Media and politicians often defer to the AMA on COVID policies. But what role should the doctors’ group have in the pandemic?

Posted on August 15, 2021 by particularkev

Lesley Russell, University of SydneyAlmost every day in recent months, Australian Medical Association (AMA) president Dr Omar Khorshid has appeared in the media, commenting on various issues related to the coronavirus pandemic.

These include changing recommendations about the use of the AstraZeneca vaccine, urging the New South Wales government to institute tighter lockdown measures, and welcoming National Cabinet’s roadmap out of the pandemic.

The raft of AMA media releases, doorstops, and television and radio slots goes beyond the pandemic to expressing concerns about climate change and doctors in Myanmar. Khorshid even outlined the AMA’s Vision for Australia’s Health at the National Press Club address in June.

Why is the AMA so regularly deferred to by politicians and media alike? And what is its role in the pandemic?

Historically, it has protected doctors’ professional and financial interests

The AMA (and its predecessor, the British Medical Association) built its reputation as a powerful, aggressive lobby group – essentially a medical union. It’s focused on protecting doctors’ professional interests and financial autonomy, and preserving the status quo in health care.

The self-published volume to commemorate the AMA’s 50th anniversary – ironically titled “More than Just a Union” – boasts of efforts to forestall government attempts to make health care universal and affordable.

The most egregious of these was the relentless opposition to the introduction of the Pharmaceutical Benefits Scheme, Medibank and then Medicare.

Underpinning this opposition was a fear of controls and interference by both governments and health insurers, and efforts to expand the scope of practice for health-care providers other than doctors.

How the AMA has shaped past health policies

Those past fears are echoed today in the AMA’s continuing opposition to a range of proposals that are seen as impinging on doctors’ autonomy.

These include resistance to payment mechanisms that would move from fee-for-service (an itemised fee charged for every visit) to capitated fees for ongoing care of a chronic condition.

Concerns about the adequacy of doctors’ Medicare rebates are ongoing and, in some cases, justified. These concerns have led to the AMA issuing its own fee guidance to doctors.

The AMA has a particular aversion to “US-style managed care” which it describes as “a recipe for cost-cutting and less choice”. The AMA fears Medicare and private health insurers will try to push doctors, hospitals and patients into coercive contracts with capped funding payments, and require defined standards for performance, quality and outcomes.

Meanwhile, the AMA has consistently pushed back on increasing the roles for midwives and nurse practitioners in the health-care system, and is vehemently opposed to pharmacists having an increased prescribing role.

A nurse shows a doctor a patient file. — The AMA has opposed nurses doing work traditionally done by doctors.
Shutterstock

Yet the AMA has also played a significant leadership role in highlighting important issues as varied as Indigenous health, tobacco and vaping regulation, boxing injuries, treatment of refugees, and climate change.

Inside the AMA machine

The AMA’s federal secretariat has excellent resources to assist with this work – experts in policy development, economic analysis and communications. This is highlighted in the report cards it regularly issues, which have the capacity and status to influence public opinions and government policy.

The AMA is diligent about making sure its voice is heard with budget commentary and submissions to a range of enquiries and reports. According to the AMA website, in 2020 it made 45 submissions – a mammoth task of preparation and approval.

This latter task is never easy for the AMA. It is an inherently conservative body, more comfortable with the conservative side of politics, although this has varied with the public face of the president.

Internal infighting was conspicuously highlighted when Dr Michael Gannon, in his successful 2016 run for AMA presidency, chided then-president Dr Brian Owler for opposing funding cuts in health in the 2014-15 Budget and the medical treatment of asylum seekers.

Gannon said:

The criticism that is made of the current leadership [of the AMA] is that it’s strong on progressive policies but not listened to by the conservative government.

Ultimately, these in-house conflicts undermine the effectiveness of the organisation’s loud public voice. It can agree with or oppose government proposals, but is rarely able to generate enough internal consensus to offer alternatives.

All this serves to cast the AMA today as something of a chameleon organisation trying to be all things to all people. On the one hand, it’s always at war with government (regardless of political party) over members’ interests. On the other hand, it elevates issues of social responsibility and publicly positions itself as seeking to advance community health.

We see this dichotomy playing out in the pandemic. Along with supportive words to the public and comments on governments’ actions, the AMA is raising the usual concerns and is “working tirelessly” to shore up its influence in the corridors of power.

How the AMA is using its influence in the pandemic

It is likely the AMA’s influence on the federal government led to the initial decision to roll out the vaccination of the general public primarily through GPs.

The AMA highlighted that rolling out the campaign through general practice was the best way to encourage the community to get vaccinated and noted “significant reservations” about the role of pharmacists in the vaccine rollout.

This follows years of opposition to pharmacists playing a role in the flu vaccinations rollout, as you can see in this media release from 2014:

But many busy GP practices were unable to gear up for COVID-19 vaccinations and initially they were unable to manage the storage requirements for the Pfizer vaccine. These were later modified and since June practices can apply to also administer the Pfizer vaccine.

Responding to questions The Conversation’s political correspondent Michelle Grattan raised last week about how the AMA shaped the vaccine rollout, Dr Khorshid said the program was slowed by “supply constraints and hesitancy due to changing advice”:

In recent weeks, we have seen how both GPs and pharmacists are needed to ramp up
vaccine delivery, especially in coronavirus hotspots.

On other issues, the AMA has been very supportive of the expanded telehealth services that were put in place early in the pandemic to allow patients to have a consultation with their doctor by video or phone.

Initially these consultations were required to be bulk billed, but the AMA has now persuaded the government to remove this requirement. This means patients whose doctors do not bulk bill will now have out-of-pocket costs for telehealth consultations.

Meanwhile, AMA media releases also credit the organisation for proposing the government’s yet-to-be-implemented vaccine indemnity scheme.

Striving for relevance and public trust

The AMA is driven by the need to demonstrate relevance to today’s cohort of doctors and the public in the face of increasing competition for members and attention.

When the federal AMA was formed in 1962, 95% of doctors were members. As of 2018 it was less than 30%.

The specialist colleges have captured many doctors and most GPs belong to the Royal Australian College of General Practitioners (RACGP) and/or the Australian College of Rural and Remote Medicine.

So it’s no surprise the RACGP is also an active player on behalf of its members – the advocacy pages of its website show it claims some of the same policy victories as the AMA. Its president is also a frequent media presence on the pandemic and other issues.

Many of Australia’s problems with vaccine rollout and compliance with lockdowns are due to confusing communication strategies from governments and the poor quality of public education campaigns. There is certainly room for effective communicators, speaking in language that everyone understands, to step into this space.

