1AC

The United States ought to implement a single-payer universal healthcare system.

 1AC — Economy
Advantage one is Economy:
Ballooning healthcare costs undermines growth---that hollows out US economic
superiority and locks in slow growth, destroying resilience.
Muhlestein and Leavitt 22 [David and Mike *Former Utah governor and U.S. secretary of Health
and Human Services **Health care researchers and strategy consultant at Health Management
Associates, 5/18/22, Perspective: America’s health care system has long been broken. Is it too late to fix
it?, Deseret News, https://www.deseret.com/2022/5/18/23061528/american-health-care-system-is-
broken-is-it-too-late-to-fix-it-gdp-medical-costs] Justin

By some accounts, America’s health care system has been wildly successful. Innovative breakthroughs have transformed care
around the world. As an industry, it dominates the country in terms of employment and income. But that success, decades in the making,
hasn’t necessarily made Americans healthier than people in other developed nations, and now it threatens to knock
the United States off its perch as the world’s economic powerhouse.

The highcost of health care that has fueled the industry’s growth accounts for about 17% of the nation’s total goods
and services — or $4 trillion — and gobbles up more than 30% of federal government spending.

That outsized impact on the U.S. economy has cost consumers financially and has limited government and the
private sector from investing in other areas that could help the country maintain its economic position in
the world. In percentage terms, it wouldn’t take much to shrink health care’s share of the gross domestic product. Reducing it to 12%
by the year 2050 could free up $1.3 trillion in present dollars annually for investment elsewhere.
But slowing the momentum of 40 years of rising health care costs won’t come easily, and it will require public and private players patiently
working on solutions. While a lot is at stake domestically and internationally if these changes in the system don’t occur, panicking and moving
too fast would also be a mistake. Instead, we need to reframe the conversation from election-cycle policies to generational policies with a long-
term focus on decreasing costs by changing current health care business models to prioritize patients’ needs over maximizing capacity in
profitable procedures.

Health care spending for individuals employers and government has more than tripled from the 1960s through 2019 as a
percent of GDP, which is the sum of all goods and services produced in a year. It has grown nearly five times faster as a percent of
federal spending and now represents more than a third of total government spending.

No other country comes close to the United States in that kind of spending on health care. Take China, the world’s fastest-
growing economy and biggest threat to the United States’ dominance in the global economy. According to the latest World Bank figures, the
U.S. spent 17% of its GDP on health care while China spent just 5.4%.

The higher spending on health care is not inherently wrong, but the challenge is in the tradeoffs — what are we, as a country, not
investing in because of our increased spending on health care?

For example, based on the size of its economy and lower spending on health care, China
can spend nearly $1.7 trillion more each
year relative to the United States in areas such as education,
infrastructure, research and development, overseas
development, military, lower taxes and increased savings. We believe that the excess spending on health care
puts the United States at an economic disadvantage in world markets and international influence and that reducing its cost
is key to the ongoing stature of the United States.

But are
Americans healthier than those living in other countries where health care costs less and is more underutilized ? Studies
suggest not. While China does not approach its health care systems or economy (or countless other things) in the same way as the United
States, its approach has been successful at growing its economy and international relevance. China’s economy has grown two to
three times faster than the United States’ in the past decade.

Healthcare is a bubble that will pop, leading to immediate recession---the plan solves.
Chiu 22 [Ethan is an author at INKSpire, 1/18/22, Healthcare – An American Comedy, INKSpire,
https://inkspire.org/post/healthcare-an-american-comedy/] Justin
MFA would boost economic prosperity while allowing all Americans to gain access to healthcare, a universal human right.

Since healthcare is considered a commodity in America, the United States has worse outcomes and spends over twice as much on healthcare as
other OECD nations. In fact, USA Today corroborates that “Private insurance companies… spend about 12% to 18% of their revenue on
overhead; Medicare spends less than 2%.” Even worse, as healthcare prices rise, insurance companies reduce benefit packages and increase
out-of-pocket costs. Notably, contrary to McConnell’s claims, the conservative Mercatus Center finds that MFA
would save $2 trillion
over a decade, which could act as a safety net for future recessions. Furthermore, MFA would allow 15-25% more workers
to start their own businesses and boost innovation as many Americans are tied to their employers’
insurance plans. In fact, 22 studies cite that MFA would facilitate around $600 billion in administrative
savings and $300 billion in prescription drug savings, freeing that money to be redirected toward
economically stimulating consumer spending.
Guaranteed healthcare would eliminate the struggle many Americans face from choosing between life or crippling debt.s

A study by UC Berkeley found that accessibility and choice of prescription medicine will increase under MFA since out-of-pocket payments and
out-of-network healthcare professionals will no longer exist. Furthermore, doctors would spend more time with patients instead of using 50%
of their workdays navigating the myriad of Byzantine private Electronic Health Record systems. Thus, with an MFA system incorporating a
unified Electronic Health Record system to centrally manage patient records across clinics nationwide, not only will patients be able to engage
with a much more extensive network of medical professionals and doctors be able to spend more time caring for patients, but administrative
delays would also be a thing of the past. Additionally, single-payer negotiated price
limits would also prevent pharmaceutical
companies from charging excessively predatory prices for medication. In fact, some companies have marked up drugs like insulin
more than 5,000%, leading many diabetic patients to their deaths. As such, the federal government must step in to promote the general
welfare of most Americans. Corroborating how MFA would benefit medical research, the
federal government already funds one-
third of medical research through the NIH, and the majority of private research funding goes to perpetuating
patent monopolies by making “me-too” drugs that are similar to those that already exist. Overall, considering that the Federal Reserve
found that tens of millions of Americans struggle with medical debts and avoid needed care and medications for fear of the cost, it is apparent
that many are being pushed into poverty. Specifically, the American Journal of Public Health quantifies that “9.28 million Americans whose
incomes before their medical outlays were above poverty were pushed into near poverty,” which is terrible for economic productivity. Even
worse, a study from The Lancet found that at least 68,000 Americans die every year as a direct result of not having any health insurance
coverage. By implementing MFA, these tragically high poverty and death rates caused by lack of healthcare access will be a calamity of the past.

MFA would notably prevent future pandemics.

According to a social studies teacher at an American High School, “if wasteful spending can be eliminated, it would certainly bode well for
people employed by hospitals and clinics. If we continue to treat healthcare as a privilege, instead of a human right, then we are accepting the
reality that over 30 million people’s lives are treated as expendable in this nation. The current COVID-19 pandemic has exposed health care
inequities for all to see, and will hopefully lead to a renewed push to make serious institutional changes, such as ‘Medicare for All.’” The New
England Journal of Medicine found that “The United States has 4% of the world’s population but… approximately 26% of its Covid-19 cases and
24% of its Covid-19 deaths.” Through a single centralized system, however, Public Citizen reports that single-payer healthcare systems can roll
out testing and contact tracers more effectively. Countries like Taiwan and South Korea could react quickly to the pandemic and rapidly begin
widespread testing since they did not have to coordinate thousands of private corporations, leading to minimal economic shock and lives lost.
Since the Center for Global Development finds that “there is a 22-28% chance that another outbreak on the magnitude of COVID-19 will occur
within the next ten years, and a 47-57% chance that it will occur within the next 25 years,” it is in America’s best interest to adopt an MFA
system to better control and mitigate future disease spread.

