Fee-for-service payments encourage high-volume services rather than high-quality care. Alternative payment models (APMs) aim to realign financing to support high-value services.

The 2 main components of gastroenterologic care, procedures and chronic care management, call for a range of APMs. The first step for gastroenterologists is to identify the most important conditions and opportunities to improve care and reduce waste that do not require financial support.

We describe examples of delivery reforms and emerging APMs to accomplish these care improvements. A bundled payment for an episode of care, in which a provider is given a lump sum payment to cover the cost of services provided during the defined episode, can support better care for a discrete procedure such as a colonoscopy. Improved management of chronic conditions can be supported through a per-member, per-month (PMPM) payment to offer extended services and care coordination.

For complex chronic conditions such as inflammatory bowel disease, in which the gastroenterologist is the principal care coordinator, the PMPM payment could be given to a gastroenterology medical home. For conditions in which the gastroenterologist acts primarily as a consultant for primary care, such as noncomplex gastroesophageal reflux or hepatitis C, a PMPM payment can support effective care coordination in a medical neighborhood delivery model. Each APM can be supplemented with a shared savings component.

Gastroenterologists must engage with and be early leaders of these redesign discussions to be prepared for a time when APMs may be more prevalent and no longer voluntary.

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The GOP presidential candidate said he would ban immigrants from sending money home to Mexico.

Donald Trump’s proposal to force Mexico to pay for a Wall guarding against the flux of immigrants into the U.S. made news this week, and rightfully so. Trump’s idea would be to curtail the ability of banks, credit unions, and wire transmission companies to send money abroad — a sharp departure from policy and law whose bipartisan aim has been to bring remittances to all countries into the financial mainstream and out from the shadowy illegal word of people moving cash in suitcases.

Encouraging remittances to go through the financial system benefits everyone: it enhances the ability to combat terrorist finance and money-laundering, it reduces crime in both the U.S. and abroad, it increases economic growth in the U.S. and overseas, and it provides for greater competition and market incentives to allow people to keep more of their hard-earned money to use as they see fit. Moving in the opposite direction would be a major mistake.

This is a big issue that affects a lot more people than one might think – more than just sending money to Mexico. In America today, more than 40 million people were born in other countries, a record number. This translates into just more than 1 in 8 Americans, a sharp increase from 1970 when fewer than 1 in 25 Americans were foreign born. Thus, it is not surprising that many people perceive America to have more foreign-born people than any time in their lifetime. However, that is not the case for the lifetime of America. Between the Civil War and the 1920s, America had as high — or higher — share of foreign born as we do today.

Remittances are not a new phenomenon. Most American families likely sent remittances at some point whenever their family first immigrated. My great-grand father sent money back to what is today the Czech Republic so that his wife and their children (including my grandmother) could come and join him and escape what became the Second World War. Today, remittance flows go toward the new generation of American immigrants and the children of those immigrants. More than $120 billion was sent abroad in 2012 according to the Pew Center and while it is true that Mexico received the largest amount at just under $23 billion, the rest of the top 5 countries may surprise you: China ($13 billion), India ($12 billion), Philippines ($10.5 billion), and Nigeria ($6 billion). And old habits remain as Germany ($2.5 billion) and France ($2 billion) are still among the top 15 countries that receive remittances from the United States.

This money comes in lots of small chunks, which can make sending it expensive. The typical new migrant worker sends money home around 14 times a year, which corresponds to once a month plus Mother’s Day and Christmas. These are usually small sums (less than $300) and represent an extraordinary level of savings given the worker’s income. The money goes through both the formal banking system including banks, credit unions, and wire transmitters who eventually use banks like Western Union and MoneyGram. Some goes through informal means, including “viajeros” who are people that literally carry cash in suitcases on planes that are often breaking the law and outside of the standard anti-money laundering and terrorist finance enforcement system. Why would anyone want to encourage that?

The idea of using this flow of funds to try to implement other policy objectives, such as border control, would be a sharp departure from current practice. The Patriot Act and subsequent federal law governing remittances in financial laws like the Dodd-Frank Act were never intended to be used to threaten to cut off the flow of migrant worker remittances. These laws were intended to track and crack down on the flow of money laundering or support for illegal and terrorist organizations while at the same time providing consumer protections to workers who are sending hard-earned cash back home to their parents, grandparents, and children. In fact, the bipartisan goal of policy concerning remittances has been to encourage the flow of money to come into the official system and to discourage the flow of funds through the underground network.