The public sees doctors as trusted voices and doctors working at the coalface are uniquely placed to comment on the health-care consequences of the pandemic.

The AMA (and other medical organisations) have spent decades building access to media and politicians. This means that often their voice is heard above those who have more expertise and their concerns are more obvious than those of affected communities. This is a privileged situation that should be used for public good, ahead of any organisational self-interest, during the pandemic and in the years ahead.

Editor’s note: The Conversation contacted the AMA for a response and in a statement, Dr Omar Khorshid said, “the issues the AMA advocates on are in the interests of doctors, the wider health professions, and patients”. He said these issues “go to the heart of our healthcare system and all health professionals, including nurses”.

Lesley Russell, Adjunct Associate Professor, Menzies Centre for Health Policy, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Is the COVID vaccine rollout the greatest public policy failure in recent Australian history?

Posted on July 25, 2021 by particularkev

Carolyn Holbrook, Deakin University; James Walter, Monash University, and Paul Strangio, Monash UniversityIs the Morrison government’s COVID vaccination rollout program one of Australia’s biggest ever public policy failures?

As COVID-19 infection numbers in locked-down Sydney show little sign of abating and Victoria extends its fifth lockdown, the prospect of life resuming some level of normality appears distant.

In recent weeks, we have learned more about the flaws in the federal Coalition government’s vaccination program. There’s the failure to procure sufficient vaccine and an accompanying over-reliance on the AstraZeneca vaccine.
The complications with rolling out the latter have exposed the shortage of supply of the Pfizer vaccine.

While other international leaders personally lobbied Pfizer executives for supplies, Prime Minister Scott Morrison and Health Minister Greg Hunt were inexplicably passive.

Then there is the sluggish pace of the “it’s not a race” vaccine rollout, particularly among vulnerable people, such as aged and disability care residents, and frontline health workers. Only 13% of Australia’s eligible population (those aged 16 and above) are fully vaccinated, while 35.3% are partially vaccinated. That’s a long way short of the goal of a fully inoculated adult population by October 2021, as initially promised.

Exacerbating these problems has been the lack of an effective public education campaign about the vaccine. This has left a vacuum, which anti-vaxxers and the vaccine-hesitant have filled.

Fallout from a shambolic vaccine rollout

Public confidence in the government’s handling of the vaccine rollout has sharply diminished. The latest Newspoll shows disapproval of the rollout jumping 11 points to 57%.

The policy missteps, which have Australia languishing at the bottom of the OECD for the proportion of its population that is fully vaccinated, have elicited a rising chorus of condemnation.

Some of the criticism comes from usually supportive sources, such as right-wing commentators Janet Albrechtsen and Miranda Divine.

Former Coalition prime minister Malcolm Turnbull claimed recently he couldn’t recall “a more black and white failure of public administration” than the vaccine program. Historian Frank Bongiorno declared the rollout “the worst national public policy failure in modern Australian history”.

Public confidence in the Coalition government and the prime minister has dropped due to the vaccine rollout.
Lukas Coch/AAP

How do we measure public policy failure?

There’s no doubt the Commonwealth government, measured by its inability to reach professed objectives, which are then repeatedly revised, has performed poorly.

Disingenuous attempts by the prime minister and senior ministers to dissimulate, or deflect responsibility to others, have been well canvassed.

But are we ready to conclude that what we are seeing is a near-unprecedented instance of policy failure, especially when there are other pressing public policy issues on which the government has also been found wanting, most noticeably climate change?

There are three principal factors for measuring public policy success or failure.

The first is an assessment of how successfully the policy action ameliorates the problem it seeks to solve. This appraisal must take into account the consequences of that action. Consequences are often unintended and unanticipated. They might not become apparent for some time and can be difficult to quantify and link unequivocally to the policy in question. For example, the Coalition’s inclination to cease support for manufacturing in Australia has led, as is now evident, to our incapacity to meet the demand even for COVID vaccine production.

Second, an assessment of policy success or failure must consider the significance of the policy. That is, the failure of a minor government program has less negative impact than the failure of an economic, social, environmental or public health policy that affects the entire community.

Third, we must take account of the reputational enhancement or damage ensuing from a particular course of action. This may have decisive effects on a government’s electoral prospects.

Applying these measures, we can say that, to date, the Morrison government’s approach to the COVID vaccination rollout fares badly on all three criteria.

On all three measures of policy effectiveness, the vaccine rollout fails.
Mick Tsikas/AAP

The vaccine rollout has failed the tests of public policy success

The problem is not that the proposal – a level of vaccination that will enable the community to “live with” endemic COVID – is misconceived. It is that incompetent planning, logistics and implementation have so far prevented it from sufficiently ameliorating the threat we face.

We can see, from international comparisons, the dimensions of risk while COVID remains insufficiently checked and potentially able to generate more dangerous mutations.

Second, the significance of success or failure in this domain – brought home by recurrent lockdowns – is manifest. There are negative flow-on effects for the entire community, not only in containing the virus, but also with clear impact on the economy, mental health, domestic violence and trust in government.

We are also confronted with counter examples: Seattle, for instance, in dire circumstances not so long ago, is now more or less back to normal because of the swift uptake of vaccination.

Third, the reputational damage to the federal government is evident in a string of public opinion polls that have found a substantial decline in confidence in the Coalition and the prime minister.

… but there is one that is worse

Some other examples help us flesh out the picture. One is a public policy from recent decades that did not achieve its intended purpose: the Rudd government’s Resource Super Profits Tax and its successor negotiated by the Gillard government, the Minerals Resource Rent Tax.

These policies failed on at least two levels. First, they did not reap anything like the revenue that was forecast. Second, the taxes were electorally damaging for the Labor governments, engendering a fierce backlash from the mining industry.

A more significant public policy failure, with consequences that took much longer to become apparent, was the Howard government’s Aged Care Act of 1997. This legislation established the framework for the funding and regulation of the aged care system. Partially privatising the aged care sector, that policy regime is widely recognised as being responsible for the underfunding of the system and associated chronic shortcomings, which the recent royal commission thoroughly documented.

Perhaps the biggest public policy failure of recent times relates to climate action where, as with COVID vaccination, Australia ranks last among developed economies.

This has been a product of the failure of the parties, but in particular of internecine battles within the Coalition and a brutal politics that, as Martin Parkinson argues, brought about “a fracture of the political centre”, rendering it incapable of the negotiation and consensus necessary for resolution.

