Are big infrastructure projects castles in the air or bridges to nowhere?
Jan 16th 2017, 16:02 BY BUTTONWOOD

castles in the air (or in Spain)： visionary unattainable schemes; daydreams　空想　幻想

巨大なインフラプロジェクトは空想かそれともどこに橋をかけるのか？



IF THERE is a consensus right now in American politics, it must be that infrastructure spending is a good thing. It employs workers, improves economic efficiency and, at the moment, can be financed at rock-bottom bond yields. So why don’t governments get on with it? 

rock-bottom：最低の
get on with it：ぐずぐずせずにやるべきことをやる

The problem is multi-faceted. Although people tend to be enthusiastic about infrastructure in general, they are more critical of specific projects. If they are in the country, then they ruin the currency; if they are in the town, then they ruin neighbourhoods or impinge on private-property rights. When it comes to public infrastructure projects, the benefits are long term but the costs are short term. The politician that authorises the project is rarely the same one that opens it. 

multi-faceted：多方面にわたる
neighbourhoods：地域
impinge：侵害する

So an elected leader gets all the flak from those who oppose this white elephant/blot on the landscape but none of the praise for the reduced traffic jams or cheaper power that ensue. Occasionally a leader might be tempted into authorising a big scheme (like Britain’s high-speed rail) but, as the Eddington report argued, the real benefits may come from smaller-scale schemes that eliminate bottlenecks. Such projects are often the first to get cut when austerity bites. 

flak：強い非難いあう
elephant：the èlephant in the (líving) ròom 誰もが知っていながら口をつぐむこと.
blot：を汚す

Private investors are happy to own infrastructure projects once they are up and running and delivering reliable yields; they are less keen on financing greenfield projects with all the risks that go with them. Another problem is that, just as economists talk of “negative externalities” (from, say, pollution), infrastructure can have positive externalities that are not captured by investors but will benefit society (the building of the internet or America’s interstate highway system, for example). 

up and running：うまく行って
yields：収益
externalities：外部への影響

As a result of all these factors, the private sector only tends to get drawn into infrastructure during bubble periods, such as the railway mania of the 1840s or the enthusiasm for fibre-optic cable in the late 1990s. In such periods, investors can see that fantastic returns will be earned by some projects, but they don’t know which ones. The “castles in the air” element means that far too many projects get built and that overall returns are disappointing. It’s a fallacy-of-composition problem. 

get drawn：引きずり込まれる
fallacy of composition： the error of assuming that what is true of a member of a group is true for the group as a whole　合成の誤謬

So that leaves the state. Clearly, lots of infrastructure has been built by governments in the past—and China has seen a massive amount of infrastructure investment in the last 30 years. But it seems to have got harder; we can only envy the achievements of the Victorians who created the Clifton suspension bridge (pictured above). Perhaps that is because, in democracies, it is simply more difficult to get the kind of bipartisan consensus that was achievable at times of crisis—after the second world war, for example. An authoritarian government like China doesn’t face the same kind of obstacle. 

leaves：離れるということはやめるという意味
envy：羨ましく思う

Robert Caro’s epic biography of Robert Moses, “The Power Broker”, reveals what it took to push through infrastructure projects in New York. As with his multi-volume biography of Lyndon Johnson, Mr Caro is caught between admiration and horror at his subject. Many of the parks, highways and bridges in New York were built on Moses’s watch; some of them would never have been built without him. But this was due to Moses’s ruthless abuse of power; he brooked no opposition and rode roughshod over the rights of communities, particularly those from ethic minorities. 

epic：叙事詩的な
biography：伝記
Robert Moses：ニューヨークの都市計画家
Power Broker：影響力の強い人・黒幕
reveals：明らかにする
took to：手段を取る・専念する
multi-volume：数巻よりなる
horror：嫌悪
ruthless：容赦のない
brooked：反対を容認する
roughshod：踏みにじる

And he was obsessed with the need for highways at the cost of public transport; one reason why the journey to and from JFK airport is so unsatisfactory is that Moses failed to make adequate provisions for cars or buses. He refused to listen to those who predicted that his new highways would fill up with cars, and become as clogged as the old ones. 

