Erin Baggott Carter, a CISAC fellow during 2014-16, recently published a Washington Post op-ed on the Chinese media coverage of the current U.S. presidential election. This is a result of CISAC's increased focus on requiring and helping all CISAC fellows publish an op-ed based on their academic research. Carter is now an assistant professor at the School of International Relations at the University of Southern California. Click here to read the entire op-ed, with charts and additional links. Below is the written portion:

Erin Baggott Carter

How do the 2016 U.S. elections appear outside the United States? The state-controlled Russian media clearly leans toward Republican nominee Donald Trump, who appears to admire President Vladimir Putin.

But what about China’s state-controlled media? Given Trump’s frequent references to China as a major cause of U.S. job losses — and his promises to get tough on trade pacts — one might expect harsh reporting on Trump.

To test this theory, I scraped China’s leading state-affiliated print news media from May 1 to Oct. 24, looking for references to the two candidates and automatically coding whether nearby words indicated a positive or a negative tone. This exercise shows that official Chinese-language media leans somewhat toward “Hillary” (as the Democratic candidate is referred to in China) in terms of favorable mentions.

Early this summer, Chinese state media covered Trump far more often than Hillary Clinton. But by this fall, the volume of coverage was nearly equal. There has been very little coverage of trade policies or economic implications for China. Instead, Chinese reporting tends to focus on scandals and missteps. This does not reflect a typical “horse-race” view of elections. Instead, as my ongoing research shows and some journalists point out, Chinese propaganda likes to emphasize the flaws of democracy as a political system.

The graph below shows the volume of coverage for both candidates. In early May, state-run newspapers mentioned Trump five times as often as they mentioned Clinton. This imbalance has steadily declined. Currently, the candidates are mentioned with nearly identical frequency.

The next graph shows the editorial tone of coverage of Trump and Clinton. Since May, Chinese propaganda has consistently covered Clinton more favorably, although both candidates have become slightly less popular over time. Clinton’s favorability rating started at 92 percent in May and declined to 77 percent in late October. Trump’s favorability rating started at 79 percent in May and declined to 71 percent in late October.

China’s state-run newspapers have said relatively little about the candidates’ policies and their implications for U.S.-China relations. Instead, coverage has focused on scandals: Clinton’s deleted emails and Trump’s affinity for Vladimir Putin, his tax returns, and his relationships with women.

Excluding generic campaign words and filler words, the most commonly used words about Clinton include “email,”  “investigation,” “Russia,” “FBI,” “lawsuit,” “Clinton Foundation,” “scandal,” “husband,” and “women.” The most commonly used words about  Trump include “Russia,” “Putin,” “intraparty,” “criticism,”  “immigrants,” “tax payments,” “slander,” “New York,” “magnate,” “women” and “real estate.”

Why is Clinton getting better coverage?

China’s preference for Clinton over Trump is notable for two reasons. First, China has a tepid relationshipwith Clinton. In her first visit to Beijing in 1995, she refused to meet with senior leaders and criticized Chinese human rights practices, neither of which endeared her to her hosts. As secretary of state, she implemented the Obama administration’s strategy of rebalancing toward Asia, which many in China interpreted as a move toward containment. After Clinton left the State Department, the China Daily wrote that she “always spoke with a unipolar voice and never appeared interested in the answers she got.”

Second, it takes a lot for Chinese leaders to take China-bashing from U.S. presidential candidates seriously. They learned from Ronald Reagan, Bill Clinton and George W. Bush that U.S. presidents rarely enact the anti-China campaign platforms that help carry them to victory. For instance, as Mitt Romney ramped up his criticism of Chinese trade practices in 2012, China’s Global Times speculated, “Is Romney’s toughness toward China just a scam? … His soft stance is only a matter of time.”

These two facts speak to the depths of Chinese concern about a Trump presidency. Despite China’s historical antipathy toward Clinton and willingness to countenance tough campaign rhetoric, Chinese propaganda still favors Clinton over Trump.

