White House Chronicle

News Analysis With a Sense of Humor

Medicare for All Is the Wrong Fix for the Healthcare Crisis

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As Charles Dickens might have said, “It is the best of times in medicine, it is the worst of times in healthcare.” It is a time of great medical discovery with artificial intelligence, it is a time of the poorest outcomes for the sick.

One of America’s most distinguished pediatric cardiologists says the nation is in desperate shape with the end of Medicaid subsidies and the 28 million people — or almost 10 percent of the population — who lack insurance. The number is growing as people trade off the cost of insurance and prescriptions against rent, food and electricity.

Cardiologist Dr. Arthur “Tim” Garson Jr., a clinical professor at the University of Houston, College of Medicine, is keen to head off those who think the answer is Medicare for All.

“It seems to me that politicians of either party, especially those who are new to healthcare, say, ‘Medicare for All’ when they mean ‘universal coverage,’” Garson said, adding, “Coverage for all people is essential, but Medicare for All is only one way — and a terrible way.”

Garson, who is a former University of Virginia provost and an elected member of the National Academy of Medicine, said: “Let me be clear: Traditional Medicare works beautifully for 34 million of us. It’s easy, actually too easy, with essentially no pre-approvals for care. But that won’t work for 338 million people — allowing anyone to have anything.”

According to Garson, analyses that say Medicare for All saves money have it wrong. “We know that with no guardrails, care can go up 25 percent to 30 percent. They showed that in South Texas.”

Particularly, he takes aim at the Medicare for All Act of 2025, which is still before Congress. It contains coverage of everything from elective surgery to dental, hearing and vision care without copays or any cost-sharing, and eliminates all insurance.

The answer for the uninsured, according to Garson, is basic, tax-supported healthcare for everyone. That may not be enough for some, so private insurance must be permitted — a system he calls the “single safety net.”

That system operates in most of the developed world.

Behind Garson’s concern for those who go without insurance and who can’t afford prescriptions is a close-to-home tragedy. He helped save a toddler’s life and watched her grow over the next 19 years. Then, when her Medicaid ran out, she died because she couldn’t afford her sustaining prescriptions and was too ashamed to ask for help.

Garson shared a draft paper with me that explains the ruinous cost of Medicare for All and the basic healthcare he believes is affordable and achievable.

It states: “We spend more than twice the average of other developed countries on healthcare per person, and waste about one-third of the $5.5 trillion that we spend on healthcare — that’s about $1.6 trillion wasted. Yet, other countries provide healthcare for everyone.”

Garson isn’t advocating for a more expensive system. He says getting rid of even a portion of the waste can pay for perfectly adequate care.

I know a bit about the healthcare systems in three countries: England, where I used to be a beneficiary of the National Health Service, and where members of my family have used it since it began in 1947; France, where I received extraordinary care after a bad fall in Paris two years ago; and Ireland, where the two-tier system is praised by friends.

If people across the developed world can have the security of illness without going into penury, and they get that for half of what we spend on healthcare, what are we waiting for?

Garson thinks it will take a long time to eliminate the waste before America can move toward coverage for all.

I am not so sure. I think the effect of tens of millions without medical insurance could be dramatic. They will clog the emergency rooms where the law says they must get treatment.

In education, Garson notes, we have public schools and private schools for those who want them, so why not at the doctors’ offices?

I say that if your house catches fire, you expect to see the fire brigade. All of you.

Time to hear the fire bell in medicine. Many wonderful things are on the way with AI medical research. Everyone should get the benefits.

My Maiden Flight Without a Necktie

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Friday, Aug. 14, was a seminal day for me. For the first time in my long life, I boarded a flight without a necktie. In seven decades of flying, I have never done that.

Truth is, I felt underdressed on the flight from Providence, R.I., to Jacksonville, Fla., as if I were wearing my pajamas at the White House. Oh, the shame of it. 

Men don’t wear neckties anymore. No matter that they look incomplete in a suit with an open-neck shirt, as though they hadn’t finished dressing.

Also with age, the neck loses any appeal it might have had. Nora Ephron, brilliant journalist, author, filmmaker and sometime wife of Watergate reporter Carl Bernstein, wrote a book titled “I Feel Bad About My Neck,” about the ravages of age.

Anyway, gentlemen, you looked a lot better with a necktie than with the neck open in a shirt clearly designed to be closed. A pocket square adds color, but also draws attention to the egregious omission: something around the neck.