obsessed：取り憑かれる
provisions：用意・準備
clogged：渋滞する

Put the public sector in charge and the risk is that you get a rigid plan that fails to respond to changing economics, or plans that are hijacked by the politically well connected so that projects are built where they are not needed—the “bridge to nowhere” problem. 

rigid：融通の利かない

How to square the circle? Perhaps policymakers have to accept that a certain degree of waste and delay is a necessary part of infrastructure delivery. Perhaps the creation of technocratic infrastructure commissions—central banks for building stuff—will remove some of the political heat. But those of us making our way to work on America’s crumbling roads (or London’s overpacked tube trains) must hope the problem gets the attention it deserves. 

square the circle：無駄な努力をする
political heat：政治的批判
crumbling：ボロボロに崩れる

 アメリカのインフラ投資は必要だが、そのためには官民の役割をきちんと決める必要がある。長期的な効果に対して投資は短期的なので、大きなプロジェクトとしての賛同を得難い。ニューヨークの都市の設計をしたRobert Mosesの例を引いているが、彼がいなければできなかったが、また失敗もした。こうしたプロジェクトはその途中で経済的な課題とか政治の影響がプロジェクトに関わってくるので、官主導で行わう必要がある。トランプの公約の一つだが、実行にあたっては様々な課題が出てくるだろう。そうした利害の衝突する厄介な投資を打算抜きで、トランプが果たしてできるのだろうか。

水曜日。昨日は元上司の森さんと会食。今日は海野塾がある。楽しい一日だ。慰安婦の最後だ。南京大虐殺、７３１部隊も行うが、まとめだけだ。これだけは知っておくべきだろうと言う内容だ。今日終われるかなあ。ではまた明日。

A new scandal rocks Israel’s prime minister
But he insists there is nothing to explain
Jan 13th 2017 | JERUSALEM | Middle East and Africa

新たなスキャンダルがイスラエルの首相を揺り動かしている。
しかし、彼は説明するものはないと主張している。



FOR months, there have been reports of investigations into Binyamin Netanyahu’s financial affairs. Now, after two sessions of questioning by the police in his official residence and then a flurry of leaks to the press, things are looking serious. The biggest surprise was the identity of a mysterious businessman who was apparently recorded discussing matters of “mutual benefit” with the Israeli prime minister. 

flurry：一陣の突風

Arnon “Noni” Mozes, the secretive owner of Israel’s largest and most influential media group, has been considered Mr Netanyahu’s nemesis for years. In February 2015, at the height of the last election campaign, Mr Netanyahu wrote that “the primary force behind the wave of mudslinging against me and against my wife is Noni Mozes. He will stop at nothing to bring down the Likud government I head.” Now Israeli media reports say that the tapes show that the two enemies were holding secret meetings in which it is alleged that they were discussing a deal whereby the prime minister would receive favourable treatment from Mr Mozes’ Yedioth Ahronoth group. In return Mr Netanyahu would act to limit the distribution of Israel Hayom, a free sheet financed by Sheldon Adelson, an American casino owner who supports Mr Netanyahu. 

secretive：秘密にしたがる
nemesis：手強い相手
mudslinging：選挙の中傷合戦
stop at nothing：のためならなんでもやりかねない
bring down：打倒する
free sheet：free up the balance sheet for を購入できる余裕がバランスシートに生まれる

The deal did not come to pass. Mr Netanyahu’s political rivals continued to receive the backing of Yedioth Ahronoth while Mr Adelson continued to pour hundreds of millions of shekels into the Netanyahu-supporting Israel Hayom. According to data published this week by Haaretz, an Israeli daily, Mr Adelson spent 730 million shekels ($190m) on the free sheet during its first seven years of operations, approximately a shekel for every copy of Israel Hayom handed out across the country. 

shekels：イスラエルの通貨単位
Israel Hayom：an Israeli national Hebrew language free daily newspaper, first published in 2007. It has the largest daily circulation in the country. 