In 2004, then Federal Reserve Governor Ben Bernanke made clear that, “The Federal Reserve is attempting to support banks’ efforts to better serve immigrant populations, with remittances and other money transfers being a key area of interest.” House Financial Services Chairman Mike Oxley (R-OH) told President Bush’s then-Treasury Secretary John Snow, “Remittances between established and emerging economies foster growth in both types of economies simultaneously. I will be interested in hearing your views on how unnecessary costs can be eliminated in this area.” When Senator Paul S. Sarbanes (D-MD) introduced legislation that became the basis for today’s law that covers remittances, he had the simple goal to “increase transparency, competition and efficiency in the remittance market, while helping to bring more Americans into the financial mainstream.”

The longstanding bipartisan support for bringing remittances into the financial mainstream is based on the fact that most immigrants, regardless of whether they are U.S. citizens, legal residents, or undocumented, send remittances. A system that tried to assert proof of citizenship or legal status upon wiring money overseas would be burdensome, costly, and ineffective at best and if effective, it would simply drive more money into illegal transmission schemes while increasing crime here in the U.S. and abroad. Imagine if an entire community knew that someone would be walking through their immigrant neighborhood with a suitcase full of tens of thousands of dollars in cash.

Thought of another way, if I went to the bank to send money to my mother who lives in France part of the year, how would I prove that I’m a citizen? My driver’s license alone is not proof of legal status. Would I need to bring my passport? What if, like the majority of Americans, (62% according to the State Department) I don’t have a valid passport? Would I have to bring my birth certificate to the local Western Union? I guess the one positive thing from such a system is that it would help stop the email scams asking for money from a Nigerian Prince….

Aaron Klein is a fellow at the Brookings Institution and served as Deputy Assistant Secretary of the US Treasury Department from 2009 to 2012. He also serves as an unpaid member of the Clinton campaign’s Infrastructure Finance Working Group; he has not served as an advisor on any banking or finance issues.

Editor’s note: This piece originally appeared on Fortune.

Like many Brits, I’m reeling. Everyone knew that the "Brexit" referendum was going to be close. But deep down I think many of us assumed that the vote would be to remain in the European Union. David Cameron had no realistic choice but to announce that he will step down.

Mr. Cameron’s fall can be traced back to a promise he made in the 2010 election to cap the annual flow of migrants into the U.K. at less than 100,000, "no ifs, no buts."Membership in the EU means free movement of labor, so this was an impossible goal to reach through direct policy. I served in the coalition government that emerged from the 2010 election, and this uncomfortable fact was clear from the outset. I don’t share the contents of briefings and meetings from my time in government (I think it makes good government harder if everyone is taking notes for memoirs), but my counterpart in the government, Mr. Cameron’s head of strategy, Steve Hilton, went public in the Daily Mail just before this week’s vote.

Steve recalled senior civil servants telling us bluntly that the pledged target could not be reached. He rightly fulminated about the fact that this meant we were turning away much more skilled and desirable potential immigrants from non-EU countries in a bid to bring down the overall number. What he didn’t say is that the target, based on an arbitrary figure, was a foolish pledge in the first place.

Mr. Cameron was unable to deliver on his campaign pledge, and immigration to the U.K. has been running at about three times that level. This fueled anger at the establishment for again breaking a promise, as well as anger at the EU. In an attempt to contain his anti-European right wing, Mr. Cameron made another rash promise: to hold a referendum.

The rest, as they say, is history. And now, so is he.

Immigration played a role in the Brexit campaign, though it seems that voters may not have made a clear distinction between EU and non-EU inward movement. Still, Thursday’s vote was, at heart, a plebiscite on what it means to British. Our national identity has always been of a quieter kind than, say the American one. Attempts by politicians to institute the equivalent of a Flag Day or July Fourth, to teach citizenship in schools, or to animate a “British Dream” have generally been laughed out of court. Being British is an understated national identity. Indeed, understatement is a key part of that identity.