This is important because the American media has recently speculated that China, like Russia, may prefer a Trump presidency because it would lead the United States to withdraw from the world. Although there are doubtless some in the 88 million-member Chinese Communist Party who hold this view, China is far more integrated into the American financial system than Russia is and has commensurately larger stakes in U.S. economic stability.

For instance, as the U.S. financial sector was unraveling in September 2008, Treasury Secretary Hank Paulson asked China not to sell Treasury bonds. China agreed, Paulson tells us in his memoirs, even though Russia invited China to weaken the American economy by dumping bonds in concert.

Now, as was the case eight years ago, when forced to choose between global stability and relative gains over the United States, Chinese leaders prefer global stability. Although Trump offers China the enticing possibility of American withdrawal from the Asia-Pacific sphere, Chinese leaders have begrudgingly cast their lot with the devil they know. This is evident from the propaganda they control, which favors Clinton over Trump.

Kathryn Stoner, Director of the Ford Dorsey Program in International Policy Studies and a Senior Fellow at the Freeman Spogli Institute for International Studies, debates for the New York Times with Matthew Rojansky, the Director of the Kennan Institute at the Wilson Center, about the U.S. foreign policy challenges, arguing that there is no natural conflict between two powers.  "As the long history of cooperation demonstrates, there is no structural reason Russia and the U.S. cannot get along. They have and did for over 30 years. It was Putin’s offer of asylum to rogue U.S. security contractor Edward Snowden in 2013, followed by his unanticipated demand that the U.S. Agency for International Development leave Russia the same year, harassment of the U.S. ambassador and other embassy officials since, and finally his seizure of Crimea in Ukraine in 2014 and support of a low boil conflict in eastern Ukraine that ended cooperation. The next U.S. president will inherit not a “Russia problem” but a Putin problem, which makes Trump’s position not only odd, but dangerous." Read more here. 

The coordinated cyber attack that crippled parts of the internet on Friday highlighted key policy problems, a Stanford cybersecurity scholar said.And while the problems were clear, there are no easy solutions, said Herbert Lin, a senior research scholar for cyberpolicy and security at Stanford’s Center for International Security and Cooperation. A research fellow at the Hoover Institution, Lin serves on the President’s Commission on Enhancing National Cybersecurity.

Beginning early Friday morning, several major websites including Twitter and Amazon went down for most of the day, and many other sites were inaccessible. The FBI and the Department of Homeland Security are investigating what is described as a DDoS (distributed denial-of-service) attack. The attacks mainly focused on Dyn, one of the companies that run the internet’s domain name system (DNS).

The following is an interview with Lin:

What happened on Oct. 21?

It was a distributed denial-of-service attack on a major internet services provider. The company operates much of the internet’s infrastructure. It’s not a consumer-facing company, but is in between the user and a company like, say, Amazon. These attacks centered on the domain name system (DNS), which is the service that translates something like stanford.edu into a numerical IP address. People remember Amazon.com, but they don’t remember the numerical IP address (which is actually where a company like Dyn sends web users going to a site like Amazon). What a DOS attack involves is the flooding of this (Dyn) company’s servers with millions of fake requests from sources for service to go to those web sites. Being forced to process all these requests, the company can’t service real people trying to use web sites. On Friday, the millions of sources making these requests appear to have been part of the Internet of Things.

What is the Internet of Things, and how did it factor into the cyberattack?

In this case, they weren’t, by and large, products like your computer or mine, but were mostly smaller things like surveillance cameras, baby monitors and home routers [everyday objects that have network connectivity to the internet]. What makes these things particularly vulnerable is that they are small, they don’t have much computational power in them, and they don’t include many, if any, security features. In fact, a Chinese company just admitted that it didn’t pay enough attention to security, and they recommend users do some things to improve security. But they shipped their products without paying much attention to security, and that’s why this was a vulnerability.

What new public policies could lessen the likelihood of this happening again?

