Friday, March 30. 2012
I went to a presentation Rannfrid Thelle gave last night to the Wichita Peace Center about Syria. It was offered mostly as historical background ("From Aram to Assad"), PowerPoint bullets with archeological pictures from Rannfrid's 2006 visit to Syria. A couple dozen people were present, mostly the usual crowd, plus two ringers with Syrian connections pushing an anti-Assad, pro-revolution line (but, thankfully, well short of calling for armed intervention). They didn't quite hijack the presentation, but they reminded me how defenseless well-meaning people are when confronted with evidence of brutal repression. The urge to help is overwhelming, swamping the critical recognition that help is something we are unable to offer.
I know I find myself moved by reports of the Assad regime's violent suppression of demonstrations, but when I hear pleas for outsiders to step in and "protect the people," all I know for sure is that if the US were to intervene in any way, all we would do is kill more. It seems clear that the Assad regime has killed more people and done more damage than any of the other targets of Arab Spring -- with the possible, but not certain, exception of Libya, where the US did add to the body count. (And for that matter, Assad has killed more than Iran and Myanmar did in forcibly suppressing major demonstration movements over the last few years.)
No doubt the Assad regime has disgraced itself. However, it is far from the only government that has done such, so why focus on it? (One could, after all, cite the elephant-in-the-room, Israel, which has killed a comparable number of people under its sovereignty, albeit stretched out over a longer timeframe.) Syria moved to the forefront of the news partly because it flowed out of the "Arab Spring" revolts in Tunisia, Egypt, Yemen, and Libya, and partly because we in the US have long held a grudge against it. In particular, Bush's generals loudly threatened to invade Syria in 2003-04 if Syria in any way aided the resistance in Iraq: the goal then wouldn't have been to liberate the Syrian people from an oppressive regime, but to get rid of an inconvenient one and replace it with something more to our liking. Indeed, the US did just that in occupying Afghanistan and Iraq. The idea that we might selflessly liberate a country so that its people could run a free democracy was at best a propaganda afterthought.
Rannfrid did a generally good job in outlining Syria's history, but she missed one essential item: in 1948, Syria woke up on the wrong side of the bed and found itself locked into conflict with Israel. What happened was that the British quit their mandate in Palestine without having established any sort of agreement on the shape of its future independent government. In this void, the Zionist organization declared Israeli independence, and marshalled its army to secure as much territory as it could within Palestine, with no concern for the two-thirds of the mandate's population who were not Jewish, and who had agreed to no such division. As the Israeli militias advanced, the Palestinians appealed to the newly independent Arab states for help (like the Free Syrian Army currently begs for outside help). The Israelis like to describe this as all the Arab armies invading on Independence Day, another example of their accustomed blindness to the Palestinian presence.
Those Arab states had various agendas. Egypt, Transjordan, and Iraq were ruled by crony kings installed by Britain, and Transjordan was practically invited to invade by the Israelis in the hope that they would pick up the Arab West Bank and prevent an independent Palestinian state from being established. Israel's success, both in expanding its territory way beyond what the UN had offered -- without consent of the people actually living there -- and in driving over 700,000 Palestinians into exile proved to be deeply embarrassing to the junior officers caught up in the 1948-49 war. This, in turn, led to military coups in Egypt, Iraq, and Syria -- to a long series of such in Syria until Hafez Assad was finally able to stabilize control of the government.
Israel signed temporary armistice arrangements to end the war, but refused to sign peace treaties -- mostly because Israel was unwilling to readmit any refugees, but also because Israel was still unsatisfied with its borders. Up to 1967, Israel repeatedly provoked border incidents with Syria, then in June 1967 Israel used the closing of shipping to Eilat as a pretext to invading and snatching large chunks of territory from Egypt, Jordan, and Syria. Later that year, Israel formally annexed the Golan Heights that it had seized from Syria and depopulated. In 1979 Egypt was able to recover its lost territories by signing a unilateral peace treaty with Israel, which left Syria permanently maimed and powerless to cut its own deal. (Ehud Barak made a token effort at a deal in 2000, then backed away when it looked like Assad might agree.)
America's relationship with Syria has always been a reflection of its relationship with Israel. When Israel sought alliances in the west, Syria had no other defense option but to turn to the Soviet Union, which only hardened US antipathy to them. Syria's relationships with other Arab nations broke up over one issue or another. Syria occasionally made gesture to appease the US, like their enthusiastic endorsement of the 1990 Gulf War against Iraq, but they were easily forgotten -- in large part because for the US Israel always came first. The US at first welcomed Syria's intervention in Lebanon, then ultimately insisted that they leave. It's hard to think of any nation the US has had a more fickle and unprincipled relationship with, although Iraq and Iran and Afghanistan come close, for much the same reasons. That Bush decided not to invade in 2004 most likely had less to do with excuses than with lack of imagination about what to do with the carcass. That in turn may be because Israel seems to like the Assad regime: it's not only the devil they know, it's such a toothless wreck of a government they can bomb it on a whim and know there won't be any consequences.
One major reason the situation in Syria has become so grave is that the regime is so isolated from the rest of the world. It has only partly rebuilt its relationship with Russia after the collapse of the Soviet Union, but it's unlikely that Russia has anywhere near the deep-seated relationship with Syria that the US was able to exploit in nudging Mubarak out of power in Egypt, even assuming Russia has any desire to do so. The only other countries with any links to Syria are China and Iran, and neither is very sensitive about the rights of pro-democracy demonstrators. One thing we've seen again and again is that the more isolated a nation is, the less its leaders have to lose in resorting to violent repression -- again, consider Iran, Myanmar, Libya. And in Syria's case, it's too late to fix that: now that the regime has so disgraced itself, the pressure is against anyone trying to build relationships.
Meanwhile, the anti-Assad opposition -- especially the exiles who are safe from retribution -- have only become emboldened, ever more militant. They plead for arms, for intervention, to fight not to depose the regime but to conquer it. We are, in effect, being asked to choose sides in a civil war we actually have no stake in and no comprehension of. Sure, we can grasp the brutality of the Assad regime, but not yet the brutality of an opposition that has already decided to resort to killing and maiming its opponents -- a process that the longer it persists the more dehumanizing it will become. Indeed, one theme that emerged in the meeting was the fear that a triumphant anti-Assad movement would take its revenge on the Allawite community that Assad came from and favors. Several people were reminded of Rwanda; my own thoughts gravitated to the ethnic cleansing of Baghdad by Shiite militias as the US decided that the only way to keep Iraqis from uniting against the occupation was to turn them against each other. On the other hand, we had to sort through wild stories about Assad importing Iranian snipers, mass incarcerations, torture, and ritualistic killings. It's impossible to know what's actually true because access is so limited and propaganda is so free.
The dehumanization of the other side is inevitably one of the first things that happens in war, and it's well under way in Syria. The longer and bloodier the struggle continues, the worse it will be for all sides. (The continuing turmoil in the so-called Libya success is an example of what happens when you militarize conflict.) It's dehumanization that leads to atrocities, which leads to more of the same. The sane way out is to back off from anything that implies violence, while maintaining a vigilant concern for any violation of basic human rights by any party. The most effective approach would be to shame the Assad regime into backing down, chilling out, and opening up. That involves engaging with the regime, no matter how distasteful that seems, and it involves rejecting any elements of the opposition who insist on fighting this out in the streets. The end result should be a democratic government where individuals can speak up and protest without fear, and the end result should have nothing to do with the ulterior motives of other countries.
Making this work will take some effort, and more carrots than sticks, but it has worked elsewhere, and the all-stick approach (so dear to John Bolton) has failed virtually everywhere. To take one example, Turkey had built up a pretty rotten human rights record, but over the last 10-20 years they've done much to turn that around. They still have a long ways to go, but the prospect of joining the European Union steered them toward reforms, and the odds of a military coup have gone way down. Latin America and the former Communist states provide more examples, and Myamnar, which only a few years ago brutally suppressed demonstrations, seems to be opening up to diplomatic efforts. The Middle East and North Africa remain in turmoil, but as more nations there become more legitimately democratic Syria will be more tempted to join them.