The investigation could hurt not only Mr Netanyahu but also the two publishers. Israel Hayom has poached a big chunk of Yedioth Ahronoth’s advertising revenue. If Mr Netanyahu could indeed have prevailed on his benefactor to limit its distribution, this would have been worth millions to Mr Mozes and could constitute a bribe. Even though the deal never happened, the mere offering of a bribe might legally be seen as a criminal action. A criminal indictment would, in all likelihood, force the prime minister to resign. 

poached ：密漁する
benefactor：後援者
indictment：起訴
in all likelihood：十中八九

It is of course far too early to write Mr Netanyahu’s political obituary. The decision on whether to press any charges will be that of the attorney-general, Avichai Mandelblit, a cautious lawyer whose previous job was as Mr Netanyahu’s cabinet secretary. He will be reluctant to indict unless he believes there is a watertight case. Mr Netanyahu has kept to his standard response that “there will be nothing because there is nothing” but has yet to comment directly on the latest allegations. 

watertight ：つけいる隙のない
allegations：申立

The case is not only about Mr Netanyahu’s political survival. Israel’s combative and relatively unfettered media have long been one of the strongest features of its democracy. Backroom deals between politicians and media-owners are of course a feature of every democracy, but this level of engagement rarely comes to light. Many Israeli journalists have been forced to ask themselves in recent days whose interests they are serving. 

combative：論争好きな
unfettered ：束縛を受けない

Netanyahuがイスラエル最大のメディアグループの総帥のArnon “Noni” Mozesとの闇取引があったのではないかという疑惑が持ち上がっている。本人はそんなことはあり得ないと否定している。そうした疑惑が上がることは彼自身にも、またメディアにもそうした疑惑がもたれるような行動があるということだろう。Trumpはこれから彼とどう付き合ってくのだろうか。

火曜日。昨日は寝不足の一日だった。朝会。夜は新宿でフィリピンの友人ご夫婦とその友人たちとの会食。今日の昼は元上司の森さんとの会食。東京倶楽部なので、ネクタイをしていかないといけない。ではまた明日。

Such efforts demonstrate how to interleave careers and learning. But left to its own devices, this nascent market will mainly serve those who already have advantages. It is easier to learn later in life if you enjoyed the classroom first time around: about 80% of the learners on Coursera already have degrees. Online learning requires some IT literacy, yet one in four adults in the OECD has no or limited experience of computers. Skills atrophy unless they are used, but many low-end jobs give workers little chance to practise them. 

interleave：白紙を本に綴じ込む
left to its own devices：好きにやらせる
nascent ：芽生えつつある
advantages：優位に立っている
Coursera：スタンフォード大学コンピュータサイエンス教授Andrew NgとDaphne Kollerによって創立された教育技術の営利団体
literacy：知識
atrophy：減退する

Shampoo technician wanted
If new ways of learning are to help those who need them most, policymakers should be aiming for something far more radical. Because education is a public good whose benefits spill over to all of society, governments have a vital role to play—not just by spending more, but also by spending wisely. 

Lifelong learning starts at school. As a rule, education should not be narrowly vocational. The curriculum needs to teach children how to study and think. A focus on “metacognition” will make them better at picking up skills later in life. 

vocational：職業訓練指導のための
metacognition： awareness and understanding of one's own thought processes.

But the biggest change is to make adult learning routinely accessible to all. One way is for citizens to receive vouchers that they can use to pay for training. Singapore has such “individual learning accounts”; it has given money to everyone over 25 to spend on any of 500 approved courses. So far each citizen has only a few hundred dollars, but it is early days. 

early days：始めの頃

Courses paid for by taxpayers risk being wasteful. But industry can help by steering people towards the skills it wants and by working with MOOCs and colleges to design courses that are relevant. Companies can also encourage their staff to learn. AT&T, a telecoms firm which wants to equip its workforce with digital skills, spends $30m a year on reimbursing employees’ tuition costs. Trade unions can play a useful role as organisers of lifelong learning, particularly for those—workers in small firms or the self-employed—for whom company-provided training is unlikely. A union-run training programme in Britain has support from political parties on the right and left. 

steering：操縦する
MOOC：Massive Open Online Course 大規模公開オンライン講座
relevant：適切な
reimbursing：払い戻す

