Former U.S. ambassador to South Korea Kathleen Stephens spoke on "Bloomberg Daybreak: Asia" about President Trump's Asia trip on the eve of his arrival in China.

Stephens noted that in canceling a trip to the DMZ--more or less a presidential tradition on visits to Korea--Trump did the "right thing" by instead focusing on the "must-do" on this first trip of reassuring South Koreans on the U.S. commitment to its alliance with the Republic of Korea.

Both North Korean and Trump administration rhetoric seems to have cooled off in recent days; Stephens noted that Trump seems to have "gotten the message" about the importance of the relationship with South Korea and the level of nervousness in the country. 

Ambassador Stephens commented on the feasibility of beginning talks with North Korea and what additional pressure might be required to get the North to the table. She noted that if denuclearizing were a precondition for talks, they wouldn't happen.

She speculated on what President Trump might ask the Chinese to do to up the pressure on North Korea, for example, cutting off oil exports. She also suggested that when it comes to talking about trade, the emphasis might be on announcing deals and Trump might act as "salesman-in-chief."

The full interview is available on Bloomberg TV.

NBC Bay Area spoke with Shorenstein APARC director Gi-Wook Shin following a press conference held by DPRK foreign minister Ri Yong-Ho on September 25, in which Ri asserted that recent comments by President Donald Trump amounted to a "declaration of war."

The verbal barrage between North Korea and the United States has sharply escalated, with increased U.S. bomber flights near and around North Korea being met by North Korean threats to shoot down such flights, even those outside its borders.

While Shin still holds that the war of words will not turn into war, he is concerned that the escalation of rhetoric is dangerous.

"The South Korean people are really worried about the possibility of a military conflict," noted Shin. He further advised the president to deescalate personal attacks on Kim Jong-un, pointing out that Kim's "god-like" status in North Korea was effectively forcing the DPRK leader to respond to White House threats.

In association with the Sejong Institute, a think tank in South Korea, Shorenstein APARC published a report from the seventeenth session of the semiannual Korea-U.S. West Coast Strategic Forum held on June 29, 2017. The forum continued its focus on Northeast Asian regional dynamics, the North Korea problem, and the state of the U.S.-Republic of Korea alliance. Participants engaged in candid, productive discussion about issues relating to these topics.

In his Tuesday address at the United Nations General Assembly, President Donald Trump threatened to “totally destroy North Korea” if the U.S. is forced to defend itself or its allies. Over the past month, North Korea conducted its largest nuclear test and fired its longest-traveling missile. The tension between the United States and the East Asian country continues to intensify.

Stanford News Service interviewed two Stanford experts about the escalating situation between the two countries and what options leaders have on the table when it comes to North Korea.

Michael R. Auslin is the inaugural Williams-Griffis Research Fellow in Contemporary Asia at the Hoover Institution. He specializes in global risk analysis, U.S. security and foreign policy strategy, and security and political relations in Asia.

Gi-Wook Shin is a professor of sociology, a senior fellow at the Freeman Spogli Institute for International Studies and director of the Shorenstein Asia-Pacific Research Center.

Since North Korea conducted its first nuclear test in 2006, the United Nations and individual countries, including the U.S., have imposed several sanctions on the country. Despite those efforts to pressure North Korea to denuclearize, the country’s nuclear capabilities have steadily increased. Why do you think these previous efforts did not work?

Auslin: North Korea has been intent on getting a nuclear weapon for decades, so the basic premise that Pyongyang would bargain away its program was likely faulty. Serious, comprehensive sanctions were never tried, in part because of Chinese and Russian opposition. By effectively taking the threat of the use of force off the table, previous administrations gave Pyongyang no incentive to take negotiations seriously. Previous North Korean undermining of agreements resulted in no serious cost and instead spurred Washington and its allies to offer further negotiations.

Shin: I think that the main obstacles to the previous efforts to pressure North Korea were China and Russia’s partial support for, and not-so-full implementation of, the sanctions. For instance, despite Beijing’s announcement that it would uphold the sanctions, border trade and economic activities between China and North Korea continued, and Beijing knowingly allowed this to happen. Additionally, North Korea is so used to living under difficult economic circumstances that it has found ways to be less affected by sanctions, learning how to get around sanctions – e.g., through smuggling – instead.