MFA would prevent an impending financial crisis caused by the healthcare bubble crash.
Presently, healthcare
spending is rising at an unprecedented rate faster than the growth of the U.S. economy,
leading insurance premiums to rise over 90% over the next few years, according to the University of Pennsylvania.
Thus, families will have to pay double the amount for healthcare as they do now due to excessively high private insurance administrative costs.
Becker’s Hospital Review warns that by allowing healthcare costs to skyrocket, the healthcare stock bubble will
pop since employers and citizens will push back on excessive healthcare costs. As a result, healthcare insurance
companies will accumulate massive debt to make up for the decrease in revenue from consumers, and investors
will rapidly sell healthcare stocks. The resulting impacts of the healthcare stock bubble pop could mirror that of the 2008
recession caused by the housing bubble pop, leading to a devastating recession that may put up to 900 million people in
poverty. The popping of the private healthcare stock bubble and subsequent recession could put many Americans out of work, causing massive
economic harm to the American nation.

Clearly, the universal coverage and economic benefits that MFA would provide are critical for the health of American citizens and the economy.
Through lower drug prices and equal access, hundreds of Americans will no longer be pushed into poverty,
avoid medical care for fear of high costs, or lose family and friends in a probable future pandemic. Ultimately, to end the dark comedy of
America’s healthcare system, America must adopt an MFA system.

Economic superiority and resilience solves existential threats---specifically, conflict

with China.
Sitaraman 20 [Ganesh is a professor of Law at Vanderbilt Law School, 8/11/20, A Grand Strategy of
Resilience, Foreign Affairs, https://www.foreignaffairs.com/articles/united-states/2020-08-11/grand-
strategy-resilience] //Re-cut EAY

--Strong econ solves pandemics, climate shocks, cyber, and geoeconomic competition.

--China can exploit a weaker US econ

Every so often in the history of the United States, there are moments of political realignment—times when the consensus that defined an era
collapses and a new paradigm emerges. The liberal era ushered in by President Franklin Roosevelt defined U.S. politics for a generation. So did
the neoliberal wave that followed in the 1980s. Today, that era, too, is coming to a close, its demise hastened by the election of President
Donald Trump and the chaos of the coronavirus pandemic.

The coming era will be one of health crises, climate shocks, cyberattacks, and geoeconomic
competition among great powers. What unites those seemingly disparate threats is that each is not so much a battle to be won as a challenge to be weathered. This year, a
pandemic is forcing hundreds of millions of Americans to stay at home. Next year, it might be a 1,000-year drought that devastates agriculture and food
production. The year after that, a cyberattack could take out the power grid or cut of critical supply chains . If the current

pandemic is any indication, the United States is woefully underprepared for handling such disruptions. What it needs is an

economy, a society, and a democracy that can prevent these challenges when possible and endure, bounce back, and adapt when necessary
—and do so without suffering thousands of deaths and seeing millions unemployed. What the United States needs is a grand strategy of

resilience. For psychologists who research child development, resilience is what enables some children to endure traumatic events and emerge stronger and better able to navigate
future stresses. For ecologists, resilience is an ecosystem’s ability to resist, recover, and adapt to ires, loods, or invasive species. For emergency, disaster relief, and homeland security experts,
a resilient system is flexible, adaptable, and can withstand an impact. The writer Maria Konnikova has summed up the concept with a single question: “Do you succumb or do you surmount?”
The highest goal for American policymakers should be to preserve and defend the country’s constitutional democracy while enabling Americans to thrive regardless of their race, gender,
location, or origin. A society that achieves that goal will be better prepared to face the next crisis. A more equal and more just nation is a more resilient one. Although Americans tend to think
of grand strategy as an overarching foreign policy vision, any true grand strategy requires a solid domestic foundation. The United States’ Cold War policy of containment, for instance, had a
domestic analog, although it is less emphasized in the foreign policy community. For a generation after World War II, Democrats and Republicans alike embraced a model of regulated
capitalism, with high taxes, inancial regulations, strong unions, and social safety net programs, and thus charted a path between the totalitarian control of the Soviet Union and the laissez-faire
approach that had plunged the United States into the Great Depression. Regulated capitalism and containment together were the grand strategy that deined the post–World War II era. A
grand strategy of resilience, likewise, will not meet with success unless the United States addresses the many forms of inequality, fragility, and weakness that undermine the country’s
preparedness from within. AGE OF CRISES “Grand strategy” is a slippery term, with perhaps as many deinitions as authors who invoke it. It can describe a framework that guides and focuses
leaders and societies on their aims and priorities. Critics of the notion believe this is impossible: no paradigm, they say, can help navigate a chaotic, uncertain future, and in any case, U.S.
society is too polarized to identify a consensus paradigm today. But the skeptics have it backward. Grand strategy is won, not found. It emerges from argument and debate. And it is useful
precisely because it offers guidance in a complex world. Start with pandemics. For hundreds of years, quarantines have been essential to preventing the spread of infectious diseases. But
today’s stay-at-home orders have exacted a devastating social, eco-nomic, and psychological toll on individuals and communities. Small businesses that are closed may never reopen. Tens of

The government’s goal should be to

millions of people are out of work. Families are struggling to juggle childcare, homeschooling, and working from home.

minimize those disruptions—to build a system that can prevent economic disaster, secure supply chains for essential materials,
and massively scale up production and testing when needed. Climate change could pose an even bigger threat. A sustained drought, akin to the
one that created the Dust Bowl during the Great Depression, could threaten the global food supply. Rising sea levels, especially when coupled with

storms, could flood low-lying cities. Fires already disrupt life in California every year. Climate-induced crises will also lead to

population migrations globally and, with them, social unrest and violence. Part of the answer is aggressive action to limit increases in
temperature. But in addition, the United States must be able to endure climate shocks when they arise. Consider also the country’s dependence on technology and the vulnerabilities it entails.

Cyberattacks have already targeted U.S. election systems, banks, the Pentagon, and even local governments. The city of Riviera Beach, Florida, was forced to pay a
ransom to cybercriminals who had taken over its computer systems; big cities, such as Atlanta and Baltimore, have faced similar attacks. Cyberattacks on the U.S. power

grid, akin to the one that led to blackouts in Ukraine in December 2015, could “deny large regions of the country access to bulk system power
for weeks or even months,” according to the National Academy of Sciences. All these challenges will play out at a time of growing rivalry—and
especially geoeconomic competition—among great powers . Over the last half century, the United States has been the
world’s most powerful economy and has thus been relatively safe from outside economic pressures. But as China’s
economic strength grows, that is likely to change. The United States and other democracies have become dependent on China for essential and
nonessential goods. China’s ability to exploit that dependence in a future crisis or conflict should be extremely

worrisome. A strategy based on resilience would help deter such coercion and minimize the disruption if it does occur.

That goes nuclear everywhere---the plan solves.