To make all this training worthwhile, governments need to slash the licensing requirements and other barriers that make it hard for newcomers to enter occupations. Rather than asking for 300 hours’ practice to qualify to wash hair, for instance, the state of Tennessee should let hairdressers decide for themselves who is the best person to hire. 

worthwhile：価値のある・役に立つ
slash：サッと切る

Not everyone will successfully navigate the shifting jobs market. Those most at risk of technological disruption are men in blue-collar jobs, many of whom reject taking less “masculine” roles in fast-growing areas such as health care. But to keep the numbers of those left behind to a minimum, all adults must have access to flexible, affordable training. The 19th and 20th centuries saw stunning advances in education. That should be the scale of the ambition today. 

shifting：切れ目なく変化する
masculine：男の
left behind：置き去りにする
stunning：衝撃的な

教育は経済の発展に大事だ。ただそうしたオンライン教育を継続して受けているのはその８０％が学位を取っている人だ。生涯学習を政府はもっと奨励するべきだし、そうした機会を設けるべきだ。労働市場が今後どんどん変化する中で誰もがそうした変化に適応できるとはかがらないが、そうした対応ができるような教育を促進していくべきだ。

確かに、日本においても同様のことが言えて、５年もしたらタクシーの運転手はいらなくなるかもしれない。企業の管理部門の半分は不要になるだろう。そうなってくると新たな雇用のためには新たなスキルが必要になってくる。ただこれからのスキルはここでも言っているように職業訓練的なスキルだけではダメだろう。より経営センスが要求されるようなスキルだろう。

月曜日。昨日は研修資料のレビューと資料作成に終始した。今日は３時半に起きてしまった。これから朝会があり、India Negotiation Styleだ。夜はフィリピンから友人が来ているのでその会食がある。ではまた明日。

Learning and earning
Equipping people to stay ahead of technological change
It is easy to say that people need to keep learning throughout their careers. The practicalities are daunting
Jan 14th 2017

stay：の先を行く
Equipping：技能を身につけさせる
practicalities：現実
daunting：

学習と金を稼ぐこと
技術変化の先を行くために人々に技能を身につけさせる。
人々が彼らの経歴を通じて学び続ける必要があると言うことは容易だ。
その現実は心を怯ませている。



WHEN education fails to keep pace with technology, the result is inequality. Without the skills to stay useful as innovations arrive, workers suffer—and if enough of them fall behind, society starts to fall apart. That fundamental insight seized reformers in the Industrial Revolution, heralding state-funded universal schooling. Later, automation in factories and offices called forth a surge in college graduates. The combination of education and innovation, spread over decades, led to a remarkable flowering of prosperity.

inequality：不平等
fall behind：遅れをとる
fall apart：バラバラになる
insight：深い理解
heralding：先駆けとなる
call forth：呼び起こす
flowering：開花する

Today robotics and artificial intelligence call for another education revolution. This time, however, working lives are so lengthy and so fast-changing that simply cramming more schooling in at the start is not enough. People must also be able to acquire new skills throughout their careers. 

cramming：にぎっしり詰める

Unfortunately, as our special report in this issue sets out, the lifelong learning that exists today mainly benefits high achievers—and is therefore more likely to exacerbate inequality than diminish it. If 21st-century economies are not to create a massive underclass, policymakers urgently need to work out how to help all their citizens learn while they earn. So far, their ambition has fallen pitifully short. 

exacerbate：悪化させる
underclas：底辺層

Machines or learning
The classic model of education—a burst at the start and top-ups through company training—is breaking down. One reason is the need for new, and constantly updated, skills. Manufacturing increasingly calls for brain work rather than metal-bashing. The share of the American workforce employed in routine office jobs declined from 25.5% to 21% between 1996 and 2015. The single, stable career has gone the way of the Rolodex. 

top-ups：追加
breaking down：失敗する
Rolodex：ローロデックス　米国製の回転式卓上カードファイル

Pushing people into ever-higher levels of formal education at the start of their lives is not the way to cope. Just 16% of Americans think that a four-year college degree prepares students very well for a good job. Although a vocational education promises that vital first hire, those with specialised training tend to withdraw from the labour force earlier than those with general education—perhaps because they are less adaptable. 

vocational：職業訓練指導のための
vital：極めて重要な

At the same time on-the-job training is shrinking. In America and Britain it has fallen by roughly half in the past two decades. Self-employment is spreading, leaving more people to take responsibility for their own skills. Taking time out later in life to pursue a formal qualification is an option, but it costs money and most colleges are geared towards youngsters. 