Aside from the short-sightedness of the Assad regime, the main obstacle to democratic reforms in Syria is Israel and its clumsy, incoherent puppet, the United States. The US has bases all over the region, which do little more than make it a target for local rage and offer opportunities for embarrassing adventures. Israel, meanwhile, has no desire for any form of peace that would entail concessions, like basic human rights, to its Palestinian subjects (let alone refugees). The whole Arab Spring movement makes Israel uneasy: Israel has long prided itself on being the region's "only democracy," but it is nothing of the sort, no longer "only" and hardly in any sense a democracy. What it is, however, is a rogue state -- with its targeted killings and nuclear blackmail -- the threat that generations of Arab dictators have used to rationalize their own corruptions. Solve the Palestinian problem, turn Israel into a normal nation, let the US pull back its tentacles, and the whole region will open up.
 Helena Cobban, citing Patrick Cockburn, makes this point effectively. Cobban goes on to counter the arguments for outside armed intervention: something you should bookmark and re-read every time you find yourself entertaining the thought that doing so just might work.
 The standard solution to the Israel-Syria conflict is for Israel to return the Golan Heights to Syria, which was pretty much (if not necessarily seriously) what Barak offered in 2000. I wonder if a simpler solution might be for Israel to buy the territory. It might work like a mini-Marshall Plan: I don't know what the price might be, but say $20 billion, offered as credits over 50 years, which works out to $400 million per year. Syria would cash in those credits by buying goods (anything but arms) from Israel, so this would be a domestic stimulus that also provided genuinely useful aid (which is pretty much what the Marshall Plan did, unlike USAID's scams to dump agricultural surplus). Just an idea. They could do similar things with settlements on Palestinian land. I would prefer for Israel to hand over the settlements with the understanding that any Jews who wish to stay become Palestinian citizens (with full and equal rights), but for a lot of (I'd say bad) reasons that ain't gonna happen. It may not be justice to convert your problems into money, but at least it makes them negotiable.
Saturday, March 17. 2012
The Wichita Eagle front-page headline is "Soldier suspected in killings gets to Kansas," the piece attributed to Kansas City Star staff and wire reports. (I can't find the piece online, but it is apparently based on this piece.) It doesn't acclaim Staff Sgt. Robert Bales as a hero, but isn't everyone who signed up for the post-9/11 Global War on Terror a hero? They're automatically acclaimed when they die, as at least 6,398 have done, or when they're wounded (as Bales was, losing part of his foot), or when they receive medals (Bales is oft described as "much decorated"). So why not when they go berserk? The Army may prefer precise and unemotional control over its violence against Afghan villagers, but Bales' methodical killing of sixteen (mostly) children wasn't far out of the long line of atrocities other US "heroes" have committed. It just underscores how unfit the US military is for the difficult task of nation building, and therefore how hopeless what Obama can only describe as "the Mission" -- an abstract noun that has thus far proven impossible to define -- really is.
Some background on Bales is available here and here, and here. He is 38, was born in the Midwest, is married, has two children (3 and 4). He served three tours in Iraq, and was recently deployed to Afghanistan. He was trained as a sniper, which is to say someone who calmly and methodically picks out targets at distance, and kills them. The Pentagon describes his career as "unremarkable." A neighbor is quoted: "A good guy go tput in the wrong place at the wrong time." Happens all the time.
Problem is, if you're Afghan, this looks like stone cold murder. And if you're Afghan, you probably have a clear idea of what justice should look like -- and it's probably not that it would only be fair to ship the killer half-way around the world to a cozy cell in Kansas to let his shrinks and lawyers come up with arguments and excuses to try show that Bales is the victim here.
There is a case to be made that Bales was indeed a victim: of a president who decided to double down on the same military that had turned eight years of arrogance into abject failure, but Obama was stuck, like Rumsfeld complained earlier, with the army he inherited, and with a political culture that insists that America's heroes will prevail eventually (unless sabotaged by cowardly politicians). No one thought of the welfare of the troops before launching this war, but ever since politicians have been hiding behind their confused feelings, ignoring the fact that they were never fit for the purpose, that their deeply trained lethality ensures a string of atrocities. Anyone who seriously believes the popular counterinsurgency theories should start by building a new army; the real one doesn't work, even if some officers have learned to talk the talk.
Talking the talk, after all, has always been the easy part. What's hard is understanding you can't occupy a country you have no business in, no understanding of, and no awareness of your own alien nature. The US entered Afghanistan seeking revenge for 9/11, and never quite satisfied that itch. Overstaying its welcome, the US set up a puppet regime, then proceeded to delegitimize it by continued dominance -- Bush was too busy starting new wars to bother cleaning up after this one. Then came Obama, proving that America's best efforts were just as futile as America's worst efforts. Now he thinks he can tiptoe away without admitting fault or error, when the entire campaign has been nothing but wrong.
Bales' massacre is deeply embarrassing for Obama because there's no way to scrub away the stain. Either it was policy or not, the latter proof that we cannot manage our policy: we can't control our own troops, nor the Afghans we've trained, even less the Taliban. Even the right is abandoning this war: the carnage doesn't bother them, but they'd rather hate Muslims from a distance than try to divide and conquer them far away. And I suspect more and more we'll see the military itself turn on the mission: as good as it's been for budgets and careers, incidents like this show that the troops are wearing out, that the strain is cracking them up. Maybe they even like the idea of leaving Obama holding the bag. His statements this past week have been the most tone-deaf of his tenure.
Some more relevant links:
Saturday, March 10. 2012
A bizarre thing happened after the Democrats won overwhelmingly in 2008, with a record turnout of American voters electing a black man as president, with an overwhelmingly Democratic Congress (including that much-touted "filibuster-proof" Senate majority): the Republican mainstream vanished from sight, and the party was taken over by the only mass force that still held a soapbox: talk radio and Fox TV. They orchestrated the faux protest movement marketed as the Tea Party, and they demanded and enforced the Republicans' no surrender/no compromise legislative strategy. The result has been a massive dumbing down of the party faithful, as their brains have become imprisoned in the contradictions of their knee-jerk rhetoric. One early indication was the insistence that government keep its hands off Social Security. Opposition to bank bailouts was matched by opposition to any kind of regulation of banks -- especially the kind that seeks to protect customers from credit card usury. Similar dynamics play out everywhere.
But the most extreme idiocies are no longer the exclusive property of the shock jocks: the long Republican presidential primary process has put the candidates out on the front lines. (Not that Rush Limbaugh hasn't tried to keep his edge, as when he insisted that if insurance companies cover the costs of birth control for women, they owe it to us to return the favor by posting tapes of themselves having sex.) But the overwhelming majority of really stupid things the right has said in the last few months has come from the mouths of front-running presidential candidates. Rick Santorum, for instance, has decided that people shouldn't go to college where they might be exposed to liberal ideas. And Mitt Romney knows that as president he won't have to care about the poor because they have their safety net. And everyone but Ron Paul wants to make sure we go to war with Iran, because diplomacy would only make us look weak. And Ron Paul wants to collapse the economy by returning to the gold standard.
A good example of this is a quote from Ryan Lizza: Life of the Party:
Where to start? A nitpick, I guess: Fox flunky Williams is only Fox's idea of a liberal; a real liberal would never use the word "entitlement." A more apt word would be "right": we believe that Americans (all people, really) should have an equal right to high quality health care services -- something that doesn't exist today because there's more profit to be made by private agencies rationing health care in an opaque, unfree market, and those who make those profits have been able to corrupt the political system to work in their interests as opposed to the interests of the vast majority of Americans. "Obamacare" is another misleading term: the law Obama signed (officially, the Affordable Care Act) isn't a system, just a band-aid on an existing system that no one should want to lend their name to.
But what exactly makes Obamacare the one-word definition of taking away "our economic freedom"? The main effect of the law is to make it harder for insurance companies to deny coverage, and to (eventually) make it easier for people to afford to be insured. So how does more (and better) insurance impact economic freedom? For most of us, having health insurance frees us from the worry of an illness or accident we cannot afford. The alternatives are either to save ahead (the idea behind health savings accounts, which locks up a large amount of money for a worst case scenario which may never happen, and is in any case an option only available to people who have more money than they know what to do with), or hope that someone else will pick up the bill if illness or accident strikes. It's hard to see how either alternative would make one free. Of course, if you're a corporation selling health care services, free may mean something else to you: like being free to extort ever-higher prices, being free to advertise benefits and hide adverse outcomes, being free of regulation or recourse like malpractice suits. Unfortunately, the ACA doesn't do much to limit those freedoms, if that's what you want to call activities that in most other spheres of life are considered crimes.
