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NOAH ENTE | COLUMN

Trouble for U.S. in Southeast Asia

S

ince before the formation of 
the post-World War II order, 
the United States has made 
notable efforts to create a network 
of allies and support throughout 
Asia. One of the earliest American 
partners was the Philippines, and 
the relationship between the two 
countries spans back to 1898. In 
the aftermath of the Spanish-
American War, Spain ceded the 
rights to its former colonies — 
which included the Philippines — 
to the U.S.
While 
the 
land 
remained 
an 
American 
territory 
and 
protectorate 
for 
nearly 
50 
years, 
formal 
diplomatic 
ties 
between the newly-independent 
Philippines and the U.S. began 
in 1946. Since then, the two 
nations have become frequent 
collaborators in defense, trade and 
other realms. The U.S. has also 
incurred heavy human costs in its 
commitment to the island nation, 
as the capital city of Manila houses 
the largest U.S. military cemetery 
of any other country. The histories 
of these countries are strongly 
intertwined, and their alliance has 
been mutually beneficial.
These days, the status quo 
of 
U.S.-Philippines 
relations 
appears to be in danger. Last 
week, Filipino President Rodrigo 
Duterte announced his decision 
to annul the 1998 Visiting Forces 
Agreement. This deal laid out 
the terms of U.S.-Filipino armed 
forces 
cooperation 
and 
the 
stationing of American troops in 
the Philippines, a fundamental 
aspect of the partnership. Duterte 
spoke of his belief that his country 
“cannot forever rely on other 
countries for the defense of the 
state.” The Filipino leader appears 
firm in his conviction and has 
given no indication of being open 
to negotiations.
This tension has been building 
over the past few years. The 
Duterte 
administration 
has 
frequently 
clashed 
with 
U.S. 
leadership since his election four 

years ago. Among the strongest 
sticking points between the two 
countries has been Duterte’s policy 
toward drug crime in his country. 
He infamously compared himself 
to Adolf Hitler and implied he 
would perpetrate genocide against 
drug users and dealers. Such 
disturbing language and resulting 
policies have resulted in Duterte’s 
alienation of the U.S., and the 
American response has been 
strong. This latest point of conflict 
came about after U.S. officials 
cancelled the visa of Philippine 
Senator Ronald Dela Rosa, who 
helped engineer Duterte’s violent 
policies against drug offenders. 
In response, Duterte threatened, 
then completed his country’s exit 
from the agreement, much to the 
chagrin of high-ranking Filipino 
foreign policy officials.
The U.S. acted justly when 
it chose to set an example that 
figures like Dela Rosa will not 
be given special consideration 
and rights to visit the country. 
Duterte’s 
demagogic 
rule 
in 
Manila has set a negative tone 
in relations with the U.S and 
produced 
horrifying 
policies. 
Yet this case of erosion of the 
American-Filipino 
relationship 
also serves as a warning for 
those concerned about American 
interests in Southeast Asia.
Throughout his time in office, 
Duterte’s Philippines has shown 
a pivot toward embracing China 
and moving away from American 
influence. One example of such 
behavior is the Filipino president’s 
willingness to collaborate with 
Chinese President Xi Jinping on 
an oil and gas project in the South 
China Sea, even with the key 
term of the agreement being that 
the Philippines would no longer 
pursue its claims against China 
for its activities in the area that 
undermine Philippine sovereignty.
Such a development should 
be quite frightening to those 
who value a vibrant network of 
American international relations. 

