In this new article, Megan Palmer, a senior research scholar at the Center for International Security and Cooperation, talks about the different ways that the FBI is collaborating with the biotech community in order to be prepared to respond to an emerging biological threat. One of them is by reaching out to student bioengineers at programs like the International Genetically Engineered Machine (iGEM) Competition. The purpose of that event is to demonstrate how synthetic biology can be used to address pressing global issues.

As the article states, whether it’s an accidental outbreak or a biological attack, the FBI seeks to create a culture of trust and transparency with the biotech community. Palmer discussed this topic recently at the Biofabricate conference for synthetic biology and design in New York City.

As Palmer noted, biological attacks are a historical reality. In 1984, cult members poisoned patrons of 10 salad bars in Oregon with salmonella, sickening more than 750 people. And in 2001 shortly after the 9/11 attacks, anthrax spores that were mailed to newsrooms and government offices killed five people. While other incidents may have simply failed, it seems prudent to prepare for future attacks that could be even more deadlier.

Enter the FBI's foreay into the biotech community. Collaboartion between the public and private sectors is increasing in this area. As Palmer said, examples exist of iGEM students acting as "white hat biohackers" to help biotech companies detect weaknesses in their systems that  all in collaboration with the FBI, Palmer says. 

“There’s the overall sense that the government has acknowledged that it is not necessarily the center of influence in technological development,” Palmer told the publication. “We’re going to start seeing many more examples of partnerships between the government and the private sector where you wouldn't have necessarily expected them before. People should be willing to give them a chance.” 

To Palmer, the key to the collaboration is open communication. She reports progress with the FBI and biotech community on this front. Palmer herself asks the FBI questions about its involvement and interest in biotech dangers. So far, they have “been willing to have more of those conversations,” she said. The true test will come when the relationship is finally tested by what Palmer describes as a “triggering event,” either a situation where there is reason to believe a biotech has occurred or one in which the FBI is prying a bit too much into the lives of biologists. Palmer said that if the relationship doesn’t withstand this type of challenge, the trust between the FBI and the community would weaken, and communication would break down.

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Stanford Health Policy faculty members Michelle Mello, David Studdert and Laurence Baker discuss repealing the Affordable Care Act (ACA) and how it could affect health coverage in the United States.

Now that the United States has elected a Republican president and Congress, what is likely to happen to the Affordable Care Act (ACA)?

Michelle Mello and David Studdert: Exactly what will happen is unclear at this point, particularly since President-elect Trump’s own position on the ACA seems to be evolving by the day. In an interview on Nov. 11, he said he is interested in keeping some of the key provisions of the law, such as a ban on insurers discriminating on the basis of pre-existing conditions and provisions allowing young people to stay on their parents’ plans until age 26. But his opposition to other provisions, including the cornerstone provision requiring individuals to purchase insurance coverage, likely will remain. At this point, about the only thing one can say with certainty is that substantial change is coming.

Is the ACA likely to be repealed fully, or will some components be spared?

Mello/Studdert: On the campaign trail, President-elect Trump said repeatedly that repealing Obamacare is a priority. House Republicans have said the same. A complete repeal seems unlikely in the short term, though. There’s more opposition to some provisions of the act than to others, and millions of Americans now depend on health insurance coverage made available through the ACA. More likely, Republicans will target certain key elements – the individual mandate, minimum essential coverage rules, the subsidies available to low-income purchasers of health insurance and federal financing arrangements for the Medicaid program. Eliminating all of these features would spell the end of Obamacare as we know it. Eliminating any one of them would seriously threaten its viability, because the ACA’s strategy depends on having all major legs of the stool in place.

What is the legal process for repeal, and what issues would likely arise?

Mello/Studdert: Although Republicans will have a majority in the House and Senate, they fall just short of a filibuster-proof majority (60 votes) in the Senate. This is why a repeal is not likely to occur – at least not straight away – unless several Senate Democrats break ranks in the vote. A more likely scenario is that Republicans will use the budget reconciliation process to make the kind of changes mentioned above. Bills of this kind require only a simple 51-vote majority in the Senate, which they have.