While the vaccine rollout has been a failure, inaction on climate change represents the biggest policy failure in recent times.
AAP/Department of Defence handout

Indeed, the intractability of climate change as a policy problem suggests that it, rather than the handling of vaccine rollout, is the biggest failure of modern times.

Despite the chaos that has been well documented, the required levels of vaccination can still be achieved, even if belatedly. The situation is potentially capable of resolution, and possibly in time for Seattle-like “normality” to be re-established. Adequate climate action, on the other hand, still appears to be incapable of resolution under this government.

But will the Morrison government’s mishandling of the vaccine rollout be politically fatal? Certainly, falling confidence in the rollout is translating into a decline in support for the Coalition. Yet we should be wary of jumping to conclusions.

The prime minister has until next May to hold an election. The government has ample time to play catch-up with the rollout. If further outbreaks are contained and the elusive herd immunity is achieved by then, lockdowns will have become a thing of the past. The relief at being able to move on may obliterate current disquiet.

Further, in normal circumstances, policy virtue is not necessarily synonymous with political success. The last federal election was an indicator of this. The Coalition triumphed despite a threadbare policy program. In other words, policy prowess is only ever one measure of a government’s success.

Carolyn Holbrook, ARC DECRA Fellow at Deakin University, Deakin University; James Walter, Professor of Political Science, Monash University, and Paul Strangio, Professor of Politics, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Be kind: GP receptionists are taking the heat with every policy update during COVID, vaccines included

Posted on July 4, 2021 by particularkev

Lauren Ball, Griffith University; David Chua, Griffith University, and Katelyn Barnes, Griffith UniversityPhones are ringing off the hook at GP clinics with people desperate to know when and how they can be vaccinated against COVID-19.

Every time there is a change in recommendations or advice, medical receptions field calls from concerned people trying to book in to talk to a GP or to cancel bookings. This is on top of supporting patients and juggling the extra workload required to perform COVID-19 triage, screening and telehealth.

GPs and practice nurses are considered central and front line in Australia’s primary care COVID-19 response. However, GP receptionists are one step in front.

Their role has changed considerably during the pandemic, taking on functions and learning new skills no-one planned for. We must not forget them and the stressful work they do.

All in a day’s work

Medical receptionists are an integral part of general practice teams and GP clinics would be challenged to exist without them. Doctors, nurses and other staff rely on medical receptionists to create a friendly, welcoming and well-organised front-of-clinic for patients.

Some people assume medical receptionists “just” answer phone calls, notify doctors when patients have arrived and make follow-up appointments. But this not only understates their true impact and influence on our health system, it does not acknowledge the challenges and pressures of their work.

Long before the pandemic, medical receptionists were increasingly undertaking clinical duties, performing tasks involving direct patient assessment, monitoring and therapy.

Medical receptionists were typically in this situation because of a lack of financial support for practice nurses. But, given receptionists are not trained health professionals and are continuously handling confidential information about patients, there’s the risk they may be held legally liable for making a mistake.

Then came the pandemic

The role of medical receptionists has profoundly changed due to the pandemic, though they have not being included in pandemic planning.

The Royal Australian College of General Practitioners has said many receptionists have been providing health and safety advice to patients and the wider community.

They are routinely asking patients questions about their travel history and symptoms, and monitoring body temperature to assess the risk of a patient being infected with COVID-19, despite not being trained to make clinical decisions.

They are increasingly performing basic triage over the phone and at the front desk, essentially assessing “how sick” a patient is and how timely their care needs to be.

Particularly during the pandemic, it is usually their decision whether a patient is granted a face-to-face appointment, seen in their car, placed in an isolation room for their consultation, or asked to go to the hospital instead.

Medical receptionists are also relied on for technical support for telehealth and to train clinicians and patients to use it.

Deciding if a patient is suitable for telehealth alone requires a basic understanding of what the doctor might need. We wouldn’t expect any medically untrained person to make these decisions, yet we expect our receptionists to.

No wonder it’s stressful

Medical receptionists are rightly concerned about contracting COVID-19 as they are so close to unwell patients in the waiting room.

Threats of violence from frightened patients are also now a reality. And when a patient has not been booked in correctly, or worse, when a patient enters a consultation room showing COVID-19 symptoms, they cop dissatisfaction from clinicians and patients alike.

Woman looking stressed or scared wearing a mask — Working as a medical receptionist in a pandemic can take its toll.
from www.shutterstock.com

The emotional demand on medical receptionists is also very high. Supporting clinical teams and their personal feelings and expressions is now part of the job, as well as advocating for, and empathising with patients.

They do all this for an average A$23.96 an hour, much less than administrative or secretary work outside the health-care sector.

Training and support are critical

There is no required qualification to become a medical receptionist. However, courses such as a Certificate III in Business Administration or Certificate IV in Health Administration are recommended. Truthfully, no training exists to equip medical receptionists for the additional pressures of the coronavirus pandemic.

Informal tips are circulating about how practice owners can support staff to avoid burnout, and also how medical receptionists can enhance their clinical and triage work.

Unfortunately, current tips and training do not address the fundamental problem of medical receptionists not being recognised, trained or paid accordingly for their growing clinical, management and administrative work.

Get vaccinated, be kind

GP clinics still play a vital role in getting Australians vaccinated and helping us emerge from the pandemic. That’s on top of their existing role.

Receptionists are at the front line of this pandemic, changing what they do at a moment’s notice to keep the rest of their teams and community safe. Their many hardships are well overdue for our respect and recognition.

Tracey Johnson, CEO of Inala Primary Care, a large GP clinic and charity in Queensland, contributed to this article.

Lauren Ball, Associate Professor/ Principal Research Fellow, Griffith University; David Chua, Primary heath care research fellow, Griffith University, and Katelyn Barnes, Postdoctoral Research Fellow, Griffith University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Airline policies mandating vaccines will be a turbulent test of workplace rights

Posted on June 29, 2021 by particularkev

Giuseppe Carabetta, University of SydneyAirlines want you vaccinated. They want as many people as possible vaccinated. The sooner that happens, the sooner borders open and they can get back to profitability.

They also have reasons to want to protect both customers and staff from COVID-19. Qantas staff, for example, have been considering legal action over workplace transmissions.

Qantas has dangled the carrot of extra frequent flyer points for fully vaccinated passengers, plus ten “mega prizes” of a year’s free travel for familes. Virgin Australia has similar plans. It also has a scheme to encourage its workers to get vaccinated. This will reportedly include the chance to win extra annual leave.

