Assessing Civil-Military Relations and the January 6th Capitol Insurrection

The events of January 6, 2021, when violent rioters attacked the Capitol building in Washington in order to disrupt validation of the 2020 presidential election, forced an unprecedented reckoning with the state of American politics. Members of Congress struggled to account for the rhetoric that gave rise to the event; law enforcement grappled with the challenge of holding accountable those who perpetrated the violence; and journalistic outlets wrestled with reporting a complex web of conspiracy theories and disinformation that gave rise to the insurrection. But for senior military leaders, the question was how to explain the troubling presence of active duty servicemembers and veterans in the first attack on the American seat of government in two centuries. The result is a profound and urgent discussion in U.S. civil-military relations.     

Tension, compression, and shear: directions, stresses, and outcomes of health care cost control

"Control" of health care costs is often portrayed as a struggle between external, "natural" forces pushing costs up and individuals, groups, and societies trying to resist the inevitable. This picture is false. Control includes strenuous efforts by some to raise costs, and by others to resist those increases, and/or to transfer costs to someone else. But all such forces originate in the purposes and interests of individuals and groups. Health care cost control is a struggle among conflicting interests over the priorities of a society, and claims of "inevitability" are simply part of the political rhetoric of that struggle. International experience supports certain conclusions. First, there is no basis for the claim that limits on expenditure growth must threaten the health of (some members of) a society. Second, there is a substantial variety of experience with cost control. Failure in the United States is often presented as evidence of the impossibility of control, but most other countries have succeeded. Finally, control requires the direct confrontation of interests, with substantial build-up of stress. Advocates of expansion are more successful if they can transform compressive forces into efforts to shift the burden onto someone else. Pressures from providers in every country for "privatization" and/or payment by users reflect this recognition of economic interest.