Countries like the Asian “tigers” that experienced rapid economic growth inevitably encounter slowdowns that signal a fundamental shift in their economies. At this juncture, transitioning their institutions and policies often proves to be a most daunting task. Cautionary comparisons like these set the tone for the conference titled “China’s Possible Futures” on May 12, 2017, when the China Program celebrated its 10th anniversary.

As China nears the end of four decades of reforms, “China’s Possible Futures” was a fitting theme to mark the China Program’s first decade at Stanford’s Shorenstein Asia-Pacific Research Center. The launch of the Program in 2007 began with an international conference titled “Growing Pains: Tensions and Opportunities in China’s Transformation,” which resulted in a book of the same title. This year’s 10th anniversary conference appropriately heralded both change and continuity of the themes that were explored in 2007. A decade ago, the conference showcased the tremendous reach and rise of China as an economic and international powerhouse, and in 2017, the conference expanded to highlight the critical juncture that China is again facing on its developmental path.

The full-day conference, held under Chatham House Rule, was divided into four sub-themes with speakers addressing China’s economic future; its political future; the future of its international relations and global economic engagements; and a comparative panel that examined China’s prospects from experiences drawn from Japan, South Korea and former Soviet and Eastern European countries.

Panel I: China’s Economic Future

Speakers agreed that China’s tremendous growth over the last 40 years has no easy parallels in history. Some argued, however, that the policies realized over the next few years will prove critical to China’s long-term growth. Favorable factors, such as demographic, migratory and structural changes supported by a stable international order, enabled China’s spectacular, double-digit growth over the last 40 years. When “miracle growth” countries of Northeast Asia – like Japan, Korea and Taiwan – entered their periods of moderate growth, however, painful readjustments were necessary. Restructuring was required because the very policies and institutions set up to enable rapid growth were counterproductive to creating a foundation for moderate, sustained growth. Speakers variously emphasized China’s need to invest in human capital and undertake financial reforms, urban-rural reforms and state-owned sector reforms.

In addition, several speakers noted that China is facing mounting demographic challenges as its population ages and as its elderly population lives longer. According to one speaker, people who are aged 60 and over in China will equal the population of people aged 0 to 14 within the next couple years; and by year 2045, the population of people who are 65 and older in China will be as large as the entire population of the United States today. This situation implicates rising costs in healthcare and calls for major institutional reforms in China’s health sector.

One speaker spoke of the rapid rise in China’s returns to education, i.e., the rise in income for each additional year of education, over the past four decades, which now looks more closely aligned with that of the international average of approximately 10 percent. Another speaker asked whether China was now pursuing a different developmental model with increasing focus on inland industrial development and explored what this might mean for social inclusion and labor conditions of workers.

Panel II: China’s Political Future

One speaker argued that Chinese President Xi Jinping’s reform agenda does not mark a break with the past, as many have argued, but rather continuity with his predecessors’ policies. Other speakers discussed the scope and scale of Xi’s corruption crackdown; fiscal imbalances in central-local state relations that underpin China’s corruption problems; and the implications of social media on Chinese governance. All speakers spoke about mounting difficulties in the political sphere, including powerful interest groups; local paralysis arising from corruption crackdowns; mounting local government debt and misalignment of central-local interests; and governance challenges stemming from the social media revolution. Overall, speakers seemed to suggest mounting difficulties for Xi’s reform agenda, which the Chinese government must push through to avoid a sharper downturn and slower growth prospects for China’s future.

Panel III: China’s International Relations and Global Economic Engagements

Speakers spoke at length regarding the history of U.S.-China relations since Deng Xiaoping’s “reform and opening”; territorial disputes in the South and East China Seas; China’s “Belt and Road” policy; and China’s outbound capital flows into various regions of the world. The speakers held varying views regarding Beijing’s motivations and intentions in the world, both militarily and economically. Speakers held different opinions about whether Beijing has a well-defined vision for its global role. One speaker questioned whether China’s maritime assertiveness in the South and East China Seas characterizes the expansionary policies of a rising power; or whether it represents something more singular as China protects what it considers its “core interests” in the region. One speaker expressed the view that the United States and the U.S.-led international order is still too important for China’s development for it to threaten its functioning in any meaningful way. Another speaker discerned a “broad brush strokes” of a developmental concept in China’s “One Belt, One Road” policy that the United States might do well to heed as it considers whether to join any parts thereof.