Could they go further and mandate vaccines? This is something Cathay Pacific is doing, telling its Hong Kong-based flight crews they must be vaccinated by August or their employmnet will be reviewed.

Qantas chief Alan Joyce signalled in November that once vaccines are widely available it will require international travellers to be vaccinated. This implicitly suggests it will require the same from international flight staff.

But the legal ground in Australia for employers to insist that employees be vaccinated remains murky.

Whether Qantas or Virgin – or indeed any other company – do so may depend on the case of Queensland regional carrier Alliance Airlines, the first employer in Australia to insist all employees be immunised.

A question of common law

Alliance Airlines specialises in flights to and from mining sites. It is 19.9% owned by Qantas, and collaborates with both Qantas and Virgin Australia.

It announced its mandatory policy for both influenza and COVID-19 vaccinations in late May. Its stated reason is to fulfil its duty to employees and passengers. But unions have questioned the policy’s lawfulness, arguing it is beyond the airline’s powers.

In Australia, there has been no general government guidance on whether employers can insist on employees getting COVID-19 vaccinations.

This differs to the United States, where the federal Equal Employment Opportunity Commission ruled in December 2020 that employers could (with some exemptions for medical and religious reasons) require employees to be vaccinated.

The Queensland and Western Australian governments have passed legislation mandating workers be vaccinated, but only in certain health and quarantine workplaces.

Whether Alliance Airlines’ policy is lawful therefore depends on a general common law “test” for determining the validity of workplace policies.

This test asks if a policy or direction is “lawful and reasonable” given the circumstances. These include:

the nature of the job, especially where it requires regular interactions with colleagues, clients and suppliers
if the work can be done remotely, or other reasonably practical precautions exist
the effectiveness or success rates of the vaccine
any guidance or directives from government and medical experts
the circumstances of individuals employee, such as whether they have reasonable grounds to refuse vaccination.

Unfair dismissal cases

Australia’s Fair Work Commission has demonstrated the balancing act needed to apply these factors in its most recent ruling in an unfair dismissal case involving a refusal to get an influenza vaccination.

The claim was brought by Maria Corazon Glover, a 64-year-old community care assistant, against Queensland aged and disability care provider Ozcare, her employer since 2009.

In May 2020, public health orders in Queensland required influenza vaccinations for entry into aged care facilities. Ozcare went “above and beyond” those requirements, mandating the flu vaccine for all its aged care workers, even those who did not work in facilities. Glover, a home-care provider, refused. She said she believed she would suffer an allergic reaction, based on what she understood had happened to her as a child. She was ultimately dismissed.

Commissioner Jennifer Hunt upheld her dismissal despite Ozcare’s policy exceeding the relevant public health orders and Glover’s concerns. Hunt ruled those factors were outweighed by the vulnerability of Ozcare’s clients, the frequency with which care workers visited clients’ homes (and their potential to become “super-spreaders”), and the employer’s “prerogative” to make a decision considered necessary to safeguard its clients and employees “so far is practicable to do so”.

Individual circumstances do count

Perhaps the most important takeaway from Glover v Ozcare is that it was decided on its particular facts. Employers must carefully assess employees’ situations to decide if a mandatory vaccination policy is justifiable.

An airline might reason that cabin crew interact with people in environments with a higher risk of COVID-19 transmission and where social distancing is impossible.

But an employee might counter that, unlike aged or disability care workers, they have much less close contact with high-risk, vulnerable individuals.

The case-by-case nature of the reasonableness test means any generalised “all in” vaccination policy is problematic. Even more so if there is employee resistance.

Discrimination may be valid

Employees who are dismissed for refusing to vaccinate might also argue it amounts to discrimination on prohibited grounds such as disability or pregnancy, where COVID-19 vaccination may be unsafe or pose medical risks.

Under the Fair Work Act, however, employers have a valid defence for discriminatory action if a policy or decision is based on the “inherent requirements” of the job.

In November 2020, Fair Work Deputy president Ingrid Asbury noted that vaccination against influenza was likely to be an inherent requirement for a position involving caring for young children, and so could be justified for child-care employees.

However, outside high-risk contexts such as child and health care, this defence may be limited and will turn on the employee’s role and the organisational context.

Looking for safe ground

The Fair Work Commission’s rulings on influenza vaccines give a fair indication of the principles it will apply to any case involving COVID-19 vaccines.

But given the different circumstances, whether it will give a green light to a general policy like that of Alliance Airlines remains up in the air.

Qantas and Virgin might be on safer ground because of their international operations, if proof of vaccination becomes mandatory for other destinations.
However, I think the issue of employee vaccinations for the airline industry will ultimately be resolved via government intervention.

In other sectors, owing to the complexities in determining whether mandatory policies are “legal”, many employers will likely stick with the safer route of voluntary “incentive schemes” to encourage vaccinations.

Giuseppe Carabetta, Senior Lecturer, Sydney University Business School, University of Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

The LNP’s child-care subsidy plan: how it works, and what it means for families and the economy

Posted on May 4, 2021 by particularkev

Danielle Wood, Grattan Institute; Kate Griffiths, Grattan Institute, and Owain Emslie, Grattan InstituteThe federal government is pitching its 2021 budget as “women-friendly”. Yesterday it announced a key feature of that – more money to make child care cheaper and boost women’s workforce participation.

The Coalition’s policy will increase spending on the child-care subsidy from July 2022 by an extra A$1.7 billion over three years. That is about a 6% increase on the current investment of A$9 billion a year.

Key changes

The policy has two main components.

First, it drops the “annual cap” that limits the total yearly subsidy to A$10,560 per child for families with combined income of more than $189,390. After that – generally if they have their children in care for four or more days a week – they pay the full cost of care. These costs are often a big disincentive for women with high-earning partners to work more than three days a week.

Second, it boosts the subsidy for second and subsequent children in care by up to 30 percentage points (capped at 95%). This means families currently eligible for a 50% subsidy would now be eligible for an 80% subsidy on their second child if both children are aged under six. Older children using after school care are not eligible for any extra subsidy.

This will reduce fees for families paying some of the highest out-of-pocket childcare care costs – those with multiple children in long day care.

So how does it work?

Consider a middle-income family where one parent earns A$85,000 and the other parent earns A$65,000, with two young children in day care paying the average cost of A$110 a day per child. Under the current scheme they are eligible for a 60% subsidy for both children. So they pay A$88 a day and the government pays A$132.

Under the new policy, the subsidy will rise to 90% for the second child (with the first child still on a 60% subsidy). This means the parents will pay $55 a day for both children, and get a $165 subsidy. If they have the children in care for four days a week, they will be $132 a week better off.