Sitting tieless on the aisle was a traumatic, maybe even a life-changing experience for me — this sense of being partly naked in a very public place. I was wearing a blazer, shirt, long pants and socks, not the weekend-at-the-beach garb. Even so, my self-respect was in the tank.

I will say without hesitation that the necktie is a useless piece of clothing, unless you use it to wipe your eyeglasses — a no-no. It doesn’t keep you warm or keep rain off. You could use it to tie up a burglar after you have subdued him. Or you could use it as a dog leash, especially if you are walking the dog on Park Avenue.

Day in and day out, the necktie, no matter how fine the silk, how great the designer’s name, or how overpriced this strip of cloth may be, has no purpose besides acting as a security blanket for your correspondent.

I had an English master in secondary school who turned up one day with an old necktie holding up his trousers. He averred that this was an old English tradition.

Indeed so. At English public schools (private in British tradition), boys sometimes wore neckties in lieu of belts, and it was tolerated. Sometimes this was because a belt had been lost or failed, or the lad was just seeing whether he could get away with it.

From time to time, quite a few men went in for the tie that upholds.

Fred Astaire, that master of urbanity, often danced around with a necktie through his belt loops, knotted at the hip in a dashing way. Don’t try that at home — his eclectic-dancing style, that is.

I first wore a necktie and learned to tie it in primary school. It was part of the first day and remained a part of every day until I left school, got a suit on credit, and launched myself into the grown-up world — with just one necktie.

If a boy in my senior school were to wear his uniform without a necktie, he would be summoned by the headmaster for “four of the best.” If you aren’t familiar with the English nomenclature, that is four strokes with the cane, administered by the headmaster himself. Check that out with a Freudian scholar, if you like.

These days I favor bow ties, thanks to Tucker Carlson. Years ago, before he joined Fox and became part of the bric-à-brac of American politics, he wore a bow tie. When I was going to interview him on television, I donned one and, as they say, the rest is history.

The makeup artist said it made me look sexy, and I am susceptible to suggestions like that. All these years later, it is bow ties for me — even though women and men say they love my bow tie because it reminds them of their grandfathers.

Bow ties can’t hold up your pants, but they do hoist your self-esteem. I wonder why Tucker doesn’t wear them anymore.

Brain Injuries From Blasts Driving Young Vets to Suicide

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We all get a warm glow when we hear the airline gate agent inviting active-duty service members to board early. What isn’t said, isn’t known, is that some of those young men and women will die eventually by their own hands, and at nearly three times the rate of civilians in the same under-34 age group.

Veterans, particularly young veterans, men and women, are in danger of walking on the dark side in terrible isolation, despair and misery — in a darkness so extreme it defies comprehension by those who are in the light.

These veterans are the victims of traumatic brain injury, a hard-to-diagnose and treat brain wounding by the force of shock waves from explosive blasts. The shock waves can cause minute tears or other damage that medical imaging and blood tests can’t detect in a living patient.

Frank Larkin, who heads up Warrior Call, an organization devoted to helping TBI-afflicted veterans, knows the problem in a savagely personal way: His son, Ryan, a decorated Navy SEAL, took his life at age 29. He was a victim of TBI.

Larkin is a former Navy SEAL, a police officer, a Secret Service agent and a U.S. Senate sergeant at arms. He is a passionate advocate for research, understanding, compassion and giving veterans an ecosystem in which they can feel secure, comforted and part of a tribal continuance that extends from the time in service to life in the civilian world.

Thomas Bowman, a Marine for 30 years and later the Republican staff director of the Senate Veterans’ Affairs Committee and deputy secretary of the Veterans Administration in the first Trump administration, knows the issue from its institutional challenges.

Larkin and Bowman joined me and my colleague, Adam Clayton Powell III, on the PBS and SiriusXM Radio program “White House Chronicle” to discuss a disturbing uptick in veteran suicide from TBI.

When a sufferer seeks and receives medical help, the chances are it will be treated as psychological rather than physical in origin. Bowman stresses how important records and continuity of monitoring are. He believes artificial intelligence will be a great asset in managing veterans’ medical histories and ensuring they are seen as a continuum, not a series of disjointed episodes.

Larkin says his son became withdrawn and “stopped smiling, as if a mask had been put over his face.” He knew his problem, but he was unable to overcome it, even with a dedicated support system. Before he took his life, Ryan asked that his brain be donated to science.

TBI victims can suffer from frequent headaches, sleeplessness, brain fog and shortened tempers. Drugs, alcohol and homelessness complicate and worsen their predicament.