Panel IV: China’s Future: A Comparative Perspective

The conference also included speakers who provided comparative examples from Japan, South Korea, the former Soviet Union and Eastern Europe to inform their views on China’s “possible futures.” One speaker warned against directly applying Japan’s development model to China, warning that Japan experienced a massive credit boom and debt accumulation in the 1980s like China is experiencing today. Zombie firms were a key factor in Japan’s economic stagnation. As the speaker warned, zombie firms also proliferate in China’s economy. Another panel member highlighted Korea’s struggles to attract and retain global talent and drew lessons for China as it strives to escape the middle-income trap and build an innovation-driven economy.

Another panel member spoke of the key difference between China’s political environment in 1978 when Deng Xiaoping announced his “reform and opening” policy and today when Xi is implementing his Third Plenum decision of 2012. Vested interest groups are stymieing the implementation of urgently-needed reforms, especially in the state-owned sector and in China’s financial sector. In 1978, by contrast, the catastrophic results of the Cultural Revolution ironically enabled Deng to successfully champion and implement his agenda because bureaucratic interests had been gutted by Mao. The speaker spoke of the urgent need for Xi to change course in the next 3-4 years and use his personal power to push through tough, market-oriented reforms. Beijing’s leaders must not only craft correct policies and identify the most effective structural correctives, they must also break through the political logjam of entrenched interests that have benefited from the current system.

Panelists pointed to the increasingly difficult challenges that the government faces as China tries to avoid the middle-income trap after four decades of impressive gains and usher in sustained economic growth driven by innovation and domestic consumption. Speakers also agreed that the leadership is encountering a more complex and diverse society, a fractured elite, and the Gordian knot of economic and demographic predicaments, which require not only painful structural adjustments but also tremendous political will to realize policies that will ensure an optimal future for China.

Related links:

Brochure: Celebrating the First 10 Years of the China Program

Former ambassador reflects on US-China relations, Thucydides Trap

Colonel Patrick Winstead, the 2016-17 FSI senior military fellow at Shorenstein APARC, writes about the second annual orientation at U.S. Pacific Command headquarters

The mission of the Department of Defense (DoD) in the Indo-Asia-Pacific region recently became a bit clearer for 22 faculty and military fellows from Stanford, the Massachusetts Institute of Technology, the Naval Postgraduate School and the Daniel K. Inouye Asia-Pacific Center for Security Studies (APCSS). The U.S.-Asia Security Initiative at the Shorenstein Asia-Pacific Research Center (APARC) in the Freeman Spogli Institute (FSI) organized a group of faculty and fellows for a two-day orientation of United States Pacific Command (USPACOM) and its component military organizations in and around Honolulu, Hawaii, April 13-14, 2017. The purpose of the orientation was to provide researchers with a comprehensive understanding of how America’s armed forces both develop and implement U.S. national security strategy, doctrine and policy throughout Asia.

The trip began with a visit to the headquarters of USPACOM at Camp H.M. Smith. After receiving briefings about USPACOM's mission and operations, the group engaged in roundtable discussions with General Terrence O’Shaughnessy (Commander, U.S. Pacific Air Forces); Major General Kevin B. Schneider (Chief of Staff, USPACOM); Rear Admiral Mark Montgomery (Director for Operations, USPACOM); Major General Steven Rudd (Director for Strategic Planning and Policy, USPACOM); as well as other key joint directors and members of the command staff. The faculty and fellows provided short presentations on the situation in the South China Sea, U.S.-Philippine relations and cyber warfare to an audience of mid-grade military officers and civilian personnel assigned to USPACOM.

In addition to meeting with the leadership of USPACOM, the group was also afforded the opportunity to interact with personnel from the four separate component commands. Deputy Commanding General of U.S. Army Pacific, Major General Charlie Flynn, provided a command briefing at the U.S. Army Pacific headquarters at Fort Shafter. The briefing stimulated a wide-ranging discussion about Army initiatives and activities in support of USPACOM’s mission in the Indo-Asia-Pacific region. At Marine Corps Base Hawaii at Kaneohe Bay, under the guidance of trainers, the visitors took part in a hands-on experience operating Humvee simulators in a virtual-reality convoy setting and firing simulated weapons that Marines typically employ in combat operations. The first day of the trip ended with a working dinner at the historic Nimitz House with the Commander of the U.S. Pacific Fleet, Admiral Scott Swift, where the conversation ranged from Chinese military modernization to evolving U.S. naval doctrine.