Effect on workforce participation and family budgets

Currently, for families with two children in long day care, the primary care giver (typically the mother) can lose more than 80% – in some cases 100% – of take-home pay in the move to take a fourth or fifth day’s work. Child-care costs on those extra days are the main contributor.

The new policy reduces the disincentives for those families.

The first graph shows a family where the father earns A$60,000 and the mother would earn the same if she worked full time. The current system means she loses 90% of what she earns on her fourth day and more than 100% on the fifth day.

Primary earner works full time, 2 children requiring care. Each day of work for second earner results in 2 days of approved care, costing $110 each.

The new policy will lower these “workforce disincentive rates”.

The mother will now lose 75% on the fourth day and 90% on the fifth day.

As the next graph shows, the family will be A$5,000 a year better off if the second earner works four days, and $7,500 a year better off if she works full-time.

For a family where both parents have the potential to earn A$100,000 working five days a week, the new policy will almost halve the current workforce disincentive rate for working a fifth day – from 100% to 55%. This is because such a family will benefit from both the extra subsidy for the second child and the removal of the annual cap.

Workforce disincentives remain high even with the new policy. But it is a significant improvement on the status quo.

The flip side of a highly targeted policy is that it benefits only a small segment of families. On the federal government’s numbers, up to 270,000 families may benefit. This compares with almost 1 million families now accessing some subsidised child care and many more who would like to access it if they could afford it.

How the Coalition’s policy compare to Labor’s

Labor announced its child-care policy in the budget reply last year.

Like the Coalition’s, it removes the annual cap. But it also increases the base subsidy (for all children) to 90%. It also reduces the rate at which the subsidy reduces as family income increases. This is one of the big contributors to growing out-of-pocket costs as mothers work more and use more child care.

So Labor’s policy is broader, with all families who use child care standing to gain, regardless of the number of children, their age and the family income.

It would cost about A$2 billion per year – roughly three times more than the Coalition’s. But it would also have bigger benefits, sharpening workforce incentives for a much wider group of families. The boost to GDP from higher workforce participation is likely to also be about three times bigger.

In terms of the impact on family budgets, the big difference between the policies is the number of children aged under six in care.

Families with only one child under six in care (or only older children in after-school care) would be unambiguously better off under the Labor policy.

For families with two children under six in care, there is little difference at most family income levels. For families with three children under six in care (probably less than 20,000 families at any given time), almost all would be better off under the Coalition policy.

A step forward, but not a game changer

Overall, the Coalition’s policy is a helpful and well-targeted package that tackles some of the worst out-of-pocket costs and workforce disincentives. It will mean a real improvement for up to 270,000 families.

What’s missing is support for all the other families using child care. Almost 1 million families now use child care, and many would like to work more if they could afford to do so.

A broader policy supporting more families would have much larger and more widespread economic benefits. Of course, it would cost more too, but our research shows such an investment can be expected to deliver a boost to GDP of at least twice the cost.

This is a step in the right direction, but much more needs to be done to create a system that truly supports women’s workforce participation and long-term economic security.

Danielle Wood, Chief executive officer, Grattan Institute; Kate Griffiths, Fellow, Grattan Institute, and Owain Emslie, Senior Associate, Grattan Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

As coronavirus widens the renter-owner divide, housing policies will have to change

Posted on April 22, 2020 by particularkev

Rachel Ong ViforJ, Curtin University

What began as a global health crisis in the form of COVID-19 is now also an economic crisis of historic proportions. Much of the housing policy focus during the pandemic has rightly centred on the plight of people who are insecurely housed or homeless. Another strand of commentary has focused on a likely fall in property values.

But what does the pandemic mean for housing market inequalities in Australia? And what are the policy implications?

The renter-owner gap will widen

Despite concerns about house prices plummeting, the spread of COVID-19 is exposing a widening gap in housing markets between those who own zero housing wealth (renters) and those with substantial housing wealth (owners).

Australians with little to no housing wealth were already experiencing at least three key types of vulnerabilities before the pandemic in the form of work insecurity, financial stress and ill-health.

The charts below show the comparisons between renters and home owners in these three categories of vulnerability, using data from the HILDA Survey. Owners are ranked in quintiles by housing equity, from the bottom 20% (Q1) to the top 20% (Q5).

Renters were much more likely to be unemployed or in casual jobs than people with high housing wealth.

Note: Sample includes all persons aged 25+ no longer living in their parents’ homes. Housing equity is defined as family home value minus mortgage debt. Population weights have been applied.
Author’s calculations from 2017 Household, Income and Labour Dynamics Survey data, Author provided

Both renters and owners with low housing equity were more likely to have difficulty paying their rent, mortgage and utility bills on time. They were less likely to be able to raise emergency funds when needed.

Note: Sample includes all persons aged 25+ who are no longer living in their parents’ homes. Housing equity is defined as family home value minus mortgage debt. Population weights have been applied.
Author’s calculations from 2017 Household, Income and Labour Dynamics Survey data, Author provided

Renters were also more likely to report poorer physical and mental health.

The spread of coronavirus has added to these existing vulnerabilities. Casual workers have been particularly vulnerable to job loss.

The social gradient in health is well-known. People on the bottom rungs of the socioeconomic ladder tend to be in poorer health. They are then more likely to develop serious health problems from the coronavirus.

Post-pandemic markets will add to inequalities

COVID-19 is making existing economic inequalities worse. And even in a post-pandemic world it can be expected to slow down wealth accumulation among renters.

Hysteresis is a term used to describe an economic event that persists into the future, after the factors that led to the event have disappeared. In labour markets, the long-term unemployed also suffer long-term damage to their job prospects as their skills deteriorate and they are regarded as less employable.

This hysteresis effect will likely spill over into housing markets. Any crisis-driven falls in house prices may be short-term as housing values remain relatively insulated by record low interest rates. People who are exposed to job loss, insecure work or ill-health during the crisis will face a greater struggle to regain their economic footing after the pandemic than those from more affluent backgrounds.

This means the wealth-accumulating capacity of people with little to no housing equity is further compromised during and after the pandemic. In short, renters could fall further behind in their ability to buy a home. The gap between the haves and have-nots will grow.

3 principles for post-pandemic policy

An even more unequal housing future for Australia is undesirable. The post-crisis housing debate will need to be conducted with three key elements in mind: equity, solidarity and security.

Equity in access to housing opportunities must not slide off policymakers’ radar. It is not a debatable fact that governments have long provided generous concessions for property buyers. These measures include capital gains tax discounts, family home exemptions from land tax and income support means tests, and negative gearing for investors.