Larkin says young veterans can find themselves “in a very dark place, suffering invisible wounds.”

Things are getting worse on the battlefield. Drones are an increased source of brain damage. These, Larkin and Bowman point out, are unlike mortars and improvised explosive devices: They explode on the same plane as soldiers’ heads.

Not all the damage takes place on the battlefield. Some of it can be part of routine training, the frequent exposure to everything from a soldier’s weapon to artillery and mortar live-fire practice.

Larkin and Bowman speak of the good work at the Department of Veterans Affairs, but also of the numbing bureaucracy there. Larkin regrets the loss of 30,000 personnel at the VA in recent government trimming.

Nonetheless, the rate of veteran suicide is going up, according to the latest VA report. The overall rate for veterans of all ages, based on data through 2023, was 35.2 deaths per 100,000 people, up from 34.7 deaths per 100,000 in 2022. The suicide rate for civilians of all ages was half the rate.

Suicide among veterans is the 12th-leading cause of death for veterans overall but the leading cause of death for veterans under 45, the VA report found.

As a former homicide detective, Larkin believes these suicides are underreported. He says this is sometimes to protect a family and for other reasons.

All suicides are terrible but particularly when the victims are young and have come to that bleak place because they served.

The ‘New Weather’ Reality Will Change the Nation, Defy Politics

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I have never done political consulting. So it was novel to me when a candidate in the midterms asked me what he should be worried about in 2027. I repeated what Harold Macmillan, British prime minister from 1957 to 1963, is believed to have said, “Events, dear boy, events.”

Actually, I had a little list of crises that I have been gathering and which will come to bear on the political establishment — and we the people. Topping the list is one that is already at hand: the climate, which I call the “new weather.”

We have had weeks of atmospheric disturbance resulting in catastrophic floods, power outages, flight cancellations, oppressive heat and fires. Weather disruptions have been the first or second stories on the networks’ evening newscasts, pushing back the news on the wars in Iran and Ukraine, as well as news from the White House.

Television stations like to tell viewers they have “news you can use.” The new weather is news that will abuse you. It knows where you live and it may call. It has called in Europe and across North America. It is a new reality.

The Southwest is parched and the Colorado River, that life channel, is running dry, severely affecting people in seven states. It also affects the food supply, as much of farming depends on the river’s bounty. Even Mexico receives some of the dwindling Colorado River water supply under a treaty with the United States.

Hundreds of thousands have lost power for hours or days, and others may be choosing between keeping the air conditioning on and spending on other necessities.

Sustained heat of over 110 degrees is a killer, and electricity for air conditioning is a lifesaver. Every year, more than a thousand people die of heat.

The Centers for Disease Control and Prevention reports the number of heat-related deaths nationwide. The worst year was 2023, with 2,325 deaths, as measured by death certificate analysis.

But heat-related fatalities are hard to collect. I would wager that the real death toll is much higher.

Liberal politicians will blame the fossil fuel industries — coal, oil and natural gas — for continuing to drive up greenhouse gas emissions in the atmosphere; conservatives will blame regulation and lack of infrastructure building. Local politicians will attack the data centers and the utilities.

President Trump has called global warming a hoax. But “say it ain’t so” doesn’t work when it is too hot for kids to play outside or streets are rivers, and when the flow of food from farm to supermarket is interrupted.

Huge infrastructure projects will be proposed at a time when there is a growing awareness that the budget deficit is out of control and there is no way America will grow out of it on its present tax trajectory.

If my candidate makes it to Congress, he will find it easier to say no to new expenditures than it is to say yes to new taxes.

Nonetheless, effective pipelines will be proposed to move water from water-rich areas to water-starved states. Some of those, like Texas, drunk on its recent Mecca-like effect on business, will have difficulty accepting that people won’t come if there is no water and inadequate electricity.

Heat, not economics, could curtail the North-to-Southwest flow of people, which has been the population realignment in recent years.

How to live with the new weather will definitely be a new priority that politicians will find difficult to address. It doesn’t fit behind a political slogan. It does favor infrastructure repair and enhancement, from boosting the electric grid to planting water-frugal crops to serious concern about where people live and how they pay their electric bill — a matter of keeping cool and staying alive.

But for the political establishment, other issues are forming, each competing with the weather for attention. For a start, there is integrating artificial intelligence into our economy without severe disruption, dealing with a broken healthcare system, and providing care that is beyond the reach of people facing higher prices for other survival services and products, like electricity and water.