What does North Korea hope to gain by amassing a nuclear arsenal?

Auslin: North Korea has wanted to prevent the possibility of any foreign attack and a nuclear capability is the best means of achieving that goal. It also seeks to use any means to intimidate its neighbors and prevent them from undertaking any anti-North Korean action. It also may hope to end its international isolation by fielding a nuclear arsenal so that it can no longer be “ignored” by the international community.

Shin: By amassing a nuclear arsenal, North Korea hopes to secure the Kim regime internally and externally. Nuclear development is a main pillar of Kim’s byeongjin policy, a policy of simultaneous development of nuclear weapons and the economy. Once North Korea obtains nuclear state status, it will try to negotiate with the U.S. and South Korea for what it really wants. This could be economic support, international recognition, a peace treaty with the U.S., etc.

Are there still diplomatic means of addressing this situation that have not been explored? What are they and what is the likelihood they would be effective?

Shin: I am a believer in diplomatic power and continue to think that we shouldn’t give up on diplomacy, but it’s true that all previous diplomatic efforts with North Korea have failed, and it is questionable whether any diplomatic approach will be effective at this point. But one possible – perhaps final – approach that has not yet been explored is a Trump-Kim summit at which the two leaders might make a “big deal” – that is, to get North Korea to denuclearize in exchange for a normalization of their relationship, i.e., a peace treaty, between North Korea and the U.S. But this would be an extremely difficult thing to pull off, both politically and diplomatically.

Auslin: No package of incentives has been effective for the past quarter-century, and both bilateral and multilateral negotiations have failed. There is little reason to believe that there are untried diplomatic means that can make a breakthrough where so many have failed.

Can a diplomatic solution be reached without the cooperation of China?

Shin: China has always advocated diplomacy with North Korea, and I believe that China’s cooperation is essential, but I would also caution against relying or counting on China too heavily. From China’s perspective, the main reason for North Korea’s nuclearization has to do with the American threat – perceived or real – to its national security.

Auslin: China has shown little appetite for constructively solving the North Korean crisis through diplomatic means. Moreover, it is unclear that China retains significant political influence in Kim Jong-un’s era, even given the importance of Chinese trade with North Korea. However, if Washington and Beijing decided that a more coercive approach was necessary, then China would have a major role to play.

What are the military options on the table for the U.S.?

Auslin: Very few, short of all-out war. The North Korean nuclear program is too advanced and dispersed to be taken out by pinpoint bombing, and its missiles are on road-mobile launchers when not hidden, making them difficult to track and destroy. Seoul remains at risk from thousands of conventional artillery launchers that would certainly be used in the event of an American strike inside North Korea.

Shin: There are a number of possibilities, including a surgical strike, but given that North Korea would most likely retaliate by attacking South Korea – an action that would lead to the deaths of hundreds of thousands of South Korean citizens, plus a good number of U.S. soldiers and citizens in the country – it’s not a tempting option. The U.S. government and its military are well aware that any military action would be very dangerous.

What potential actions could lead to even more destabilization and should be avoided?

Shin: Any major military action should be avoided, as it would put both South Korea and possibly the U.S. at great risk. Given that North Korea will continue its efforts to become a nuclear state, and given that military options are not viable, we may have to find a way to live with a nuclear North Korea. It is a reality that we have worked hard to avoid, but time is not on our side. I hear more and more South Koreans calling for South Korea to go nuclear now and a similar movement could begin in Japan. This would mean that the region is entering into a very unfortunate and dangerous situation.

As the war of words escalates between Donald Trump and North Korean leader Kim Jong-un amid a series of North Korean missile launches and a September 3 nuclear test, Gi-Wook Shin, director of the Shorenstein Asia-Pacific Research Center, expressed concern that what is happening "might be more than an escalation of rhetoric. . . there may be escalation of expectations." Read the news item in the Independent here. In an interview with Deutsche Welle, Shin said "one could argue that the [Trump administration's] contradictory messages fit well with its somewhat paradoxical North Korea policy, 'maximum pressure, maximum engagement.'"

