February 4, 2009

Memo to the President

Faculty weigh in with advice for Barack Obama as he begins his term

Michael Rosenblatt, dean, School of Medicine, and professor of physiology and medicine

  1. Put forward a plan that creates health insurance coverage for all, enables the training of a sufficient number of qualified physicians for America’s growing and aging population, and makes career avenues attractive in critically needed areas of medicine, such as primary care, family medicine, pediatrics and ob-gyn. Physicians, hospitals and clinics should be rewarded for quality of care. The high cost of a medical education should be largely subsidized by government scholarships and supplemented by loans.
  2. Funding of biomedical research is important to the future health of Americans and is highly leveraged in terms of creating new jobs and economic return. The government should increase NIH funding as part of the new economic stimulus package.
  3. We need to establish the “rules of the road” that enable academic institutions to collaborate with the device, biotechnology and pharmaceutical industries. Clear guidelines need to be established so that the nation can leverage its strengths in biomedical research in academia and industry. This needs to be done to maximize the benefits of research for the American population and to strengthen our competitive position in the life sciences globally.


Stephen Bosworth, dean, Fletcher School, and former U.S. ambassador to the Republic of Korea

I think Barack Obama should basically continue saying the things he’s been saying, stressing this country’s willingness to lead, but understanding that we need to work with other countries if we are going to be successful.

We have to recognize that our foreign policy problems are very tough, and it’s going to take time and patience and a lot of energy to make progress. If all our problems were easy ones, they would have been solved long ago.

We’ve been dealing with the problems of the Middle East since World War II, and while there’s been some progress, as through the Camp David Accords, there are enormous issues to be solved.

The arc of crisis in the Middle East extends from Israel and Palestine all the way over through Syria, Iraq, Iran, and Afghanistan and Pakistan. That’s a big chunk of land and a lot of people, and there are a lot of nuclear weapons there and countries trying to get nuclear weapons. It’s an area that is vital to our security, to say nothing of the fact that 80 percent of the world’s oil reserves are there.

We have to set priorities. At the moment I think our number one priority has to be to reverse the economic crisis, and to do that, we have to approach it globally, not just nationally. Because our economy is so tied into the rest of the world, there is no unilateral solution to our problems. We have to have all the major economies of the world acting within a common framework, which will provide guidance for how we get out of this.

We also have to recognize that things have changed. We are no longer the dominant and preeminent global power that we were; there has been a diffusion of power over the last generation, particularly with the rise of China and now India. We no longer have the ability, even if we were so inclined, to unilaterally decide what happens in the world.

These are daunting times. There can be a new tone, and I think the new tone has already been established—reaching out, wanting to work collaboratively with other countries, a preference for dialogue over the use of force. The new tone is there, but it will take time to actually have different policies in place.


Gilbert Metcalf, professor of economics

First, President Obama needs to put in place a strong fiscal stimulus plan to help stave off what could be the worst recession since the Great Depression. That includes resisting pressure to lower taxes in place of raising spending. Economic theory and empirical research confirm that spending provides a bigger bang for the buck than do tax cuts.

That spending should be on productive infrastructure, including roads and bridges in need of repair, as well as green technologies and the infrastructure to support those technologies. That includes significant spending on a national transmission grid capable of handling the intermittent loads of wind- and solar-generated electricity.

Second, President Obama should provide leadership in carrying out global regulatory reform to avoid replications of the financial turmoil that the United States and other countries are currently suffering. Simply clamping down on new market innovations like mortgage-backed securities, credit default swaps and other creative market instruments is the wrong approach, as these new securities can serve a productive purpose in the marketplace. Smart regulation can help curtail abuses in the use of these instruments. Because financial capital is global, regulation needs to be global as well. Obama enters office with strong political capital and high regard globally. This will help him provide leadership on this issue.

Third, the president should move swiftly to put a national carbon price in effect, either through a cap and trade system or—preferably—through a carbon tax. A carbon price should start at a moderate level, in the neighborhood of $25 per ton of CO2, and rise over time to achieve substantial reductions in domestic greenhouse gas emissions over this century.

While reductions by major developing countries will also be needed to curtail global warming, the United States should commit and act now, regardless of what China and other major developing nations do. This provides a credible stage from which the United States can work to bring these nations into a worldwide system to address global warming.