Easier to say your opponent is a rascal, the other party is fascist or communist, and to worry about the use of AI on cellphones in classrooms.

We all have the weather to deal with, Democrat or Republican, and it is still an issue for governance.

How U.S. Natural Gas Came Back from the Dead

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The Trump administration is proud of America’s dominance in natural gas. The nation is the world’s largest producer and a net exporter.

We produce a quarter of the world supply of the fuel, which has become fundamental to electricity production. Forty-three percent of our electricity is generated from natural gas. According to the Energy Information Administration, it is followed by renewables, between 24 percent and 30 percent, depending on the season; nuclear is at just over 18 percent; and coal a little above 16 percent. Hydro, wood, geothermal and oil make up the rest.

The natural gas success represents a confluence of technologies, collaborations, leadership and commercial courage over more than 50 years. It is a remarkable story of the coming together of a resource, the politics that govern it, the technologies that liberated it, and the machines that use it.

I had occasion to reflect on this when visiting the Rayburn Energy Station in Sherman, Texas. The plant represents a significant move into natural gas-fired generation by the Rayburn Electric Cooperative, which is the power supplier to four distribution co-ops northeast of Dallas.

Panda Power Funds LP built the original plant, which began commercial operations in August 2014; Rayburn bought it in 2023.

The original combined-cycle gas plant consists of two Siemens combustion turbines and one steam turbine, producing 758 megawatts of baseload power. Siemens built these turbines at their plant in Charlotte, N.C.

At an adjacent site, Rayburn is building a station that will have 10 peaking “black start capable” turbines, each rated at 57 MW, which Siemens is building in Sweden. Black start refers to the ability of the turbines to start without external power. That way, they can help restart other generators after a power failure.

Taken together, the installations in Sherman represent the virtues of natural gas: a small environmental footprint, speed of construction, security of fuel supply, reliability, and modularity, meaning units can go out of service for maintenance without isolating the generating station.

No one issue or technology can claim credit for today’s natural gas boom. It is the happy confluence of events and technologies that has saved the day for the electric industry.

In 1977, the fledgling Department of Energy declared that natural gas had no future. Jack O’Leary, the first deputy secretary of energy, told The Energy Daily’s Richard Myers to stop asking about natural gas as it was “a depleted resource.”

With the technologies of the day, that was true. However, the picture was also complicated by a regulatory burden, with gas divided into “intrastate gas” and “interstate gas,” and into “old gas” and “new gas.”

It took the actions of three presidents — Jimmy Carter, Ronald Reagan and George W. Bush — to finally untie the regulatory knot.

Likewise, the tech breakthroughs that changed gas from an orphan fuel into coal’s heir took many years.

The oil industry had been experimenting with angled drilling since the 1920s. However, it was horizontal drilling in the 1980s that ushered in a new era in gas extraction with the advent of hydraulic fracturing. This met with new turbine designs that owed much to aircraft jets, and had been pioneered by the Navy for small ship propulsion.

Hydraulic fracking had been tried for years by the oil industry. It took 20 years of trial and error, mostly by the Houston-based Mitchell Energy & Development Corp., to perfect it with development of a better fracking fluid, a new mud pump, and a better drilling bit. Also, 3D seismic enhanced the accuracy of finding gas. The Energy Department worked closely with the developers of these new technologies.

The Rayburn Energy Station is emblematic of what is happening nationwide as utilities face up to rising electricity demand and limited options.

Rayburn President and CEO David Naylor is enthusiastic about the full range of generation options and has embraced distributed generation — which links solar, conservation, demand-side load management, residential batteries and consumer participation to create what is known as a virtual power plant. However, gas was Rayburn’s immediate option, as it is for many utilities.

While Alex O’Brien, the manager of the Rayburn Energy Station, has a penchant for nuclear (he, like many of the plant’s staff, is a veteran of the Nuclear Navy), he understands the immediacy of gas.

Rayburn broke ground on its new peaker turbines this year, and they will be up and running in 2028. In utility terms, that is overnight.

Environmentalists have been critical of natural gas as a greenhouse gas-emitter. In New England, they have blocked pipeline construction. The resulting shortage in the region has been acute, so much so that liquefied natural gas must be imported, at a price, sometimes from Europe.

Until new nuclear power arrives, the utilities are looking to a mix of renewables and natural gas: the fuel that came back from the dead.

Foreign Aid That Works — the Malawi Story

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In 2005, Gordon Brown, British chancellor of the exchequer, later prime  minister, was in Washington, seeking to raise $50 billion annually in  additional international aid for Africa.