In an appearance on PBS Newshour, Kathleen Stephens, former U.S. ambassador to South Korea and William J. Perry Fellow at Shorenstein APARC's Korea Program, expressed concern that the presidential brinkmanship was undermining diplomatic efforts to deescalate tensions on the Korean Peninsula. Stephens suggested the U.S. President "restrain from twittering" the war of words in a recent interview with Yonhap News.

Yong Suk Lee, deputy director of the Korea Program at the Shorenstein APARC, said "the harsh rhetorics going back and forth between Kim Jong Un and Donald Trump may indeed fuel the probability of military action. And it indeed seems like the hardliners are getting  a stronger voice domestically, not just in the U.S., but also in North Korea. However, the increased tension may actually serve as an opportunity. When the stakes are this high — with the possibility of a nuclear war, and for North Korea, an economy that is just starting to develop — the incentive to strike a deal may be higher." Listen to his interview with KCRW: To the Point here.

The Shorenstein Asia-Pacific Research Center (APARC) at Stanford is now accepting applications for the Shorenstein Postdoctoral Fellowship in Contemporary Asia, an opportunity made available to two junior scholars for research and writing on Asia.

Fellows conduct research on contemporary political, economic or social change in the Asia-Pacific region, and contribute to Shorenstein APARC’s publications, conferences and related activities. To read about this year’s fellows, please click here.

The fellowship is a 10-mo. appointment during the 2018-19 academic year, and carries a salary rate of $52,000 plus $2,000 for research expenses.

For further information and to apply, please click here. The application deadline is Dec. 20, 2017.

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A career diplomat by training, Kim most recently served as senior secretary to the president for foreign affairs and national security in South Korea from October 2015 to May 2017 during which he played a key role in enacting the North Korea human rights law. He led the South Korean negotiation team for inter-Korean dialogue that led to the reunion of separated families in 2014.

"Kyou Hyun Kim brings wealth of knowledge in the Korean affairs to Shorenstein APARC. He has decades of experience in diplomacy and national security, and it is very timely that he joins the Korea Program as this year’s Koret Fellow,” said Gi-Wook Shin, director of Shorenstein APARC.

Kim’s extensive diplomatic career includes serving as first vice foreign minister (2013-14), deputy foreign minister for political affairs (2012-13), ambassador for performance evaluation, and special advisor to the minister of foreign affairs (2010-12). He also served at the South Korean embassy in the United States as minister for political affairs. His 37 years of public service was mostly dealing with South Korea’s foreign and security policies and North Korean affairs.

During his fellowship, Kim will review South Korea’s past administrations’ policies toward North Korea and aim to focus on a path leading to unification of two Koreas for permanent peace and stability in and around the Korean Peninsula.  He will also attempt to map out ways to narrow the physical, economic, societal and identity gaps between South and North Korea in order to help the South Korean public to tolerate and accept North Koreans as equal citizens in a unified Korea. His two main research questions will be (1) how to build the internal capability for socioeconomic transformation in North Korea, and (2) how to build domestic support for reunification in South Korea.

Kim received a Doctor of Dental Surgery from the School of Dentistry at Seoul National University, and a Master of Public Administration from Harvard University.

Supported by the Koret Foundation, the fellowship brings leading professionals to Stanford to conduct research on contemporary Korean affairs with the broad aim of strengthening ties between the United States and Korea.

Sophia Hu, a Stanford student and prospective anthropology major, writes a summary of an annual forum that examines China’s health policy in comparative perspective

The Asia Health Policy Program held its Third Annual Forum on China’s Community Health Services and Primary Health Care Reform on June 22 in Beijing. The forum featured a diverse panel of speakers who addressed how to improve China’s primary care and community health care services. From discussing insurance plans to evaluating national policies and encouraging students to consider working as rural doctors, the speakers presented a wide array of research and experience. A brief summary of each presentation is detailed below.