Many Scots, Welsh and Northern Irish feel a much stronger affinity to their home nation within the U.K. than they do to Great Britain. Many Londoners look at the rest of England and wonder how they are in the same political community. These splits were obvious Thursday.

Identity politics has tended in recent years to be of the progressive kind, advancing the cause of ethnic minorities, lesbians and gays, and so on. In both the U.K. and the U.S. a strongly reactionary form of identity politics is gaining strength, in part as a reaction to the cosmopolitan, liberal, and multicultural forms that have been dominant. This is identity politics of a negative kind, defined not by what you are for but what you are against. A narrow majority of my fellow Brits just decided that at the very least, being British means not being European. It was a defensive, narrow, backward-looking attempt to reclaim something that many felt had been lost. But the real losses are yet to come.

Editor's Note: This piece originally appeared in the Wall Street Journal's Washington Wire.

SUMMARY

Replacing inefficient kerosene lighting with electric lighting or other clean alternatives can rapidly achieve development and energy access goals, save money and reduce climate warming. Many of the 250 million households that lack reliable access to electricity rely on inefficient and dangerous simple wick lamps and other kerosene-fueled light sources, using 4 to 25 billion liters of kerosene annually to meet basic lighting needs. Kerosene costs can be a significant household expense and subsidies are expensive. New information on kerosene lamp emissions reveals that their climate impacts are substantial. Eliminating current annual black carbon emissions would provide a climate benefit equivalent to 5 gigatons of carbon dioxide reductions over the next 20 years. Robust and low-cost technologies for supplanting simple wick and other kerosene-fueled lamps exist and are easily distributed and scalable. Improving household lighting offers a low-cost opportunity to improve development, cool the climate and reduce costs.

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INTRODUCTION

In August, 2010 the government of Kenya adopted a new constitution. This followed a referendum in which an overwhelming majority of Kenyans voted for change. The decisive impetus for reform came from the widespread violence and political crisis that followed the 2007 election. While claims of electoral fraud provided the immediate catalyst for violence, the deeper causes were to be found in the interaction of a highly centralized ‘winner-take-all’ political system with deep social disparities based in part on group identity (Hanson 2008).

Provisions for equity figure prominently in the new constitution. Backed by a bill of rights that opens the door to legal enforcement, citizenship rights have been strengthened in many areas,including access to basic services. ‘Equitable sharing’ has been introduced as a guiding principle for public spending. National and devolved governments are now constitutionally required to redress social disparities, target disadvantaged areas and provide affirmative action for marginalized groups.

Translating these provisions into tangible outcomes will not be straightforward. Equity is a principle that would be readily endorsed by most policymakers in Kenya and Kenya’s citizens have provided their own endorsement through the referendum. However, there is an ongoing debate over what the commitment to equity means in practice, as well as over the pace and direction of reform. Much of that debate has centered on the constitutional injunction requiring ‘equitable sharing’ in public spending.

On most measures of human development, Kenya registers average outcomes considerably above those for sub-Saharan Africa as a region. Yet the national average masks extreme disparities—and the benefits of increased prosperity have been unequally shared.

There are compelling grounds for a strengthened focus on equity in Kenya. In recent years, the country has maintained a respectable, if less than spectacular, record on economic growth. Social indicators are also on an upward trend. On most measures of human development, Kenya registers average outcomes considerably above those for sub-Saharan Africa as a region. Yet the national average masks extreme disparities—and the benefits of increased prosperity have been unequally shared. Some regions and social groups face levels of deprivation that rank alongside the worst in Africa. Moreover, the deep fault lines running through society are widely perceived as a source of injustice and potential political instability.

High levels of inequality in Kenya raise wider concerns. There has been a tendency in domestic debates to see ‘equitable sharing’ as a guiding principle for social justice, rather than as a condition for accelerated growth and enhanced economic efficiency. Yet international evidence strongly suggests that extreme inequality—especially in opportunities for education— is profoundly damaging for economic growth. It follows that redistributive public spending has the potential to support growth.