Eric Edelman and Brands 17, Hal Brands is senior fellow at the Center for Strategic and Budgetary
Assessments (CSBA) and Henry A. Kissinger Distinguished Professor of Global Affairs at the Johns
Hopkins School of Advanced International Studies (SAIS). Eric Edelman is counselor at CSBA and the
Hertog Distinguished Practitioner in Residence at SAIS., 6-21-2017, "America and the Geopolitics of
Upheaval," Foreign Policy, http://www.foreignpolicyi.org/content/america-and-geopolitics-upheaval

"The essence of a revolution is that it appears to contemporaries as a series of more or less unrelated
upheavals ,” Henry Kissinger wrote in 1969. “But the crises which form the headlines of the day are symptoms of
deep-seated structural problems .” Kissinger wrote this passage as the postwar international system was coming under unprecedented strain,
with profound shifts in the global distribution of power driving incessant disruptions in U.S. foreign policy. His admonition applies just as well today, at the onset of a

new era of upheaval. During Donald Trump’s presidency and after, U.S. foreign policy is likely to be wracked by crises . The
instability and violence along a resurgent Russia’s periphery , the growing frictions with an increasingly
assertive China , the provocations of a rapidly nuclearizing North Korea and the profound chaos at work
throughout the Middle East : these and other challenges have recently tested U.S. officials and are likely
to do so for the foreseeable future. The world now seems less stable and more dangerous than at any
time since the Cold War; the number and severity of global crises are increasing . Yet crises do not occur in a
vacuum; they are symptomatic of deeper changes in the international order . Accordingly, America’s responses will be ill-
informed and astrategic unless Washington first forms a deeper conception of the current moment. The geopolitical changes underway are

often framed in terms of “polarity”—the debate on whether America’s “unipolar moment” is over and a multipolar world has emerged. But
this debate is misleading . On the one hand, discussions of polarity frequently exaggerate American decline, obscuring
the fact that even though Washington’s international superiority has diminished , its global lead over any
single challenger remains quite impressive . On the other hand, the polarity debate actually obscures both the degree and breadth of the
ongoing changes in the international system, and of the challenges facing American officials. The fundamental fact of international politics today is that the post–
Cold War era has ended. The defining features of that period were uncontested U.S. and Western primacy, marked declines in ideological struggle and great-power
conflict, and remarkable global cooperation in addressing key international-security challenges. Now, however, the
world has returned to a more
normal—which is to say, more dangerous and unsettled—state. The core characteristics of the emerging
era are the gradual erosion of U.S. and Western primacy, revived great-power competition across all three
key regions of Eurasia, renewed global ideological struggle, and empowerment of the agents of
international strife and disorder. What makes the present period so tumultuous is that these forces
often compound one another’s destabilizing effects ; moreover, their collective impact is magnified by a growing uncertainty about
whether America and other traditional defenders of the international system will continue playing that role in the future. American primacy is not

dead , in other words, and true multipolarity is still a long ways off. But U.S. primacy is far more contested than at any time in a quarter-century, and the
friendly contours of the post–Cold War system have given way to a darker and more challenging environment. The best way to understand the present era is to
compare it to the previous one. The post–Cold War era was defined by four phenomena that made it historically favorable to American interests. The first was

uncontested U.S. primacy. America emerged from the Cold War with clear economic dominance , possessing nearly 25 percent of
global GDP in 1994. It controlled nearly 40 percent of world defense outlays, along
with utterly unrivaled advantages in global
power-projection capabilities. Crucially, these capabilities not only gave Washington an enormous lead over any
geopolitical competitor; they also provided the ability—as Saddam Hussein discovered in 1991—to marshal decisive
military might in virtually all the key strategic regions around the world . In the nineteenth century, the British ship of the
line symbolized London’s global primacy; in the late twentieth century, the American carrier strike group symbolized an even more imposing preeminence. Nor was
American dominance purely unilateral, because it was powerfully accentuated by the strengths of the broader Western coalition. In 1994, America’s treaty allies in
Europe and the Asia-Pacific accounted for 47 percent of global GDP and 35 percent of global military spending, giving Washington and its closest friends upward of
70 percent of global economic power and military spending. Throughout the post–Cold War era, allied involvement thus lent added force to U.S. diplomacy on key
issues of international order; from the Gulf War to the war in Afghanistan, allied contributions reinforced America’s ability to project military power overseas. This
was no balance of power; it was one of the most pronounced imbalances the world had ever seen. U.S. dominance was also evident in a second phenomenon—the
decline of international ideological competition. Francis Fukuyama’s “end of history” thesis has been much derided, but it captured three indisputable facts about
the post–Cold War era: that democracy and markets were spreading more widely than ever before; that there was no credible global competitor to the liberal-
capitalist model; and that even former U.S. enemies, such as Russia, and authoritarian states, such as China, were making unprecedented efforts to integrate into
the liberal order either economically, politically or both. To be clear, Western concepts of human rights and political democracy were far from fully accepted in
these countries, and Russian and Chinese leaders—among others—sooner or later came to see liberal proselytism as a grave threat. But the intense ideological
struggles of the twentieth century were clearly over, and the liberal model seemed incontestably ascendant. These first two phenomena related to a third—the
remarkable great-power comity of the post–Cold War era. The end of the Cold War did not, as was widely expected, see a fragmenting of America’s alliances, or a
resurgence of Japanese and German revisionism. Rather, the major Western powers remained tied to America, largely because Washington continued to provide
crucial global public goods such as security and leadership of an open global economy. Moreover, the sheer geopolitical dominance of the
Western coalition meant that it was dangerous if not impossible for countries like Russia and China to
mount serious great-power challenges of their own. Admittedly, there remained sometimes-serious disagreements between the
United States and these countries, over issues from NATO enlargement to Taiwan, and those disagreements would grow more pronounced with time. But the

danger of great-power war was nonetheless historically low during the 1990s, and great-power rivalries
were more muted than at any time since the Concert of Europe . All of these characteristics fed into a final post–Cold War
phenomenon: remarkable multilateral cooperation in addressing the relatively mild international disorder of the day. With great-power conflict

dormant, U.S. foreign policy and the international community focused largely on combating lesser
geopolitical “spoilers,” from ethnic cleansing to mass-casualty terrorism to the actions of aggressive
regional powers such as Iraq or North Korea . These efforts, in turn, were greatly aided by the relatively
tranquil state of international politics. The absence of great-power conflict made it far easier to
organize broad coalitions to confront malevolent actors, whether Saddam Hussein in 1990–91 or Al Qaeda after 9/11. In the same vein, great-power
peace allowed America and its allies to devote increasing attention to other forms of post–Cold War disorder. The fact that NATO could focus on “out of area”
interventions for roughly two decades after the Soviet collapse, for instance, was directly related to the paucity of more traditional geopolitical threats. It would be a
mistake, of course, to exaggerate how benign or pliable the post–Cold War environment really was. The “global disorder” of the period hardly seemed mild for the
victims of catastrophic terrorism or ethnic cleansing; U.S. primacy was not omnipotence, as Washington’s travails in places from Mogadishu to Srebrenica to
Helmand amply demonstrated. But by any meaningful historical comparison, the structure of international politics was uniquely conducive to the promotion of U.S.
interests and ideals—a fact that is now the source of some nostalgia as the global system changes in five significant ways. The first key structural shift underway is
the erosion of U.S. and Western primacy. It is incorrect to see this change as a transition from unipolarity to multipolarity, for true multipolarity will not arrive
anytime soon. The United States still possesses substantial economic advantages over its closest competitor, China, namely an
$18 trillion GDP that (as of 2015) was more than $7 trillion larger than China’s, and a per-capita GDP roughly four times that of China. U.S. defense spending also
remains around three times that of China, and Washington maintains enormous advantages in the power-projection capabilities—aircraft carriers, advanced tactical
aircraft, nuclear-powered submarines and others—that allow it to command the global commons and exert disproportionate influence around the world. What