The whole thing about Catholic hospitals smells too. Religious freedom is necessarily personal, otherwise religions would constantly battle to impose their beliefs on each other. A hospital that denied services to patients based on the religious principles of its owners would be the denier, not the observer, of religious freedom. Of course, this is a subtle point that wouldn't impress Santorum, who has repeatedly decried the separation of church and state -- showing that his misunderstanding of freedom of religion is total.
The fish thing is equally bizarre. What he's basically describing is his fear that a government that does things for the people might in turn be supported by those people. That would seem to be the very essence of democracy, so you have to wonder about someone who thinks that people who understand democracy and vote their interests are "mindless fish." From the dawn of democracy the rich have feared that their enfranchised lessers would use their votes to help themselves, but they've usually seen education as a way of training the masses to respect their betters. Bush's desire to turn schools into test-taking factories reflected this position, but conservatives like Santorum distrust any process that even suggests the possibility of learning and thinking, especially one that costs the rich money -- an unconscionable transfer since the rich have their own schools, as do Santorum's religious favorites.
Santorum's defense of extremism is, of course, crassly self-serving and otherwise ludicrous -- even the idea that a second helping of Reagan would be a good thing is a horrendous thought. But then he does do something classically Reagan-like, as he reduces his campaign take-home message to a self-flattering chant. Why, after all, try to present a logical argument, especially after deciding that reasoning is enemy turf, when you can just whip yourself up into a nonsensical frenzy?
Santorum is probably the most extremely dippy of the Republicans' remaining presidential candidates, but they're all more or less like that. They've given up on reason, and have no real plans other than to make the rich richer and to further reduce the safety net for everyone else. They hate government and campaign to take it over so they can wreck it further. And all they have to draw on is the emotional fever pitch of truisms that are ultimately no deeper than "we're great" -- plus a lot of money and a well-oiled media.
No big surprise, but Rick Santorum won the Kansas Republican caucuses today, with 51.2% of the vote, compared to 20.9% for Mitt Romney (so much for Kobach's endorsement), 14.4% for Newt Gingrich, and 12.6% for Ron Paul (so much for Koch's commitment to libertarianism). By the way, total vote in the caucus was 29,857, which works out to 1.7% of the number of registered voters in KS. Ain't democracy grand?
Thursday, February 9. 2012
Another excerpt from the Wichita Eagle Blog today, titled Pompeo takes on Kochs' critics:
There's been a groundswell of "pity the billionaire" articles about the Kochs recently, which like all of their groundswells suggests central planning. And who better than Pompeo to praise them, especially since he was their guy in the 2008 Republican primary. Coincidentally, I have another quote from Thomas Frank's book, Pity the Billionaire (pp. 76-77):
I actually have a lot of respect for entrepeneurs who founded companies that build things, although I can also think of plenty of examples of such who went on to use their wealth and power for ill purposes -- Henry Ford's notorious antisemitism is a classic example -- and they tend to be the rule rather than the exception, probably because there's something fundamentally rotten about living off a profit margin. But whereas Ford built his company from scratch, the Kochs inherited theirs, and while I do have respect for Charles Koch as a smart and principled businessman -- David is another story altogether -- he grew his company mostly through shrewd acquisitions and stern management, not to mention tax breaks and political payola. (The Bush Administration, for instance, settled hundreds of EPA charges against Koch for pennies on the dollar, with no concession of wrongdoing. In some ways, a "get out of jail card" is even better than a bailout.) To say that Koch created 50,000 jobs is nonsense.
Still, the Kochs aren't being attacked for their business work -- although they are in a notoriously dirty business, and they have an utterly scandalous environmental track record, and the oil industry has long been the poster boy for government corruption (although finance and pharmaceuticals have more than caught up). The problem with the Kochs is that they pump so much money into subverting our democracy. The more we have become aware of their activities, the more conscious we become of where that money comes from and what kind of world they want to create.
Wednesday, February 8. 2012
Since you asked, the Wichita Eagle headline was: Santorum's victories shake up GOP race. But note that the headline was buried on Page 8A, just above "Greece, Bulgaria battle flooding" and "Russian envoy calls visit to Syria useful." Curious that the Eagle decided to give the story so little play, given that Kansas is a midwestern caucus state -- so the Missouri, Minnesota, and Colorado races are more predictive here than any of the primaries so far -- and that Kansas is almost certain to favor Santorum. (In 2008 Huckabee carried the Kansas GOP caucuses by a huge margin even though McCain had already almost secured the nomination.) On the other hand, the Eagle is not a red meat paper, even if it trends somewhat to the right.
Santorum is actually the scariest of the Republican candidates, less because he's stupid and priggish than because he's an apocalyptic warmonger who wouldn't hesitate to think before starting a war with Iran. Still, nobody (but Ron Paul) has noticed that point, in part because Gingrich is almost exclusively backed by an Israel hawk, and Romney wishes he were. Alex Pareene wrote this (evidently before the caucuses):
Emphasis added for what strikes me as the key point: all of the Republican candidates are vulnerable to attack ads, so they bobble up and down depending on how much attention they get. Santorum won Iowa because everyone was focusing on Romney and Gingrich, and most wanted neither. He got beat down in New Hampshire, then ignored until now he finally seems less tawdry than Romney or Gingrich. But it won't take much to beat him back down to obscurity -- just money, which remains Romney's sole claim to fame.
Also in the Eagle today, one of their "Excerpts From Our Blog" titled "Chrysler ad about pulling together is controversial?":
No doubt Obama lucked out with Chrysler, which contributed nearly all of the growth in the latest industry figures: not that the plan itself was so daring or improbable, but because he finally resisted the advice of advisers like Austan Goolsbee to let the company die. (For me, the most shocking revelation in Ron Suskind's Confidence Men: Wall Street, Washington, and the Education of a President was Goolsbee's argument that Chrysler should be sacrificed to help GM recover, and that Obama was initially swayed by Goolsbee.)
The unnamed operative quoted above is evidently Karl Rove. As Paul Krugman writes:
Much like only the Republicans are patriots, and only Republicans believe in traditional family values, only Republicans worship God, and only Republicans care about fiscal responsibility. I'm not very happy that Obama has decided to stake his reelection on being the one candidate who actually does follow those nostrums. I wouldn't be surprised if he finally gets some credit for it come November -- not just because the Republicans are so hypocritical on these counts but also because their self-righteousness has become so tiresome. And because they seem to take such perverse pleasure in doing what they can to tank the economy.
Coincidentally, I just read this in Thomas Frank's Pity the Billionaire: The Hard Times Swindle and the Unlikely Comeback of the Right (p. 20):
But in 2009-12 the Republicans have done just that, and while the thinking is slightly less harsh than Mellon's, that's only because it's more muddled. (Frank's many quotes from Glenn Beck make plain the right's lust for punishing the economy's losers, but he still falls short of liquidating agribusiness.) What's unclear is whether Republican sabotage is driven by bad ideology or craven politics, since both are so obvious.
Also see Andrew Leonard on the Eastwood commercial, rubbing it in Rove's face.
Update: When I wrote the above, I hadn't yet noticed this piece by Ed Kilgore, You Have Not Suffered Enough, America:
Of course, it's remarkable how easy it is for people to think that policies that benefit themselves personally (even if only relative to other people) are "good for the country" -- especially given how little of the country people see beyond their immediate circles.
Saturday, February 4. 2012
The news has been overrun with stories about the grave threat of Iran's nuclear program, or at least the grave threat of Israel's well publicized desire to pre-emptively bomb sites in Iran on the theory that doing so would slow Iran's development program down. Israel's treat has some credibility give that Israel launched similar bombing runs on nuclear power sites in Iraq and Syria, but those sites were smaller and closer, and Israel's plans weren't anywhere near as broadly advertised. Iran's sites are numerous, widely scattered, many in deep underground bunkers, presumably defended with anti-aircraft weapons.