The current paper focuses on a group of 12 counties located in Kenya’s Arid and Semi-Arid Lands (ASALs). They are among the most disadvantaged in the country. Most are characterized by high levels of income poverty, chronic food insecurity and acute deprivation across a wide range of social indicators.

Nowhere is the deprivation starker than in education. The ASAL counties account for a disproportionately large share of Kenya’s out-of-school children, pointing to problems in access and school retention. Gender disparities in education are among the widest in the country. Learning outcomes for the small number of children who get through primary school are for the most part abysmal, even by the generally low national average standards.

Unequal public spending patterns have played no small part in creating the disparities that separate the ASAL counties from the rest of Kenya—and ‘equitable sharing’ could play a role in closing the gap. But what would a more equitable approach to public spending look like in practice?

This paper addresses that question. It looks in some detail at education for two reasons. First, good quality education is itself a powerful motor of enhanced equity. It has the potential to equip children and youth with the skills and competencies that they need to break out of cycles of poverty and to participate more fully in national prosperity. If Kenya is to embark on a more equitable pattern of development, there are strong grounds for prioritizing the creation of more equal opportunities in education. Second, the education sector illustrates many of the wider challenges and debates that Kenya’s policymakers will have to address as they seek to translate constitutional provisions into public spending strategies. In particular, it highlights the importance of weighting for indicators that reflect need in designing formulae for budget allocations.

Our broad conclusion is that, while Kenya clearly needs to avoid public spending reforms that jeopardize service delivery in wealthier counties, redistributive measures are justified on the grounds of efficiency and equity.

The paper is organized as follows. Part 1 provides an overview of the approach to equity enshrined in the constitution. While the spirit of the constitution is unequivocal, the letter is open to a vast array of interpretations. We briefly explore the implications of a range of approaches. Our broad conclusion is that, while Kenya clearly needs to avoid public spending reforms that jeopardize service delivery in wealthier counties, redistributive measures are justified on the grounds of efficiency and equity. Although this paper focuses principally on basic services, we caution against approaches that treat equity as a matter of social sector financing to the exclusion of growth-oriented productive investment.

Part 2 provides an analysis of some key indicators on poverty, health and nutrition. Drawing on household expenditure data, the report locates the 12 ASAL counties in the national league table for the incidence and depth of poverty. Data on health outcomes and access to basic services provide another indicator of the state of human development. While there are some marked variations across counties and indicators, most of the 12 counties register levels of deprivation in poverty and basic health far in excess of those found in other areas.

Part 3 shifts the focus to education. Over the past decade, Kenya has made considerable progress in improving access to basic education. Enrollment rates in primary education have increased sharply since the elimination of school fees in 2003. Transition rates to secondary school are also rising. The record on learning achievement is less impressive. While Kenya lacks a comprehensive national learning assessment, survey evidence points to systemic problems in education quality. In both access and learning, children in the ASAL counties—especially female children—are at a considerable disadvantage. After setting out the national picture, the paper explores the distinctive problems facing these counties.

In Part 4 we look beyond Kenya to wider international experience. Many countries have grappled with the challenge of reducing disparities between less-favored and more-favored regions. There are no blueprints on offer. However, there are some useful lessons and guidelines that may be of some relevance to the policy debate in Kenya. The experience of South Africa may be particularly instructive given the weight attached to equity in the post-apartheid constitution.

Part 5 of the paper explores a range of approaches to financial allocations. Converting constitutional principle into operational practice will require the development of formulae-based approaches. From an equitable financing perspective there is no perfect model. Any formula that is adopted will involve trade-offs between different goals. Policymakers have to determine what weight to attach to different dimensions of equity (for example, gender, income, education and health), the time frame for achieving stated policy goals, and whether to frame targets in terms of outcomes or inputs. These questions go beyond devolved financing. The Kenyan constitution is unequivocal in stipulating that the ‘equitable sharing’ provision applies to all public spending. We therefore undertake a series of formula-based exercises illustrating the allocation patterns that would emerge under different formulae, with specific reference to the 12 ASAL focus counties and to education.

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Like many Brits, I’m reeling. Everyone knew that the "Brexit" referendum was going to be close. But deep down I think many of us assumed that the vote would be to remain in the European Union. David Cameron had no realistic choice but to announce that he will step down.

