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October 15, 2010 was the 100th anniversary of the birthday of Edwin O. Reischauer, former U.S. Ambassador to Japan and a key leader in establishing the field of East Asian studies. George R. Packard, president of the United States-Japan Foundation, worked with Reischauer in the 1960s and recently published a biography about him entitled Edwin O. Reischauer and the American Discovery of Japan. Packard spoke at the Walter H. Shorenstein Asia-Pacific Research Center on October 28 to share his perspective on Reischauer's life and career.

Reischauer was born to missionary parents in Japan, where he spent the first part of his life. According to Packard, Reischauer had a lifelong appreciation for Japan that deepened with time, but he also recognized that the more time he spent living in and studying Japan, the more that there was for him still to learn. Reischauer attended Oberlin College as an undergraduate and Harvard University as a doctoral student. During World War II, he worked for the U.S. State Department translating intercepted messages.

The Pearl Harbor-era view of Japan in the United States was that of a "treacherous" country-one that still surfaces from time to time, according to Packard. Reischauer's life's work was to improve American education and understanding about Japan. While teaching at Harvard University, Reischauer, along with China studies pioneer John King Fairbank, helped to build the field of East Asian studies in the United States. Packard credits their efforts for changing the British imperial-era designation of the "Far East" to "East Asia." In addition to his works such as Japan, Past and Present and A History of East Asian Civilization, Reischauer was committed to writing about Japan in popular publications like Reader's Digest.

Reischauer served as U.S. Ambassador to Japan from 1961-1966. While there, he helped to diminish the "Occupation mentality" of Americans in Japan and planted the seeds for the eventual return of Okinawa, said Packard. During his time as ambassador, Reischauer suffered many professional and personal setbacks, including the death of President Kennedy, a supporter of his efforts; the escalation of the Vietnam War, for which he drew criticism although he was not a proponent of it; and being stabbed by a deranged student. According to Packard, after the stabbing incident Reischauer was deeply concerned about generating negative sentiment toward Japan, and thus intentionally kept quiet about it to the media. After returning to Harvard University in the late 1960s, Reischauer continued to draw criticism for the Vietnam War and in later decades was labeled as a "Japan apologist."

Despite his critics, the wisdom of Reischauer's work in academia and government rings true today, as evidenced by Japan's place as a global economic power and the successful and significant role that the U.S.-Japan relationship plays in the peace and economic stability of East Asia. 

 

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George R. Packard, president of the United States-Japan Foundation, speaking at Shorenstein APARC on October 15, 2010.
Debbie Warren
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Beyond his childhood ties to Hawai'i and Indonesia and his self-styled designation as "America's first Pacific President," President Barack Obama has demonstrated significant and genuine interest in Asia and in developing trans-Pacific ties. He embarked on November 5 for the second presidential visit to Asia during his term, and while there he will visit India, Indonesia, South Korea to attend the summit of the Group of 20 (G20), and finally to Japan to attend the annual heads of state meeting of the Asia-Pacific Economic Cooperation (APEC) conference. Secretary of State Hillary Clinton will travel a week ahead of Obama to attend the Association of Southeast Asian Nations (ASEAN) gathering and the East Asia Summit (EAS) in Vietnam, followed by visits to Malaysia, Papua New Guinea, New Zealand and Australia. Her trip will include an added-in stop to China's Hainan Island. To address major issues surrounding the President's trip to Asia--including the "China question" and historic U.S. bilateral alliances--four scholars from the Walter H. Shorenstein Asia-Pacific Research Center (Shorenstein APARC) gathered for a public panel discussion on October 27.

Thomas Fingar, Oksenberg/Rohlen Distinguished Fellow of the Freeman Spogli Institute for International Studies, spoke about the symbolic aspects of Obama's visit, noting the importance of a presidential visit for showing a sense of real commitment to the region and an acknowledgement of the "rise" of countries like China and India. On a more pragmatic side, he also suggested that meeting in person with other leaders is crucial in order to "bring about deliverables." The omission of a visit to China should not be weighed too heavily, Fingar said, pointing out that the President visited China last year. The stops in Japan and South Korea are tied to important multilateral meetings, though they will also reaffirm longstanding ties with those allies, while the visit to India is an indication of growing relations between the two countries. Of particular importance is Obama's participation in the G20 Summit in South Korea and the APEC meeting in Japan because, Fingar stated, a major purpose of the visit is about the "United States having a role in building new multilateral institutions." Finally, while much of the success of the Asia trip rests on how well Obama conducts himself, Fingar expressed confidence that the President would skillfully manage the visit.