It's not clear that Israel has the capability of launching an effective attack. Israel's case for attacking is uncritically examined in a long article by Ronen Bergman in The New York Times, Will Israel Attack Iran? Indeed, one thing that is clear from the article is that Israel is already attacking Iran. Israel has long backed anti-Iranian terror groups like the MEK. Israel has reportedly launched cyberattacks against Iran. And Israel has already managed to assassinate a number of Iranian scientists. Israel has been successful at goading the US and Europe into adopting crippling economic sanctions against Iran, and many of these have been adopted explicitly in hopes that by appeasing Israel they will forestall even larger and more deadly acts of war.
Tony Karon explains how this works:
Not to put too fine a point on it, but Israel's strategy is nuts. For starters, they assume that a nuclear-armed Iran would behave differently from every other state that has nuclear arms: namely, that it would use those weapons, perhaps even clandestinely, to preŽmptively destroy another state. All other states keep their weapons in reserve to deter an attack through the threat of retaliation and mutual destruction. The US is a partial exception to this: during its monopoly period the US became the first and last nation to ever drop atomic bombs on an enemy. Since then, some US officials have threatened to use nuclear weapons on enemies with no nuclear weapons, as in Korea and Vietnam, but there were never any concrete operations to do so. The US did perpetrate the only instance of "nuclear blackmail" when Kennedy threatened the Soviet Union over Cuba, and Nixon later bluffed an attack on Russia -- something he dubbed his "madman theory." Even now, when US presidents like Bush and Obama boast of keeping "all options on the table," the world is well aware that one of those options is nuclear.
Israel's fear of annihilation has deep psychological roots, most specifically in the Holocaust, but that paranoia also depends on the assumed identity between the Jewish people and the Israeli state -- an assumption that many who are troubled by the latter do not share. For Israel to see a potentially nuclear-armed Iran as an existential threat requires a whole chain of assumptions that are more or less dubious: that Iran would develop nuclear weapons expressly to attack Israel, and that Iran would be indifferent to nuclear retalliation by Israel. It would be far simpler, and far more logical, to think that Iran's sole interest in nuclear weapons would be to deter attack from hostile neighbors -- as, for instance, the examples of India and Pakistan show, or for that matter as was the case with Israel's own program. (I cautiously use the past tense here, as Israel too brags about keeping "all options on the table"; Israel's options include nuclear weapons, and indeed it's hard to see how Israel could manage to destroy Iran's bunkers without using nuclear weapons -- so to a large extent, Israel's perception of an Iranian nuclear threat is a reflection of Israel's own willingness to use nuclear weapons against Iran.)
One of the big points in the Bergman article is this idea that Ehud Barak has that there is only a limited time window in which Israel can act to stop Iran (presumably with acceptable consequences for Israel, if not necessarily for its allies), and beyond that window Iran will be immune from Israeli threats. That sounds like a very big incentive for Iran to push ahead: in essence, Israel is saying that as long as Iran doesn't have nuclear weapons Israel will feel free to attack it, but once Iran has nuclear weapons, Israel will have to treat Iran with more respect.
But stop for a moment and think what this means. Israel likes to be able to bully its neighbors. If Israel's security honchos think that Syria is doing something it doesn't like, Israel just swoops over and bombs it -- no questions asked, no risk. Syria doesn't dare strike back against Israel. And when Syria complains to the UN, the US is there to veto any resolution. Same with Lebanon, Jordan, Egypt, Iraq, you name it: Israel can act with impunity, because no one else can stand up to it. But a nuclear-armed Iran would cramp their style, forcing them to think twice before blowing something up or killing a scientist or political figure or whatever.
Another thing that's nuts about Israel's ploy: why should the world be willing to support, or humor, or appease, Israel's desire to do something insane? When Sarkozy, for instance, came out in support of sanctions, he sounded like Chamberlain in Munich, reluctantly doing so only to buy "peace for our time" -- the clear implication there was that the threat to peace he was appeasing was Israel, not Iran. The fact is that Israel has behaved criminally ever since its founding, when its first move was to overrun the UN partition boundaries to seize Jerusalem, and when the UN sent a mediator in Israelis promptly killed him. Israel then drove over 700,000 Palestinians into exile, stripped them of their citizenship and confiscated their property, in violation of UN resolutions. From 1949-67 Israel repeatedly violated the armistice borders, and in 1967 they more than doubled their territory, again ignoring UN resolutions to return the land in exchange for peace treaties. Instead, they set up hundreds of illegal settlements and outposts while stripping the occupied population of all rights. They promoted a civil war in Lebanon, and occupied the country for 18 years, then six years later came back and bombed it again, just out of spite. They've sent agents out into dozens of countries to commit murder. They've committed "false flag" acts of terrorism like the Lavon bombings of British offices in Egypt. They've developed nuclear weapons. And as Gershom Gorenberg shows in his recent book, The Unmaking of Israel, Israel's contempt for law has lapped over into their daily life.
The nations of the world should be working to rein in Israel's insanity -- not flattering it, or catering to it. One might, for instance, couple sanctions against Iran with a promise that the same (or stiffer) sanctions will be applied against Israel if the latter attacks Iran, or if Israel doesn't desist from activities to sabotage and destabilize Iran. (As the Bergman article explains, Israel's endgame viz. Iran is "regime change" -- how they would do this, let alone why the Iranian people would acquiesce in yet another foreign country picking its leaders, isn't explained at all plausibly.) One might, after all, reasonably suspect that Iran's desire to obtain nuclear weapons is conditioned by fear of attack by a nuclear-armed adversary like Israel (or, for that matter, the US). Since sanctions are seen as a route toward some sort of negotiated agreement with Iran, wouldn't they be even more effective if combined with an effort to make Iran more secure, as opposed to threats which only make nuclear weapons seem more desirable?
All this assumes that the charge that Iran desires to build a nuclear arsenal is correct, and not just a hallucination conjured from the paranoid psyches of Israel's security establishment. There is in fact much reason to doubt this. Iran is a member of the NPT, and as such has officially forsworn nuclear weapons development, and everything verified about Iran's nuclear power program conforms to NPT strictures. Iran's Ayatollah Khamenei has declared nuclear weapons to be inimical to Islam -- an unequivocal statement which will be awkward, to say the least, to amend in the future. Iran's desire to build nuclear power plants isn't unreasonable (although, given the inherent risks of nuclear power may not be wise -- the US continues to promote nuclear power plants around the world but there haven't been any concrete efforts to build new ones here in a couple decades). And Iran's long isolation from world trade -- part its own fault and part not -- has made it all the more critical to Iran to be self-sufficient. (Iran has already gone through the experience of inheriting an Air Force full of American F-15s that it is unable to buy parts for. The Bushehr reactor, started under the Shah, has long been at the mercy of foreign suppliers. On the other hand, one suspects that much of the opposition from France, Germany, and Russia is fear that Iran will succeed and wind up competing for sales of nuclear technology.) Moreover, history has shown that nuclear weapons are expensive and useless; however, having the materials, technology, and expertise may be enough to deter foreign attack. As Karon points out, a number of nations have "threshold capacity" -- everything they need to build a bomb but no finished bombs (he cites "Japan, Brazil, Argentina and others"). There is also a fair amount of ego at stake for Iran: they want to be seen as an advanced nation, one credential for which is mastery of nuclear technology.
Unless you think that Iran's leaders enjoy some death wish where the path to heaven passes through Jerusalem -- a strange perversion of Mohammed's "midnight flight" -- it's hard to think of any reason Iran would want nuclear weapons other than to put an end to Israel's persistent goading. Israel has been predicting that Iran will develop nuclear weapons in 3-5 years ever since 1995. The only thing different now is that they've finally shortened the time frame -- which oddly makes one think they must know something even though they have a two decade track record of knowing nothing.