Mr. Cameron’s fall can be traced back to a promise he made in the 2010 election to cap the annual flow of migrants into the U.K. at less than 100,000, "no ifs, no buts."Membership in the EU means free movement of labor, so this was an impossible goal to reach through direct policy. I served in the coalition government that emerged from the 2010 election, and this uncomfortable fact was clear from the outset. I don’t share the contents of briefings and meetings from my time in government (I think it makes good government harder if everyone is taking notes for memoirs), but my counterpart in the government, Mr. Cameron’s head of strategy, Steve Hilton, went public in the Daily Mail just before this week’s vote.

Steve recalled senior civil servants telling us bluntly that the pledged target could not be reached. He rightly fulminated about the fact that this meant we were turning away much more skilled and desirable potential immigrants from non-EU countries in a bid to bring down the overall number. What he didn’t say is that the target, based on an arbitrary figure, was a foolish pledge in the first place.

Mr. Cameron was unable to deliver on his campaign pledge, and immigration to the U.K. has been running at about three times that level. This fueled anger at the establishment for again breaking a promise, as well as anger at the EU. In an attempt to contain his anti-European right wing, Mr. Cameron made another rash promise: to hold a referendum.

The rest, as they say, is history. And now, so is he.

Immigration played a role in the Brexit campaign, though it seems that voters may not have made a clear distinction between EU and non-EU inward movement. Still, Thursday’s vote was, at heart, a plebiscite on what it means to British. Our national identity has always been of a quieter kind than, say the American one. Attempts by politicians to institute the equivalent of a Flag Day or July Fourth, to teach citizenship in schools, or to animate a “British Dream” have generally been laughed out of court. Being British is an understated national identity. Indeed, understatement is a key part of that identity.

Many Scots, Welsh and Northern Irish feel a much stronger affinity to their home nation within the U.K. than they do to Great Britain. Many Londoners look at the rest of England and wonder how they are in the same political community. These splits were obvious Thursday.

Identity politics has tended in recent years to be of the progressive kind, advancing the cause of ethnic minorities, lesbians and gays, and so on. In both the U.K. and the U.S. a strongly reactionary form of identity politics is gaining strength, in part as a reaction to the cosmopolitan, liberal, and multicultural forms that have been dominant. This is identity politics of a negative kind, defined not by what you are for but what you are against. A narrow majority of my fellow Brits just decided that at the very least, being British means not being European. It was a defensive, narrow, backward-looking attempt to reclaim something that many felt had been lost. But the real losses are yet to come.

Editor's Note: This piece originally appeared in the Wall Street Journal's Washington Wire.

First it was the Europeans who sought an escape from the tragic realities of power that had bloodied their 20th century. At the end of the Cold War, they began to disarm themselves in the hopeful belief that arms and traditional measures of power no longer mattered. A new international system of laws and institutions would replace the old system of power; the world would model itself on the European Union—and if not, the U.S. would still be there to provide security the old-fashioned way.

But now, in the wake of the wars in Iraq and Afghanistan, it is the U.S. that seems to be yearning for an escape from the burdens of power and a reprieve from the tragic realities of human existence.

Until recent events at least, a majority of Americans (and of the American political and intellectual classes) seem to have come close to concluding not only that war is horrible but also that it is ineffective in our modern, globalized world. "There is an evolving international order with new global norms making war and conquest increasingly rare," wrote Fareed Zakaria of CNN, borrowing from Steven Pinker of Harvard, practically on the eve of Russia's invasion of Ukraine and the Islamic State's march across Syria and Iraq. Best-selling histories of World War I teach that nations don't willingly go to war but only "sleepwalk" into them due to tragic miscalculations or downright silliness.

For a quarter-century, Americans have been told that at the end of history lies boredom rather than great conflict, that nations with McDonald's never fight one another, that economic interdependence and nuclear weapons make war among great powers unlikely if not impossible. Recently added to these nostrums has been the mantra of futility. "There is no military solution" is the constant refrain of Western statesmen regarding conflicts from Syria to Ukraine; indeed, military action only makes problems worse. Power itself isn't even what it used to be, argued the columnist Moisés Naím in a widely praised recent book.