I hosted a press event for Brown at the National Press Club, and I  asked him how all this money would get to the people who needed it?

“We’ll give it to the right people,” he said crossly.

I told him I had seen foreign aid stolen, diverted and spent by the agencies that were supposed to deliver it on pet projects and themselves.

But there is another way, and it is working in the small, peaceful and democratic Southern African country of Malawi.

An organization called GiveDirectly has been handing $550 to every  adult — men and women — in villages with no strings attached. It is  estimated that for every $1,000 disbursed, there is an economic impact  of $2,400.

This differs radically from foreign aid that has poured into sub-Saharan Africa since the end of colonial rule. Normally, this is passed on to a local government agency or a non-governmental organization and has been earmarked for a school, a hospital, water supply or famine relief. Often, this has led to bureaucratic delays and high overhead costs.

The aid organizations, mostly from North America and Europe, haven’t  always earned plaudits. I have heard them described as “cheap tourists”  and worse.

Another source of friction has been the tendency of aid workers to  impose their values on recipients — for example, promoting green  technologies or Western dietary preferences.

“We are flipping the traditional aid logic on its head. Rather than  us figuring out what people need and having a kind of one-size-fits-all  approach, we are saying people are the best placed to say what they need and what will be best for their circumstances,” Grace Jackson,  GiveDirectly country director for Malawi, told me and my co-host, Adam  Clayton Powell III, on the television program “White House Chronicle.”

“What we can do is to provide the tools, i.e. cash, so they can go ahead and do what is the most important and most useful to them,” she  added.

Everyone over the age of 18 in a village gets the money delivered via a phone wallet, and if the villager doesn’t have a phone, Jackson said  GiveDirectly provides one.

They also make sure there is a viable local financial entity with enough money on hand to pay out as villagers require it.

I believe this approach works well because of the nature of  subsistence life in rural Africa, typified by village life in Malawi. It is wrong to think of poverty in the African countryside, and it is  extreme, the way we think of urban poverty in America.

Rural people in Malawi — and a majority of its 22 million people are rural — simply have nothing. I repeat, nothing. They have few clothes, no shoes and no food security.

They survive by subsistence farming, mostly growing corn, which, with an occasional protein, is their diet. They have to eat all year on what they grow.

Yet families hold together as do the villages. Often, grown children live with their parents and help with the farming, generally done with simple hand tools. In the nothingness there is order.

The Malawi experiment is working, lifting whole villages above the international poverty line. Jackson, who is English, said the money was used in various ways. People bought more land, got medical attention, paid school fees or pooled the money for big things like electrification.

Recently, the program has received a $150 million boost from the Canva Foundation, the charity established by billionaires Melanie Perkins and Cliff Obrecht, co-founders of Canva, a popular graphic design tool.

GiveDirectly was created by MIT and Harvard students as a giving circle, based on their studies of the efficacy of charity programs. It was formalized in 2012. The organization hasn’t just helped the needy overseas, it has also handed out aid in the form of debit cards to U.S. disaster survivors.

The idea of letting the recipients of the aid decide how to spend it  may appeal to conservatives and incline them more favorably toward  foreign aid, especially if it is entirely derived from the private  sector.

By the way, Gordon Brown’s grand scheme never got off the ground.

Is Rubio Starting a Nuclear Arms Race in the Middle East?

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The Trump administration has announced and appears to be crowing over an agreement with Saudi Arabia to help the kingdom not only to build nuclear power plants but also to enrich the uranium fuel.

There is no reason for the Saudis to enrich uranium. There are plenty of willing suppliers of enriched uranium and more are coming online.

Besides, it has always seemed curious that Saudi Arabia, with its huge fossil reserves and its abundant, reliable sunshine, should want to stress its industrial infrastructure with a nuclear power program when it clearly doesn’t need it. We are at war with Iran not because of nuclear power, but because it refuses to abandon its enrichment ambitions.

Enrichment raises the potency of uranium fuel by increasing the amount of the fissile isotope Uranium-235.

Today’s generation of light water reactors — the workhorses that provide about 20 percent of U.S. electricity — use uranium that has been enriched by 3 percent to 5 percent. The uranium for the new small modular reactors will be enriched by about 20 percent.

Weapons-grade enrichment is generally considered to be uranium that has been enriched by over 90 percent. But Ernie Moniz, who was secretary of energy in the Biden administration and is a nuclear physicist, told a conference organized by the Earthshot Foundation on June 8 that “you can make a pretty good bomb” with 60 percent- enriched uranium, a reference to the Iranian stockpile that we are trying to destroy.