Though Duterte’s foreign policy 
is mainly a break from that of his 
predecessors, it is concerning 
that one of America’s longest-
tenured allies in Asia is quickly 
gravitating toward China’s sphere 
of influence at the expense of the 
U.S. If the Philippines can fall 
into President Xi’s hands, what 
is to stop other Southeast Asian 
countries from being lost as well? 
China’s meteoric rise to the upper 
echelon of the world’s economies 
has paid off in attracting new 
partners around the world. If it can 
successfully present itself to states 
in the region as an alternative to 
American partnership, the U.S. 
will be worse off in the future.
Though 
the 
current 
state 
of affairs might represent a 
problematic emerging pattern, 
it is important to remember 
that Rodrigo Duterte is just one 
man. It is possible, especially 
given the opinions carried by the 
Filipino people toward China, 
that his time at the premiership 
of 
the 
Philippines 
will 
end 
shortly. Perhaps other Southeast 
Asian nations will look to the 
Philippines as an example of how 
not to approach a relationship 
with their American partners.
Regardless, 
the 
U.S. 
must 
continue to invest its time, capital 
and energy in its relationships 
with nations around the globe, 
but particularly in Southeast Asia. 
At a time when China’s brand of 
authoritarian rule appears to be 
a fashionable model for foreign 
governments, 
America 
should 
continue to not only lead by 
example, but serve as an active 
and engaged partner for its friends 
worldwide. As for the Philippines 
specifically, the U.S. should not 
bend the knee to Duterte. It 
should remain willing and eager 
to continue building strong ties 
when a new leader steps into the 
president’s office in Manila.

Noah Ente can be reached at 

noahente@umich.edu.

ALLISON PUJOL | COLUMN

Judge, jury and — too often — the executioner
W

hen cousins Walter and 
Gaspar came to the 
United States fleeing 
gang violence and widespread 
corruption in El Salvador, their fate 
was a sadly familiar one for many 
applying for asylum. The two men’s 
applications were denied and they 
were deported back to El Salvador. 
Once they were back home, Walter 
and Gaspar were taken from their 
beds and beaten for days by local 
police.
Walter and Gaspar were lucky. 
After 
experiencing 
extensive 
physical 
and 
psychological 
abuse in police custody, they 
were eventually released. But 
not everyone escapes dangerous 
police interrogations alive. A week 
ago, rights advocacy organization 
Human Rights Watch (HRW) 
released a report detailing the 
violence that many unsuccessful 
asylum applicants — much like 
Walter and Gaspar — often face 
when they are forced to return to 
their respective home countries 
after being denied asylum.
No one really monitors what 
happens when denied applicants 
are sent back to El Salvador, and 
HRW’s recent report aims to help 
“fill that gap.” When an immigrant 
applies for asylum, their case will be 
reviewed in front of an immigration 
judge. That one individual controls 
the 
difference 
between 
life 
and death for asylees. In many 
instances of asylum application 
denial, a judge will rule that the 
applicant cannot demonstrate they 
had a credible and well-founded 
fear of persecution or harm in their 
home country or that the applicant 
would be a significant national 
security risk to the U.S. Several of 
the cases in the HRW report call 
into question whether many of 
the deportations that result from 
denied applications are to blame for 

the deaths and injuries of asylum 
applicants upon returning to their 
countries of origin.
President Donald Trump has 
made his hardline stance on 
immigration a cornerstone of his 
political agenda as well as a crucial 
rallying cry for his base. While the 
president has attracted attention 
for the crude language he has used 
to describe immigrants, Trump 
himself directly regulates and 
oversees little of U.S. immigration 
policy. 
Instead, 
administrative 
agencies within the executive 
branch, such as the Department 
of Justice, carry out much of the 
political changes and intricacies 
of the legal immigration process. 
Still, Trump’s widely-discussed 
executive 
orders 
that 
have 
attempted to restrict immigration 
flows — such as announcing a travel 
ban on predominantly Muslim 
countries or ending temporary 
protected status for Salvadorans, 
much to the protest of senior agency 
officials at the Department of State 
who strongly advised against the 
decision — are only the tip of the 
immigration iceberg. 
HRW’s recent report is powerful 
because it indicates some denied 
applications are dismissed all too 
easily. When establishing landmark 
decisions, 
immigration 
judges 
should be aware of the power they 
hold over vulnerable people and 
consider reports like HRW’s as 
evidence of the growing need for 
asylum approval.
The U.S.’s current asylum policy 
clearly endangers lives. Previous 
immigration decisions — such as 
Matter of AB-, which overturned 
protections for victims of domestic 
abuse or gender-based violence — 
should be revisited by immigration 
courts and reconsidered when used 
as legal precedent in cases for those 
trying to apply for asylum relief. 