Laurence Baker: Republicans have substantial ability to remove parts of the law under budget reconciliation. They can make changes to aspects of the ACA that involve financial in- and outflows to the federal government, but not other things. Reconciliation thus allows them to make changes to the major things like the mandate – because it involves a tax penalty – the subsidies and Medicaid. But they would not be easily able to repeal things like the exchange structures, guaranteed offers of insurance regardless of health status and other provisions. Guaranteed issue would be a real problem for insurance companies without the mandate, so repealing one but not the other threatens significant disruptions in insurance markets.

Most of the discussions thus far have focused on efforts to repeal the ACA’s expanding coverage aspects, but there are other aspects of the ACA that could be addressed. The ACA set up and funds the Center for Medicare and Medicaid Innovation (CMMI) and Patient-Centered Outcomes Research Institute (PCORI), two organizations that have not been discussed much in the repeal debates and which are seen by some Republicans in a more positive light. The ACA also makes changes to Medicare payments. It seems likely that repeal debates will focus more on coverage and less on these things, but it’s hard to tell at this point.

How will this affect Americans who current receive subsidies for health insurance?

Mello/Studdert: Elimination of the subsidies would have a major effect on the ACA’s core objective to cover the uninsured. By 2017, about 25 million people will have purchased their health insurance on the exchanges set up under the ACA, and about three-quarters of them will receive subsidies to help make premiums affordable. If the subsidies disappear, we should expect that health insurance will become unaffordable for many of these people or no longer look like a good deal. The tax credits and health savings accounts currently being discussed won’t make up for what is lost, and many people who currently have insurance can be expected to drop it. Elimination of the individual mandate will further open the way for this to happen.

Baker: The reality of the health care system is that there are not easily available alternatives to the ACA that would protect coverage and be palatable to broad groups of Republicans. Single-payer, or national health insurance, is a non-starter, so they’d be left with market-oriented reforms, and there are not obvious ways to pursue those without at least some core features of the ACA. Most of the proposals recently put forward for a replacement, including those highlighted by the Trump campaign, like cross-state competition, tax credits for insurance purchase and block granting Medicaid, would not really offer coverage to a large number of the people who would lose it under repeal. So a key question is what alternatives the Republicans come up with. In a similar way, the ACA and its provisions have become increasingly woven into our insurance system. Insurers and employers, among others, have made decisions and investments incorporating the ACA. Undoing those threatens disruptions and political challenges.

Michelle Mello is a professor of law and of health research and policy.

David Studdert is a professor of law and of medicine.

Laurence Baker is a professor of health research and policy, chair of the Department of Health Research and Policy in the School of Medicine and a senior fellow at the Stanford Institute for Economic Policy Research.

Stanford students are applying lean start-up techniques to some of the world’s most difficult foreign policy issues.

The fall 2016 quarter class, Hacking for Diplomacy: Tackling Foreign Policy Challenges with the Lean Launchpad, is a first-of-its-kind course for studying statecraft, created as a reflection of the best that Stanford and Silicon Valley offers in the way of pioneering paradigms. Hacking for Diplomacy is co-taught by Joe Felter, a senior researcher at Stanford’s Center for International Security and Cooperation (CISAC). It is based on the Lean LaunchPad methodology, created by course designer Steve Blank, a Stanford lecturer and entrepreneur.

The teaching team also includes Jeremy Weinstein, a political science professor at the Freeman Spogli Institute; Zvika Krieger, the U.S. Department of State's Representative to Silicon Valley; and Steve Weinstein, the CEO of MovieLabs.

'Breaking free'

The class is based on cultivating ideas and imagination, breaking free of the traditional “business plan” approach to rolling out new products and solutions. In the case of diplomacy, the lean start-up method is fast and flexible above all. It has three key principles based on concepts such as "mission model canvas," "beneficiary development," and "agile engineering,” according to Felter, also a research fellow at the Hoover Institution.

“The first principle is accepting that any proposed solution to a problem whether in the commercial world or public sector is initially just a set of untested hypotheses – at best informed guesses – as to what may solve the needs of a customer or beneficiary,” said Felter.

Regarding beneficiary development, he said, experiential learning is central.

“There are no answers to complex challenges ‘inside the building,’ if you will, and students must ‘get out of the building’ to find out –in as intimate detail as possible – the various pains and gains experienced by the various beneficiaries, stakeholders and end users that must be addressed to find viable and deployable solutions to their problems,” Felter said.

The last principle, “agile development,” is based on the view that proposed solutions are generated and constantly updated through a collecting of data and feedback. This in turn, Felter explained, is rapidly tested and new solutions are designed based this iterative process.