h as happened over the past fifteen years, however, is that the extent of U.S. and Western primacy has
diminished . The U.S. shares of global wealth and military spending have declined from 25 percent and 42 percent, respectively,
in 2004, to around 22 and 34 percent in 2015. The drop-off among America’s allies has been more severe. U.S. allies in Europe and the Asia-Pacific commanded 47
percent of global GDP and 35 percent of global military spending in 1994; those shares had fallen to 39 and 25 percent, respectively, by 2015. Moreover, many of
America’s most powerful allies—particularly in Europe—have undergone severe military decline. The British Royal Navy once ruled the waves, but now struggles to
rule even the waters around the home islands; the German army faces equipment shortfalls so severe that its troops have had to exercise with broomsticks in place
of machine guns. Western
overmatch remains impressive by historical standards, but the global playing field is
slanted much less dramatically than before . Meanwhile, the relative positions of America’s principal
competitors have improved significantly . Russian economic power remains unimpressive, but an
aggressive military modernization program has roughly doubled defense spending over a decade while
also developing the capabilities needed to compete with the West —airborne assault units, special-operations forces, ballistic
and other missile systems, and anti-access/area-denial capabilities, among others. China, meanwhile, has expanded its share of global

wealth more than threefold, from 3.3 to 11.8 percent, between 1994 and 2015, and its share of world military spending more than
fivefold, from 2.2 to 12.2 percent. As in Russia’s case, China’s military buildup has featured the tools—ballistic and

cruise missiles, diesel-electric and nuclear submarines, advanced air defenses, and fourth-generation
fighters—needed to offset longstanding U.S. advantages in the Asia-Pacific, as well as capabilities, such as aircraft carriers, needed
to project Chinese power even further afield. The uncontested U.S. primacy of the 1990s has become the highly
contested primacy of today . This is no academic distinction; the pernicious effects of this shift are
already being seen . The decline of allied military power has made it harder for those allies to defend themselves
against growing security threats , and to make more than token military contributions to addressing
global challenges such as the rise of the Islamic State . Secretary of Defense Robert Gates famously warned in 2011 that NATO faced a
“dim if not dismal future” if European capabilities continued to erode; American frustration has only become more pronounced since then. More fundamentally

still, the changing power balance means that U.S. rivals and adversaries now have greater ability to shift
the international order to suit their own preferences, a factor driving a second key shift in global
politics today . If great-power comity was the post–Cold War norm, great-power competition is the
standard today . Authoritarian rivals that were never fully reconciled to the post–Cold War order, and accepted it only to the degree compelled
by U.S. and Western primacy, are now using their greater relative power to push back against that order in key
geopolitical regions from East Asia to the Middle East to eastern Europe. Because Washington’s
principal adversaries can concentrate their resources regionally, rather than having to distribute them
globally, the power shifts that have occurred in recent years are having outsized effects at the regional
level . And because the regional orders now being challenged have been the foundation of the broader
post–Cold War system, these countries are effectively subverting the system “from the bottom up.”
Consider Chinese behavior in East Asia. Chinese leaders always saw America’s post–Cold War dominance as a transitory condition to be suffered for a time, not
something to be welcomed forever. And so as China’s geopolitical potential has soared, Beijing has taken bolder steps to erect a Sino-centric regional order. It

has asserted expansive maritime claims and used techniques such as island building to shift facts on the
ground without risking a premature military clash with America. It has challenged longstanding norms such as
freedom of navigation in the South China Sea, and steadily increased efforts to coerce its neighbors. It
has probed and worked to weaken U.S.
alliances and partnerships, by simultaneously wooing and intimidating America’s regional friends. Finally,
Beijing has conducted a major military buildup focused precisely on capabilities that will give it dominance over its neighbors and prevent the United States from

intervening in their defense. These efforts are now having an accumulating effect . Chinese coercion has dramatically altered
perceptions of momentum and power in the region, while the Chinese buildup has made the outcome of a Sino-American war over Taiwan or other regional
hotspots far more doubtful. Chinese economic diplomacy has drawn many countries in the region closer into Beijing’s economic orbit. “America has lost” the
struggle for regional supremacy, President Rodrigo Duterte of the Philippines announced in 2016—an exaggeration, surely, but a marker of how contested the

region has become. Great-power

competition is even more unvarnished in Europe , where a militarily resurgent
Russia is reasserting lost influence and undoing key aspects of the post–Cold War settlement . Moscow has
waged wars of conquest against Georgia and Ukraine; it has worked to undermine NATO and the European Union through efforts
ranging from paramilitary subversion, to military intimidation, to financial support for anti-EU and anti-NATO politicians and other intervention in Western political
processes. In doing all of this, Russia has fundamentally contested the notion of a post–Cold War Europe
whole, free and at peace; it has challenged—with some success—the institutions that have long
maintained security and prosperity in the region . And as with China, these actions have been underwritten by a military buildup that has
restored Russian overmatch along NATO’s exposed eastern flank and enhanced Moscow’s ability to project power as far afield as the Middle East. Russia has
become an ambitious great power again: it is asserting its prerogatives in ways that only seem anomalous in contrast to the remarkable cooperation of the post–
Cold War era. Finally, geopolitical revisionism is alive and well in the Middle East. Iran
is not in the same power-political class as Russia
or China, but it is a regional power seeking to assert regional mastery. It is doing so via the use of proxies and
its own forces in conflicts in Syria, Yemen and Iraq, via the weaponization of sectarianism in countries
across the region, and via investments in asymmetric capabilities such as ballistic missiles and special-
operations forces. This agenda has led Tehran into conflict with U.S. security partners such as Egypt,
Saudi Arabia and the United Arab Emirates; it has contributed significantly to the instability that
plagues the region . Each of these geopolitical challenges is different, of course. But taken collectively, they represent a geopolitical sea change from the
post–Cold War era. The revival of great-power competition entails sharper international tensions than have been
known for decades, and the return of Cold War phenomena such as arms races and security dilemmas . It entails intensifying
conflicts over the global rules of the road , on issues from freedom of navigation in the S outh C hina
S ea to the illegitimacy of altering borders by force. It entails starker struggles over states that reside at
the intersection of rival great powers’ spheres of influence, such as the Philippines , Ukraine and Iraq .
great-power rivalry could lead to great-power war —a phenomenon that seemed
Finally, it raises the prospect that

to have followed the Soviet Union onto the ash heap of history with the end of the Cold War. The world
has not yet returned to the titanic geopolitical struggles of the twentieth century, but it is returning to
the historical norm of great-power strife—with all the dangers that entails .
 1AC — Disease
Advantage two is Disease:
Expanding Medicare solves future infectious diseases.
Galvani et al. 20 {Alison Galvani (Ph.D. She was named the Burnett and Stender Families Professor of
Public Health in 2015. She is the youngest faculty member in Yale School of Medicine's history to be
appointed to a named professorship. Anthony Fauci, director of the US National Institute of Allergy and
Infectious Diseases, described Dr. Galvani as an international star in the field of modelling of infectious
diseases), Alyssa Parpia Abhishek Pandey, Charlotte Zimmer, James Kahn, Meagan Fitzpatrick (May 17,
2020) “The imperative for universal healthcare to curtail the COVID-19 outbreak in the USA”
https://doi.org/10.1016/j.eclinm.2020.100380 // gordon]