I have been covering nuclear power — and by extension nuclear proliferation — for more than 50 years. For most of that time, Saudi Arabia has hankered for nuclear power and enrichment. The question is why.

When I began my coverage, there was great fear of nuclear proliferation — that more countries would get nuclear weapons. Those who have, in that time, are Pakistan and North Korea. China acquired a weapon in 1964.

Israel has never declared itself nuclear-armed, but the arms control community believes it has a weapon and that the United States helped it get one years ago.

The original nuclear weapons nations, the United States, Russia, Britain and France, held the technology close and were loath to see any country step in that direction.

Making civilian nuclear power available to the world has been a plank of U.S. foreign policy since President Dwight Eisenhower launched the “Atoms for Peace” program in 1953.

One of the beneficiaries of that program was Iran. In fact, before the Iranian Revolution of 1979, American companies, led by Bechtel, the giant engineering firm, were set to build reactors across Iran.

America’s global nuclear policy was, de facto, nuclear civilian power, yes, nuclear enrichment, no. It was pretty sensible and has worked well. Now it is set aside.

The U.S.-Saudi Arabia deal comes at a time when many nations would like to start down the weapons path. The wars in Ukraine and Iran are a stark inducement to go nuclear.

If Ukraine hadn’t given up its nuclear weapons, would Russia have invaded? Almost certainly not. If Iran had a proven bomb, would Israel and the United States have attacked? I think not.

Nonetheless, every nuclear weapon is a threat to world security. The danger isn’t only that desperate or ambitious countries will use them aggressively, but also that the danger of accidental detonation is ever-present.

The United States and the Soviet Union were so concerned about this that they shared safety technology. For example, when we developed an insensitive TNT for the trigger of a nuclear device, we shared this with the Russians. Neither side wanted a thermonuclear war triggered by someone dropping a weapon off a forklift.

Secretary of State Marco Rubio would seem to be so busy that he hasn’t had time to read up on the history of proliferation.

Rubio, declared about the U.S.-Saudi Arabia deal, “Suffice it to say that any agreement that we are going to make with any country in the world on civil nuclear is going to be one that will have safeguards in place to ensure that it can’t be turned into a weapons program.”

Rubio might want to take a few minutes to ponder these three things: How it is that we came to be at war with Iran, how Iran started with civilian power and went on to weapons, and how safeguards were bypassed.

Saudi Arabia’s neighbors in that volatile region will soon be at Rubio’s door looking for nuclear power — and enrichment. First up, expect Turkey, then Egypt.

If Congress approves Rubio’s deal, then a nuclear arms race in the Middle East is more or less assured. Is there a worse place to have that happen?

Soft Power, the Secret Sauce of the British Empire

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When President Trump, on the first day of his second term, closed the U.S. Agency for International Development and began dismantling the Voice of America, he also severely curtailed what had been America’s soft power dominance in the world.

With those actions, we abandoned something of inestimable value: the ability to project Americanism, our ideals. Trump retired an entire diplomatic system that had served the United States well since we more or less inherited it from the British.

Soft power was codified as a concept by the late Harvard professor Joseph S. Nye, Jr. in four books published between 1990 and 2023.

While Nye made soft power his own — he coined the term in 1990 — and wrote, lectured and testified before Congress about it, he never totally convinced conservatives what a valuable weapon it was in the national armory.

The proof of that is in the current administration’s indifference to diplomatic and social muscle, and its lack of a mechanism to talk to the Iranian people in Farsi, their language.

Nye believed an important part of soft power was our educational system, and U.S.-educated foreign students going home and spreading the good news about America.

I believe, although it was never thought of that way, that soft power was one of the things that kept the British Empire together. I saw it in action in Africa as colonial rule waned.

James R. Schlesinger, who served as chairman of the Atomic Energy Commission, director of the CIA, secretary of defense, and secretary of energy, was a friend of mine throughout his public career and afterward. The one question he asked me constantly was how the British Empire was able to hold together with so few troops spread across so much of the world.

Schlesinger, a former history professor, wondered how those lessons might be applied to America in the late 20th century.

I told him that it was a combination of the hard power of the Royal Navy and British Army but also, importantly, of the then-unnamed soft power.

Take the massacre in Amritsar, in the northwestern Indian state of Punjab. This occurred on April 13, 1919, when a local British commander in the Punjab feared a meeting in a garden might turn violent and opened fire without warning on thousands of unarmed civilians. Official figures reported 379 dead and 1,200 injured; Indian estimates exceed 1,000 deaths.