Those themes carried into the second day, when the group met for several hours with faculty at APCSS for plenary presentations and multiple breakout sessions to facilitate in-depth dialogue on select topics including the threats posed by nuclear weapons on the Korean Peninsula and in South Asia. The day continued with a tour of the U.S.S Hopper, an Arleigh-Burke class guided missile destroyer, based at Pearl Harbor, Hawaii. Once onboard, the ship’s captain, Lieutenant Commander J.D. Gainey, provided briefings on Hopper’s mission and operational capabilities. In addition, the group spoke with members of the ship’s crew. The experience allowed the faculty and fellows to interact informally with sailors who serve in the Asia-Pacific theatre and to candidly discuss issues of concern. The second day of the orientation ended with a visit to the headquarters of U.S. Pacific Air Forces and a dialogue with O’Shaughnessy and his staff about the unique security challenges of the Indo-Asia-Pacific region, such as tyranny of distance, limited support bases and multiple emerging threats, and how those challenges impact the Air Force and the entire U.S. military’s preparations for contingencies in the region.

Overall, the orientation provided a unique opportunity to engage directly with high-level leaders of USPACOM and to learn first-hand about the challenges faced by those who serve in the armed forces. The orientation also provided a forum to discuss the United States’ national security interests in the region and its efforts to maintain peace and stability in the Indo-Asia-Pacific and to help maintain a rules-based, liberal democratic order.

Related links:

Photo gallery

Emily Tuong-Vi Nguyen, a Stanford student studying human biology, writes about the Asia Health Policy Program’s international conference on diabetes

The Asia Health Policy Program at the Shorenstein Asia-Pacific Research Center hosted the Net Value in Diabetes Management Workshop in March to discuss progress on an international research collaboration. Research teams from Hong Kong, Singapore, China, Taiwan, South Korea and the United States convened at the Stanford Center at Peking University (SCPKU) in Beijing to work on research that compares utilization and spending patterns on diabetes across different countries and to develop a method for measuring the net value of diabetes internationally, based on previous methods discussed in a Eggleston and Newhouse et al. 2009 study with Mayo Clinic Data for Type 2 diabetes.

The research teams from various Asian countries are attempting to calculate the net value of diabetes in those countries by observing the changes in diabetes value and spending. These calculations include monetizing the value of health benefits of new treatments and improvements in health, as well as avoided spending on treatments when prevention was effective, and associated mortality and probability of survival. Previous models used to measure diabetic values and risks, such as the United Kingdom Prospective Diabetes Study (UKPDS) risk engine that was created from U.K. data and populations, are not very relevant for Asian populations. The goal is to create separate risk models specifically suited for populations from Hong Kong, Singapore, China, Taiwan and South Korea.

During the workshop that spanned two days, the research teams had an opportunity to share updates on their individual projects and to discuss methods and ideas for future collaboration.

On the first day, each research team presented its work, describing data sets and explaining the risk models that were used or developed. Karen Eggleston, director of the Asia Health Policy Program, delivered introductory remarks and shared current progress by the Japan and Netherlands research teams on calculating value and risk for diabetes with data from the Netherlands and Japan. The data sets from those two countries were best estimated by the JJ Risk Engine for the Japan data and the UKPDS model for the Netherlands data.

Chao Quan of the University of Hong Kong presented the risk model used for Hong Kong populations. His work primarily looked at how the UKPDS risk engine predicted risk in Hong Kong populations as compared to a local Hong Kong risk engine and how to best calibrate the Hong Kong risk engine. His next step will be to monetize the value for improved survival in diabetes in Hong Kong. He offered to re-estimate the model using the risk factors available on others’ datasets so that the Hong Kong risk model could potentially be used by other teams as well.

Stefan Ma and Zheng Li Yau of the Ministry of Health of Singapore discussed the 5-year prediction model and statistical methods they used for all-cause mortality of Singaporean individuals with diabetes. Their work is based on Singapore’s extensive administrative and claims data as well as data provided by the national health surveys conducted every six years by the National Health Service of Singapore. The researchers plan to look into how their overall risk model compares with models for specific subpopulations, such as Chinese, Malay and Indian populations in Singapore.

Katherine Hastings from the Stanford University team, led by principal investigator Latha Palaniappan, presented preliminary ideas about measuring cardiovascular risk with the Atherosclerotic Cardiovascular Disease Risk Score in analyses of Stanford health system diabetic patients. The researchers are collaborating with a clinical bioinformatics team at Stanford to use machine learning to expedite the analysis.