It’s hard to grapple with the 
flaws in immigration policy when 
you aren’t an immigration judge 
or administrative agency official. 
While students at the University 
of Michigan can’t individually 
change the U.S.’s immigration 
policy, they can certainly show up 
to support a candidate who does 
in the Michigan primary in March 
and 
the 
presidential 
election 
in 
November. 
The 
remaining 
Democratic 
candidates 
have 
opinions about immigration that 
fall across the political spectrum, 
so it’s important for potential voters 
to be informed about what each 
of the candidates advocates for. 
Joe Biden’s plan for immigration, 
for example, is likely the most 
conservative of the remaining 
candidates, as it seeks to keep 
many current statutes concerning 
undocumented 
immigration 
in 
place and does not structurally 
change asylum policy. Protestors 
have been quick to point that out 
as well as express frustration 
regarding 
former 
President 
Barack Obama’s track record of 
deportations.
Candidates 
such 
as 
Pete 
Buttigieg, U.S. Rep. Tulsi Gabbard, 
D-Hawaii, Sen. Elizabeth Warren, 
D-Mass., Tom Steyer and Sen. 
Bernie Sanders, I-Vt., have all 
stated the need for improving 
asylum application reviews and 
eliminating or limiting family 
detention (Biden, Bloomberg and 
Klobuchar did not take a stance 
on asylum on either Politico’s or 
The Washington Post’s poll). The 
other candidates’ platforms would 
certainly be small victories in the 
larger fight for asylum applicants 
in the U.S., but important steps 
toward progress nonetheless.

Healthy equality is not equity

JENNY GURUNG | COLUMN

A

ccording to Healthline, 
27.5 million people did not 
have health insurance in 
2019, and about half of uninsured 
adults cited high cost of coverage as 
the reason for remaining uninsured. 
One of the main barriers to health 
care is the expense of the programs. 
High 
premiums, 
deductibles, 
copays 
and 
coinsurance 
of 
insurance 
plans 
are 
a 
major 
issue, especially given that most 
individuals in the U.S. have private 
insurance. According to the Centers 
for Disease Control and Prevention, 
most uninsured adults came from 
low-income backgrounds. Among 
adults, 27.4 percent of those who 
were poor, 25.1 percent of those who 
were near-poor and 8.3 percent of 
those who were not poor lacked 
health insurance coverage in 2018. 
(“Persons categorized as ‘poor’ 
have a ratio less than 1.0 (i.e., their 
family income is below the poverty 
threshold); ‘near poor’ persons have 
incomes of 100% to less than 200% 
of the poverty threshold; and ‘not 
poor’ persons have incomes that 
are 200% of the poverty threshold 
or greater.”) The result of this: 
Americans with higher income 
have better health outcomes than 
those with low income because 
they are almost always guaranteed 
health care coverage.
This “disproportionate risk of 
being uninsured, lacking access 
to care, and experiencing worse 
health outcomes” is called a 
health inequality, also known as 
a health disparity, which refers 
to a difference in the presence 
of 
disease, 
health 
outcomes 
and health care access between 
different populations. A health 
inequality can be an inevitable 
health difference based on age or, 
more notably, a higher likelihood 
of low-income individuals to suffer 
from chronic conditions like heart 
disease and diabetes which have 
an adverse effect on quality of 
life. These health inequalities are 
closely tied to income inequality 
which is exceptional in the U.S. It 
has become increasingly important 
for federal and local governments 
to prioritize initiatives aimed at 
reducing 
income-based 
health 
disparities, especially as income 
inequality has persisted and health 
care costs have increased.
In the past year, health care 
has been a defining issue many 
Democratic 
candidates 
have 
campaigned on. In 2019, Sen. Bernie 
Sanders, I-Vt., introduced the bill 
S.1129-Medicare for All, which 
would automatically enroll all U.S. 
residents for health insurance and 
cover essential medical services. 
Medicare for All is a single-payer 
health care proposal that would 

streamline the current multi-payer 
health care system and eliminate 
the private sector’s role in providing 
and paying for health care.
Currently, 
Medicare 
is 
a 
government-provided 
health 
insurance program only available 
to people aged 65 or older (and some 
younger people with disabilities). 
Medicare covers about half of all 
health care expenses and people 
often have to pay out-of-pocket 
(OOP) expenses or join another 
health insurance to cover the 
uninsured services. These OOP 
expenses include copays, premiums 
and deductibles, which go back to 
financing the insurance.