I've made vague reference to "the world" above, which may or may not include the US, but I'm thinking more of Europe, Russia, China, Japan, and a few others -- India and Brazil especially hate to be excluded. The World doesn't have a lot of commitment one way or the other, but generally dislikes nuclear proliferation -- even if the risk is small, who wants more? -- and worries about an oil price spike, which is likely to happen if Iran's oil is taken off the world market, and certain if oil stops flowing through the Straits of Hormuz -- the main place where Iran's military could fight back (where, in effect, Iran could apply economic sanctions on the rest of the world, not that it would be so neat). (You'd also like to think that the World would put a high value on peace and justice, but their focus on Iran and not Israel here isn't encouraging.) World interests need to find a way to mediate the crisis, but for the most part they've assumed their risks are so minimal that they've just let Israel and the US steer their options.
The US is part of the World, but is also very peculiar -- at least where Israel is concerned. The US should share the World's concerns, and even more acutely. The US economy is exceptionally sensitive to oil price spikes, partly because oil is such a large part of the US trade deficit, partly because the US has kept gas taxes low so price spikes are relatively large. And the US has extensive business interests, not to mention troops, all around Iran, so if war broke out the US would feel the destruction as much as any country other than Iran. But even as Obama has backed out of the war in Iraq and is starting to back away from Afghanistan, his administration has turned aggressively against Iran. The reason is plainly that for domestic political reasons Obama has lost his command of US foreign policy toward Iran: he has subcontracted it out to Israel. (Of course, we should have recognized this the moment Obama appointed long-time Israel flack Dennis Ross as his "Iran advisor.")
There are lots of ways to understand why this worked out this way, but one as good as any is explained by David Bromwich in a review of Newt Gingrich's campaign tome (To Save America: Stopping Obama's Secular-Socialist Machine), a piece called The Republican Nightmare.
You can see how this works: Obama's basic sense of strategy is to take whatever the Republicans say as his normative guideline, then dial it back 10-15% toward sanity, confident that that's all the difference he needs to promise to keep his base and enough of the middle. This approach is bad enough on issues where the parties differ only in degree, but 85% of totally fucking nuts is way too far gone. Presidents normally have a lot of leeway in foreign policy, but here the AIPAC-whipped Congress insists on tying Obama's hands, preventing his administration from even talking to anyone in Iran, lest they figure out how to derail imminent war.
The funny thing is this is a situation that could be resolved if only both sides took some responsibility. All sanctions against Iran should be dropped as long as Iran's program is open to and approved by NPT inspectors. This means that Iran can have its nuclear power industry, including its own enrichment facilities, but cannot divert fuel for weapons development. On the other hand, Israel, the US, and any other party will be prohibited from any efforts to sabotage or destabilize Iran or to influence Iranian politics, under threat of severe sanctions. In effect, the World would guarantee that Iran cannot be be attacked or threatened, as has been the case almost constantly since the Shah was deposed in 1979. In turn, Iran would ensure that the Straits of Hormuz will remain open to shipping, and Iran would agree not to interfere in other nations except as agreed by those nations. This would also be a good time to solve the issue of Hezbollah in Lebanon: if Israel would return its last sliver of Lebanese soil and the several thousand Lebanese it has kept jailed since 2000, and agree not to ever attack Lebanon again or interfere in Lebanon's politics, Iran would agree to stop shipping arms to Hezbollah, and Hezbollah would in time disband its militia. (I don't see a need for them to do so until they can trust that Israel would keep up its end of the bargain. Iranian support of Hamas is another issue, but doesn't really amount to much. It would, of course, be good to resolve that too, that that is a much thornier problem from the Israeli side.) As these agreement go into place, the US would open diplomatic and commercial relations with Iran. In particular, Iran could (if it wishes) draw on US expertise to improve the safety and reliability of its nuclear power plants, since it's in everyone's interest that the damn things not blow up or melt down.
This is hardly utopian: pretty much everything I just described was offered for negotiation by Iran a decade ago, when Iran had a relatively reformist prime minister and proved helpful in getting international agreement on how to run Afghanistan. Bush not only rebuffed such efforts, he assigned Iran to his "axis of evil" -- a phrase that came out of the efforts of Israel-worshipping neocons who saw invading Iraq as a stepping stone to toppling Iran (they liked to say, "anyone can go to Baghdad; real men go to Tehran"). Obama was in large part elected because the American people was sick and tired of Bush's warmongering and the quagmires it led to, but since taking office he has never been able to muster the guts to face down the forces of militarism (of which the Israel lobby looms large). The Republican hawks are giving him another chance to campaign against senseless, fruitless wars. Maybe at last he can find himself, if only he doesn't embarrass himself too badly in the meantime.
Thursday, November 17. 2011
Saw this in the Eagle this morning, and it turned my stomach: Ben Feller: Countering China, Obama asserts US a Pacific power. AP article. Some quotes:
There's a tendency to treat this as business as usual, but at a time when the US occupation of Iraq has nearly wound down and the operating assumption is that US troop levels in Afghanistan will start to decline, when there's nearly universal agreement on the need to reduce military spending, this is an unnecessary and provocative new venture, intended to, well, do what? Prove that the world's most genocidal Anglo-settler nations are still joined at the hip? Show that the US is planning on entering yet another generation of Asian land wars? Prove that Obama is still under the thumb of the Joint Chiefs?
Over the last few years, we've seen a virulent outbreak of books fretting over the looming threat that China, with its huge population and burgeoning economic growth, might challenge the US for dominant superpower status. Reading such books involves a lot of navel gazing, since the essential premise is that China in the future will wind up acting exactly like the US has in the past. Perhaps the most disturbing prospect from today's news is that Obama may actually be reading such rubbish. True, one might argue that the US has lost leverage recently in its ability to influence politics in the bottom tier of "developing countries" but this has nothing to do with lack of military resources, and everything to do with their uselessness.
Meanwhile, Obama has utterly failed to confront the real Chinese threat: the way its currency manipulation preserves a crippling US trade deficit. The core reasons here is that Chinese businesses think in terms of national (which is to say popular) interests, where US government policymakers have chosen to support the world capitalist class with little or no regard for Americans who merely work for a living. Such policies started in the Cold War when the US gladly built up the economies of former powers like Germany and Japan as as well as borderlands like Korea and Taiwan as bullwarks against Communism. At first the US could afford such largesse. Later, as we started sinking billions into foreign oil, the ascendant right was happy to repatriate our losses by swelling the financial sector and selling off assets for inflated prices: in effect, our trade deficits became a pipeline redistributing wealth from the working class to the very rich.
No one but the neocons really thinks China's going to be impressed by the US caching arms in Australia. That Obama's bought into their phallic fantasies -- the whole "real men go to Tehran" thing -- is just sad. That he would defend the country from military threats that exist only in the fevered imaginations of discredited neocons but has no interest or desire to stop companies -- after forty consecutive years of trade deficits as likely to be foreign owned as not, and certain to have massive foreign investments -- from shutting down US jobs and moving them overseas is cowardly and indifferent. That he would mourn the loss of soldiers abroad 70 years ago but won't stand up to banks throwing people out of their homes, to business owners shutting down factories, to schools closing, here in America today, is just plain perverted.
As for Australia, the people there need to ask themselves how many more Koreas and Vietnams and Iraqs and Afghanistans will they let the US drag them into, not to mention the possible Gallipolis our alliance promises them.
Saturday, November 12. 2011
Striking letter to the editor in the Wichita Eagle this morning, from Debbie Jabara. Don't know anything about her personally, but the Jabara family name is eminent enough that it adorns an airport. She was either born into money, or married into it. Either way she seems to have gotten the knack of being rich and privileged and ungrateful:
It wasn't too long ago when it was commonly understood that it was the rich who were the freeloaders, collecting rents through their control of property and exploiting workers -- the people who actually made things and provided services -- for their profits. Moreover, that understanding is certain to return as the ill effects of ever-more-concentrated wealth become too obvious to rationalize away -- as will the notion that the idle rich have become decadent and delirious and depraved.