During his visit to Indonesia, Obama will meet with Indonesia's President Susilo Bambang Yudhoyono for a bilateral discussion of such issues as economics, security, and higher education. Donald K. Emmerson, director of the Southeast Asia Forum, said that the postponement of earlier-planned visits to Indonesia has lessened some of the enthusiasm for Obama's "homecoming" to Jakarta. China's omission on the trip agenda is noteworthy, he suggested, and Clinton's addition of a stop in Hainan is due, in part, to help alleviate recent tension between the United States and China regarding China's claim of sovereignty over the South China Sea. Clinton's involvement in the EAS is an "important multilateral engagement" for the United States because of the presence of its ally Japan and the fact that the United States and China both have a voice there, unlike the ASEAN Plus Three meetings that do not include the United States. While in recent months the U.S.-China relationship has become more strained, Emmerson asserted that the "United States is not going to get into a cold war with China."

Obama will travel from Indonesia to South Korea for the G20 Summit, another major multilateral engagement during his travels. David Straub, associate director of the Korean Studies Program, described several significant aspects of this time in South Korea. While not technically an organization, Straub said, the Summit is an important forum for the discussion of economic stability and growth. Similar to Fingar, Straub noted the efficacy and significance of in-person meetings. The Summit provides an opportunity for world leaders to have face-to-face discussions on non-economic issues, such as North Korea's political situation. Straub suggested that President Lee Myung-bak's investment in the Summit is based, in part, on raising South Korea's global prestige, which is tied also to increasing the status of the G20 to become the premiere global financial organization. Finally, Straub stated that alongside the G20 meeting, Obama and Lee are expected discuss bilateral relations, which are at an all-time high, including the stalled U.S.-South Korea free trade agreement (Korus FTA). The FTA, which would be the most significant free trade agreement for the United States since NAFTA, has faced opposition and mixed support on both sides.

Obama's visit to India will be the third U.S. presidential visit there in the past decade, which is indicative of changing U.S. perceptions of India brought about through the IT boom and growing economic ties, suggested Daniel C. Sneider, associate director of research for Shorenstein APARC. Sneider pointed to a broader shared agenda despite a lack of clarity on some issues, such as Pakistan, and a focus on India as Asia's "other" growing economy. He stated that he would be watching for the United States and India to work together to emphasize India's role in East Asia, highlighted by India's participation in the EAS. India's Prime Minister Manmohan Singh has championed a "look east" policy and expressed stronger interest in East Asia, especially China. In terms of Obama's visit to the APEC heads of state conference in Japan, Sneider noted the importance of this trip also for the U.S.-Japan alliance. The newly formed government of Prime Minister Naoto Kan has worked to ease tensions in the alliance and both countries hope to use the visit to bolster a more positive image of the alliance. Certain points of contention, like the move of the U.S. military base on Okinawa, have been put aside for the time being. Sneider stated that recent China-Japan tensions have also served to reinforce the importance of the relationship.

Events during Obama's Asia visit in the next two weeks will help to solidify or possibly call into question his image as the "Pacific President," and undoubtedly influence the role of the United States in Asia for the future.

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President Barack Obama and Secretary of State Hillary Clinton talk with Prime Minister Singh of India in the Cross Hall of the White House. November 24, 2009.
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Understanding the relationship between female employment and fertility is a vital ingredient for effective population policy. This column presents new findings from China based on well over 2000 women between 20 and 52 years old. It finds that non-agricultural jobs for women reduce the number of children per woman by 0.64 and the probability of having more than one child by 54.8%.

As the realities of an ageing population tick ever closer, policymakers have sharpened their focus on fertility. While low fertility in Europe has been labelled a crisis (Doepke et al. 2008), fertility in some high-income countries of East Asia, such as Japan and South Korea, is even lower. Fertility has also fallen significantly even in rapidly developing middle- and low-income economies, including those of China, India, Indonesia, and Vietnam (Figure 1). In China, the personal forces promoting fertility decline reinforce ongoing policies to curb population growth.

