010, acknowledging that "the persistence of sizable uninsured populations in many communities in the United States… [redirects] funds to the uninsured away from core

public health programs that address control of communicable diseases and emergency preparedness" [13].

2nc Biotech Scenario

The Science Behind the Biotech Industry Is on The Brink of A Golden Age- Healthcare would force consolidation which would Kill the Industry FT Business 09 (May 25th, “Analyst: Axa Framlington, Financial Times Business, Nexis, AB)Andy Smith's experience of the past 18 months has been very different from that of most equity fund managers. While global stock markets plunged by 30-40 per cent in 2008, the GBP49.9m Axa Framlington. Biotech fund he runs grew by 15 per cent. Moreover, as optimism has returned to the markets, pushing most managers' three-month track records into the black, Mr Smith's fund has lost its lead. Mr Smith cannot claim full credit himself for the strong performance of

Biotech last year. First, he only took on the portfolio in April 2008. Second, the fund underperformed the biotechnology niche as a whole. The Nasdaq Biotech index, which Mr Smith uses as a benchmark, climbed 21 per cent during 2008. Various independent drivers are responsible for last year's rise in biotechnology stocks. Merger and acquisition activity pushed up valuations in July, when four larger deals were announced. Crucially, the reason for these takeovers was not the spectre of bankruptcy, as was the case in the financial services industry in 2008, but instead the necessity for cash-rich pharmaceutical giants to secure strategic assets. This meant it was a sellers' market - good news for biotech investors like Mr Smith. "There isn't a single pharmaceutical company that doesn't have a big patent expiry coming up in 2011-2012. Products typically take 7-10 years to develop. It's quicker and easier for a pharmaceutical to use its cash and buy in products

developed by biotech companies," he explains. For this reason, the manager believes the good news is going to continue . January saw three further acquisitions, fuelling another market bounce. "We're all waiting to see when the next one will come. I know it will happen, but I don't have any idea when or which company it will be," he says.

Another reason for the buoyancy of the biotech niche last year was the surprising strength of corporate earnings. Mr Smith says 2008 was the first year when the US biotech sector - which is made up of large-cap companies with portfolios of successful, lucrative

drugs on the one hand, and smaller, loss-making firms still in the process of developing products, on the other - was profitable as a whole. For Mr Smith, this is evidence the maturing US biotech industry is on the brink of a "golden age ". The reason why biotech companies succeeded in maintaining earnings last year, when most of the other sectors were contracting, is that the goods they develop and sell tend to be essential to survival, such as drugs that prolong the life of a cancer patient. It is to this quality that they owe their reputation as a "defensive" play or "safe haven" - a reputation that further boosted their performance last year, as fund managers piled out of

manufacturing and banks in search of less cyclical alternatives. A final driver of returns for UK investors in 2008 was currency. Most biotech companies are based in the US and register their earnings in dollars. As the pound fell against the dollar, sterling performance therefore bounced. But the pound is unlikely to fall further against the dollar: investors cannot expect the same 'free lunch' this year. Likewise, the risk-aversion of last autumn is not a sustainable driver of stock market

performance - in fact, it is likely to punish the sector in the short term, as managers gradually take on more risk. More worryingly, Mr Smith reports a dip in the biotech sector's profitably in the first quarter of this year. He puts this down to pharmacies running down their inventories due to the

economic uncertainty, however. This suggests the results are a temporary hiccup rather than evidence of a structural or even cyclical trend. Casting a much longer shadow is Barack Obama's promised overhaul of the hugely expensive US health care system . Biotech stocks took a dive in March after the US president announced his 2010 budget proposals for health care reform , including cost-cutting measures such as generic drug use. The Nasdaq Biotech index is now down 11 per cent year-to-date, while the broader equity markets are flat after a V-shaped dip. Mr Smith's fund fell considerably less than the index, however - only 4 per cent for the year to May 5. He puts this down to a well-timed move out of the large, profitable stocks into more speculative mid-cap companies, which would be less penalised in an overhaul of the existing system than the current cash cows. At the end of last year, profitable biotech companies accounted for 75 per cent of his portfolio; now they represent 70 per cent.

Biotech causes mass starvation – terminator genes cross overKimbrell, executive Director of the International Center for Technology Assessment and Executive Director of the Center for Food Safety, senior attorney and policy director of the Greenhouse Crisis Foundation, senior consultant with the Environmental Law Institute in their International Environmental Law Project , 5/12/09, (Andrew, “Myth Seven – Biotechnology Will Solve the Problems of Industrial Agriculture” excerpted from “Fatal Harvest: The Tragedy of Industrial Agriculture”, http://ukiahcommunityblog.wordpress.com/2009/05/12/myth-seven-%E2%80%93-biotechnology-will-solve-the-problems-of-industrial-agriculture/)Far from being an answer to world hunger, genetic engineering could be a major contribut or to starvation. There are currently more than a dozen patents on genetically engineered “terminator” technology. These seeds are genetically engineered by biotech companies to produce a sterile seed after a single growing season, insuring that the world’s farmers cannot save their seed and instead will have to buy from corporations every season. Does anyone believe that the solution to world hunger is to make the crops of the world sterile? With more than half of the world’s farmers relying on saved seeds for their harvest, imagine the mass starvation that would result should the sterility genes escape from the engineered crops and contaminate non-genetically engineered local crops, unintentionally sterilizing them. According to a study by Martha Crouch of Indiana University, such a chilling scenario is a very real possibility .