The new Medicare for All 
bill based on Sanders’s proposal 
is an expanded version of the 
current program all U.S. residents 
would be eligible for. It would 
essentially eliminate all private 
insurance, 
including 
employer-
based coverage. The bill states 
that private insurance can only 
be “supplemental” to the program 
to offer coverage for services 
not covered under it. This would 
be a huge change to the current 
health care system, where over 
68.9 percent of adults have private 
insurance. 
Furthermore, 
this 
current system costs significantly 
more than public health insurance.
There are a number of defining 
health 
insurance 
proposals 
made by Sen. Elizabeth Warren, 
D-Mass., a cosponsor of Sanders’s 
bill, former Vice President Joe 
Biden and other candidates. Biden 
has proposed the Biden Plan, which 
is a public insurance program 
that would reshape rather than 
eliminate private insurance while 
increasing the scope of Obamacare 
(Affordable Care Act).
Regardless of the type of 
policy, providing health care to all 
individuals is the first step toward 
eliminating 
health 
disparities 
in the U.S. The rhetoric, though, 
shouldn’t 
be 
about 
“insuring 
more 
than 
an 
estimated 
97 
percent of Americans” as Biden 
says. Everyone should already 
have access to health care, not 
just 97 percent of us. Health is a 
fundamental human right and 

these policies only resolve the 
first problem, lack of access to 
health care. The availability of 
health care to everyone should be 
a given. These policies only make it 
so that everyone has access to the 
same level of health care, but does 
not address the systemic health 
inequities that have become deeply 
rooted in our health care system.
Health inequities are specific 
types of disparities that are 
avoidable, unjust and the result 
of 
continued 
and 
persistent 
health differences. When health 
differences are “preventable and 
unnecessary, allowing them to 
persist is unjust,” writes Mariana 
Arcaya, Alyssa Arcaya and S.V. 
Subramanian 
from 
Global 
Health Action. The underlying 
difference between inequality 
and inequity is that the latter 
suggests injustices against a 
vulnerable 
population 
group 
based on race or ethnicity. Unlike 
age-related health differences, 
health 
inequities 
are 
clearly 
demonstrated in things such as 
higher rates of infant mortality 
among 
Black 
children 
than 
white children. This difference 
in mortality rate is seen among 
Black and white children in the 
same income group as well which 
suggests the underlying cause of 
this inequity is “rooted in social 
injustice.”
A powerful visual for health 
equity is three people standing 
behind a fence, each a bit shorter 
than the person before him. If 
you give them all an equally sized 
stand, only the tallest one will be 
able to see beyond the fence. The 
two others still won’t be able to see 
beyond the fence. Health equity 
is the idea that you give each of 
them the correctly sized stand that 
lets them all see beyond the fence. 
Healthy equality is not equity.
The current policy proposals 
presented only touch upon the 
underlying 
causes 
of 
health 
disparities and inequities in our 
health 
care 
system. 
Equitable 
health care access involves more 
than equal access to health care. It 
requires the equitable distribution 
of resources, finances and benefits 
to those who need it. Our current 
multi-payer 
system 
is 
neither 
equitable nor equal. We, as college 
students and voters, need to call 
upon our representatives to reassess 
the distribution of both resources 
and funding to fully understand 
how we can redesign and shape 
our current health care system to 
reduce persisting health disparities 
and inequities. 

Allison Pujol can be reached at 

ampmich@umich.edu

These health 
inequalities are 
closely tied with 
income inequality.

STANFORD
ENVIRONMENTAL
& WATER STUDIES
SUMMER PROGRAM
ewssummer.stanford.edu

June 22 - August 15, 2020

STANFORD UNIVERSITY, CALIFORNIA

SUMMER SESSION ACADEMIC DEVELOPMENT

FOR UNDERGRADUATE & GRADUATE STUDENTS

COURSEWORK • RESEARCH • SCHOLARS PROGRAM

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4 — Tuesday, February 25, 2020
Opinion
The Michigan Daily — michigandaily.com

