East Asia is a global geopolitical fault line, where historically great powers have interacted, collided, receded, and rebounded. Seen in the context of this long history, the end of World War II ushered in at least four paradigm changes of international and regional politics in Asia-Pacific.

This paper was published as part of the "America's Alliances with Japan and Korea in a Changing Northeast Asia" Research Project.

This discussion focuses on U.S.-Japan and U.S.-Korea relations and how the two interact. The U.S.-Japan review of the 1978 Defense Guidelines also will be considered, in terms of what it does and does not entail and in terms of its application to the security of the Korean peninsula and, more broadly, Asia.

An underlying theme of this presentation is that the U.S.-Japan and U.S.-Korea relationships can survive and prosper only if the United States, Japan, and Korea share some degree of confluence of views on relations with China. There are common objectives in Northeast Asia shared not only by the United States, Japan, and Korea, but by China, Russia, and perhaps even North Korea. Many of these objectives concern the Korean peninsula, where all of the powers want stability and no one wants to see war. From a theoretical viewpoint, everyone is looking toward a "soft landing" and eventual peaceful reunification. Sometimes the visceral South Korean view seems to differ, and some of the Republic of Korea's policies may be in contradiction with the stated desirable outcome; this may cause tension in the U.S.-Korea alliance in the future.

The desire for a soft landing does not mean that the major powers are pushing to hasten reunification. Ironically, the country least anxious to see it, namely China, is the one least often accused of trying to prolong separation of the two Koreas. South Koreans accuse Japan of trying to keep Korea divided, and whenever the United States talks with North Korea, it is similarly charged. That is not the policy direction of either Japan or the United States; in fact, the Koreans seem not to need help from the outside to be hostile to each other.

Published as part of the "America's Alliances with Japan and Korea in a Changing Northeast Asia" Research Project.

One of the most persistent and important questions in international comparisons of health systems pertains to the wide divergence in costs between countries. Japan has significantly lower per capita health care costs than does the United States, despite having a fee-for-service reimbursement system and universal coverage, and aggressively purchasing and utilizing equipment-embodied medical technologies. 1 One important factor in the increase in American health care costs over time has been the substitution of surgical intervention for medical treatment. 2 This leads us to consider differential rates of surgery as a potential explanation for divergent cost performances. Indeed, although Japan has one-half the inpatient admission rate of the United States, it has only one-quarter the surgery rate per capita

Reprint from the Journal of the Japanese and International Economies, 1995.

"Reprint from Educational Policy, 1995.

We use newly released data on Japanese hospitals to explore patients’ perceptions of hospital quality, the implications of these assessments for the structure of demand for hospital care, and the role of the availability and quality of hospital care in influencing access. We find that the primary influences on hospital choice for Japanese patients are interpersonal aspects of care, that Japanese hospital markets are not segmented, and that availability has no influence on access. These results are interpreted in light of institutional differences between the Japanese and American health care systems.

What can be said about the social and cultural characteristics of the Asian region as a whole? Are there, for example, traditional similarities that unify the region—something one might label “Asian culture”? Various scholars have seen an Asian-ness in such things as the way authority has been understood in the region 1 or, even more typically, they point to the Confucian heritage common to China and the nations on its periphery as a unifying characteristic. 2 At least one contemporary Asian leader, Mahathir Mohamad, prime minister of Malaysia, has argued for the legitimacy of a distinctly Asian approach to politics and society, one that is at odds with what he infers is a Western cultural hegemony in such matters. 3 Others, certainly the majority of scholars, have expressed skepticism with any interpretive framework that has attempted to embrace the entire region in cultural terms. Are there other ways to think of cultural connections that are not based in traditions or in religious, linguistic, historical, or other origins? Or is the initial question itself misplaced?

In this volume of concise and informative essays, leading specialists examine the nature, impact and prospects of China's post-1978 party±market symbiosis. Criticizing the collapse thesis derived from Eastern European conditions, it argues that economic liberalization has created new forms of interdependency between the state and market in China. The corollary is that party cadres have developed a new and useful role as facilitators of market transactions.

Since China did not take the big bang route to economic liberalization, cadres retain great discretion over the fate of fledgling private enterprise. So, despite their objective economic importance, China's entrepreneurs remain politically passive (Young's chapter). Oi argues that it is naive to assume that the state merely encumbers and preys upon private enterprise. She shows how village businesses are helped by a primitive form of `administrative guidance' commonly associated with Japanese industrial policy (pp. 69±72). From the perspective of property rights and their reassignment, Walder's essay demonstrates the spatial redistribution of power favouring provincial cadres (vis-aÁ -vis Beijing) and local and enterprise level cadres. Owing to her gradual reformism, China has not suffered the scale of social dislocation witnessed in Russia's transition. Nevertheless, within the overall improvement of living standards, reform has produced social discontent from those who have lost status and income, notably public sector employees (see the essays by Ma, Unger and Kent). In playing a facilitating role for market transactions, cadres have derived considerable personal profit. This `visible hand' of the cadres has attracted much popular resentment and undermined the legitimacy of the Chinese Communist Party (CCP) now trapped between its egalitarian roots and the international democratization wave.

While overt opposition has been effectively contained since 1989, economic liberalization has nevertheless created the potential for further social protest. Much will depend on the CCP's readiness to accommodate nascent social forces (with workers, as discussed by Chan, for example) into some meaningful channels of consultation and grievance redress, which in turn raises questions about the future shape of the regime and the role of the party within it