Weichang Wang, director of the Ningxia Health Care Reform, discussed his experiences implementing a reformed health insurance payment system, originally developed by a team of researchers at Harvard and executed in Ningxia, China. Through this plan, his team created a medical insurance fund for the town that prioritized reimbursement for lower-level institutions, i.e. primary care centers. The plan resulted in increased accessibility, frequency of visits and patient satisfaction at primary care centers. It also saved money; however, some issues did arise such as how to develop accurate projections for the medical fund.

Quilin Chen of the Chinese Academy of Social Sciences, informed by his experience in Inner Mongolia, examined the disparity of hospitalization rates among different regions. He analyzed several factors, including financial incentives for patients and hospitals, regional differences in culture, and technological changes among primary care centers.

Jiaying Zhao of Australia National University and Shanghai University proposed using artificial intelligence (AI) to support primary care centers. She highlighted the benefits of AI, including how it can help inform physician decisions and bolster patient trust in primary care centers. Zhao, whose presentation motivated a spirited debate, shared important insights on the growing role of technology/CS in the health care field.

Jeroen Struijs of the Netherlands National Institute of Public Health and the Environment gave an overview of the primary care system in the Netherlands. With one of the most highly regarded systems in the world, the Netherlands prioritizes primary care-centric health care. He described how Dutch citizens seek care with their primary care physicians first – or face a penalty – before going on to specialists or hospitals. He also explained their bundled payment system. This system pays health services providers for a “bundle” of treatment for certain diseases, helping to align provider incentives with efficient convenient care, rather than fee-for-service which financially rewards quantity of services.

Hyuncheol Kim, an assistant professor at Cornell University, examined trends in long-term care insurance and public cancer screening programs in South Korea with a regression discontinuity design. His analyses helped to explain the relative success and failure of those programs. For example, his analysis was consistent with a theory that an intervention has a higher likelihood of failing if those receiving the intervention have other channels to receive benefits, i.e. patients are able to seek private as opposed to public insurance. His presentation also inspired discussion about primary care in Korea and the challenges Korea faces – similar to those in China – in trying to move away from a hospital-centric delivery system.

Lingui Li, director of Ningxia Medical University’s Public Sector Management Centre, delivered an overview of strategies to recruit health care workers in rural areas. He emphasized the need to balance primary public health service with primary clinical service and highlighted the dearth of doctors in villages.

Jinglin Yue, deputy dean of the Zhongshan University’s Institute of Public Administration, presented about his experiences establishing a hierarchical treatment system that aims to bring more people to primary care before pursuing treatment at hospitals. He explained the various incentives of the diverse interest groups involved, and emphasized the need for future government policies that support a 2-way referral system.

Xiaoguang Yang of Fudan University’s School of Public Health also described efforts to create a two-way referral system, based on his research of an integrated health system in Shenzhen. This initiative, using a people-centered reform paradigm, introduced the concept of “community of common destiny” to Luohu, China. The reformers tried to manage supply and demand using financial incentives to help providers including hospital groups coordinate in promoting a more integrated system.

Xiaoyun Liu of Peking University examined the efficacy of a new national program that contracts with students to commit to practicing medicine in rural areas in exchange for free medical school tuition. Using surveys, he gathered data on why students chose the program and where they chose to become rural doctors, among other factors. He then used this data to propose changes to enhance the effectiveness of the program.

Guanyang Zou, a researcher at Queen Margaret University, presented an overview of international experiences or “models” of health and social care that catered specifically to aging populations. These models included the integration of ambulatory medical care and aspects of social care and long-term care services.

Bei Lu of the University of New South Wales took an economic approach toward addressing the issue of long-term care for elderly populations. In her research, she worked closely with policymakers in Qingdao, China, and used a model to estimate how long-term care insurance could be structured so that the elderly could get optimal care without imposing a disproportionate financial burden on young taxpayers and fairly compensate providers.

Each presentation contributed important knowledge toward understanding primary care in China and elicited substantial discussion. This forum would not have been possible without the participation of the numerous speakers and the generous support of the Asia Health Policy Program and Chinese affiliates.