Self-employment：自営
geared：適合する

The market is innovating to enable workers to learn and earn in new ways. Providers from General Assembly to Pluralsight are building businesses on the promise of boosting and rebooting careers. Massive open online courses (MOOCs) have veered away from lectures on Plato or black holes in favour of courses that make their students more employable. At Udacity and Coursera self-improvers pay for cheap, short programmes that bestow “microcredentials” and “nanodegrees” in, say, self-driving cars or the Android operating system. By offering degrees online, universities are making it easier for professionals to burnish their skills. A single master’s programme from Georgia Tech could expand the annual output of computer-science master’s degrees in America by close to 10%. 

Pluralsight：多元的視点
boosting：高める
rebooting：再起動する
veered：変える
Plato：観念論・理想主義
black hole： 重力が強いため光や熱を放出するエネルギーを使い果たして崩壊した天体。 インターネットのホームページなどにおいて、消去されてもはや存在しない情報へのリンク
employable：雇用に適した
bestow：与える
burnish：磨き上げる

これからは勉強しないと技術の進歩についていけない人がどんどん増えて行く。大学の授業だけではもうダメで、自分でどよくしていかないとそうした社会の変化についていけない。そういう意味で今後、貧富の格差が広がって行く。大学の中身も変化して行く必要があるだろう。今までのような理論的な学問を学生に教えても実世界では役に立たない。

教授自身も変化して行く必要があるだろう。私が今教育者として研鑽しているのは今の大学の教育においてグローバル人材が誰も育たないからだ。どうしてそうなのかを誰も何十年も考えてこなかったからに他ならない。だから、私が今こうしたことを十数年かけて教材を作成し、教えている。当たり前のことをしているだけだが、誰もしてこなかった。

日曜日。昨日は海野塾があった。懇親会もあった。塾生は２次会にも行ったようだ。今日は朝から研修資料の編纂がある。ではまた明日。

Spying and politics in America
Trump bashes the spooks
With his relentless criticism, Donald Trump is destroying trust in the intelligence agencies
Jan 14th 2017 

アメリカにおけるスパイ行為と政治
Trumpはスパイを激しく批判する
Donard Trumpは諜報機関を厳しく批判するとともに、彼らに対する信頼をなくしている。



DONALD TRUMP doesn’t give many press conferences. But when he does, as on January 11th—for the first time since July—they are utterly unlike the press conferences of any other American president-to-be. Speaking without notes, Mr Trump threatened and cajoled Mexico and the pharma industry (its shares tumbled). He boasted about his genius for business (and went some way to reduce his own conflicts of interest). He poured scorn on a shocking report that Russian intelligence had dirt on him and had worked with his people during the election (he shouted down a reporter from the news channel that revealed the report’s existence). And that was just the highlights. It was such a spectacle and pointed in so many directions at once that you could fail to catch a drumbeat which, for the safety and security of the United States, Mr Trump needs to silence immediately: his continuing hostility towards America’s intelligence agencies. 

utterly：全く
president-to-be：もうすぐ
cajoled：おだてる
tumbled：暴落する
boasted：自慢する
genius： 才能
scorn：バカにする
dirt：中傷
spectacle：見世物

Relations were already rocky. Before the election the agencies let it be known that they had concluded Russia hacked, stole and leaked documents which damaged Hillary Clinton, Mr Trump’s opponent. Most of the agencies (but not all) think that Russia’s intention was to help Mr Trump win. He responded by mocking them for being wrong before the invasion of Iraq in 2003 about weapons of mass destruction. This week things got uglier, when it was leaked that the agencies had supplied Mr Trump with a summary of the report, whose claims remain unverified, despite plenty of effort by plenty of people. In a tweet, Mr Trump complained that enduring such leaks was like “living in Nazi Germany”. And in his press conference he repeatedly suggested that the agencies had done the leaking, casting doubt on their conduct and loyalty. 