The tea party movement will be remembered as a lot of hoo-ha bankrolled by right-wing billionaires and ballyhooed by the usual crowd of Fox demagogues to advance their political agenda, then abandoned when it became embarrassing. The government they railed about is one that flows both ways depending on who has the most political clout: it could be used to better serve the interests of those OWS recognizes as the 99% -- and indeed in a democracy that is how it should work -- or it can be used, as it increasingly has been over the last thirty years, to help the rich plunder the rest. Aristocrats, like the Jabaras, have always feared that democracy might permit the masses to help themselves. But they have never been able to choose the nature or manners of the mobs that rise up to counter them -- except to make them worse by violent repression.
Thursday, October 20. 2011
I spent the last four days observing the notorious US health care system in action. My wife underwent surgery, and I mostly hung out, observing. I had been reading more than my share of nightmare stories, but it all went about as well as it could. The case was complicated, but the surgeon and her team seemed to understand it and appreciate the intricacies. The surgery itself went quicker and smoother than anticipated, and the projected three day hospital stay was cared for with patient confidence. There were a few problems that cropped up -- too-frequent oxygen saturation warnings, nausea coming out of the anesthesia -- but they were recognized and sorted out. The nursing staff was far more attentive than I recalled from ten years ago when my parents had extended hospital stays, or my wife's previous surgery when she was booted out of the hospital with unseemly (and as it turned out unfortunate) haste. The room was private, and I was invited to stay as long as I wanted -- 24 hours a day. I even found the nurses asking if there was anything they could do to help me. I managed to be present pretty much every time a doctor came by, and every step was intelligibly explained. It helped that my wife was fully cognizant of the whole process, and always knew what she needed to work on when to make progress. In short, it was pretty close to ideal: the way a hospital should work. No doubt the bill was damn expensive, but I didn't get the sense of wasted effort or overtreatment.
It no doubt helped that the surgery was a well understood procedure, and that the treatment was very closely aligned with it. My wife had no significant illness going into the surgery. That is, for instance, a very different situation from the one where my father entered the hospital with MDS, being treated by a staff of cardiologists who had no idea what they were up against, who made one mistake after another before they finally dumped him off on a doctor who had a clue. Or I could dredge up other cases from my own limited personal experience. (E.g., when my father spent four days in surgical ICU due to a lung infection that defied their treatment until it was fully cultured and identified. Or when my father-in-law was prescribed a drug for an eye problem but given a drug that crashed his blood sugar level, which then resulted in several days of unpleasant tests investigating his presumed hypoglycemia.)
Still, it isn't hard to imagine lots of things that could have gone wrong here that didn't. For one thing, the hospital had instituted a software system that tracked drug doses and interactions -- probably the samd system the VA hospitals are famous for: it slowed the nurses down repeatedly scanning patient and drug barcodes, but it eliminates errors that elsewhere are astonishingly frequent (I recently read as much as one per patient per day). The ratio of nurses to patients was higher than I had ever seen outside of an ICU. We never had to wait more than 1-2 minutes after calling a nurse, and they were never in an excessive rush to go elsewhere. Occasionally I would step out into the hall and see one at a computer . . . looking at what appeared to be continuing ed materials.
I suspect that this was a rare case where business competitiveness served to improve the care level: well-insured patients could choose to come to this hospital vs. the other competitor, and for the types of surgeries this particular ward handled there was enough profit to be made to reinvest some in quality service. So to some extent you can chalk this experience up as a victory for the American system (although as my wife is on Medicare I don't give any credit to the private profit-seeking insurance companies). Still, this doesn't argue that health care reform is not necessary. Rather, this reminds us that a reformed system has to maintain this sort of quality level, and to extend it more evenly and equitably. And it reminds me that it can be done, for even if this particular case represents a shrewd business decision on how to run a wing as a profit center, one key reason it succeeded is that the people working there were free to serve without having to constantly recalibrate their actions in favor of padding the business' bottom line.
Personal note: we're back home today. My wife still has a ways to go to get back to normal, but that seems certain to happen in due course. And I need some sleep, but that too will happen.
Wednesday, October 12. 2011
Went to the DMV today, which remains most people's prime case example of how inefficient and rude government can be. Simple task: needed to get my driver's license renewed. When I got there I was pointed toward a queue the length of one wall then wrapped around another: twenty-some people ahead of me. Wasn't too bad: I could lean against the wall, and I had a book, although I ran out of book in the hour or so it took me to get to the head of the line. The guy a couple slots ahead of me was talkative. A guy with a gray ponytail limped up behind me, and the two started comparing army records. The guy behind me offered to save him a slot if he wanted to sit down, and he did. The two kept yakking for much of the stretch -- mostly touching on politics. The guy ahead of me declared himself to be "a big Ron Paul supporter." The ponytail guy was psyched by Occupy Wall Street. The Ron Paul guy declared them to be "commies" but cut some slack for the crippled vet. Both agreed that politicians are crooks, that money has changed everything, but the Ron Paul guy was fixated on taxes whereas ponytail thought the government should work better.
Occasionally a woman behind me talked about the economy. She pointed out that when she was young she couldn't wait to get her driver license and get a job and get out of her parents' house, but her grown son isn't interested in any of that. On the other hand, she lives in a small town and there are no jobs -- nothing positive to draw her son out into the world. All these people could have understood their problems better, but there was no mistaking that those problems are real, and little sense that any of them are likely to be solved anytime soon. There once was a time when people would think twice before talking politics with total strangers -- same for religion and various other uncomfortable topics. Not now. Politics is everywhere, and everything is politicized -- much like the 1960s, at least for my generation back then.
Watched Charlie Rose tonight and he had on one person pulled from the Occupy Wall Street demonstrators and three left-leaning academic sympathizers -- I guess Rose figured he was wet blanket enough to dampen the enthusiasm. It reminded me again of the 1960s: the movement rep was an ordinary guy who couldn't really articulate the issues, but deep down knew someone has to make a stand, otherwise we're going to keep getting rolled over. On the other hand, Paul Krugman, Marshall Ganz, and Jared Bernstein had plenty of understanding of what's wrong. But they still had problems explaining it all: the problem they faced is that problems are so vast and interconnected that it's hard to know where to start. Money in politics is obviously a big part of the problem, but it's not just that. The problem with money is that it's allowed the rich to tilt the levers of government (and privately owned institutions the public depends on, like the media) to make them richer even at the expense of everyone else.
This actually is a problem that many of us recognized long ago. We have even understood that such increasing inequality is unstable and unviable: that the longer it goes on and the worse it gets, the more damage will be done not just to individuals at the bottom but to the entire social fabric. Yet it's been virtually impossible to get people's attention over such an "abstract" concept. But there really is nothing abstract about it: just start picking people at random from the 99% and you'll see real effects. And now it turns out that many of those people would do something about their plight if they only knew they could. That's the door that the demonstrations have opened, and down at the DMV I could feel the pent-up energy searching for some way to express itself.
One reason I see this resembling the 1960s is that when you think about it you'll realize that the new left won the culture wars back then: civil rights, getting out of Vietnam, abolishing the draft, women's liberation (everything from abortion to equal pay), clean air and water, consumer protection. The problem was that we didn't build the institutional framework to consolidate power to protect (and extend) those gains -- but one key reason that didn't happen was that we distrusted and never grew comfortable with power. So we left the rich too rich and the military-security state too well dug in -- the bases for the right's counterrevolution -- and we lost focus and, at least for a while, just lapsed and enjoyed the better world we had made.
But there's at least one important difference between the movement now and in the 1960s. Back then the US was a relatively affluent, relatively equitable, and much more idealistic society, so much of the movement generously fought for other people's rights. (That at least was the stereotype, although I for one always had personal reasons for my politics.) But things have gotten so much worse that now we all have "skin in the game," and that raises the political stakes -- the need, the resolve, the demand that change be real and secure.
Update: Let me add that the reason the new left issues won out was because they were intellectually persuasive, in large part because they tapped into basic ideas about equality, freedom, justice, and sustainability. The right has worked hard to erode those values, to cheapen and deprecate them, substituting greed and self-interest, order, and faith that if you just follow your betters all will be well. Those are shabby arguments, for as we clearly see now, they do not bode well.
Wednesday, September 28. 2011
Illustration from Paul Krugman:
His original context concerns the Euro, but it actually does a nice job of encapsulating the Obama administration's view of the economy: they've locked themselves in the bubble of "things that are considered politically feasible" -- a definition that they've generously allowed to the Republicans to make, and then to remake in order to keep it constantly out of reach, and not coincidentally ever further from those "things that might actually work."