Blips in food prices kill billionsTampa Tribune, 1-20-1996On a global scale, food supplies - measured by stockpiles of grain - are not abundant. In 1995, world production failed to meet demand for the third consecutive year, said Per Pinstrup-Andersen, director of the International Food Policy Research Institute in Washington, D.C. As a result, grain stockpiles fell from an average of 17 percent of annual consumption in 1994-1995 to 13 percent at the end of the 1995-1996 season, he said. That's troubling, Pinstrup-Andersen noted, since 13 percent is well below the 17 percent the United Nations considers essential to provide a margin of safety in world food security. During the food crisis of the early 1970s, world grain stocks were at 15 percent. "Even if they are merely blips , higher international prices can hurt poor countries that import a significant portion of their food ," he said. "Rising prices can also quickly put food out of reach of the 1.1 billion people in the developing world who live on a dollar a day or less." He also said many people in low-income countries already spend more than half of their income on food.

2nc Biotech Scenario—Biodiversity

Biotech kills biodiversity – genetic pollution, superweeds Kimbrell, executive Director of the International Center for Technology Assessment and Executive Director of the Center for Food Safety, senior attorney and policy director of the Greenhouse Crisis Foundation, senior consultant with the Environmental Law Institute in their International Environmental Law Project , 5/12/09, (Andrew, “Myth Seven – Biotechnology Will Solve the Problems of Industrial Agriculture” excerpted from “Fatal Harvest: The Tragedy of Industrial Agriculture”, http://ukiahcommunityblog.wordpress.com/2009/05/12/myth-seven-%E2%80%93-biotechnology-will-solve-the-problems-of-industrial-agriculture/)The idea that biotechnology is beneficial to the environment centers on the myth that it will reduce pesticide use by creating plants resistant to insects and other pests. In actuality the government’s own independent research has disproved this claim. A study by the U.S. Department of Agriculture in 2000 revealed that there is no overall reduction in pesticide use with genetically engineered crops . Even as it does nothing to alleviate the chemical pollution crisis, biotech food brings its own very different pollution hazard: biological and genetic pollution . In 2000, Purdue University researchers found that the release of only a few genetically engineered fish into a large native fish population could make that species extinct in only a few generations. Meanwhile, scientists at Cornell University discovered that the pollen from Bt-corn could be fatal to the Monarch butterfly and other beneficial insects. The Union of Concerned Scientists has shown that the genetically engineered Bt crops could lead to pests becoming resistant to Bt. This non-chemical pesticide is essential to organic and conventional farmers throughout the country. If plant pests develop a resistance to it, this could fatally undermine organic farming in the United States. Another significant environmental issue with GE foods is that the crops are notoriously difficult to control. They can migrate, mutate, and cross-pollinate with other plants. If a pest- or herbicide- resistant strain were to spread from crops to weeds, a “superweed” could result and be nearly impossible to stop. Overall, the environmental threat of biotechnology caused 100 top scientists to warn that careless use could lead to irreversible, devastating damage to the environment .

Biodiversity is critical to prevent extinctionRichard Margoluis, Biodiversity Support Program, 1996, http://www.bsponline.org/publications/showhtml.php3?10Biodiversity not only provides direct benefits like food, medicine, and energy; it also affords us a " life support system." Biodiversity is required for the recycling of essential elements, such as carbon, oxygen, and nitrogen. It is also responsible for mitigating pollution, protecting watersheds, and combating soil erosion. Because biodiversity acts as a buffer against excessive variations in weather and climate, it protects us from catastrophic

events beyond human control. The importance of biodiversity to a healthy environment has become increasingly clear. We have learned that the future well-being of all humanity depends on our stewardship of the Earth. When we overexploit living resources, we threaten our own survival .

Tix Good

Politics tests a key opportunity costSaideman, associate professor of political science - McGill University, 7/25/’11(Steve, “Key Constraint on Policy Relevance,” http://duckofminerva.blogspot.com/2011/07/key-constraint-on-policy-relevance.html)