Racial and economic disparities in the US healthcare system are being magnified by the pandemic. Rates of
adequate health insurance coverage are much lower among people of color [7]. With less access to preventative healthcare,
people of color are disproportionately affected by comorbidities, such as diabetes, obesity, asthma, and

cardiovascular disease. These comorbidities exacerbate the severity of COVID-19 clinical outcomes, including death [8], as does delay in seeking care due to concerns about
medical bills. COVID-19 is widening socioeconomic fissures facing people of color as well. Since the start of the outbreak, Latino populations have reported much higher rates of job and wage

loss than Americans at large [9]. The solution to these challenges is the provision of comprehensive healthcare as a
human right. Further, universal healthcare will be most cost-effectively achieved by a single-payer system,
such as that proposed in the Medicare for All Act [1]. Not only would Medicarefor-All save lives, it would resolve costly
inefficiencies that currently make our healthcare system the most expensive in the world. Among the major sources
of savings, a single-payer system would consolidate administrative costs , reduce overhead, empower

pharmaceutical price negotiations, and truncate executive pay. A single-payer system is also incentivized to invest
in cost-effective preventative services that can avert life-threatening clinical outcomes and expensive
downstream treatment. Another advantage of Medicare-for-All during this pandemic would be its implementation of a standard billing and
payment system, which would accelerate COVID-19 case reporting. Billing procedures currently vary across dozens of insurers, and for
private insurance is proprietary. Within a consolidated system, patterns in the billing data can signal outbreak

hotspots to public health surveillance officials. This consideration is not hypothetical – the single-payer system in Taiwan
has facilitated exhaustive COVID-19 data collection and reporting [10]. Universal healthcare is
fundamental to the continued prosperity of our country in the wake of this and future infectious
disease threats. Obstacles to prompt diagnosis and case isolation not only impact the individual, but pose a broader societal risk. A pandemic illustrates an omnipresent truth:
that we are each only as safe as the most vulnerable member of our society. We urge investment now in the common good of healthcare security, by extending comprehensive insurance to all

By
who currently lack it. Then, we should move swiftly to create a single-payer system, such as Medicare for All, which is the more efficient way to provide universal coverage [1].

eliminating financial obstacles to healthcare, we can pave the way for more efficient outbreak control,
in both this pandemic and the next.

Only the plan solves disease.

Kahn 17 – Laura H Kahn, physician and research scholar in the Program on Science and Global Security
at Princeton University's Woodrow Wilson School of Public and International Affairs, M.D. from Mt. Sinai
School of Medicine, a Master of Public Health from Columbia University and a Master of Public Policy
from Princeton University, formerly managing physician for the New Jersey Department of Health and
Senior Services, a medical officer for the Food and Drug Administration in Rockville, Maryland, an
attending physician/educator at Prince George’s Hospital in Cheverly, Maryland and a staff physician at
Gouverneur Hospital (“Why access to health care is a national security issue,” Bulletin of the Atomic
Scientists, June 5th, http://thebulletin.org/why-access-health-care-national-security-issue10819)
As the Congressional Budget Office report suggests, the American Health Care Act would make healthcare essentially unaffordable for people with pre-existing
conditions, because it would allow insurance companies to dramatically increase their premiums. Ten years ago, I
wrote about the security
impact of the uninsured during the George W. Bush presidency. In 2005, almost 47 million people (about 16 percent of the total US population) were
uninsured. Thanks to the Affordable Care Act passed under the Obama administration, that number dropped to a low of 11 percent, according to a Gallup poll taken
during the first quarter of 2016. TheAffordable Care Act was a big step in the right direction, but it didn’t close the
gap, and the national security and public health challenges of having a large fraction of the population
uninsured remain as relevant today as they were a decade ago . Uninsured people delay seeking health
care. Once they seek it, often in a busy emergency room, they are typically given less attention than
people with insurance. This failure to get care becomes a danger not only for the individual but for the public at
large when the problem is a deadly infectious disease. We saw this scenario play out in Dallas during the
Ebola crisis of 2014 and 2015. A poor Liberian man, infected with the virus, presented himself to Texas Health Presbyterian Hospital with severe abdominal
pain and a high fever. He was examined and sent home with a bottle of antibiotics. Amazingly, he did not set off an Ebola outbreak in

his community, though the risk that he could have was significant and the wider public shouldn’t count
on being so lucky next time. Before dying, he infected two nurses who had received inadequate training and equipment to protect themselves.
During the anthrax crisis of 2001, in which spores of the deadly disease were sent through the US mail, many people infected were federal employees with health
insurance. If these postal workers hadn’t had easy access to health care, the death toll might have been higher than only five; 17 more were infected but survived
thanks to timely medical attention. Anthrax spores do not spread from person to person, but it’s no stretch to imagine a different scenario: Suppose
a
future attack involves smallpox, a highly communicable virus, and that the initial victims are uninsured
childcare workers or food handlers. The initial signs of smallpox include fever, chills, and headache. Uninsured victims would
likely delay trying to get care, hoping for the symptoms to pass. By waiting they would certainly expose others to the
virus, potentially setting of a pandemic. Countries like Canada, which has universal health coverage and a well-funded public
health infrastructure, are much better prepared to handle deadly epidemics . In 2003, Canada confronted Severe Acute Respiratory
Syndrome (SARS), which originated in China. A physician from Guangdong province inadvertently infected a number of tourists with the SARS virus, setting off a
global pandemic after everyone returned to their home countries. Among the infected travelers was an elderly Canadian woman who returned to Toronto after a
10-day vacation in Hong Kong. Over the course of about four months, the Canadian health system worked hard to contain the virus, treating 400 people who
became ill and quarantining 25,000 Toronto residents who may have been exposed. Ultimately, 44 people died from the disease in Canada, but the result would
have been much worse without a quick and well-organized response. The Canadian government’s response had its glitches—primarily in the form of poor political
leadership. Mel Lastman, the mayor of Toronto and a former furniture salesman, became angry when the World Health Organization (WHO) issued a travel advisory
against his city. He railed against the WHO’s decision on television, revealing his complete lack of knowledge about either the organization or public health in
general. As a result of Lastman’s poor leadership, he was ultimately relegated to a secondary role as the deputy mayor took his place. Lastman’s credibility and
legitimacy never recovered from the SARS outbreak. Likewise, US
leaders will be judged by how they handle a bioterrorist
attack or pandemic. Unlike Canada, America’s piecemeal healthcare and public health systems are inherently
less able to handle such crises. The Affordable Care Act helped fill in the gaps, but really, the only way to prepare for the
eventuality of pandemics or bioterrorist attacks is with a single-payer government-run system that
covers everyone. The United States might consider modeling its health care system after the one in Israel, a country that, given longstanding threats, takes
every terrorist risk very seriously. In 1994, it established universal health coverage for all citizens. The country’s Ministry of Health monitors and promotes public
health, oversees the operations of the nation’s hospitals, and sets healthcare priorities. As a result, Israel’s public health, emergency response, and hospital systems
are state-of-the-art, highly efficient, and coordinated—a necessity when responding to terrorist attacks. The preamble to the US Constitution states the goals to
“provide for the common defense” and “promote the general Welfare.” The
US government won’t fulfill either of these duties if it
fails to protect its citizens against pandemics and bioterrorism. The mandate requires a robust public
health infrastructure and a universal healthcare system that covers all Americans. The Trump Administration and
Congressional Republicans threaten to undermine this essential function of government, unnecessarily jeopardizing American lives.