These preferential tax treatments have far exceeded government spending on renters. Notwithstanding the benefits commonly associated with home ownership, restoring some balance in the distribution of subsidies between owners and renters is essential to narrow the widening chasm between them.

Solidarity between generations will be more crucial than ever before to preserve Australia’s social and economic fabric. The surge in national debt created in response to the crisis will likely be a multi-generational burden.

Some might be tempted to return to pitting the young against the old in housing debates. Policy thinking that encourages solidarity, rather than stoking tensions between generations, will be increasingly important. For instance, abolishing stamp duty together with levying land tax on all land will remove a key financial barrier to home purchases for both young first-time buyers and older downsizers.

The formation of the national cabinet to oversee the response to COVID-19 also provides a post-pandemic forum to forge federal-state cooperation on the required reforms. Federal support will be needed to help cover state revenue shortfalls in a gradual transition to land tax. On the other hand, the release of housing equity by older downsizers should ease pressures on the federal retirement incomes system.

Finally, it is time to reprioritise housing security as a foundation for fostering good health and economic participation. Critical public health measures to avoid the spread of disease, such as social distancing and staying at home, are inherently shelter-related. These measures are rarely achievable for people who are homeless or in overcrowded housing.

Rachel Ong ViforJ, Professor of Economics, School of Economics, Finance and Property, Curtin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Bushfires won’t change climate policy overnight. But Morrison can shift the Coalition without losing face

Posted on January 14, 2020 by particularkev

When polling resumes after the summer, Scott Morrison may be surprised by the public’s assessment of his government’s handling of the bushfires.
Mick Tsikas/AAP

Chris Wallace, Australian National University

The hope of many people enduring this summer’s firestorms is that better climate policy will arise phoenix-like from the ashes.

It is expressed loudly, fervently, sometimes abusively by people directly affected and those feeling solidarity with them.

It is also expressed secretly, whispered to like-minded confidants, by others who are part of or allied with the Liberal-National (LNP) coalition government of Prime Minister Scott Morrison.

On Sunday, Morrison indicated that he would take a proposal to establish a royal commission into the bushfires to his Cabinet.

But when it comes to climate policy, there are three possible scenarios in the aftermath of the crisis: everything magically changes for the better, everything stays the same or something different happens.

What these three scenarios look like

Everything magically changes for the better would look like this: Morrison announces the crisis has transformed his previous token admission of a link between bushfires and climate change into a revelation of the reality of global warming, with consequential policy change.

As logical and desirable as this seems, it is unlikely, not least because of Morrison’s character and personal beliefs.

Everything stays the same has a powerful impetus behind it. Morrison does not want policy change any more than his likely successor in the event of leadership change, Peter Dutton.

Government-friendly journalists and commentators at News Corp and 2GB show no sign of changing tack either, so even if the government wanted to shift its policy, the media environment makes it difficult to do so. The forces of inertia are powerful.

Then there is the slim hope that something different happens. This scenario relies on all three of Australia’s main political groupings – the LNP, Labor and the Greens – realising they each face their own distinct climate policy challenge and rising to it.

As Australian burns, its politicians squabble over who’s to blame and how to prevent future disasters.
David Mariuz/AAP

Avoiding the appearance of a backflip

Opinion polls are not done over the summer holiday period, meaning the LNP has yet to see the impact of the bushfires on their public standing.

When polling resumes, Liberal and National MPs will understand the impact, and they won’t like it. Morrison and others will likely urge party members to hold their course since the next election is years away and a dozen other issues could distract attention from climate policy between now and then.

This tactic can prevail for some time but is not strategically sustainable: firestorms like those in the summer of 2020 will not be the last.

The emerging LNP argument that inadequate hazard reduction burns are to blame for the current crisis is risible. The Australian who has emerged with the most credibility from the bushfires – NSW Rural Fire Service Commissioner Shane Fitzsimmons – rejects it out of hand.

The LNP’s challenge, then, is to realise its current position won’t hold strategically and to transition to better policy ahead of that becoming obvious, managing the optics to avoid the appearance of a backflip.

The challenge for Labor and the Greens

Labor is benefiting from leader Anthony Albanese’s call for “an adult conversation” in Australia about climate policy. He is astutely citing British Tories like the late Margaret Thatcher and current Prime Minister Boris Johnson, who long ago accepted and acted upon the climate science the Morrison government viscerally rejects.

Labor’s homework now is to reconcile the views and interests of members and supporters prioritising climate policy over mining jobs, and vice versa.

This can and must be done if Labor is to build a coalition of support big enough to win office and then enact the climate and other policies the current firestorms make so urgent.

The Greens, meanwhile, need to have an internal conversation about whether they want to continue making perfect policy the enemy of the good – leaving Australia with no emissions trading system (ETS) at all, for example, because they would not vote for one that did not meet their every demand – or join in efforts to begin on the path to better policy.

Central to that conversation must be a realisation their current strategy isn’t working – the LNP keeps returning to power.

Greens leader Richard Di Natale has said the bushfires should be a
David Crosling/AAP

A possible way forward

There is an obvious point the LNP, Labor and Greens might momentarily agree upon to move policy forward. It is the ETS proposed by Liberal Prime Minister John Howard in 2007.

Howard saw climate change coming. In late 2006, he established a prime ministerial task group on emissions trading chaired by the secretary of his Department of Prime Minister and Cabinet, Peter Shergold.

The Shergold Report, released in May 2007, said “emissions trading should be preferred to a carbon tax” and among the various kinds possible, a national “cap and trade” ETS was best.

In an address to the Liberal Party Federal Council in October 2007, Howard promised to establish a national ETS starting no later than 2012.

This will be a world-class emissions trading system more comprehensive, more rigorously grounded in economics and with better governance than anything in Europe.

Implementing an emissions trading scheme and setting a long-term goal for reducing emissions will be the most momentous economic decisions Australia will take in the next decade.

This emissions trading system must be built to last. It needs to last not five or 10 years, it needs to last the whole of the 21st century if Australia is to meet our global responsibilities and further build our economic prosperity.

Howard positioned the LNP as the party Australians could trust to implement an ETS in a way that gives “firms and families” the ability to “plan for the future with confidence”.

His authorship – and his framing of his ETS as an act of economic responsibility –provides a fig leaf Morrison can now use to move the LNP to a credible, sustainable and politically viable climate policy position.