Dan Drezner has a great post today about how the foreign policy smart set (his phrase) gets so frustrated by domestic politics that they tend to recommend domestic political changes that are never going to happen.I would go one step further and suggest that one of the key problems for scholars who want to be relevant for policy debates is that we tend to make recommendations that are "incentive incompatible." I love that phrase. What is best for policy may not be what is best for politics , and so we may think we have a good idea about what to recommend but get frustrated when our ideas do not get that far.Lots of folks talking about early warning about genocide, intervention into civil wars and the like blame "political will." That countries lack, for whatever reason, the compulsion to act. Well, that is another way of saying that domestic politics matters, but we don't want to think about it . Dan's piece contains an implication which is often false--that IR folks have little grasp of domestic politics. Many IR folks do tend to ignore or simplify the domestic side too much, but there is plenty of scholarship on the domestic determinants of foreign policy/grand strategy/war/trade/etc. Plenty of folks look at how domestic institutions and dynamics can cause countries to engage in sub-optimal foreign policies (hence the tradeoff implied in my second book--For Kin or Country).The challenge, then, is to figure out what would be a cool policy and how that cool policy could resonate with those who are relevant domestically. That is not easy, but it is what is necessary . To be policy relevant requires both parts --articulating a policy alternative that would improve things and some thought about how the alternative could be politically appealing.Otherwise, we can just dream about the right policy and gnash our teeth when it never happens.

pc = real

PC high, despite recent controversyStoddard, columnist – The Hill, 1/6/’12(http://thehill.com/blogs/pundits-blog/the-administration/202775-for-obama-an-actual-good-week)

For the first time in a while, President Obama is enjoying a pretty good week. The jobs picture brightened slightly Friday, and though 200,000 new jobs still aren’t enough to keep pace with population growth and a healthy number of the unemployed have stopped looking for work, brighter beats darker any day. The full picture of forecasts for growth, particularly in the critical housing industry, remains worrisome and weak. But politically the metric for the public, and for Obama's political fortunes, is the unemployment number , and this month that number went down to 8.5 percent for the first time in three years. He can and will call it progress.Meanwhile, with all eyes on a split vote in the Iowa caucuses and a very split GOP, Obama wedged himself into the news cycle with a frontal attack on congressional Republicans. Four recess appointments they had sought to avoid, and while far fewer than presidents George W. Bush or Bill Clinton, Republicans are livid. Richard Cordray 's appointment to head the Consumer Financial Protection Bureau prompted screaming press releases from congressional Republicans, and challenges to the constitutionality of Obama's move will make later headlines. The bump he got with his base, and likely some independent voters, is probably larger than any damage he did with other independents who don't like recess appointments.The act itself was only part of the story, as the campaigner-in-chief went on the road to provide the appointment full display — in Ohio. Before a boisterous crowd, he blamed House and Senate Republicans for blocking his agenda to protect the middle class. Having won round one of the payroll tax cut extension fight, Obama is clearly feeling buoyed. And though the eventual Republican nominee isn't likely to be a member of Congress, Obama will work hard to contrast himself with congressional Republicans, whose popularity is lower than 25 percent in opinion polls, as long as he can.

Political capital is a true theorySchier 9, Professor of Poliitcal Science at Carleton, (Steven, "Understanding the Obama Presidency," The Forum: Vol. 7: Iss. 1, Berkely Electronic Press, http://www.bepress.com/forum/vol7/iss1/art10)

In additional to formal powers, a president’s informal power is situationally derived and highly variable . Informal power is a function of the “ political capital ” presidents amass and deplete as they operate in office. Paul Light defines several components of political capital: party support of the president in Congress, public approval of the presidential conduct of his job, the President’s electoral margin and patronage

appointments (Light 1983, 15).Richard Neustadt’s concept of a president’s “professional reputation” likewise figures into his political capital. Neustadt defines this as the “impressions in the

Washington community about the skill and will with which he puts [his formal powers] to use” (Neustadt 1990, 185). In the wake of 9/11, George W. Bush’s political capital surged, and both the public and Washington elites granted him a broad ability to prosecute the war on terror. By the later stages of Bush’s troubled second term, beset by a lengthy and unpopular occupation of Iraq and an aggressive Democratic Congress, he found that his political capital had shrunk.Obama’s informal powers will prove variable, not stable, as is always the case for presidents. Nevertheless, he entered office with a formidable store of political capital. His solid electoral victory means he initially will receive high public support and strong backing from fellow Congressional partisans, a combination that will allow him much leeway in his presidential appointments and with his policy agenda. Obama probably enjoys the prospect of a happier honeymoon during his first year than did George W. Bush, who entered office amidst continuing controversy

over the 2000 election outcome.Presidents usually employ power to disrupt the political order they inherit in order to reshape it according to their own agendas. Stephen Skowronekargues that “presidents disrupt systems, reshape political landscapes, and pass

to successors leadership challenges that are different from the ones just faced” (Skowronek 1997, 6). Given their limited time in office and the hostile political alignments often present in Washington policymaking networks and among the electorate, presidents must force political change if they are to enact their agendas. In recent decades, Washington power structures have become more entrenched and elaborate (Drucker 1995) while presidential powers – through increased use of executive orders and legislative

delegation (Howell 2003) –have also grown. The presidency has more powers in the early 21st century but also faces more entrenched coalitions of interests, lawmakers, and bureaucrats whose agendas often differ from that of the president. This is an invitation for an energetic president – and that seems to describe Barack Obama – t o engage in major ongoing battles to impose his preferences .