Why does cellist Yo-Yo Ma refer to the Silk Road as the ‘Internet of antiquity’? What is globalization? What is economic interdependence? What are diversity and inclusion? These are some of the questions that high school students from Yokohama Science Frontier High School (YSFH) considered during a visit to the San Francisco Bay Area in January 2019. Alumni of the U.S.-Japan Council’s TOMODACHI Emerging Leaders Program (ELP) and SPICE staff encouraged the students to critically consider the questions during their visits to Facebook, Apple, and Stanford University.

Prior to their arrival, YSFH students shared their goals for the trip. YSFH student Ken Horikoshi, who aspires to become a robotics engineer, noted, “I will need communication skills, skills of thinking deeply, and of course, knowledge about space or robotics to make my dreams come true. So, I’d like to make an effort to improve these skills.” With the students’ goals in mind, ELP Chair and SPICE’s Rylan Sekiguchi organized visits to Apple and Facebook and assisted with a one-day seminar at Stanford.

Derek Kenmotsu talks with students and teachers on Apple campus.

Mana Nakagawa gives students and teachers a tour around Facebook headquarters.

During the seminar at Stanford, SPICE staff introduced the YSFH students to SPICE lessons from Along the Silk Road to illustrate that globalization is not just a modern phenomenon. The staff noted that in some ways, the ancient Silk Road was the first real conduit of globalization, as it connected vast lands into a trade network that spread goods, beliefs, and technologies far from their areas of origin. ELP alumna Naomi Funahashi, instructor of SPICE’s online course on Japan, illustrated this by showing how musical instruments were carried along the Silk Road and gradually adapted to cultural and geographic features of local environments. She mentioned, for example, similarities and differences of lutes that can be found in Europe, China, Korea, and Japan. She also noted a description of the Silk Road by cellist Yo-Yo Ma, founder of Silkroad, who has described the Silk Road as the “Internet of antiquity”; expounding upon this notion, Sekiguchi and SPICE’s Jonas Edman noted that by studying about the Silk Road, we can gain historical insights into how the contemporary stage of globalization is changing our world and our lives.

A highlight of the seminar featured the YSFH students giving presentations on their science-related research to the SPICE staff and visiting scholars at Stanford from Japan. YSFH student Kazuhiro Okada’s presentation on his ambition to design underwater cities stretched the audience’s notions of globalization and interconnectedness. One commented, “It would be interesting if you could someday design a subway stop under the ocean between Aomori Prefecture and Hokkaido.”

The ELP identifies, cultivates, and empowers a new generation of leaders in the U.S.–Japan relationship. Chair Sekiguchi, other ELP alumni, and SPICE staff extended this mission to the generation behind them. YSFH teacher Nobuyo Uchimura described the experiences that they provided her students as very precious ones that expanded their learning beyond the confines of a classroom, and YSFH teacher Yukimasa Uekusa noted his desire to prioritize programs such as this into the future.

President Trump caught the world by surprise once again yesterday with a decision not to sign a deal with his North Korean counterpart, Chairman Kim Jong-un, in Hanoi, Vietnam. While walking away is a common tactic in working-level negotiation, what happened in Hanoi was a rare case and the least expected outcome.

Read the full article on Axios.

Trump and Kim share a common desire for development.

At first glance U.S. President Donald Trump and North Korean leader Kim Jong Un seem like an unlikely pair. A few years back they were calling each other “Rocket Man” and a “dotard,” and tension between the United States and North Korea was escalating rapidly in 2017. But in a few days they are slated to meet for the second time, and according to Trump they had “fallen in love” not long after their first encounter. What could have created such intimate bond between the two? The common interest that brings the two together is the desire for development — economic development in the case of Kim and property development in the case of Trump.

Read the full article on The Diplomat.

Stanford e-Japan is an online course that teaches Japanese high school students about American society and culture and U.S.–Japan relations. The course introduces students to both American and Japanese perspectives on many historical and contemporary issues. It is offered biannually by the Stanford Program on International and Cross-Cultural Education (SPICE). The Fall 2018 cohort was the seventh group of students to complete Stanford e-Japan.

In August 2019, three of the top students of the Fall 2018 Stanford e-Japan distance-learning course will be honored at an event at Stanford University. The three Stanford e-Japan Day honorees—Sakura Hayakawa (Katoh Gakuen Gyoshu Senior High School), Ryotaro Homma (Kaisei Senior High School), and Taiki Yamamoto (Ritsumeikan Uji Senior High School)—will be recognized for their coursework and exceptional research essays that focused respectively on “Importance of Youth Political Participation and Citizenship Education,” “The Abolition of the Electoral College: A Synthesis of the Positive Aspects,” and “The U.S.-Japan Alliance: Is a New Framework Necessary?”

Mayu Fujinami (Keio Girls Senior High School) and Tatsuya Sugiyama (Saitama Prefectural Urawa High School) received Honorable Mentions for their research papers on “The Importance of Paternity Leave for Gender Equality” and “Design Thinking: Lessons from the U.S.,” respectively.

Applications for the next session of Stanford e-Japan (Spring 2019) are currently being accepted through February 24, 2019. More information is available at stanfordejapan.org.

To stay informed of SPICE news, join our email list or follow us on Facebook and Twitter.