History has a way of answering such claims. The desire to escape from power is certainly not new; it has been the constant aspiration of Enlightenment liberalism for more than two centuries.

The impossibility of war was conventional wisdom in the years before World War I, and it became conventional wisdom again—at least in Britain and the U.S.—practically the day after the war ended. Then as now, Americans and Britons solipsistically believed that everyone shared their disillusionment with war. They imagined that because war was horrible and irrational, as the Great War had surely demonstrated, no sane people would choose it.

What happened next, as the peaceful 1920s descended into the violent and savage 1930s, may be instructive for our own time. Back then, the desire to avoid war—combined with the surety that no nation could rationally seek it—led logically and naturally to policies of appeasement.

The countries threatening aggression, after all, had grievances, as most countries almost always do. They were "have-not" powers in a world dominated by the rich and powerful Anglo-Saxon nations, and they demanded a fairer distribution of the goods. In the case of Germany, resentment over the Versailles peace settlement smoldered because territories and populations once under Germany's control had been taken away to provide security for Germany's neighbors. In the case of Japan, the island power with the overflowing population needed control of the Asian mainland to survive and prosper in competition with the other great powers.

So the liberal powers tried to reason with them, to understand and even accept their grievances and seek to assuage them, even if this meant sacrificing others—the Chinese and the Czechs, for instance—to their rule. It seemed a reasonable price, unfortunate though it might be, to avoid another catastrophic war. This was the realism of the 1930s.

Eventually, however, the liberal powers discovered that the grievances of the "have-not" powers went beyond what even the most generous and conflict-averse could satisfy. The most fundamental grievance, it turned out, was that of being forced to live in a world shaped by others—to be German or Japanese in a world dominated by Anglo-Saxons.

To satisfy this grievance would require more than marginal territorial or economic adjustments or even the sacrifice of a small and weak state here or there. It would require allowing the "have-not" powers to reshape the international political and economic order to suit their needs. More than that, it would require letting those powers become strong enough to dictate the terms of international order—for how else could they emerge from their unjust oppression?

Finally, it became clear that more was going on than rational demands for justice, at least as the Enlightenment mind understood the term. It turned out that the aggressors' policies were the product not only of material grievances but of desires that transcended mere materialism and rationality.

Their leaders, and to a great extent their publics, rejected liberal notions of progress and reason. They were moved instead by romantic yearnings for past glories or past orders and rejected Enlightenment notions of modernity. Their predatory or paranoid rulers either fatalistically accepted (in the case of Japan) or positively welcomed (in the case of Germany) armed conflict as the natural state of human affairs.

By the time all this became unmistakably obvious to the liberal powers, by the time they realized that they were dealing with people who didn't think as they did, by the time they grasped that nothing short of surrender would avoid conflict and that giving the aggressors even part of what they demanded—Manchuria, Indochina, Czechoslovakia—only strengthened them without satisfying them, it was too late to avoid precisely the world war that Britain, France, the U.S. and others had desperately tried to prevent.

This searing experience—not just World War II but also the failed effort to satisfy those who couldn't be satisfied—shaped U.S. policy in the postwar era. For the generations that shared this experience, it imposed a new and different sense of realism about the nature of humankind and the international system. Hopes for a new era of peace were tempered.

American leaders and the American public generally if regretfully accepted the inescapable and tragic reality of power. They adopted the posture of armed liberalism. They built unimaginably destructive weapons by the thousands. They deployed hundreds of thousands of troops overseas, in the heart of Europe and along the rim of East Asia, to serve as forward deterrents to aggression. They fought wars in distant and largely unknown lands, sometimes foolishly and sometimes ineffectively but always with the idea—almost certainly correct—that failure to act against aggressors would only invite further aggression.

In general, except for a brief bout of fatalism under President Richard Nixon and former Secretary of State Henry Kissinger, they were disinclined to assuage or even acknowledge the grievances of those who opposed them. (President Harry Truman and Secretary of State Dean Acheson, the architects of armed liberalism, never had much interest in bargaining with the Soviets, while President Ronald Reagan was interested chiefly in bargaining over the terms of their surrender.)