Jerome P. Kassirer, professor, Tufts University School of Medicine, editor-in-chief emeritus, New England Journal of Medicine

  1. Devise a [health-care] plan that covers all Americans. It is the only way to gain control over excessive spending.
  2. Don’t falter in your resolve to reform the system when opponents from the pharmaceutical industry, the health insurance industry and the high-income specialists try to oppose reform. (They will do so.)
  3. Don’t expect too much from automation of medical records. There is too much variation from one electronic medical record to another, and computers still haven’t learned to talk to one another efficiently.
  4. Fix primary care. It will require more than adjusting incomes of internists and family doctors.
  5. Comparative effectiveness assessment is much harder than most people believe, and it is a political hot potato. Don’t rush into it without caution.


Neva Goodwin, co-director, Global Development and Environment Institute

Perhaps the greatest challenge for our new president will be to remind the people of this country—and the world—that a good life is possible, which is very different from recent versions of the American dream. It is critical to think about what the future can look like, and then start to lay the groundwork to achieve that.

Many decades of ecological and social resource depletion and degradation have not only brought about the threat of climate change, but also a growing culture of materialist consumerism, with the motto “greed is good.” Old-fashioned values of thrift and responsibility have been denigrated, and many real pleasures and values have been forgotten.

We should work toward reversing the trend that we’ve seen since the Industrial Revolution, of reducing labor relative to energy and material inputs in production. Relative costs of goods and services will change in a more labor-intensive economy, especially if we can re-value the essential work of society, including the provision of care, nurturance and education. In that light, the trend for health care to take up a growing part of the national budget should be recognized as positive and necessary.

The cost of food needs to rise relative to other, less-basic needs. Industrial agriculture, replacing human labor with machines and chemicals, improved the lives of a few affluent farmers, while conditions remained very bad for low-wage, often migrant workers. The result has been cheap food of questionable nutritional value. Considerations of equity, ecology and human health all point to smaller farms, reduced fuel and chemical inputs, and better-paid workers.

The cost of formal education should increase as a portion of the national budget, but perhaps fall less heavily on households. I’d recommend a new, wide-ranging version of the GI Bill, not only for returning veterans, but also for their families and for other people who have worked for the social good or who choose to do specified types of work in order to qualify. We need to educate people to understand that their living standards may rise when they pay for quality, such as for more nutritious foods. The relative wages of the people who would be most hurt by rising costs will need to be raised. This will require imaginative interference with some of the workings of the market as we’ve known it in recent decades. The social and ecological failures of the free market have created an opportunity, indeed a mandate, to think of new ways to channel market forces to work for, not against, our most important goals.

For more information, see Neva Goodwin’s working paper, “An Overview of Climate Change: What Does It Mean for Our Way of Life? What Is the Best Future We Can Hope for?


Richard M. Lerner, the Bergstrom Chair in Applied Developmental Science and director, Institute for Applied Research in Youth Development

President Barack Obama has the opportunity to create a new conversation about the potential of young people to become healthier, more resolute and empowered citizens, to build stronger families and more vibrant and cohesive communities that engage in and contribute to civil society.

There are three steps that I recommend: focus on youth strengths, promote positive youth development and create better youth-serving institutions.

Young people need not be regarded as problems to be managed. They can and should be seen as resources to be developed. New research in social science focuses on positive youth development, which emphasizes that all young people have the potential for healthy and successful development. The research points to positive characteristics of young people: competence, confidence, connection, character and caring, which, when they coalesce, lead to greater contributions to society.

We should act to promote positive youth development instead of just working to prevent problem behaviors. Parents, teachers and community mentors need to provide positive and sustained adult-youth relations; help build fundamental life skills; and provide the opportunity for youth to use these skills in home, school and community activities.

We must also create better youth-serving institutions, the most important of which is what I call “the good school,” a setting where children learn how to be fulfilled, happy and healthy and learn how to be successful in life, not just people competent in performing well on standardized tests. Schools in such a vision become institutions that work collaboratively with families and communities to integrate and enhance the resources devoted to the positive development of young people.

President Obama begins his term with both great opportunity and great challenges. He also begins his presidency with a belief that if he can bring to the forefront of our nation the best in America’s character, our future will be bright. Such a hopeful future for our nation can be assured by helping all American youngsters develop more hopeful futures for themselves. Informed by research in the science of youth development, President Obama can enhance the lives of this and future generations of America’s youth.

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