Future diseases cause extinction

Diamandis 21 (Eleftherios P. Diamandis, Division Head of Clinical Biochemistry at Mount Sinai Hospital
and Biochemist-in-Chief at the University Health Network and is Professor & Head, Clinical Biochemistry,
Department of Laboratory Medicine and Pathobiology, University of Toronto, Ontario, Canada, April 14 th
2021, “The Mother of All Battles: Viruses vs. Humans. Can Humans Avoid Extinction in 50-100 Years?”
modified to fix author typo [“could result n”  “could result in”
https://www.preprints.org/manuscript/202104.0397/v1) MULCH
The recent SARS-CoV-2 pandemic, which is causing COVID 19 disease, has taught us unexpected lessons
about the dangers of human extinction through highly contagious and lethal diseases. As the COVID 19
pandemic is now being controlled by various isolation measures, therapeutics and vaccines, it became
clear that our current lifestyle and societal functions may not be sustainable in the long term. We now
have to start thinking and planning on how to face the next dangerous pandemic, not just overcoming the one that
is upon us now. Is there any evidence that even worse pandemics could strike us in the near future and

threaten the existence of the human race? The answer is unequivocally yes. It is not necessary to
get infected by viruses of bats, pangolins and other exotic animals that live in remote forests in order to
be in danger. Creditable scientific evidence indicates that the human gut microbiota harbor billions of
viruses which are capable of affecting the function of vital human organs such as the immune system,
lung, brain, liver, kidney, heart etc. It is possible that the development of pathogenic variants in the gut can lead to contagious viruses which can
cause pandemics, leading to destruction of vital organs, causing death or various debilitating diseases such as blindness, respiratory, liver, heart and kidney failures.
These diseases could result [in] the complete shutdown of our civilization and probably the extinction
of human race. In this essay, I will first provide a few independent pieces of scientific facts and then combine
this information to come up with some (but certainly not all) hypothetical scenarios that could cause
human race misery, even extinction. I hope that these scary scenarios will trigger preventative measures
that could reverse or delay the projected adverse outcomes.

Empirical studies prove Pharma innovation is low now. High drug prices fail to
stimulate innovation.
Backfisch 21 [Ute Laermann-Nguyen, School of Business and Economics, Philipps University Marburg,
Research Group Economic Policy; Martin Backfisch, Center for Advanced Studies, Baden-Wuerttemberg
Cooperative State University; 11-11-2021; "Innovation crisis in the pharmaceutical industry? A survey";
SN Business & Economics volume 1; https://link.springer.com/article/10.1007/s43546-021-00163-5; KL]

Conclusion In this article,we carried out a comprehensive literature review regarding the possible existence of an
innovation crisis in the pharmaceutical industry. The aim of this work was to outline the current state of knowledge about whether a crisis indeed
exists and, if so, what reasons could be made responsible for it. Therefore, we examined empirical studies on various indicators and discussed

numerous possible reasons from an economic point of view. Such a comprehensive analysis has not been carried out previously . Our
evaluation of the empirical studies shows that the framework conditions for innovation in the industry are generally good: technological advances have led to new opportunities for the

treatment of diseases, the patent system provides sufficient incentives to invest in R&D, and global drug demand and healthcare expenditures are
growing. Nonetheless, the success rate of pharmaceutical R&D projects decreased during the last
decades, while the attrition rate, the average development time, and the cost per new drug increased.
While there is evidence that the success rate and the attrition rate have recovered slightly in recent years, growing development times and escalating

costs remain a cause of concern. Thus, the empirical studies indicate that the pharmaceutical industry is
indeed in an innovation crisis. However, further research on the long-term development of the indicators would be desirable to confirm these findings.

Pharma has zero incentive to innovate. They profit big off existing drugs. Models
prove.
Li et al. 21 (Xuelin Li is an Assistant Professor of Finance at the University of South Carolina's Darla
Moore School of Business. His research focuses on innovation, venture capital, and information
economics., Andrew Wen-Chuan Lo is the Charles E. and Susan T. Harris Professor of Finance at the MIT
Sloan School of Management. Lo is the author of many academic articles in finance and financial
economics. Richard T. Thakor is an Assistant Professor of Finance at University of Minnesota, Carlson
School of Management. He is also a Research Affiliate at the MIT Laboratory for Financial Engineering
(LFE). His research interests are in empirical and theoretical corporate finance, in the areas of
managerial decision-making, R&D investments, healthcare finance, and the effects of financial frictions
on firm project investments., June 2021, accessed on 7-16-2021, National Bureau of Economic Research,
"Paying off the Competition: Market Power and Innovation Incentives",
https://www.nber.org/papers/w28964)

*“[Actavis]” added for clarity

How does a firm’s market power in existing products affect its incentives to innovate? We explore this fundamental question using granular project-level and firm-level data from the
pharmaceutical industry, focusing on a particular mechanism through which incumbent firms maintain their market power: “reverse payment” or “pay-for-delay” agreements to delay the
market entry of competitors. We first show that when firms are unfettered in their use of “pay-for-delay” agreements, they reduce their innovation activities in response to the potential entry
of direct competitors. We then examine a legal ruling that subjected these agreements to antitrust litigation, thereby reducing the incentive to enter them. After the ruling [Actavis], incumbent
firms increased their net innovation activities in response to competitive entry. These effects center on firms with products that are more directly affected by competition. However, at the

Overall, these results are

product therapeutic area level, we find a reduction in innovation by new entrants after the ruling in response to increased competition.

consistent with firms having reduced incentives to innovate when they are able to maintain their
market power, highlighting a specific channel through which this occurs. 1 Introduction The effect of competition among firms
on innovation is a critical issue for policymakers, given the importance of innovation as a driver of economic growth. However, the relationship between increased

competition and innovation is not clear-cut in the literature (e.g. Aghion, Bloom, Blundell, Griffith, and Howitt (2005)). On the one hand, measures such as
greater patent protection to reward firms for innovation by limiting competition may encourage further innovation in order to reap monopoly profits. On the other hand, an

incumbent firm with an existing product under such protection may feel no need to innovate further if it can
already rely on a guaranteed revenue stream from the product. Understanding the interaction between these
forces is crucial for ascertaining the effect of policies aimed at increasing innovation by changing the degree of competition in a market, such as antitrust enforcement and patent
policy. In this paper, we explore this issue by providing evidence from a legal mechanism through which innovative firms may maintain their market power, and its ramifications for innovation.
We do so in the setting of a particular sector known for developing innovative products through its research and development (R&D) activities—the pharmaceutical industry. In this industry,
firms that are first to pass clinical trials and obtain Food and Drug Administration (FDA) approval for their drugs enjoy marketing exclusivity for a number of years, during which no other firm
can directly compete against that drug. However, after marketing exclusivity expires, other firms may enter the market by launching generic versions of the specific drug through what is known

incumbent pharmaceutical firms have regularly entered

as a Paragraph IV filing. In order to continue their monopoly over marketed drugs,

into “pay-for-delay“ agreements—also known as “reverse payments” —settlements with entering generic 2 manufacturers, whereby
the generic firm agrees to delay product launch in exchange for a cash amount. These agreements effectively provide an endogenous tool through

which incumbent firms can reduce the competition that they face. Using detailed data on public
pharmaceutical firms and their drug development portfolios from 2005 to 2016, we construct a firm-
specific measure of the amount of competition that each incumbent faces through Paragraph IV generic drug entry filings. We
show that unconditionally over our sample period, incumbent firms responded to potential entry from direct competitors by reducing their innovation activity and initiating a smaller number
of new drug trials.1 The results suggest that firms appear to reduce their levels of innovation when faced with increased competition. We then explore the effect of a Supreme Court ruling in
2013, FTC v. Actavis, which increased the legal risk of engaging in pay-for-delay agreements. The ruling stated that under antitrust law, the Federal Trade Commission (FTC) could target such

Consistent with the increased legal risk, we

agreements, and granted the FTC broader bargaining power in these types of antitrust settlements.