“Something different” has to start somewhere. If Morrison can deploy the cunning he showed winning the 2019 election by drawing on Howard’s deep well of credibility within the LNP to implement the plan himself and then inviting – daring – Labor and the Greens to back him, it would be a signal political achievement.

And if Morrison doesn’t want to, Labor, the Greens, independent MPs and conscientious LNP MPs should vote together to turn Howard’s ETS into law right away. With political will, “something different” can start now.

Updates to add that the latest Newspoll, released late Sunday, shows Morrison’s standing has taken a massive hit over the bushfires, dropping nine percentage points as preferred prime minister from 48% to 39% since the last poll in early December. Opposition leader Anthony Albanese stood at 43% – a massive reversal of Morrison’s 14 percentage point lead over the Labor leader in early December.

Chris Wallace, ARC DECRA Fellow, Australian National University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Listen to your people Scott Morrison: the bushfires demand a climate policy reboot

Posted on January 9, 2020 by particularkev

Scott Morrison’s response to the bushfires has been roundly criticised as being too slow and out of touch.
James Ross/AAP

Tony Walker, La Trobe University

Frank Jotzo, the director of the Centre for Climate and Energy Policy at Australian National University, has some constructive advice for Prime Minister Scott Morrison in a column today for the ABC: do not waste an opportunity to recalibrate his government’s approach on climate change.

Morrison should heed Jotzo’s suggestion that he and his cabinet need to “drop the old anti-climate change stance”. As Jotzo writes,

You’ve been politically locked into a no-action position, but the bushfires give you the reason to change […] You can make it your mission to protect the country from harm, an essential conservative cause.

Jotzo speaks with authority as one of the country’s foremost experts on climate reduction policies. He has a global reputation.

Whether Morrison is capable of a course correction on climate change and, in the process, yield on an issue he has used to wedge his political opponents remains to be seen. However, he would be unwise to pretend that once the immediate bushfire danger passes and the smoke clears, the country will return to normal politically.

The nation will expect – indeed it will demand – that any government, conservative or Labor, face up to what is the new normal of a drying continent rendering human settlement increasingly vulnerable to extreme weather. Failure to do so will exact a heavy political price.

Scott Morrison’s holiday trip to Hawaii immediately came under fire from those who accused him of being out of touch with fire victims.
Steven Saphore/AAP

Morrison’s fallback positions are less defensible

The prime minister insists he has not denied there is a link between climate change and bushfires, but at best his responses on the subject have been evasive and self-serving politically.

Pressed on the issue, his fallback position is to say

I am sure you would also agree that no response by any one government anywhere in the world can be linked to one fire event.

That might be true, but it is hardly the point in the wider scheme of what measures might be adopted to address problems of a sluggish response to the bushfire emergency.

Morrison and others in his government might also go easy on claims that local opposition to hazard reduction burning in native forests contributed to the fires. This is a coded attacked on the Greens and is not supported by the evidence.

When in doubt, politically you might say, blame the Greens.

Memo to Scott Morrison: people are fed up with politics proving to be a constraint on the development of a credible and sustainable climate policy that involves reasonable transitional steps to a low-carbon economy over time.

As such, he might also drop his claim that calls to reduce carbon emissions are “reckless”.

Where the prime minister is particularly vulnerable – this will be subject studied closely by any future commission of inquiry – lies in his refusal to meet a group of former emergency services leaders calling itself Emergency Leaders for Climate Change.

In April, the leader of the group, Greg Mullins, a former commissioner of NSW Fire and Rescue, wrote to Morrison warning him of the threat of “increasingly catastrophic extreme weather events”.

In September, this expert group wrote again to the prime minister asking for a meeting.

They received no constructive response.

Likewise, academic warnings about risks of climate-induced extreme weather events have been ignored.

In a March 2019 report for the Australian Strategic Policy Institute, ANU professor Robert Glasser called specifically for a national strategy to deal with climate disaster preparedness.

More than 500 Australians, about the same number who died in the Vietnam War, die each year from heat stress alone. The annual economic costs of natural disasters are projected to increase to A$39 billion by 2050, which is roughly equivalent to what the Australian government spends annually on defence.

Bear in mind Glasser’s report was written before these Christmas-New Year bushfire disasters.

We need to begin preparing now for this changing climate, by developing a national strategy that outlines exactly how we move on from business as usual and adopt a more responsible approach to climate disaster preparedness.

Demonstrating empathy, not political calculations

This bring us to issues surrounding the PM’s own leadership during the crisis.

Rosemary Williamson of the University of New England concluded a useful survey of Australian prime ministers’ responses to natural disasters last year with these words:

Australians will expect prime ministers to come and see for themselves, to demonstrate empathy and to instil confidence in recovery.

If these are the benchmarks for prime ministerial behaviour during a crisis brought on by disaster whether it is flood, fire or cyclone, Morrison has not lived up to these expectations.

First, he was – inexplicably – out of the country on holiday while uncontrollable fires began ravaging his home state of New South Wales.

Second, he has had trouble demonstrating reasonable empathy for victims of the fires.

And third, he has had difficulty accepting the Commonwealth had a shared responsibility for assisting the states in coping with the fallout from arguably the worst natural disaster in Australian history.

What has been most surprising is the time it has taken for Canberra to understand that such are the dimensions of this disaster that military assistance was necessary.

Weeks passed without the Australian Defence Force (ADF) being called out. The explanation for this delay is that states had not asked for military involvement, as if the out-of-control bushfires themselves respected state boundaries – or Commonwealth-state relations.

Coordination between Canberra and the states has improved in recent days, but in the early stages such cooperation left much to be desired.

In all of this, it is clear Morrison has laboured under a constraint of not wanting to antagonise the climate-sceptic right of his party by immediately conceding that global warming and bushfires are linked.

This would explain his tardiness in acknowledging the extent of the disaster.

Politically, he may well believe that climate remains an important point of difference between parties of left and right.

Debate over climate – whether it is changing, and if so what to do about it – has become a culture wars issue over the years to the point where it has proved to be a useful political device for parties of the right.

As a politician of the right, Morrison would be reluctant to yield ground on issues to do with electricity prices that might benefit him politically in the future.

These are the political considerations that would be weighing in his calculations.

Morrison tours a scorched farm in Victoria last week.
James Ross/AAP

Charting a new course

However, the ground is shifting politically.

Polls indicate the environment is assuming greater importance among Australians. It is not far behind the economy and health in people’s concerns, according to an exhaustive poll conducted by the ANU’s 2019 Australian Election Study.