Overall, he noted, the core idea is that entrepreneurs are everywhere, and that lean startup principles favor experimentation over elaborate planning, offering a faster way to get a desired product or solution to market.

Real-world instruction

In the class, student teams analyze real-world foreign policy challenges. They then use lean startup principles to find new approaches to seemingly intractable or very complex problems that have bedeviled the foreign policy world. The teams actually work with mentors and officials in the U.S. State Department and other civilian agencies and private companies.

Each week, the teams present their findings (“product”) to a panel of faculty and mentors, who will critique their solutions. The outcomes will range, as they vary from problem to problem. Examples include human rights, food security, refuges and labor recruitment, and mosquito disease threats, among others.

On Oct. 10, U.S. Secretary of State John Kerry visited the class. “Brilliant minds are applying technology to world’s toughest problems. Their perspective will inform,” Kerry tweeted after the class.

Kerry’s State Department gave the students seven challenges to address – human trafficking, avoiding space collisions, tracking nuclear devices, and countering violent extremism. The students will explore and analyze these issues through the rest of the quarter.

One student, Kaya Tilev, later asked Kerry what the students should be striving for to make their “solutions” a reality for national policymakers.

Kerry said, “Well, you’re doing it. You’re in it. You’re in the program. And I have absolute confidence if you come up with a viable solution it is going to be implemented, adopted, and institutionalized.”

Zvika Krieger, the state department official, told the students that Kerry was impressed with them and the class.

“He (Kerry) brought up our class in all of his meetings that day, including at a lunch with the CEOs/founders of Google, Airbnb, and Lyft; in a podcast interview with Wired magazine, and in remarks at the Internet Association's conference,” Krieger wrote in an email to them.

Global flashpoints are proliferating around the globe – the Syrian War, conflict and civil wars across the Middle East and in parts of Africa; the pursuit of weapons of mass destruction by states and non-state groups; the most significant flow of refugees since World War II; North Korea nuclear testing; Russian adventurism on its borders; China’s forays into the South China Sea; and a changing climate.

In other words, there is no shortage of thorny problems for young minds to solve as they embark on their careers.

‘Hungry to apply their energy’

Jeremy Weinstein, the political science professor, described the students as “hungry to apply their energy and talents to real-world problems, and to use hands-on experiences as a way of accelerating their learning.”

The class taps into that motivation by bringing together data scientists, engineers, and social scientist, he noted. In the end, the idea is for students to learn how to “innovate inside government.”

Weinstein is optimistic that this class – and a stronger connection between the State Department and Stanford’s technical and policy expertise – can drive more innovation inside government.

“Technology can play a critical role in addressing many of today’s foreign policy challenges, and this class is one new way for senior U.S. officials to tap into the passion, creativity and talent of Silicon Valley,” he said.

Hacking for defense

Last year, Felter and Blank also led a Hacking for Defense class based on the same lean start-up principles. Hacking for Diplomacy is co-listed as both an International Policy Studies and a Management Science and Engineering course – it counts for international relations and political science majors as well.

Blank, a consulting associate professor in engineering, told the Stanford News Service in a recent story that he seeks to cultivate in students a passion for giving back to society and their world.

“We’re going to create a network of entrepreneurial students who understand the diplomatic, policy and national security problems facing the country and get them engaged in partnership with islands of innovation in the Department of State,” said Blank, who also wrote about the new hacking for Diplomacy course in the Huffington Post.

“Teams must take these products out to the real world and ask potential users for feedback,” he noted.

The Japan Program held the fourth annual Stanford Juku on Japanese Political Economy from September 29 – October 1. Over 40 scholars from various parts of the US and Japan participated in the conference, which took place at the Oksenberg Conference Center at Encina Hall. The first portion of the program (9/29 and morning of 9/30) focused on research in political science/political economy and international relations, and the latter portion of the program (afternoon of 9/30 and 10/1) focused on research in economics.

The main goal of the program is to attract young researchers who will go on to become leaders in the study of Japanese politics and Japanese economy in the near future.  Distinctive features of the Juku are the long times allotted to each paper to allow for two in-depth discussants and discussion among participants, as well as ample time for informal discussions and interactions among participants allowing for collaborations and expansion of the network of researchers on Japan in political science and economics. We received a large volume of quality paper submissions this year, which made the selection process very competitive. 