document a sharp decline in the number of pay-for-delay agreements after the ruling, a stark reversal of
the previous trend. Furthermore, we show that the ruling did not appear to change the incentives of generic entrants, which filed at the same rate both before and after the
ruling.2 We therefore interpret the ruling as an unexpected regulatory change that reduced the ability of incumbent firms to enter into agreements to impede new competition. Our initial

Put differently, pharma firms

result, that incumbent firms reduce their levels of innovation when faced with increased competition, reverses itself following this ruling.

after the ruling increase their number of new drug trial initiations and decrease their number of
suspensions of existing projects in response to generic entry filings. This suggests that the initial negative
relationship between generic competition and innovation is driven primarily by the ability of incumbent
firms to protect their monopoly power through pay-for-delay agreements. Such agreements allow firms to resolve the uncertainty
of product competition and reduce the need to maintain their competitive edge with novel drugs. However, after this channel becomes legally risky,

firms need to rely on innovation activities to escape neck-and-neck competition (e.g. Aghion et al. (2005)). While the
above results are suggestive, they are subject to concerns about endogeneity and reverse causality , since generic entry and signing

pay-for-delay agreements are contemporaneously endogenous decisions made by both incumbents and entrants. In order to address these concerns, we use

the FTC v. Actavis ruling as a natural experiment, and conduct a differences-in-differences (diff-in-diff) analysis by exploiting firm heterogeneity in their
exposure to the ruling. Specifically, incumbent firms with drugs slated to lose marketing exclusivity in the years immediately following the

ruling had increased exposure to generic entry , and thus, to the court ruling. Furthermore, since the expiration date of marketing exclusivity for these drugs
had been predetermined at the end of the drug approval process, which spans a number of years (e.g. DiMasi and Grabowski (2007)), the institutional framework alleviates concerns of self-

selection into the treatment group. This diff-in-diff analysis shows that exposed firms had a relative increase in innovation
through a higher number of new trial initiations, a lower number of suspensions. We additionally
provide evidence that the economic value of new 4 innovations increases by relatively more for exposed firms,
consistent with an increase in effort by developing firms that resulted in higher-quality innovation. We validate these results through a number of robustness checks.

First, we replicate the same exercise at the firm -therapeutic-category level and document that these effects also hold both across different

categories within a single firm as well as across different firms within a single category.3 Second, our identification strategy requires that the loss of market exclusivity
significantly increases innovation activities only after FTC v. Actavis. To show this, we perform a placebo test by counterfactually assuming the

ruling occurred in 2009, and using firms with drug exclusivities expiring between 2009 and 2012 as the pseudo-treatment group. We obtain no significant results via this
test for our outcome variables. We also document a number of other results that are consistent with the diminished ability of firms to engage in pay-for-delay driving these effects. First, using

effects are centered on two groups: firms that have drugs with high sales whose
data on drug sales, we find that these

exclusivity was set to expire after the Supreme Court ruling, and firms with a large number of drugs whose exclusivities
were set to expire after the ruling. Both of these effects are consistent with the hypothesized responses of firms that are the most affected by the law. Second, we find that the
affected firms are more likely to acquire projects from other firms, which is consistent with firms choosing to in-source existing projects from other firms as an alternative to in-house

we find that the affected firms increased their R&D expenditures and decreased their cash
innovation. Third,

holdings following the ruling, which is consistent with firms spending to expand their net innovation activities. Finally, we use hand-collected data from 10-K filings and
searches of news articles to find mentions of litigation faced by incumbent companies. We show that patent infringement settlements went down

after the Supreme Court ruling. In contrast, the number of litigated court cases with rulings and the number of rulings where generic
drugs were allowed to enter (i.e. cases that are not settled) went up. These effects are consistent with the hypothesized effects of the original FTC v. Actavis
ruling.

Innovation is key to new antibiotics against AMR.

Davies 6-4 (Professor Dame Sally Davies is UK Special Envoy on Antimicrobial Resistance; Thomas
Cueni is Director General of the International Federation of Pharmaceutical Manufacturers and
Associations (IFPMA), 6-4-2021, accessed on 6-11-2021, The Telegraph, "The silent pandemic of
superbugs could be far deadlier than Covid-19 – we must fix it", https://www.telegraph.co.uk/global-
health/science-and-disease/silent-pandemic-superbugs-could-far-deadlier-covid-19-must/)
In 2016, the United States National Security Council drew up a playbook on fighting pandemics so that the next response to an epidemic was better handled than the response to the spread of

G7 put tackling antimicrobial resistance (AMR) on the agenda. Today, the twin global health
Ebola. The same year, the

security threats of viruses and bacteria are very real. Every corner of our health system depends on antibiotics. It’s thanks to antibiotics that
illnesses such as pneumonia, meningitis and TB are now treatable. They are used for caesarean sections, routine operations such as arthroscopic knee surgery, and cancer chemotherapy.

Worryingly, bacteria mutate, just as viruses do. As a result, increasingly people are dying of diseases where the existing antibiotics did not work. Since 2016, over 3.5
million people have died of a drug-resistant infection. Overuse of antibiotics and declining investment in research for new and novel drugs are the
causes of this pandemic hidden in plain sight. Without urgent action, 10 million people globally could die annually as a result of AMR by 2050. The

question is, how to make sure that one goes from policy papers, dire projections and simulations to action? In the case of Covid-19, against the odds and in record time, we already

have a range of vaccines to protect against the SARS-CoV-2 virus. The speed of the response is thanks to decades of research on vaccine technologies. In contrast,
research for new antibiotics that could stave off the worst of AMR has been stuck in the doldrums. And
whilst there are exciting signs at the early end of the pipeline, this innovation is primarily happening in small companies without the infrastructure to take a promising product all the way to
market. Between 2018 and 2020, four companies that had brought new antibiotics to market declared bankruptcy or put themselves up for sale, despite having survived the perilous, decade-
long process of development and testing to get a new drug approved. To give a boost to the antibiotics pipeline, the AMR Action Fund has been created to develop two to four new antibiotics
by 2030, thanks to close to $US 1 billion from pharmaceutical companies, topped up with support from the European Investment Bank and the Wellcome Trust. To ensure there is a healthy
pipeline of antibiotics that keep up with bacteria’s natural evolution to build resistance, we need more than a fund to boost innovation. Once new antibiotics are approved, they need to be
used sparingly to preserve effectiveness and slow the development of further resistance. While this makes sense for public health, it doesn’t support the level of investment needed to

We need
maintain a robust antibiotic pipeline. Despite the huge societal costs of AMR, our health care systems are not currently designed to recognise the value of new antibiotics.

adapted market-based policy reforms, including reimbursement reform and new ‘pull’ incentives to
create market conditions that enable sustainable investment in antibiotic R&D. We need industry to fully recognise the
insurance value that antibiotics provide them. We need healthcare systems to pay their ‘fair share’ for innovation. And most of all, we need governments, researchers and life sciences

United
companies to work together, to put patient needs at the forefront. Some governments have started to take decisive action to revitalise the antibiotics market. The

Kingdom NHS’s ‘Netflix’ model to value antibiotics differently and pay for them by subscription rather
than per pill has been designed to empower the health service in England to keep watch over antibiotic use whilst also encouraging investment in developing the new treatments we
 is a positive example of what can emerge from collaborative dialogue between government, clinicians and industry. In the United States, the
all need. It

PASTEUR Act that is currently before Congress should create a predictable path to rewarding new
antibiotics for their value to society via a subscription contract (valued at $750m to $3bn) that prepays
for all US federal use of the drug. This would be a delinked pull incentive that is large enough to move the R&D needle, with powerful support for antibiotic
stewardship. More generally, the global community is also moving to take action on AMR – 135 countries have finalised national action plans, but they must be fully funded and implemented.
These are good actions and are pointing us in the right direction. But, if Covid-19 has taught us something, it is that global health security, as the name implies, needs to be truly global. As the
G7 Health Ministers meet, it is crucial that they give AMR a last push and agree global action to strengthen research and development for new antibiotics, once and for all. Let us not fall into

this silent pandemic of AMR, which

the trap of tunnel vision and squander the opportunity that we have been building up to over the past seven years, to fix

otherwise could have consequences far more deadly than Covid-19 .