rocky：多難な・不安定な
let it be known：第三者を通じて発表する
mocking ：あざ笑う
casting：疑う

Mr Trump would hardly be the first president to have scratchy relations with the intelligence services. Career officers mutter about Barack Obama’s reluctance to stand up to China and Russia and what they saw as his soft line on spy-catching. However, Mr Trump’s disputes are in a different class, because they eat away at trust. 

scratchy：チクチクして着心地が悪い
mutter：つぶやく
stand up to：の言うことに抵抗する
spy-catching：counterespionage スパイ活動の防御 
eat away：徐々に蝕む

The agencies’ job is to tell the president about threats and opportunities facing the United States. Even though America’s intelligence machine is the world’s most formidable, it deals mostly in judgments and informed speculation, not certainties. In speaking truth to power, intelligence officers will sometimes have to bear bad news. They take that risk and the president listens to what they have to say because it makes the United States better prepared for whatever is coming its way. 

formidable：なみはずれた
informed：情報に基づく
speculation：推測
certainties：確かな見込み
bear：悪い知らせを伝える

By ridiculing the agencies for their findings, Mr Trump has signalled that he does not want to hear their bad news. By saying he cannot be bothered with the president’s daily briefing, he suggests their work is of little value. By claiming that the agencies have a political agenda, his people are themselves politicising intelligence work. By impugning their motives, he is undermining public confidence, which was already damaged by Edward Snowden, and which, as with any institution, is essential if they are to go about their duties. 

ridiculing：嘲ける
impugning：を非難する
go about：取り掛かる

If he wants America to be safe, Mr Trump must make amends. He took a first step by criticising Russia for the Democratic hack (albeit reluctantly and mildly). Unlike his national security adviser, his nominees as directors of the CIA and of national intelligence enjoy support among spooks. In 90 days, he has said, they will produce a report on hacking: he should follow its advice. As president, he needs to stop criticising the agencies and demonstrate they have his backing. None of that is hard. Except that it is a test of Mr Trump’s self-control. 

amends：行いの埋め合わせをする

トランプが諜報機関を信じていないし、彼らとの関係が良くない。こうした機関はアメリカへの脅威と好機を大統領に知らせる役割がある。彼らは見込みではなく、判断力と情報に基づいた推測でことにあたっている。アメリカを安全にするためには彼らを信頼する必要がある。そろそろ大統領としては彼らを批判することをやめるべきだろう。確かにトランプはガキ大将で、まだ、アメリカの大統領だと言う立場を理解していない。時間が経てば彼はそうしたことを理解していくだろう。

土曜日。昨日は本書きと来週の研修資料の作成をした。１日雨だったので、スケートの練習はできなかった。運動不足ではないのだが、一日１０何時間も座っているので、背中が痛い。今日は朝から海野塾だ。ではまた明日。

Donald Trump Said He’d Lower Drug Prices. But They’re Already Going Up
Kerry Close
Updated: Jan 10, 2017 8:03 AM JST Time

Donald Trumpは薬価を下げると言った。しかし、すでに値段が上がっている。



President-elect Donald Trump has promised to lower the astronomical cost of prescription drugs. Whether it's feasible for him to fulfill that promise is another matter.

In an interview with TIME ahead of his selection as its 2016 Person of the Year, Trump said he doesn't "like what's happened with drug prices" and promised to "bring down" the cost of prescription medications. Although drug stocks took a dip after his comments, it doesn't seem like their decline is shaping up to be a long-term trend. 

medications：病気治療のための薬
took a dip：ちょっと低下する
shaping：思い通りに進展する

In the first few days of the new year, prices for Ampyra, a drug for multiple sclerosis patients, jumped by 9.5%, CNN Money reported on Thursday. Meanwhile, arthritis drug Orencia, made by Bristol-Myers Squibb, will be 6% costlier in 2017. They're among many drugs that will increase in price in 2017. 

sclerosis：多発性動脈硬化症
arthritis：関節炎

Why Prices Are Rising
Drug prices have soared over the past several years. MONEY has previously reported that the average price of the 50 most popular generic drugs increased 373% between 2010 and 2014, per data from pharmacy benefit management company OptumRx. Egregious examples include Mylan's 548% price jump on the price of EpiPens and Valeant Pharmaceuticals, which hiked the price of two heart medications by 300%. 