It bears repeating that the main reason the left is so ticked off at Obama isn't because he's abandoned so much of his campaign rhetoric and turned out to be a closet conservative. It's because he keeps doing things that won't work, selected mostly because they fall into his limited understanding of what is "considered politically feasible." And this has become even more frustrating as the Republicans have consolidated ironclad power to disrupt anything Obama proposes: the main error in the diagram is the suggested size of the "things that are considered politically feasible" -- in the real world that bubble is vanishingly small as it turns out that nothing is actually feasible.
What distinguishes the left from Obama is not just a stubborn insistence on defending principles against the constant assault from the right; it's also the belief that it's possible to do something even when the right seems to hold all the cards.
By the way, I think that the set of "things that might actually work" is broader than the set of things that the left actually wants and supports. It is possible, for instance, to stimulate the economy without making it substantially more equitable -- the approach I'd prefer. It is possible to regulate banking without massively shrinking the finance sector. It is possible to fix some of the most dysfunctional aspects of our health care system without adopting a single-payer model. It is possible to extricate ourselves from Afghanistan without dismantling the entire system of imperial overreach. In each of these cases I'd prefer the more radical solution, and I think such a solution would ultimately work better. But Obama is not only not doing the right thing; he's rarely does anything that would work, and on occasion he actually makes things worse. And worse for himself and his prospects, by not proposing and not selling policies that might actually work, he's let the self-appointed guardians of the "politically feasible" move the debate ever further into the realm of the ridiculous, half-baked nonsense spouted by the far right.
Tuesday, September 27. 2011
Op-ed in the Wichita Eagle this morning, by Dr. Margaret Flowers: Medicare for all would save lives and money. Flowers is co-chair of the Maryland chapter of Physicians for a National Health Program (PNHP), a minor celebrity for getting arrested protesting in Washington trying to get single-payer back on the Democrats' agenda. (See her interview by Bill Moyers). She's in Wichita today, to give a talk at the Murdoch Theater tonight.
I'm going to quote the whole piece below, but break it up so I can get some words in edgewise. What she has to say is fundamentally right but incomplete and inadequate, so I want to build on that.
I believe the "37th" figure is rank based on average longevity -- one of many measures where the US has mediocre performance. The rub there is "average" given how inequitably health care services are distributed among Americans. Of course, most Americans think they're well above average, and they're right that the stats are distorted by those who aren't. It's just that they have trouble understanding how easily, and how arbitrarily, one can slip and fall into the other. Reminds me of the DC sniper story: one moment you're out on a routine shopping trip, next you're cut down by an invisible assassin's bullet. Isolated individuals can get fired, lose their insurance, suffer a debilitating illness or accident, go bankrupt, almost as suddenly.
Last time I checked, the health care sector accounted for 18% of GDP, with 20% projected not too far off. Back when Clinton tried to pass his scheme in 1993-94 the number was 14%. It's a bit simplistic to translate these figure to the current budget quandry -- only part of the total health care bill goes to the government, and most of that goes to Medicare and Medicaid which are funded on a different set of books -- but the longterm prognosis is bleak: the industry is set on a path to devour the economy, and while it's not clear where the choke point is, it's clear that something has to give sooner or later. You can't sustain infinite growth indefinitely, yet the logic of the investors demands that they try.
It's worth noting that until 1990 Switzerland had virtually the same health care cost structure that the US had, with both pulling away from the rest of the world. But where the US continued on its profit-seeking path, Switzerland clamped down and forced its private insurance companies to be run as non-profits, and that simple act stabilized their cost structure. Switzerland still has the world's second most expensive health care system, but as a percentage of GDP is is virtually the same as it was in 1990. As T.R. Reid shows in The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care, there are lots of ways to manage health care costs without giving up progress and quality, but the essential element of all of them is to limit profit-seeking.
The ACA does provide some measure of cost controls -- enough to claim to be revenue-neutral while providing insurance for many more people than are currently covered. (I don't know where this "23 million uninsured through 2019" figure comes from -- that's way more than I had been led to believe, although it's always been clear that the ACA scheme wouldn't provide universal coverage.) The main problem is that by leaving most people without any sort of non-profit health insurance option the profit-seeking private insurance companies will have no competition and therefore very little restraint on their ability to increase costs.
There are various approaches to containing Medicare/Medicaid costs -- all unpopular with vendors who are conditioned to feel the pinch even before it arrives -- but the most serious attacks on Medicare have been schemes to increase costs, mostly by pushing Medicare recipients into private insurance plans. The so-called Medicare Advantage plans were a prime example. Obama's offer to raise the eligibility age for Medicare is even more ominous. The rationale there is to move costs off the federal budget and onto people who will wind up paying much more -- in their lives even more than money.
Medicare does bear some responsibility for rising health care costs, especially early in its history from 1965 into the 1980s: by agreeing to pay "customary" fees to hospitals and doctors they basically handed out blank checks, which vendors took advantage of to constantly roll up prices much faster than the inflation rate. By the 1980s, prices had risen so much that the government started to impose restraints. At the same time, the industry was becoming more profit-seeking, with vendors working persistently to game their way around the rules.
On the other hand, Medicare is vastly more efficient than private insurance companies, imposing much less overhead -- close to 3% vs. 30% for private insurance companies.
There's no doubt that a single-payer insurance system would be the single most effective way to improve our current health care industry, and that it would be the single most important step to solving the longterm problems endemic to the current system. As we generally understand the term, it also represents an important commitment to universal health care, and all that implies -- the sense that as a people we share responsibility for each other's welfare, and that as a democracy we believe that the government exists to serve the people and take purposeful collective action for our behalf.
That last sentence, of course, is anathema to the faction of the American people known as Republicans. They've lately been obsessed with disempowering people -- with scaring poor people away from the polls (where they might vote their self-interest), with busting unions, with preventing people from appealing to the regulators and/or the courts for protection from corporate abuses. They're upset that banks should be limited from scamming customers, or each other. And they'd rather die than cramp the freedom of the health care industry to price gouge, overtreat, undertreat, or commit the occasional malpractice. They won't even allow Medicare to negotiate the price of drugs -- just send more blank checks.
The biggest advantage of single-payer is simplification: everyone gets the same insurance, so nobody has to market a bunch of differences; every vendor gets paid filing out one standard set of forms, instead of having to work up different coding schemes one for each separate insurance company each with its own schedules and formularies and pencil pushers dedicated to the easiest way to improve the company's bottom line: by denying benefits. You also get rid of the collection agencies pursuing bills the insurance companies denied, and the bankruptcy lawyers. This also eliminates the need for vendors to overcharge paying customers for those who don't pay, which starts to bring prices back in line with costs.
Universal coverage also solves a lot of problems. It means, for instance, when when you're wheeled into the emergency room, the first person you see is someone trying to help you, rather than trying to pick your pocket. (A big problem now is emergency rooms dodging patients so they don't get stuck with the bill.) It means that your car insurance costs will drop since one can safely assume that future medical costs will be covered. It means that malpractice damages will be reduced (for the same reason, although not having to cover the lawyer's premium is a bonus). It means that people can move more freely from job to job, can retire early, or can afford to start new businesses without worrying about losing their coverage.
So single-payer insurance with universal coverage would produce an enormous cost savings right from the start. It would also eliminate one of the main forces behind the persistent inflation of costs -- the private profit-seeking insurance companies -- and it would provide the basis for negotiating fair and manageable compensation for the vendors. But to get there, we have to get past the political obstacles, which is mostly the desire of a certain political party (and a few of its admirers in the "loyal opposition") to preserve a system of larcenous capitalism exploiting our deepest health fears, and their key ploys: that everyone should pay their own way, that no one (other than the companies) should organize, that progress is magically linked to free enterprise, that trampling on the prerogatives of billionaires will destroy "our way of life," that your democratically elected government is set on killing you first chance they get. It shouldn't take much thought to realize that all this is nonsense -- which is a good part of the reason they work so hard to keep you from thinking.