The first day included four papers in political science/political economy and international relations. Daniel Smith from Harvard University presented a paper co-authored by Yusaku Horiuchi (Dartmouth College) and Teppei Yamamoto (Massachusetts Institute Technology) entitled, "Identifying Voter Preferences for Politicians' Personal Attributes: A Conjoint Experiment in Japan," with discussants Ethan Scheiner (University of California, Davis) and Mike Tomz (Stanford University).

Amy Catalinac (New York University) presented a paper co-authored by Frances Rosenbluth (Yale University) and Hikaru Yamagishi (Yale University) entitled "Party Strategies and Foreign Policy in Post-Electoral Reform Japan." The Discussants for the paper were Gary Cox (Stanford) and Teppei Yamamoto (MIT).

Jacques Hymans from University of Southern California presented his paper on “The Limits of Japan's Energy Angst: The Case of Geothermal Power.” Mark Thurber (Stanford) and Steve Vogel (University of California, Berkeley) were the discussants.

The fourth paper was “Democratic Community and Its Consequences: Evidence from Japan” by Jonathan Chu (Stanford), discussed by Christina Davis (Princeton University) and Megumi Naoi (University of California, San Diego).

Christina Davis (Princeton) started off the second day by presenting her paper “Joining the Club: Accession to the GATT/WTO." Discussants were Jonathan Chu (Stanford) and Phillip Lipscy (Stanford).

The political science/political economy section ended with Megumi Naoi (UC, San Diego) presenting a paper co-authored by Chun-Fang Chiang (National Taiwan University), Jason Kuo (Post-doc, Georgetown University), Jing-tan Liu (National Taiwan University) entitled, "What Do Voters Learn from Foreign News? Experimental Evidence on PTA Diffusion in Japan and Taiwan." Discussants were Kenji Kushida (Stanford) and Yuki Takagi (Stanford). 

After lunch, two economics papers were presented.  Wataru Miyamoto (Bank of Canada) presented a paper co-authored by Thuy Lan Ngyuen (Santa Clara University) and Dmitriy Sergeyev (Bocconi University) entitled, "Government Spending Multipliers under the Zero Lower Bound: Evidence from Japan" with discussants Yuriy Gordonichenko (UC, Berkeley) and Johannes Wieland (UC, San Diego).

The second paper was “Government Spending Multipliers under the Zero Lower Bound: Evidence from Japan”, by Robert Dekle (USC), Nobuhiko Kiyotaki (Princeton) and Tsutomu Miyagawa (Gakushuin University).  Huiyu Li (Federal Bank of San Francisco) and Shuichiro Nishioka (West Virgina University) were the discussants.  A group dinner followed the second day.

The final day included four papers in economics.  The first was “Will the Sun Also Rise? Five Growth Strategies for Japan” by Yoko Takeda (Mitsubishi Research Insitute).  Discussants were Michael Hutchison (US, Santa Cruz) and Ryo Kambayashi (Hitotsubashi University).

The second paper was "Natural Disaster and Natural Selection" by Hirofumi Uchida (Kobe University), Daisuke Miyakawa (Hitotsubashi), Kaoru Hosono (Gakushuin), Arito Ono (Chuo University), Taisuke Uchino (Daito Bunka University) and Iichiro Uesugi (Hitotsubashi).  Discussants were Nobuhiko Hibara (Waseda University) and Johannes Wieland (UC, San Diego).

Koichiro Ito (University of Chicago) presented a paper co-authored by Takanori Ida (Kyoto University) and Makoto Tanaka (GRIPS) entitled “Information Frictions, Switching Costs, and Selection on Elasticity: A Field Experiment on Electricity Tariff Choice.”  Karen Eggleston (Stanford) and Hitoshi Shigeoka (Simon Fraser University) were the discussants.

The final paper was “Good Jobs and Bad Jobs in Japan: 1982-2007” by Ryo Kambayashi (Hitotsubashi) and Takao Kato (Colegate University), discussed by Takeo Hoshi (Stanford) and David Vera (California State University, Fresno).

CISAC nuclear scientist Siegfried S. Hecker earlier this year released a book, Doomed to Cooperate, about how American and Russian scientists joined forces to avert some of the greatest post-Cold War nuclear dangers. Physics Today and Arms Control Today recently ran reviews on the work. Below is a Nov. 1 article that Hecker wrote on this subject for Russia Matters:

By Siegfried S. Hecker