Min Yu and Haibin Wu of the Zhejiang Center for Disease Control and Prevention shared results from their analysis of health data collected from community health centers for diabetes management, diabetes surveillance data, cause of death data and insurance claims data that showed relationships between different patient characteristics and insurance types. The researchers then estimated the annual cost of Type 2 diabetes and its complications in Tongxiang province, China.

Hai Fang and Huyang Zhang of Peking University worked with claims data of diabetic patients insured by the New Cooperative Medical Scheme in Beijing, and at the workshop, shared regression analyses on the relationship between outpatient visits and inpatient admissions.

Jianqun Dong of the People’s Republic of China Center for Disease Control and Prevention presented ongoing research about diabetes management in China, including preliminary results of a randomized control trial of diabetes self-management strategies.

Wankyo Chung of Seoul National University shared preliminary estimates of a risk model for mortality among diabetic patients in South Korea and discussed next steps for estimating net value of diabetes management using the detailed clinical and claims data available in South Korea.

On the second day, the workshop concluded with a videoconference between workshop participants in Beijing and collaborators at Stanford Graduate Business School, including Stanford professor Latha Palaniappan and Harvard visiting professor Joseph P. Newhouse, using the Highly Immersive Classroom.

The workshop was a good opportunity for the research teams to discuss preliminary models, to offer each other suggestions regarding research methods, and to discuss the future direction of the international collaboration on the net value of diabetes. All research teams are preparing comparative research papers that will be included in the working paper series of the Asia Health Policy Program. A follow-up event will be held at Stanford in November 2017 in recognition of World Diabetes Day.

Researchers urge Moon Jae-in to form a close working relationship with Donald Trump and to establish a new special envoy role for North Korea policy emulating the “Perry Process”

Researchers from the Shorenstein Asia-Pacific Research Center (APARC) said they are optimistic about the election of South Korean president Moon Jae-in who assumed office last week following waves of protest across the country.

Now that the vacancy left in the wake of former President Park Geun-hye’s impeachment has been filled, the South Korean government needs to work to strengthen bilateral relations with the United States amid escalating tensions in Northeast Asia, they said.

The Moon administration should immediately engage U.S. President Donald Trump and his senior staff at the White House and government agencies, said Kathleen Stephens, the William J. Perry Fellow at Shorenstein APARC.

“Moon would do well to establish a personal relationship with Trump,” said Stephens, who was U.S. ambassador to South Korea from 2008 to 2011. “The new administration must set up a meeting as early as possible and be ready to engage on a range of issues.”

“In a sense, Moon has to play catch-up,” said Shorenstein APARC Director Gi-Wook Shin, who noted that Trump already held in-person meetings with other Asian heads of state in the United States, including summits with Chinese President Xi Jinping and Japanese Prime Minister Shinzo Abe.

Shin added that a coherent U.S. strategy toward Asia and senior staff appointments in the State and Defense Departments would also aid in supporting the foundation upon which the South Korean and American governments work together on policy challenges, especially North Korea.

North Korea’s nuclear and missile capabilities have become more and more advanced over the past few months, and provocations have continued to ratchet up, including its firing of a ballistic missile that landed in the sea near Russia on Sunday and repeat threats to conduct a sixth nuclear test.

The Moon administration must focus on establishing trust and cooperation with the Trump administration because it is the only pathway to finding a resolution to North Korea’s program, said Siegfried Hecker, a senior fellow at the Center for International Security and Cooperation, an additional center in the Freeman Spogli Institute.

“Any solution must be compatible with the interests of Seoul, but it has to be done in concert with Washington to get Pyongyang’s attention,” said Hecker, who served as director of the Los Alamos National Laboratory and has traveled to North Korea seven times since 2004 to survey its nuclear facilities.

During the campaign, Moon repeatedly spoke of his proposals to reengage the North Korean regime, such as holding talks with its leader Kim Jong-un and re-opening Kaesong Industrial Complex, a joint economic zone on the North Korean side of the border.

Stephens and Shin said Moon’s proposals for North Korean engagement would be a step in the right direction if pursued in due time and led under the direction of a special envoy from South Korea emulating the American “Perry Process.”

The Perry Process, proposed by former U.S. Secretary of Defense William Perry and implemented in the late 1990s under the Clinton administration, entails the appointment of a senior-level, bipartisan representative to pursue a two-track approach of engagement through joint projects and of continued dialogue on denuclearization with North Korea.

Appointing one person in South Korea to lead North Korea policy would help centralize and streamline its organization, which currently requires coordination of activities across dozens of government agencies, the two researchers noted.