Stanford e-Japan is currently accepting applications for the Spring 2019 session, which runs from April 22 to August 23, 2019. The deadline to apply is February 24, 2019.

Now in its eighth session, Stanford e-Japan is SPICE’s online course for high school students in Japan. Accepted students engage in an intensive study of U.S. society and culture and U.S.–Japan relations. Ambassadors, top scholars, and experts throughout the United States provide web-based lectures and engage students in live discussion sessions.

The Spring 2019 session is generously supported by the Yanai Tadashi Foundation, Tokyo, Japan.

This year, Stanford e-Japan has moved to an online application system. All applications must be submitted at https://spicestanford.smapply.io/prog/stanford_e-japan/ via the SurveyMonkey Apply platform. Applicants and recommenders will need to create a SurveyMonkey Apply account to proceed. Students who are interested in applying to the program are encouraged to begin their application early.

For more information about Stanford e-Japan, please visit http://stanfordejapan.org.

To stay informed of news about Stanford e-Japan and SPICE’s other student programs, join our email list or follow us on Facebook and Twitter.

SPICE offers separate courses for U.S. high school students. For more information on those, please visit http://reischauerscholars.org (online course on Japan), http://sejongscholars.org (Korea), and http://chinascholars.org (China).

Related articles:

• Winners announced for the Spring 2018 Stanford e-Japan Award
• Japan Day 2018: Recognizing future leaders in the U.S.–Japan relationship

Anna Oura (Tokyo Gakugei University International Secondary School) received Honorable Mention for her research paper on “A Comparative Study on Japanese and U.S. History Textbooks.”

Applications for the Spring 2019 session of Stanford e-Japan will be accepted online from January 10 to February 24, 2019.

To stay informed of news about Stanford e-Japan and SPICE’s other programs, join our email list and follow us on Facebook and Twitter.

• Japan Day 2018: Recognizing future leaders in the U.S.–Japan relationship
• Winners announced for the Fall 2017 Stanford e-Japan Award

To prescribe or not prescribe? In the realm of the nation’s opioid epidemic, it’s an important question.

Research has shown that inappropriate use of prescription opioids is part of the reason behind a dramatic rise in opioid-related deaths since 2000. By 2015, the amount of opioids prescribed in the U.S. had tripled — enough for every American to be medicated around the clock for three weeks, at 5 milligrams of hydrocodone every four hours. 

Now, new research by a trio of Stanford scholars shows how different insurance strategies affect the volume of opioid use and could help stem inappropriate prescribing behaviors. 

The study, released in a working paper by the National Bureau of Economic Research, was co-authored by Stanford Health Policy’s Laurence C. Baker, M. Kate Bundorf, and Daniel P. Kessler. Baker and Bundorf are professors in the Department of Health Research and Policy at the Medical School; Kessler is a professor in the Law School and Graduate School of Business, and a senior fellow at the Hoover Institution.  All are also senior fellows at the Stanford Institute for Economic Policy Research (SIEPR).

Their study — the first to investigate the effect of the form of Medicare drug coverage on opioid use — found that enrollment in Medicare Advantage, a combined medical and drug insurance plan, significantly reduces the likelihood of beneficiaries filling an opioid prescription, as compared to enrollment in a stand-alone drug plan.

Compared to beneficiaries enrolled in stand-alone plans, those enrolled in the integrated Medicare Advantage plan were 37 percent less likely to get an opioid prescription, according to their analysis of drug claims from 2014.

The researchers also found that enrollment in integrated insurance coverage under Medicare Advantage had a disproportionate effect on the likelihood of filling an opioid prescription from the nation’s highest opioid-prescribing doctors — the top 1 percent of prescribers in Medicare Part D. The lower likelihood of prescriptions from these high prescribers to Medicare Advantage enrollees accounted for more than half of the reduction, according to their findings.

To understand the scope of this health plan-related effect and what’s at stake, consider the backdrop laid out in the study:

Since its implementation in 2006, Medicare Part D has become the nation’s largest purchaser of prescription opioids. More than 42 million Americans are enrolled in Medicare Part D — either under the stand-alone drug plan or the integrated Medicare Advantage plan.

What’s more, opioid prescriptions are concentrated among a relatively small group of “high prescribers.” 

According to research published in the 2016 edition of JAMA Internal Medicine, more than one-third of opioid prescriptions under Medicare Part D were made by about 8,000 doctors, making up the top 1 percent of prescribers. And according to the Office of the Inspector General of the Department of Health and Human Services, “extreme use” and “questionable prescribing” have put almost 90,000 beneficiaries at serious risk for opioid misuse or overdose.

Because the researchers did not examine patient health outcomes, they could not definitively determine that enrollment in Medicare Advantage reduced only inappropriate opioid use. However, because the reduction in opioid use came disproportionately from high prescribers, and previous work has found that Medicare Advantage enrollees had higher prescription drug use overall, the reduction in use that the researchers found was targeted rather than a result of a broader effort to restrict access to treatment.  

The researchers’ results support the conclusions of previous work that integration of prescription drug coverage with the other benefits provided by Medicare Advantage plans

improves the quality of care. Further study will be needed to drill deeper into the reasons behind the impact of Medicare Advantage plans, and whether a similar effect occurs in non-elderly populations, the researchers said.