This massacre hardened Mahatma Gandhi’s attitude to British rule over the subcontinent. His initial reaction, on hearing of the slaughter, was disbelief that the British would do such a thing. He had bought the soft-power assertion of British values, of decency.

Winston Churchill, then serving as the minister of war, told Parliament early the next year that the shooting was “unalterably monstrous.”

I tried to explain to Schlesinger over many evenings, over many years, what I had seen growing up in British Africa as the essence of British soft power.

To me, it boiled down to a kind of moral posture, a determination to project British justice as inviolate, British exceptionalism as a moral force, and a general admirable state of decency. The term soft power hadn’t yet been created, but it was the essential ingredient in British colonial administration.

When American commanders sought the “hearts and minds” of the Vietnamese, they might well have said they were seeking to establish “soft power.” But it was too late.

The concept of soft power and how it blossomed for America has wilted under the Trump administration. The posture now is that economic and military power are how we project influence and authority.

Ironically, while I think Nye did something of great value in identifying and promoting the concept of soft power, he and I didn’t enjoy a warm relationship. He had been President Jimmy Carter’s point man for nuclear disarmament and had favored an end to nuclear reprocessing as well as other aspects of the U.S. nuclear ecosystem.

In 1977, we debated in London, and the argument got so intense that we spilled into the street, shouting at each other.

A British Immigrant’s Defense of Immigration

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Migration, people moving to new lands, is as old as human history, and as fraught. Today it is a global problem complete with layered hypocrisy, cruelty and, always, hope among those on the move. War and extreme poverty collude in driving people to seek a livable future.

There is no simple solution, no slogan that encompasses a fair and reasonable course of action for the receiving country.

I moved from a British African colony, Southern Rhodesia, to the homeland, Britain, when that was our birthright, and to America a few years later. I did that because it was the place I wanted to be, the happening place, the place of all possibility and challenge.

I didn’t plan to stay, and now it is more than 60 years later. And, yes, I was elated to become a citizen.

In those days, if you were British, immigration was no harder than filling in some forms and swearing that you weren’t a communist and wouldn’t live in “moral turpitude” when you got to America. That reprehensible state wasn’t described.

To me, America was more than a country; it was, and remains, a state of mind.

At its best, America is generous, caring, open and empathetic to the world and its hurts. Yet, how human a country! It is replete with hideous mistakes from the Palmer Raids, to McCarthyism and the Red Scare, to the Vietnam War. The gash of slavery hasn’t healed, and racism has left its mark.

America’s genius is that it realizes itself as a work in progress. 

Our major weakness, it always seemed to me, was the obverse of our strength: wishing our ways on others; wanting them to see the light we see. 

Like so many others, my attitudes are conflicted, hypocritical and without a simple, elegant defense. About 30 years ago, I first raised the issue of immigration’s effect on the nation. My concern then was that Spanish was becoming a second language. If that were to happen, I feared the country would enter into the same debilitating, two-nation status that has divided Canada and Belgium.

Also, I have argued against the way immigration has left its mark on Europe, especially from North African migrants who have set up enclaves where there is no attempt to integrate and where their religion has maintained them in isolation; angry minorities in their urban strongholds. That undermines the value of the journey both to the migrant and the host country.

I have come to believe that Spanish isn’t the threat it appeared at that time, and that our ability to absorb and prosper as a result of immigration is at a real and present danger of being wasted, denying us the talent flow that has made us a beacon to the world.

Never forget that every deportation is a human disaster: a life and a family sent into an unknown purgatory.

Recently, I had a weeklong stay at a Rhode Island hospital and marveled at doctors who were from distant lands, including Iran and Arab countries. In the late reaches of one night, I had a crisis. My room was flooded with nurses and their assistants, all helping and caring. From their accents, I was certain that at least four of my angels weren’t born here. I was glad of them.

Just as I am glad that we lead the world in high tech and, at the apex of its leadership, sit immigrants. They dominate at the top tech behemoths.

Not every immigrant has added to America’s greatness; some have brought with them creeds that are hard to accommodate, some have brought crime. Overall, each wave of immigrants has lifted America and its people to new heights.

From those early settlers to the German filmmakers, to the Scandinavians who planted the Great Plains, to the Irish who have informed our culture, to the Italian builders, to the German filmmakers, who came in the 1920s and 1930s and created the Hollywood we know and treasure, to the Jewish refugees from Europe who gave us everything from great music to the magic of Broadway, to high science and lifesaving medical research.