“We recognize that establishing such a position and filling the position would be far from easy,” said Shin, co-author of the study Tailored Engagement. “But the magnitude of the nuclear crisis requires restructuring the way in which the South Korean government deals with North Korea, achieving domestic consensus, and shoring up international support for its efforts.”

The United States, China, Japan and Russia are the key international countries concerned with the peace and stability of Northeast Asia, yet South Korea has both an acute need and the potential to assume greater leadership of North Korea policy, said Shorenstein APARC Fellow Thomas Fingar.

China, as North Korea’s largest trade partner, exercises influence over North Korea by maintaining a commercial relationship in the hope of avoiding a collapse of the regime. Yet, its leverage only goes so far, he added.

The Moon administration should consider the limits of Chinese influence before making policy decisions regarding North Korea, Fingar said, for example, whether to freeze or remove the U.S. anti-ballistic missile system, Thermal High Altitude Area Defense (THAAD), deployed last April in South Korea, which the Chinese government strongly opposed.

“There is little that Beijing can or will do that would persuade Pyongyang to be more receptive to initiatives from Seoul than it would otherwise be,” said Fingar, a China specialist who served as chairman of the U.S. National Intelligence Council. “Seoul should not ‘pay’ much to obtain Chinese assistance because China already supports reengagement and would not do more no matter what Seoul offered as an inducement.”

It is of vital importance the Moon administration seeks to strengthen trilateral cooperation between South Korea, Japan and the United States, and to consider holding a summit to address areas of collaboration, all of which would function alongside the China-Japan-South Korea trilateral structure toward creating stability in the region, according to Daniel Sneider, associate director for research at Shorenstein APARC.

“Such cooperation is essential to the security of the region – without it, the United States cannot fulfill its obligation to defend South Korea against the threat posed by North Korea,” said Sneider, who leads the Divided Memories and Reconciliation research project. “Moreover, it’s in the interest of all three countries to tighten such cooperation to balance the rise of China.”

The Moon administration should, above all else, take time to consider its first steps despite pressures to perform early, said Michael Armacost, a fellow at Shorenstein APARC who held a 24-year career in the U.S. government.

“Getting things right is more important than making a quick splash,” said Armacost, a former U.S. undersecretary of state for political affairs. “I would advise any new president to proceed at a deliberate pace, focusing particularly on the key personal issues first, and consulting widely before enunciating major policy departures.”

Related links:

South Korea's election: Shorenstein APARC scholars offer insight

Yonhap News: 미 한반도 전문가 그룹 "한국형 페리 프로세스 필요" (May 16, 2017)

VOA: 미 전문가들 "한국 정부, 미국과 북 핵 협력 중요...대북특사도 임명해야" (May 17, 2017)

Shorenstein APARC Fellow Thomas Fingar, FSI Senior Fellow Siegfried Hecker, and CISAC Senior Fellow Scott Sagan are part of a group of 80 national security experts included in a Massive Open Online Course (MOOC) focused on the prospects for peace and security in South Asia.

The MOOC, titled Nuclear South Asia: A Guide to India, Pakistan, and the Bomb, is an inaugural course in a series produced by the Stimson Center in Washington, D.C. It is free to enroll and can be taken anytime and at any pace from a digital device.

Learn more about the MOOC.

Moon Jae-in was elected South Korea’s president on a pledge to address domestic inequality and to renew dialogue with North Korea. In the midst of Tuesday’s vote, Shorenstein APARC scholars offered insight to local and international media outlets.

Gi-Wook Shin, professor of sociology and director of Shorenstein APARC’s Korea Program, provided comment to The Economist about the challenges facing an administration led by Moon, a progressive candidate who is assuming power when an active conservative camp remains. He is also cited in an article in the New York Times focused on Moon's economic agenda and featured in a video from a Korea Society event that examines next steps for the new president.

Rennie Moon, the Koret Fellow in the Korea Program, co-authored an analysis piece on the East Asia Forum with Shin analyzing recent polls and the Moon administration's economic and security agenda.

Daniel Sneider, associate director for research at Shorenstein APARC, wrote an analysis piece for The National Bureau of Asian Research. In the piece, he explores how the election could impact the U.S.-Republic of Korea alliance amid escalating tensions on the Korean Peninsula.

Kathleen Stephens, the William J. Perry Fellow at Shorenstein APARC, appeared in a live interview on CNBC. In the taping, she discusses the significance of the vote and the new administration’s priorities as Moon swiftly takes office following the removal of his predecessor.