AMR is an existential threat, nonlinear, and has an invisible tipping point. It’s
systematically ignored by pharma now.
Silverman ’16 (Rachel Silverman – MPhil with Distinction in Public Health @ the University of
Cambridge, Senior Policy Analyst and Assistant Director of Global Health Policy @ the Center for Global
Development, focusing on global health financing and incentive structures, “Confronting Antimicrobial
Resistance: Can We Get to Collective Action?” 19 April 2016, https://www.cgdev.org/blog/confronting-
antimicrobial-resistance-can-we-get-collective-action)

Dr. Chan issued a serious warning about the size and

Antimicrobial resistance is already causing huge harm – and the worst is yet to come. To open the panel,

scope of the AMR threat: “everyone will be affected if we do not address this problem .” AMR is already

responsible for an estimated 700,000 global deaths each year, 50,000 of which take place in the US and Europe. Extensively drug-resistant (XDR)
tuberculosis—cases where the most effective first- and second-line drugs are rendered useless—infected an estimated 47,000 people worldwide in 2014, only one ‘last-line’ antimicrobial is

available to reliably treat gonorrhea, andfew new antimicrobial drugs are in the development pipeline . According to the
latest review, AMR could cause 10 million deaths each year by 2050, with knock-on effects draining
many trillions from the global economy. Summers suggested that AMR and potential pandemics, alongside
climate change and nuclear proliferation, represent the top three existential threats to life on earth as we know it. And as Dr. Chan explained,

the worst-case scenario implies the end of modern medicine as we know it. Even worse, Summers suggested that
AMR seems like a “quintessential non-linear phenomenon, and therefore more dangerous.” Year by year
the effects are small and mostly invisible. But at some point in the future they could suddenly become
catastrophic, like a “levee that doesn’t hold and unleashes a flood .” Dr. Chan concurred that “the tipping point is not
predictable because…microbes are invisible. We don’t even know when they’re going to make the switch ” to
become resistant to existing drugs. Antimicrobial efficacy is a global public good threatened by serious market failures. In response to this huge threat, why don’t
pharmaceutical companies invest in new antibiotics? “It does not pay” for them to do so, explained Osborne.
Pharmaceutical companies want to invest in technologies that will make a lot of money , and soon; so long as
other antibiotics remain effective, the market for new options will be tiny and unprofitable .
 1AC – Framing
The standard is maximizing expected well being.
Prefer –
Extinction outweighs.
MacAskill 14 [William, Oxford Philosopher and youngest tenured philosopher in the world, Normative
Uncertainty, 2014]

The human race might go extinct from a number of causes: asteroids, supervolcanoes, runaway climate change, pandemics,
nuclear war, and the development and use of dangerous new technologies such as synthetic biology, all pose risks (even if very small) to the
continued survival of the human race.184 And different moral views give opposing answers to question of whether
this would be a good or a bad thing. It might seem obvious that human extinction would be a very bad thing, both because of the loss
of potential future lives, and because of the loss of the scientific and artistic progress that we would make in the future. But the issue is at least
unclear. The continuation of the human race would be a mixed bag: inevitably, it would involve both upsides and downsides. And if one regards
it as much more important to avoid bad things happening than to promote good things happening then one could plausibly regard human
extinction as a good thing.For example, one might regard the prevention of bads as being in general more important that the promotion of
goods, as defended historically by G. E. Moore,185 and more recently by Thomas Hurka.186 One could weight the prevention of suffering as
being much more important that the promotion of happiness. Or one could weight the prevention of objective bads, such as war and genocide,
as being much more important than the promotion of objective goods, such as scientific and artistic progress. If the human race continues its
future will inevitably involve suffering as well as happiness, and objective bads as well as objective goods. So, if one weights the bads sufficiently
heavily against the goods, or if one is sufficiently pessimistic about humanity’s ability to achieve good outcomes, then one will regard human
extinction as a good thing.187 However, even if we believe in a moral view according to which human extinction
would be a good thing, we still have strong reason to prevent near-term human extinction. To see this, we
must note three points. First, we should note that the extinction of the human race is an extremely high stakes moral issue.
Humanity could be around for a very long time: if humans survive as long as the median mammal species, we will last another two million
years. On this estimate, the
number of humans in existence in the The future, given that we don’t go extinct any time
soon, wouldbe 2×10^14. So if it is good to bring new people into existence, then it’s very good to prevent
human extinction. Second, human extinction is by its nature an irreversible scenario. If we continue to exist, then we
always have the option of letting ourselves go extinct in the future (or, perhaps more realistically, of considerably reducing population size). But
if we go extinct, then we can’t magically bring ourselves back into existence at a later date. Third,
we should expect ourselves to
progress, morally, over the next few centuries, as we have progressed in the past. So we should expect that in a few
centuries’ time we will have better evidence about how to evaluate human extinction than we currently have.
Given these three factors, it would be better to prevent the near-term extinction of the human race, even if we thought that the extinction of
the human race would actually be a very good thing. To make this concrete, I’ll give the following simple but illustrative model. Suppose
that we have 0.8 credence that it is a bad thing to produce new people, and 0.2 certain that it’s a good thing to produce
new people; and the degree to which it is good to produce new people, if it is good, is the same as the degree to which it is bad to produce
new people, if it is bad. That is, I’m supposing, for simplicity, that we know that one new life has one unit of value; we just don’t know whether
that unit is positive or negative. And let’s use our estimate of 2×10^14 people who would exist in the future, if we avoid near-term human
extinction. Given our stipulated credences, the expected benefit of letting the human race go extinct now would be (.8-.2)×(2×10^14) =
if we let the human race continue and did research for 300 years, we would know for certain
1.2×(10^14). Suppose that,
whether or not additional people are of positive or negative value. If so, then with the credences above we should
think it 80% likely that we will find out that it is a bad thing to produce new people, and 20% likely that we will find out that it’s a good thing to
produce new people. So there’s an 80% chance of a loss of 3×(10^10) (because of the delay of letting the human race go extinct), the expected
value of which is 2.4×(10^10). But there’s also a
20% chance of a gain of 2×(10^14), the expected value of which is
4×(10^13). That is, in expected value terms, the cost of waiting for a few hundred years is vanishingly small
compared with the benefit of keeping one’s options open while one gains new information.
 1AC – Underview
1] 1AR theory is legit – anything else means infinite abuse – drop the debater,
competing interps, no rvis – 1AR is too short to make up for the time trade-off – no
RVIs or 2NR theory and paradigm issues– 6 min 2NR means they can brute force me
every time. Aff theory first – it’s a much larger strategic loss because 1min is ¼ of the
1AR vs 1/7 of the 1NC which means there’s more abuse if I’m devoting a larger
fraction of time.