Also available in Chinese: "Gongzuo he zinü: Zhongguo nongcun nüxing jiuye he shangyulü."  Comparative Studies (Bijiao) 49(4) (Beijing: China CITIC Press): 1-7.

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Please join Marvin Kalb to discuss the impact of the Vietnam War on presidential/strategic decisions about national security issues. 

Marvin Kalb is also a contributing news analyst for National Public Radio and Fox News Channel. In addition, he is frequently called upon to comment on major issues of the day by many of the nation's other leading news organizations.

Kalb had a distinguished 30-year broadcast career, working for both CBS News and NBC News, where he served as Chief Diplomatic Correspondent, Moscow Bureau Chief, and moderator of Meet the Press. Among his many honors are two Peabody Awards, the DuPont Prize from Columbia University, the 2006 Fourth Estate Award from the National Press Club and more than a half-dozen Overseas Press Club awards. He has lectured at many universities, here and abroad. Kalb was the founding director of the Joan Shorenstein Center on the Press, Politics, and Public Policy at the Kennedy School of Government at Harvard University.

A graduate of the City College of New York, Kalb has an M.A. from Harvard and was zeroing in on his Ph.D. in Russian history when he left Cambridge in 1956 for a Moscow assignment with the State Department. The following year, he joined CBS News, the last correspondent hired by Edward R. Murrow. Kalb has authored or co-authored 10 nonfiction books and two best-selling novels. His latest book, The Media and the War on Terrorism (co-edited with Stephen Hess), was the recipient of the 2004 Arthur Rowse Award for Press Criticism. He is currently engaged in research for a book on U.S. involvement in the Vietnam War and its impact on American politics and foreign policy.

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Marvin Kalb James Clark Welling Presidential Fellow at The George Washington University and Edward R. Murrow Professor Emeritus at Harvard's Kennedy School of Government Speaker
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Since the Democratic Party of Japan came to power in August 2009, upsetting fifty years of conservative rule, U.S.-Japan relations have been on rocky ground. It would seem that the DPJ is upending decades old policies, hewing its own path with the United States, China, and the Asia-Pacific region. As Shorenstein APARC Director for Research Daniel Sneider notes, Japan’s new tack not only has caught the United States flat-footed, but also has other countries in the Asia-Pacific worried. Most importantly, Tokyo seems to be making uncharacteristically friendly overtures to Beijing. But it would be wrong to assume that Sino-Japan relations are really much improved. From oil and gas rights in the East China Sea to China’s military modernization there are still plenty of points of contention. Moreover, the much-contested issue of U.S. marines stationed on Okinawa remains the biggest deterrent to North Korean aggression and Chinese expansion – two fears not far from Tokyo’s mind. This is not to say U.S.-Japan relations will return to the status quo, but that the interlocutors are likely to recall the reason for such a persistent alliance.

The dramatic end to Japan's half-century of conservative rule in a late August election led almost immediately to a public spat with the United States. An inward-looking Japan that had reflexively followed the American lead suddenly was no longer an obedient ally.

At a time when the US was trying to woo a recalcitrant China to become a "strategic partner", Japan's insistence on reopening an agreement over US military bases seemed to upset the regional balance. But there are recent signs of a concerted effort on both sides to put underlying strategic interests back in the forefront, propelled in part by the recent eruption of frictions between China and the US.

The row began with the newly elected Prime Minister Yukio Hatoyama's call for more "equal" relations with the US, his advocacy of an East Asian Community à la the EU, and his focus on repairing ties with China. Put together, some saw a nascent urge to abandon the post-war security alliance. A senior State Department official went so far as to tell the Washington Post in late October that the "the United States had ‘grown comfortable' thinking about Japan as a constant in US relations in Asia. It no longer is, he said, adding that ‘the hardest thing right now is not China, it's Japan.'"