Behind the actions of the U.S. architects of containment lay the belief, based on hard experience, that other peoples couldn't always be counted on to value what the liberal world valued—prosperity, human rights or even peace—and therefore the liberal world had to be constantly on its guard, well-armed and well-prepared against the next stirring of the non-liberal, atavistic urges that were a permanent feature of humankind.

How much easier it was to maintain this tragic vigilance while the illiberal, conflict-based ideology of communism reigned across more than half of the Eurasian continent—and how much harder has it been to sustain that vigilance since the fall of communism seemingly ushered in a new era of universal liberalism, and with it the prospect, finally, of a Kantian peace in a world dominated by democracy.

For a time in the 1990s, while the generations of World War II and the early Cold War survived, the old lessons still guided policy. President George H.W. Bush and his national security adviser, Brent Scowcroft, sent half a million American troops to fight thousands of miles away for no other reason than to thwart aggression and restore a desert kingdom that had been invaded by its tyrant neighbor. Kuwait enjoyed no security guarantee with the U.S.; the oil wells on its lands would have been equally available to the West if operated by Iraq; and the 30-year-old emirate ruled by the al-Sabah family had less claim to sovereign nationhood than Ukraine has today. Nevertheless, as Mr. Bush later recalled, "I wanted no appeasement."

A little more than a decade later, however, the U.S. is a changed country. Because of the experiences in Iraq and Afghanistan, to suggest sending even a few thousand troops to fight anywhere for any reason is almost unthinkable. The most hawkish members of Congress don't think it safe to argue for a ground attack on the Islamic State or for a NATO troop presence in Ukraine. There is no serious discussion of reversing the cuts in the defense budget, even though the strategic requirements of defending U.S. allies in Europe, Asia and the Middle East have rarely been more manifest while America's ability to do so has rarely been more in doubt.

But Americans, their president and their elected representatives have accepted this gap between strategy and capability with little comment—except by those who would abandon the strategy. It is as if, once again, Americans believe their disillusionment with the use of force somehow means that force is no longer a factor in international affairs.

In the 1930s, this illusion was dispelled by Germany and Japan, whose leaders and publics very much believed in the utility of military power. Today, as the U.S. seems to seek its escape from power, others are stepping forward, as if on cue, to demonstrate just how effective raw power really can be.

Once again, they are people who never accepted the liberal world's definition of progress and modernity and who don't share its hierarchy of values. They are not driven primarily by economic considerations. They have never put their faith in the power of soft power, never believed that world opinion (no matter how outraged) could prevent successful conquest by a determined military. They are undeterred by their McDonald's. They still believe in the old-fashioned verities of hard power, at home and abroad. And if they are not met by a sufficient hard-power response, they will prove that, yes, there is such a thing as a military solution.

This lesson won't be lost on others who wield increasing power in other parts of the world and who, like Vladimir Putin's autocratic Russia and Abu Bakr al-Baghdadi's fanatical Islamic State, have grievances of their own. In the 1930s, when things began to go bad, they went very bad very quickly. Japan's invasion of Manchuria in 1931 exposed the hollow shell that was the League of Nations—a lesson acted upon by Hitler and Mussolini in the four years that followed. Then Germany's military successes in Europe emboldened Japan to make its move in East Asia on the not unreasonable assumption that Britain and the U.S. would be too distracted and overstretched to respond. The successive assaults of the illiberal aggressors, and the successive failures of the liberal powers, thus led to a cascade of disasters.

The wise men and women of our own time insist that this history is irrelevant. They tell us, when they are not announcing America's irrevocable decline, that our adversaries are too weak to pose a real threat, even as they pile victory upon victory. Russia is a declining power, they argue. But then, Russia has been declining for 400 years. Can declining powers not wreak havoc? Does it help us to know that, in retrospect, Japan lacked the wealth and power to win the war it started in 1941?

Let us hope that those who urge calm are right, but it is hard to avoid the impression that we have already had our 1931. As we head deeper into our version of the 1930s, we may be quite shocked, just as our forebears were, at how quickly things fall apart.

This piece was originally published by Wall Street Journal.