The primary policy recommendation is that we need policy that encourages – or mandates, depending on how strong you want to be about it – at least minimal security measures for devices that connect to the internet, even Internet of Things devices. How you actually promote, encourage or incentivize that without a legal mandate is problematic, however, because nobody quite knows what the market will accept. Also, if you’re going to force manufacturers to pay attention to security, you’re going to reduce the rate of innovation for these products. Then there’s the question of who’s going to buy them, because the unsecure ones will probably be cheaper. The fundamental problem here is that guys who use the Internet of Things, like surveillance cameras, will find those cameras work perfectly fine, even if they were compromised. So they don’t care about security. They have no incentive to do so. Why should they pay more to protect me?

Does this show that our November election is even more vulnerable to hacking?

At this point, it looks unrelated … But I don’t know, it is all just speculation.

Herb Lin's research interests focus on policy-related dimensions of cybersecurity and cyberspace, especially regarding the use of offensive operations in cyberspace as instruments of national policy. In addition to his Stanford positions, he is chief scientist, emeritus, for the Computer Science and Telecommunications Board, National Research Council (NRC) of the National Academies. Prior to this, he was a professional staff member and staff scientist for the House Armed Services Committee (1986-1990), where his portfolio included defense policy and arms control issues. To learn more, read Lin's "An Evolving Research Agenda in Cyber Policy and Security."

MEDIA CONTACTS

Herbert Lin, Center for International Security and Cooperation: (650) 497-8600, herbert.s.lin@stanford.edu

Clifton B. Parker, Center for International Security and Cooperation: (650) 725-6488, cbparker@stanford.edu

Health policy expert Bob Kocher likes to show a slide of the signature page of the Affordable Care Act, which he helped draft when he worked in the White House.

The mottled page shows an official time stamp of March 23, 2010, and the choppy signature of President Obama, who had to use the 22 pens he would later gift each member of Congress who helped him pass the landmark health-care law.

“We thought it would be pretty simple,” Kocher recalled with a grin. “We had 60 Democrats in the Senate and a huge majority in the House, a popular president. But then you saw what happened.”

Kocher was the keynote speaker at Health Policy through 2020: The ACA, Payment Reform and Global Challenges, a half-day symposium of speakers and panels covering some of the greatest challenges facing health care and policy here at home and abroad.

“Everything that you could imagine that would throw a monkey wrench into it, did,” said Kocher, a physician and partner at the Silicon Valley venture capital firm, Venrock, which invests in health-care and technology startups.

Six years after its rocky start — and ongoing threats to repeal the law by Republicans — Kocher still believes the ACA has had a tremendously important impact on the nation.

“Despite the single worst launch of a website in the history of the internet,” he said, 20 million more Americans now have access to health care; 13 million more are privately insured by their companies; and 7 million more are enrolled in Medicaid.

“I believe the ACA is working better than expected by virtue of the fact that there’s nobody in the ecosystem who is not behaving differently,” Kocher said.

Large employers have been forced to engage with their employees about the costs and quality of their health plans, and hospitals are adopting new technology by “liberating their data” with electronic medical records and embracing telemedicine, Kocher said.

“And for the first time, you see patients beginning to engage with new technologies and their doctors willing to entertain new models.”

Kocher, who specializes in investing in healthcare IT and services, said technology would eventually strip away some of the cost of patient care.

“One of the fun parts of my job as a venture capitalist is that I get to see a lot of these embryonic ideas and many of them have powerful ways to pull down costs without hurting quality,” he said. “We’ll have the technology and coordinated care, and data that helps guide the care, so I’m more hopeful than ever about being a patient.”

Kocher, a consulting professor at Stanford Medicine, was one of 15 speakers at the symposium to launch Stanford Health Policy, a community of faculty, physicians, scholars and students across the campus who are focused on improving health care and policy here at home and around the world.

Precision Health

Stanford School of Medicine Dean Lloyd B. Minor shared what he called “some surprising statistics” with the 200 people at the symposium on Oct. 14.

When looking at a pie chart representing the determinants of health, Minor said, only 5 percent are genetically based, 20 percent are based on health care and another 20 percent are due to behavioral factors.

But a full 55 percent of the determinants of health are socially and environmentally determined, Minor said, and that presents challenges for academic medical centers.