The trigger was growing frustration over the Hatoyama government's handling of the relocation of the US Marine air base at Futenma on Okinawa. The Democratic Party of Japan (DPJ) consistently opposed the deal to relocate the base elsewhere within Okinawa, expressing sympathy for the disproportionate burden of the US military presence in Japan born by Okinawans. American officials were loathe to reopen an agreement that had taken years to negotiate and believed the Japanese government exaggerated its domestic political constraints.

At the same time, Japan seems eager to hew its own course with China, to improve relations and begin to build the foundation for a new Asian community. If one is to believe US officials, alarm bells have been ringing among their allies and others in Asia over the rift with Japan. The talk of building a regional organization that might exclude the US made Singapore, Australia, South Korea, the Philippines and even Vietnam worried that this would only aid Chinese ambitions.

Meanwhile, the Obama administration itself was ardently wooing China. President Obama, on the eve of a trip in November, spoke of creating a "strategic partnership." In Beijing, the President avoided public finger wagging. Discussion of difficult issues such as human rights, Tibet and sanctions against Iran were conducted largely, if at all, behind closed doors.

Given their own pursuit of Chinese partnership, American officials could hardly object to Tokyo's efforts along the same lines. In public, they said this is not a zero sum game, that an easing of Sino-Japanese tensions could aid security and stability in the region for everyone. But some US officials soon saw evidence of Sino-Japanese collusion to push the US out of Asia. Privately they pointed to what was considered a telling moment following a trilateral summit of Chinese, Japanese and South Korean leaders in Tianjin in October. Talking to reporters after the meeting, Hatoyama had spoken about Japan's desire to lessen its "dependence" on the US. American officials considered Hatoyama's actions a gross display of obeisance to the Chinese.

Accusations that Japan was drifting into Chinese arms grew louder after DPJ Secretary General Ichiro Ozawa led a group of about 140 lawmakers on an adulatory visit to China in early December. Then Hatoyama and Ozawa raised hackles when they pushed for the Emperor to receive a visiting Chinese senior official, the heir apparent for leadership, Xi Jinping. However, these depictions of Tokyo lurching toward Beijing ignore the gradual evolution of Japanese policy and the deep-seated rivalry that persists.

Sino-Japanese relations reached a low point five years ago after anti-Japan demonstrations were apparently sanctioned by Chinese authorities. Unresolved wartime historical issues drove those outbursts, prompted by Prime Minister Junichiro Koizumi's visits to the Yasukuni shrine, which honors Japan's war dead. Disputes over oil and gas rights in the East China Sea threatened to explode. And China launched a campaign to block Japan's bid for permanent membership in the UN Security Council.

Japanese policymakers began to worry about the impact of these tensions on Japan's growing economic interdependence with China. They were critical of Koizumi's one-sided focus on the US-Japan security alliance.

"To weather the wild seas of the 21st century, Japan's diplomacy must have two elements: the Japan-US alliance and a Japan-China entente," wrote Makoto Iokibe, a defense specialist who now heads the Japanese Defense Academy, in the summer of 2006. "A combination of a gas field accord and a depoliticized Yasukuni issue would provide Japan and China with a clear view for the joint management of East Asia."

Beginning in late 2006, a succession of Japanese administrations has made concerted efforts to repair ties with Beijing and Seoul. Though the atmosphere with China has improved, substantive differences remain. In January, Japan's foreign minister warned that Tokyo would take action if China continued to violate a 2008 deal to develop oil and gas fields jointly. When Ozawa met the Chinese defense minister in December, he said the Japanese see China's military modernization as a threat. Ozawa suggested that if such fears were not eased, Japan might be prompted to undertake its own arms build up.

The Hatoyama government has also moved to upgrade ties, including security links, with Asian powers that share a fear of China, including India, Indonesia and South Korea. Ozawa stopped in Seoul after his visit to China where he apologized for Japan's colonial rule in Korea and pledged to push through legislation granting voting rights to Korean residents in Japan, an issue of great importance to Koreans and opposed by conservatives in Japan.

Recent events seem to have caused the US to reassess its handling of relations in Northeast Asia. There is growing evidence of an emboldened China that seems to interpret America's bid for a strategic embrace with the country as a sign of weakness. The authorities in Beijing took a tougher line toward internal dissent, openly clashed with the US at the climate change talks in Copenhagen, balked at cooperation on sanctions against Iran, and brushed off American protests over evidence of cyber attacks on Western firms.