Egregious：トンデモナイ

Part of the reason is years of mergers. As MONEY reported in March 2016, three major companies now control 40% of generics companies. That means that drug companies are able to charge your insurer more for drugs. 

insurer：保険会社

What Trump Could Do
The issue has yet to be successfully addressed through legislation. On his website, Trump doesn't list a concrete plan for addressing the high cost of prescription drugs. On the campaign trail, he proposed requiring Medicare, the government insurance program that covers those 65 and over and others with certain disabilities, to negotiate with drug companies to lower costs, as well as importing drugs from abroad, where drug prices are regulated. 

disabilities：障害

Allowing Medicare to negotiate drug prices could be an effective move for cutting certain costs, according to a February 2016 report from the Kaiser Family Foundation. Although the Congressional Budget Office didn't provide specific figures, "there is some potential for savings" if the prices of unique drugs without rivals—like high-priced specialty drugs—could be brokered. 

brokered：仲介する・調停する

The Challenges
However, it might be a tall order for the president-elect to develop such a policy under a Republican-controlled Congress. In 2003, a GOP-majority House passed a restriction that forbid the government from negotiating Medicare drug prices—a move some criticized as influenced by the powerful drug lobby. Indeed, the following year, in 2004, the pharmaceutical and health industries donated $12.5 million to Republicans, compared to $6.8 million for Democrats, according to numbers from OpenSecrets.org. The pocketbook of the drug lobby has consistently favored the right since: In 2016, Republicans got $21.3 million, while Democrats received $16.6 million. 

tall order：手に負えない仕事
forbid：禁じる
pocketbook：資金力
favored：Repablicanは右だから

A more direct solution would be to regulate drug prices in the U.S., a practice that has been enacted successfully in many other countries, said Dean Baker, co-founder of the Center for Economic Policy and Research. In Australia, for example, drugs are given a value based on the value they give to patients and how many people will need them. Under this system, a cancer drug might receive a higher rating because it could save your life, while an arthritis drug—which, while it eases pain, is "not a life or death story"—could get a lower score. 

arthritis：関節炎

Unfortunately, developing regulations for drug prices would be a time-consuming and—given the opposition of the "powerful drug lobby" to doing so—a politically challenging process, Baker said. What’s more, the U.S. does not have publicly funded universal health care. Australia and most other developed countries have nationalized medicine, and governments use their clout as huge buyers to negotiate lower prices with drug makers. 

nationalized：国営化する・国民的なものにする

Still, another of Trump's proposed solutions—importing drugs from abroad—could be an effective and realistic step to cutting costs, Baker said. Although it's technically illegal to do so now, the FDA has a policy that says it will "typically" not object to individuals importing drugs it hasn't approved "under certain circumstances." Those exceptions include drugs for a serious condition for which treatment is not available in the U.S. and that don't present an unreasonable risk to patients and others.While it's not the most "economically sensible" plan, Baker said, officially allowing people to import drugs from abroad could be a feasible solution. "No one politically wants to be arresting people in their 70's for trying to get drugs they need," he said. 

トランプは薬の値段を下げようと公約して来たが、思うようにいかないだろう。製薬会社はRepablicanに相当の献金をして来ている。それと政府が薬価に対して関与できない法律がある。いっそのことそうした医薬品の輸入を許可するという方法もあるが、FDAの問題もある。確かにアメリカだけでなく、特定の医薬品は高価すぎる。こうした医薬品はタクシー料金とは逆に、国家が関与するべきだ。助かる命が助からない。日本の同じだ。日本も医薬業界が政府に圧力をかけているのだろうか。

金曜日。昨日は１日雑用をしていて、まとまった仕事はできなかった。今日は本書きと来週の研修準備をするつもりだ。ではまた明日。