“I’m really excited in that I believe that we are beginning to come up with some ways we can address that need, as a leading academic medical center, to chart the future for how we can improve the delivery of health care in our country and then ultimately around the world,” Minor said. “For us, that vision for how we fulfill that need begins with what we describe as precision health.”

Minor said precision medicine, now embraced by the Obama administration, is about using genomics, big data science and personalization in order to individualize the treatment of acute diseases such as cancer, heart and neurological diseases.

“It’s about understanding the determinants and predisposing factors of disease in being able to more effectively intervene earlier,” he said. “And of course there’s no better place to do that than at Stanford because our academic medical center is such an integral part of this great research university.”

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The ACA Moving Forward

Kocher, who often lectures in health economics and policy courses at Stanford, conceded there are serious problems with Obamacare and offered some solutions moving forward.

But the climbing cost of health care and prescription drugs in the United States — which continue to outpace the economy and job growth — is his first concern.

Health insurance on average costs a family of four is $18,000 a year.

“That’s the price of a Corolla,” he said, referring to Toyota’s compact car. “The idea that you’re effectively buying a new car every year doesn’t feel like we’re getting the right amount of cost pressure on the system that we need. So I think that’s going to be the most fundamental problem going forward.”

Despite the gnashing of teeth over what would become of the ACA under a Trump or Clinton administration, Kocher predicted few changes.

“If Hillary Clinton wins, her priorities are actually going to be totally separate from ACA tweaks,” he said, adding that she likely would first focus on K-through-12 education, work on infrastructure spending and then international affairs.

“The odds that she wants to relive 1993 seems implausible to me,” he said.

As first lady, she pushed President Bill Clinton’s universal health-care plan with a mandate for all employers to provide health insurance coverage to all employees. The Health Security Act was widely condemned by conservatives and the health insurance industry and after a rancorous year of debate and counter-proposals, it died.

And what happens to the ACA if Donald Trump is elected president on Nov. 8?

“I can’t bring myself to comment,” Kocher said, lowering his head and chuckling.

He quickly moved on to some suggestions to make health care work better and faster.

“The first thing we need is to make these adolescent exchanges grow into adults and be stable and work better,” Kocher said of the health insurance marketplaces, which have foundered in some states and thrived in others.

He said the Covered California exchange, which insures some 1.7 million Californians, is the only exchange working really well because it has large bidding regions, doesn’t let all insurance providers into the system and does great outreach to young, healthy people.

Secondly, he said, the market power of hospitals has become too strong.

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“I realize there are some hospital leaders in the room and I salute you — you’ve done many things right, including getting market power,” Kocher said, addressing David Entwistle and Chris Dawes, the CEOs of Stanford Health Care and Lucile Packard Children’s Hospital, respectively, who also spoke at the symposium.

“But we need to figure out how to make the demand side of the equation more balanced with the supply side.”

He called health care today “massively inefficient” and “insanely unaffordable,” and said the average hospital stay is now $6,000 in the United States.

Kocher said he recently took his daughter to an emergency room and was charged $52 for a Tylenol. He told them he was a doctor and offered a Tylenol from his backpack.

“But I was told I couldn’t because of the safety of the hospital,” he said, shaking his head.

Kocher said hospitals must be accountable for their quality of the care and fined for failure to achieve promised quality indicators. As hospitals continue to bundle services and acquire private practices and physicians, costs have not gone down as expected.

Instead, hospital prices nationally have risen 6 to 9 percent in the last five years, faster than the rate of inflation. Perhaps, he suggested, some procedures and services should be tied to Medicare rates above a certain percentage of market share. And federally subsidized drug prices should be tied to patient income, not the facilities they use.

Kocher said there continues to be great debate over how high the penalty should be for those who decline to join a health exchange if they are uninsured by an employer.

The annual fee for not having insurance in 2016 is $695 per adult and $347.50 per child.

A higher mandate, he said, would get a lot more people into the system.

“But there’s no chance Congress is going to think about that.”

You can watch all the videos from the event here: 

Health Policy through 2020 by Stanford Health Policy on Exposure