Among issues that will burden governments – both federal and state – over the next months will be the heavy costs associated with cleaning up the mess. All up, costs will run into the billions given the dimensions of destruction.

Inevitably, the bushfires will have an impact on economic activity in the December and March quarters. Growth is anaemic in any case, and may well become weaker as a consequence of reduced economic activity during the bushfire season.

Whatever economic fallout ensues, the political costs for the prime minister will continue to weigh heavily.

He would do himself a favour by advancing a credible climate and land management policy that ensures the country is better prepared when the next disaster strikes, as it surely will.

Tony Walker, Adjunct Professor, School of Communications, La Trobe University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Iran – USA Crisis

Posted on January 6, 2020 by particularkev

With the US and Iran on the brink of war, the dangers of Trump’s policy of going it alone become clear

Posted on January 4, 2020 by particularkev

Klaus W. Larres, University of North Carolina at Chapel Hill

President Donald Trump’s policy toward Iran is in deep crisis. The president’s approach has the support neither of America’s allies nor of its strategic rivals, China and Russia. And his policy – made even more confrontational by the shooting of a high-ranking Iranian official – has boxed him into a situation where, short of dramatic reversal, Washington and Tehran are edging close to war.

By failing to forge policies in cooperation with allies, the U.S. was robbed of advice and expertise in how to tackle the problems posed by Iran. Above all, it led to the dangerous deterioration of relations between the U.S. and Iran after the U.S. became the sole country to withdraw from the Iran nuclear deal. That deal was painstakingly negotiated by the Obama administration in cooperation with five other world powers.

Instead of Trump’s harsh policy imposing maximum pressure on Iran, Iran has turned the tables and has put pressure on a freshly impeached U.S. president whose reelection is by no means assured and whose international diplomatic isolation and weakness is no secret in the region.

And once again, Trump took unilateral action early on Friday morning. The killings of Iran’s revered and powerful military commander, General Qassem Soleimani, and Iraqi militia leader Abu Mahdi al-Muhandis in a U.S. drone strike on Baghdad airport has further escalated tension in the region.

The killings immediately caused huge anti-American protests in Iran and led to the rise of global oil prices and the fall of stock markets around the world.

Iran has vowed “harsh revenge” for the assassination of Soleimani, the strategic mastermind behind Tehran’s entire ambitious Middle East policy. He also coordinated Iran’s widespread covert operations program and provided much of the strategic expertise for President Bashar Assad’s war in Syria.

President Trump holding the memorandum announcing the US withdrawal from the Iran nuclear deal, May 8, 2018, in Washington.
AP/Evan Vucci

Wishful thinking?

Since coming to office in January 2017, President Trump’s approach to resolve America’s longstanding quarrel with Iran has consisted of two stages.

The politics of maximum pressure – imposing stiff economic sanctions – combined with harsh rhetoric toward Tehran’s leaders was to be followed by a second stage of intense personal diplomacy that would culminate in the signing of a great new deal of cooperation with longtime enemy Iran.

It would turn Trump into one of America’s greatest foreign policy presidents and might even, or so he hoped, earn him a Nobel Peace Prize.

As an international relations scholar and former diplomatic and foreign policy adviser at the German embassy in Beijing, I believe this approach consisted of a lot of wishful thinking.

Iran’s Supreme Leader Ali Khamenei simply refused to engage with Washington on the conditions laid down by Trump. Those conditions included Iran halting all uranium enrichment and ceasing support for the region’s militant groups.

Tables turned

Trump’s unorthodox idea – conducting the nation’s diplomacy singlehandedly and without asking for much advice from experts in the State Department or from his allies – has been revealed as untenable.

Trump’s withdrawal from the 2015 multi-party nuclear deal with Iran was caused by his unhappiness that the deal was not meant to restrain Iran’s aggressive politics in the region. Trump also believed it would not effectively prevent Tehran’s ability to manufacture nuclear weapons in the long run.

But his policy toward Iran appears not to have contained and intimidated the country’s leaders. It has instead emboldened the country to aggressively challenge U.S. policies in the Middle East.

U.S. withdrawal from the deal was deeply resented by both Iran and the international community. And it started the rapid deterioration of relations with Tehran.

The recent siege of the U.S. embassy in Baghdad by violent protesters who were clearly directed by the Tehran regime recalled the Iranian hostage crisis 40 years ago that decisively contributed to President Jimmy Carter’s electoral defeat.

The shooting down of an expensive American drone by Iran in June as well as Tehran’s open support of the Assad regime in Syria and the Hezbollah terrorist organization in Lebanon were further indications of Iran’s challenge to the U.S.

It appears that Trump’s airstrike on the Baghdad airport was an attempt to demonstrate America’s power and to break out of a largely self-inflicted foreign policy failure.

New tack

I believe that President Trump’s diplomacy toward Iran requires urgent course corrections.

The only option left – and one not yet seriously considered by the Trump administration – is to fall back on cooperation with other great powers, not least with Washington’s many allies, such as the U.K., France and Germany, who are still anxious for American global leadership. The Trump administration has little option but to return to the Obama-era nuclear deal with Iran, though perhaps it could be somewhat modified to enable Trump to save face.

The administration could then embark on a unified Western policy to restrain both Iranian leadership ambitions in the Middle East and Tehran’s nuclear ambitions.

The killing of Soleimani and the angry reaction to his death, however, has made this almost impossible in the short run. But tempers may cool.

Despite recent joint Russian-Chinese-Iranian naval maneuvers, Moscow and Beijing are also still interested in containing Iranian ambitions. Iranian dominance in the Middle East and the resulting further tension and escalating rivalry with Saudi Arabia for regional control would hardly benefit the great powers and the stability of the region.

Whether or not the Trump administration is capable of and willing to embark on such a major change of course is unclear. But I believe it is the only way out of a crisis largely caused by Trump’s unilateral policies.

[ Insight, in your inbox each day. You can get it with The Conversation’s email newsletter. ]

Klaus W. Larres, Richard M. Krasno Distinguished Professor; Adjunct Professor of the Curriculum in Peace, War and Defense, University of North Carolina at Chapel Hill

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Sharing my thoughts with the world from a Particular Baptist perspective

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Key changes

Effect on workforce participation and family budgets

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The renter-owner gap will widen

Post-pandemic markets will add to inequalities

3 principles for post-pandemic policy

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What these three scenarios look like

Avoiding the appearance of a backflip

The challenge for Labor and the Greens

A possible way forward

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Morrison’s fallback positions are less defensible

Demonstrating empathy, not political calculations

Charting a new course

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Wishful thinking?

Tables turned

New tack

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