NASA’s Asteroid Initiative encompasses efforts for the human exploration of asteroids—as well as the Asteroid Grand Challenge—to enhance asteroid detection capabilities and mitigate their threat to Earth. The human space flight portion of the initiative primarily includes the Asteroid Redirect Mission (ARM), which is a proposal to put an asteroid in orbit of the moon and send astronauts to it. The program originally contemplated two alternatives for closer study: capturing a small 10m diameter asteroid versus simply recovering a boulder from a much larger asteroid. Late in March, NASA offered an update of its plans. It has decided to retrieve a boulder from an asteroid near Earth’s orbit—candidates are the asteroids 2008 EV5, Bennu, and Itokawa—and will place the boulder on the moon’s orbit to further study it.

This mission will help NASA develop a host of technical capabilities. For instance, Solar Electric Propulsion uses solar electric power to charge atoms for spacecraft propulsion—in the absence of gravity, even a modicum of force can alter the trajectory of a body in outer space. Another related capability under development is the gravity tractor, which is based on the notion that even the modest mass of a spacecraft can exert sufficient gravitational force over an asteroid to ever so slightly change its orbit. The ARM spacecraft mass could be further increased by its ability to capture a boulder from the asteroid that is steering clear of the Earth, enabling a test of how humans might prevent asteroid threats in the future. Thus, NASA will have a second test of how to deflect near-Earth objects on a hazardous trajectory. The first test, implemented as part of the Deep Impact Mission, is a kinetic impactor; that is, crashing a spacecraft on an approaching object to change its trajectory.

The Asteroid Initiative is a partner of the agency’s Near Earth Object Observation (NEOO) program. The goal of this program is to discover and monitor space objects traveling on a trajectory that could pose the risk of hitting Earth with catastrophic effects. The program also seeks to develop mitigation strategies. The capabilities developed by ARM could also support other programs of NASA, such as the manned exploration of Mars.

NEOO has recently enjoyed an uptick of public support. It used to be funded at about $4 million in the 1990s and in 2010 was allocated a paltry $6 million. But then, a redirection of priorities—linked to the transition from the Bush to the Obama administrations—increased funding for NEOO to about $20 million in 2012 and $40 million in 2014—and NASA is seeking $50 million for 2015. It is clear that NASA officials made a compelling case for the importance of NEOO; in fact, what they are asking seems quite a modest amount if indeed asteroids pose an existential risk to life on earth. At the same time, the instrumental importance of the program and the public funds devoted to it beg the question as to whether taxpayers should have a say in the decisions NASA is making regarding how to proceed with the program.

NASA has done something remarkable to help answer this question.

Last November, NASA partnered with the ECAST network (Expert and Citizen Assessment of Science and Technology) to host a citizen forum assessing the Asteroid Initiative. ECAST is a consortium of science policy and advocacy organizations which specializes in citizen deliberations on science policy. The forum consisted of a dialogue with 100 citizens in Phoenix and Boston who learned more about the asteroid initiative and then commented on various aspects of the project.

The participants, who were selected to approximate the demographics of the U.S. population, were asked to assess mitigation strategies to protect against asteroids. They were introduced to four strategies: civil defense, gravity tractor, kinetic impactor, and nuclear blast deflection. As part of the deliberations, they were asked to consider the two aforementioned approaches to perform ARM. A consensus emerged about the boulder retrieval option primarily because citizens thought that option offered better prospects for developing planetary defense technologies.  This preference existed despite the excitement of capturing a full asteroid, which could potentially have additional economic impacts. The participants showed interest in promoting the development of mitigation capabilities at least as much as they wanted to protect traditional NASA goals such as the advancement of science and space flight technology. This is not surprising given that concerns about doomsday should reasonably take precedence over traditional research and exploration concerns.

NASA could have decided to set ARM along the path of boulder retrieval exclusively on technical merits, but having conducted a citizen forum, the agency is now able to claim that this decision is also socially robust, which is to say, is responsive to public values of consensus. In this manner, NASA has shown a promising method by which research mission federal agencies can increase their public accountability.

In the same spirit of responsible research and innovation, a recent Brookings paper I authored with David Guston—who is a co-founder of ECAST—proposes a number of other innovative ways in which the innovation enterprise can be made more responsive to public values and social expectations.

Kudos to NASA for being at the forefront of innovation in space exploration and public accountability.