After all this, America has begun to soften its tone toward Tokyo. Officials pledge patience as the new government looks for a solution to the base problem, while also mounting a public effort to convince Japan that the Marine presence in Okinawa is key to "deterrence" of North Korea and China. There is a renewed emphasis on broadening the security agenda to include other issues, from cyber security to climate change. Hatoyama, too, has emphasized that the Japan-US alliance remains "a cornerstone for Japan to enhance its cooperative relations with other Asian countries, including China."

Whether any real lessons have been learned in Tokyo or Washington remains to be seen. But perhaps the turn in Sino-US relations has reminded people in Tokyo and Washington that there remains a strategic purpose to the alliance.

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In December 2009, the Asia Health Policy Program celebrates the first anniversary of the launch of the AHPP working paper series on health and demographic change in the Asia-Pacific. The series showcases research by AHPP’s own affiliated faculty, postdoctoral fellows, and visiting scholars, as well as selected works by other scholars from the region.

To date AHPP has released eleven research papers in the series, by authors from China, South Korea, Thailand, Taiwan, Pakistan, and the US, with more on the way from Japan and Vietnam. Topics range from “The Effect of Informal Caregiving on Labor Market Outcomes in South Korea” and “Comparing Public and Private Hospitals in China,” to “Pandemic Influenza and the Globalization of Public Health.”  The working papers are available at the Asia Health Policy website.

AHPP considers quality research papers from leading research universities and think tanks across the Asia-Pacific region for inclusion in the working paper series. If interested, please contact Karen Eggleston.

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The principal-agent problem in health care asserts that providers, being imperfect agents for patients, will act to maximize their profits at the expense of the patients’ interests. This problem applies especially where professional regulations are lacking and incentives exist to directly link providers’ actions to their profits, such as a fee-for-service payment system. The current analysis tests for the existence of the principal-agent problem in the private health market in Vietnam by examining the prescribing patterns of the private providers. We show that

  1. private providers were able to induce demand by prescribing more drugs than public providers for a similar illness and patient profile;
  2. private providers were significantly more likely to prescribe injection drugs to gain trust among the patients; and
  3. patients’ education as a source of information and empowerment has enabled them to mitigate the demand inducement by the providers.

Our hypotheses were supported with evidence from Vietnam National Health Survey 2001 and 2002, the first and, so far, only comprehensive health survey in the country.

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The health sector's successes in Vietnam have been described as "legendary" by international donors, but there is always the other side of the story. One can question the objectivity of reports from the government of Vietnam, the World Bank, and the World Health Organization. One can wonder in what areas the health sector has failed, who has paid for a "success story" and at what cost, and how much information is well documented and has been made public. Are there "stylized facts" regarding those aspects of health that have been successfully reformed compared with those where reform has lagged? Given these concerns, how can the research community contribute to improving health policy in Vietnam?

Dr. Truong will share his thought on recent socioeconomic development in Vietnam, discuss key health policy issues, and reflect upon his experiences including a research project in which the University of Queensland collaborated with Ministry of Health of Vietnam. Additional evidence will be drawn from a study of the cost-effectiveness of interventions to reduce tobacco use in Vietnam.

Khoa Truong was a visiting faculty member at the Hanoi School of Public Health and a research fellow at the Health Strategy and Policy Institute in 2008-2009.  Prior to that he spent six years as a doctoral fellow at the RAND Corporation.  His research interests include tobacco, alcohol, and illicit drug control policies; the impacts of built environments on health; international health issues; and economic development.

He received his doctorate and master of philosophy in policy analysis from the Pardee RAND Graduate School and earned a master's degree in development economics from Williams College. A native of Vietnam, he began his career working with NGOs in bilateral and multilateral development projects in Southeast Asia. He was awarded a Fulbright scholarship and wrote “most outstanding paper” submitted at an AcademyHealth's Annual Research Meeting (acknowledged as the premier forum for sharing the results of scholarship on health services).

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Dr. Khoa Truong Assistant Professor of Department of Public Health Sciences Speaker Clemson University
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