When I first arrived in New York, I wrote to a friend, “This is an extraordinary place, less of a mixing bowl and more of a stew, where all of the ingredients remain intact and yet work together in a kind of wondrous unity.” I wouldn’t withdraw or amend a word of that more than 60 years later.

People move because they aspire to a better life for themselves and their families. Grabbing those who slipped in and sending them to all they sought to leave behind is, to this grateful immigrant, un-American.

We are a big country, big-hearted, too, and we have room for these big contributors to our future.

The Birth of a New Reactor: Thorium Past and Present

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If you are designing a car from scratch, there are certain essentials to begin with. You need to start with the wheels on the corners, for example.

But when it comes to building a nuclear reactor, things are different. There are hundreds and maybe thousands of ways of doing it. The constant is that you need fissionable fuel and a moderator to collect the heat and manage the neutron flux.

That embarrassment of choice — now reflected in the number of small modular reactors (SMRs) vying for market acceptance — may be why thorium reactors, which began with promise, have been left on the shelf.

The nuclear establishment, goaded by the Nuclear Navy’s Adm. Hyman Rickover, wanted light water technology. That is what the first 100-plus U.S. civilian reactors employed.

At the dawn of the civilian nuclear age, it was a straight contest between two fuels: uranium and thorium. Thorium is fertile but not fissile: It can’t start a chain reaction unless it is triggered by a small amount of the isotope uranium-235.

Once this happens, thorium becomes uranium-232 and fizzes wonderfully with a steady stream of neutrons, producing heat in the moderator, which is where the first steps in making electricity are taken.

That heat is captured to create steam that turns a turbine.

Thorium was used in part in the first power-producing, commercial nuclear reactor: the 60-megawatt Shippingport Atomic Power Station in Beaver County, Pennsylvania. With three different fuel assemblies, it ran for 25 years, starting in 1957. It used solid fuel, which was to become the standard for civilian nuclear power.

Meanwhile, at the Oak Ridge National Laboratory in Tennessee, under its director, physicist Alvin Weinberg, work went ahead on what would become a legendary fast-breeder thorium reactor, using a liquid fuel embedded in molten salt. It went critical in 1965 and operated for five years before it was closed by the Atomic Energy Commission (forerunner of the Department of Energy) in a political move.

A fast reactor uses extra neutrons to create new fuel and burn up radioactive waste. The process is akin to perpetual motion — but isn’t, of course.

Now a charismatic nuclear engineer, Yash Patel, founder and CEO of AMReactor, is planning to bring thorium back as a viable future option for space exploration, power generation and, eventually, ship propulsion.

Patel told me that his reactors – he has designs for a microreactor (under 20 MW) and for a SMR (250 MW). The planned reactors are molten salt-moderated, thorium-fueled fast reactors.

He believes they will not only be cheaper, but will also operate better than the SMRs now entering the market.

Patel’s plan for Austin-registered AMReactor is to outsource as much of the fabrication as possible.

A fast reactor is called a breeder reactor because it generates more neutrons than are needed to produce fission, and these transmute waste into additional fuel.

Patel went to school in California and while looking for a career, a break came that changed the trajectory of his life. He got an internship with NASA at the Jet Propulsion Laboratory. There he worked on Curiosity, the plutonium-fueled Mars rover. His nuclear love affair, he told me, was “complete and instant.”

From NASA, he went to Texas A&M and graduated in nuclear engineering. He was well along with his PhD, when a family illness caused him to abandon it.

Patel lists two great blessings in his life. “The first was that I moved to America from India. The second was attending Texas A&M. That was another wonderful break.”

After a stint in biopharma, where he prospered, Patel started designing reactors in all his waking hours along with a friend, D’mitri Scott, now the chief technology officer at AMReactor.

Patel said the numbers didn’t work for their plans until they switched to thorium. It was a eureka moment.

There followed a period which he likened to Bill Gates and Steve Wozniak working on the first computer operating system. The two young men were obsessed and inspired by what they believed was extraordinary. “Our girlfriends, now our wives, saw very little of us. We sometimes worked all night,” Patel said.

With thorium, they found all they were looking for: a stable source of reliable power that was safe, couldn’t melt down, and was able to handle most of the fission products.

And it was proliferation-proof because of the presence of intense gamma radiation, which made it hard to process, steal or divert. “Thorium was the winner,” he said.

A new reactor is on the way.