I meant to get the above done and posted before the lecture, but ran out of time. Big crowd. Bottom floor was about 80% full when we got there, so we went up to the balcony, which wound up about 30% full. Flowers dispelled most of my reservations. She advocated something more than current Medicare for all, calling for an Expanded & Improved Medicare which among other things would dispense with the co-payments and limits of the current program. (Those seem to be carved out mostly to support private secondary insurance programs. People who buy such insurance often feel like they're paying for their own insurance when they're actually just tipping a company that assumes virtually no risk.) Especially when reformers talk about cost control, people get nervous that their benefits will be cut -- ignoring that the cost controls of private insurance companies are far more restrictive, and much harder to appeal, than anything Medicare might do. Still, my recommendation is to pitch single-payer less as a way to manage costs and provide universal coverage than as the essential way to improve health care quality.
Flowers actually did a pretty good job of explaining why this is so. She pointed out that under the current system many people are overtreated, many are undertreated, and many are mistreated. A single-payer system would provide more consistent coverage, more consistently in line with evidence-based best practices, with greater transparency. She called for efforts to realign doctors' incentives with better outcomes -- no simple task, but the focus should be less on paying doctors more for the desired results than on disinteresting doctors from the financial impact of their treatment options. She called for better resource planning, noting that it is more effective to have centers in a given area specialize than to have them compete across the board, adding excess capacity which they then have a stake in filling up. She fielded a question on malpractice, correctly noting (as I did above) that bad outcomes wouldn't have to be budgeted ahead of time, and that there were other ways to limit the expense. She suggested paying centers to maintain a given level of capacity regardless of utilization instead of having them risk overbuilding then have to figure out how to make it pay off.
Someone asked about high technology driving costs up, and she covered various aspects of this, especially how patentability distorts pharmaceutical research. She pointed out that most of the real research is public-funded, especially by NIH. She didn't go as far as I would in eliminating patents and promoting more competitive sourcing, and she didn't point out how proprietary research has been used to hide drug defects, and how this in turn has led to massive class action suits that have cost companies billions of dollars (as well as patients thousands of lives -- another area where reform promises to improve quality).
She also pointed out that the health care industry, huge as it is, only affects a limited aspect of public health: much more important is a clean environment, safe workplaces, education, good food, security from crime and violence, the sense of shared responsibility that comes with an equitable society -- not her phrasing but that's the gist of it. So a political system that has been captured by corporate profiteers has not only turned health care into a system for reaping enormous profits but has done so by corrupting the very nature of democracy. Change the latter and fixing the health care system becomes easy; fail to do so and the system will lurch on until it falls apart, to our great horror.
Saturday, September 24. 2011
This from an AP piece by Matthew Brown which appeared (somewhat shorter) in the Wichita Eagle this morning, titled Victim in Mont. grizzly attack was shot by friend:
One could use this to question the sanity of encouraging every fool in the country to carry guns, but more than anything else this reminds me of George W. Bush's foreign policy, albeit on a much more intimate scale. There, too, doing things one shouldn't do in the first place led to reckless endangerment and death, often by "friendly fire." There, too, "no charges are expected."
Thursday, September 22. 2011
Sometimes one gets an idea and just doesn't know what to do with it. I'm not normally in the business of dispensing tactical political advice. And I'm certainly in no position to do anything about this, but here's my idea:
As I said, if this is the level of politics you are into, this is an idea worth pursuing. At this point it seems much more important to elect a Democratic Congress than it is to reŽlect Obama. Moreover, it's something you can campaign for. Obama has backpedalled, compromised, and/or flat out surrendered on nearly every issue he was thought to stand for, the result being that the best he can promise is to be a bit less awful than his opponent. One can (and no doubt will) vote for such a person, but little or nothing more. A Congress focus would help to clarify these issues, to get people interested, to bring out the vote.
While I'm at it, I want to gripe about an op-ed in the Wichita Eagle today: Davis Merritt: Give Our Leaders Permission to Compromise. In particular, Merritt spends a lot of time whining about both parties as if they are equally stunted:
Actually, there is nothing fallacious about this choice. There is a general requirement that revenues and expenses be balanced -- not that it's not possible to run some degree of deficit year after year; indeed, we've often done just that -- so given our current and projected deficits it does make sense to raise revenues, cut expenditures, or both. In excluding revenue gains, Boehner insists on balancing the budget by cutting expenses, especially on social spending. The net effect of this is to reduce the living standards of the poor, the elderly, the disabled -- the sort of people more likely to vote Democratic than Republican. Pelosi's position is to defend that social spending -- indeed, she most likely would like to see more of it, as would most of the people who vote for Democrats. But neither side is saying we can have both lower taxes and higher social spending: Pelosi, like most Democrats, is on record as favoring higher taxes to pay for more spending. So this is a real issue. The only way Merritt can imagine it as a false one is to disconnect the rhetoric from reality and to generously assume that both parties are equally entitled to their views. (Unfortunately, Obama, whose grasp on reality seems to include nothing more than polls and the views of the punditocracy, shares Merritt's sense of fairness -- a worrisome point for anyone in the real world likely to pay for his compromises.)
One curious thing here is that while Merritt imagines that both sides are taking extreme positions, only one side is. The Democrats are asking for little more than preserving the historic levels of support for Social Security and Medicare, paid for by restoring tax rates on the rich to levels that are still below historic norms (at least over the last 70 years). While the Republicans are insisting on draconian cuts in spending to allow them to cut taxes on the rich even more. This range of options is so skewed that any compromise between the two positions would be a major surrender to the right, for no reason other than the right is so much more aggressive in its goals.
But let's go back to reality. The fact is that we're in the midst of a profound economic downturn with very high long-term unemployment and very little productive investment, with the rich sitting on hordes of cash that is not being put to good use. And this is on top of a long-term trend that has suppressed the labor market while engorging the already rich. There is a historically proven way of dealing with such crises -- one embraced by every Republican president since Hoover -- which is to crank up public spending to make up for the private sector's shortfall. But aside from a minor stimulus bill Obama squeaked through when the Democrats had control of Congress, we haven't been doing that. Indeed, the main point of the Republicans' budgetary stranglehold has been to keep public policy from improving, or even ameliorating, the economy -- presumably the theory is that Obama will be blamed for the prolonged economic slump and be defeated, allowing them to capture all three branches of federal government and restore the crony capitalism regime that the Bush administration had perfected.
Saturday, September 10. 2011
I highly recommend that you read Mike Lofgren: Goodbye to All That, subtitled "Reflections of a GOP Operative Who Left the Cult." Lofgren has evidently been working as some sort of staff person on the GOP side of Congress for the last 30 years -- his details on that are sketchy at best. I don't give him much credit either for his background or perspective, other than that he doesn't feel like defending the Democrats except as a side-effect of defending sanity. He starts off:
After that, he treads rather lightly on the psychosis -- although come to think of it that's a subject that someone should investigate a bit further. Rather, he focuses in on how Republican tactics have evolved into "war minus the shooting" -- a single-minded determination to gain political advantages regardless of the cost to the nation as a whole. He quotes John Judis:
I've been reading a lot of early American history recently, including Sean Wilentz's massive The Rise of American Democracy: Jefferson to Lincoln, so Calhoun and company are quite vivid on my mind -- so much so that I'm now wary that a South Carolina congressman might take a cane to a Massachusetts senator.
Lofgren then continues:
Shortly after the 2010 elections I realized that virtually all of the widely touted Republican "gains" were the result of Obama voters not showing up to vote, but I've never seen those numbers reported in quite that way. Obama's described the loss as a "shellacking": the implication was that his party and policies got rejected by the middle of the political spectrum, not that he had lost the faith of the people who had voted for him by repeatedly selling them out to the moneyed interests of Washington. Of course, that's me talking; Lofgren puts it like this:
Lofgren sums up the Republican platform in three points, where militarism and religion bring up the rear, but most important by a big margin:
Anyhow, read the piece. Pass it along. It may not convince your Fox-washed gun nut cousin -- not mine, anyhow -- but it's clearly written and thought out, and it shows that the author is not just reacting to the sour taste his Republican colleagues have left in his mouth, he's done some research on his own.