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27 November 2009

Affordable Access to Health Care

The Democratic health-reform plan never was primarily about affordable access to health care by all—not if affordability for all is meant to denote a uniform price that can be paid by everyone. In fact, what is affordable for one person may be out of reach for the overwhelming majority. The false ideal of equal financial treatment is the unrealistic standard set by opponents of health care reform.

The actual goal of health care reform is to attain equality in the level of medical treatment. The American health care industry is widely recognized as providing the best solutions for almost any disease or malady; however, those solutions are not available to everyone. Health insurance plans or personal finances limit most patients’ care to the dispensation of those techniques that are well compensated by the rules and procedures of the government or of employer-funded policies. They cannot afford the level of medical service that wealthy patients, often from abroad, purchase out-of-pocket.

Health-care mandates are merely a burden-sharing device that allows the entire population to benefit from the technological and scientific progress that has made medical practice in the U.S. the envy of the world. Let us make the availability of medical care in the U.S. the envy of the world, too.

22 November 2009

Rationalizing the War on Terrorism

Don’t hand KSM and Bin Laden an excuse for using terrorism to dispute U.S. policy

Don’t excuse the Bush administration (or, for that matter, the Obama administration) for adopting war to combat terrorism.

Writers like Ray McGovern of Consortium News could be suspected of doing the bidding of autocratic Middle Eastern regimes, like Egypt, Saudi Arabia, Kuwait, etc. They divert attention from the complicity of those regimes in the preservation of the Israeli power structure at the expense of Palestinian autonomy. The more farsighted policy for oil-rich Arab nations to pursue (and this is not a religious conflict) would be to invest in making Palestine a depot for their energy projects and a spring of the intellectual resources needed for their own economic development.

There is nothing acceptable in wielding terrorism (again, calling it Islamic is a red herring) to effect change in U.S. or NATO policy vis-à-vis Israel. Not only is terrorism an outrageous violation of the standards of civil behavior, it is being directed at the wrong target. Energy (and particularly oil and gas) is certainly at the center of the unrest in the Middle East; but the real culprits are not the users of energy—the energy suppliers are at fault. They have been unwilling to make the sacrifices necessary to achieve their professed pan-Arab goals and instead have been seduced by a sense of entitlement. Because fate gave them natural wealth under their lands and waters, they believe they can demand compliance with those goals from less well-endowed countries without diminishing their immediate returns.

Remember Robert Heinlein’s immortal acronym, TANSTAAFL (There Ain’t No Such Thing As A Free Lunch). The Arabs who used terrorism to achieve their political goals on 9/11 neglected this truth—if you want something badly enough, you’re going to have to pay for it. Moreover, they have been giving their oppressive governments a free ride by not demanding greater accountability in the use of the wealth generated by their energy resources. Here is the anomaly of the religious issue: Terrorism is Islamic because it is being used in defense of the shortsighted policies of autocratic regimes (particularly Saudi Arabia) that have wrapped their authority in the legitimacy bestowed by religious dogma.

15 November 2009

PTSD and the All-Volunteer Army

America in the Twenty-first Century is not ready to sustain an all-volunteer military force—not if it expects that force to fight long wars. There are Americans who are psychologically apt to withstand the trauma of the battlefield, even when that battlefield is defined by terrorist attacks that can happen anywhere without warning. However, many of the volunteers who have joined America’s armed forces (37% by one estimate) are ill-suited to combat and suffer from post traumatic stress disorder when exposed to the life-threatening and brutalizing pressures of warfare.

That proportion of America’s fighting force may actually have been higher when the fighting force was assembled by a draft, but I doubt it. Although the military is now patently self-selected, it is not correct to assume that voluntary enlistment eliminates those who are not psychologically suited to such a stressful occupation. In fact, the military has been shown to be filled with large numbers of commissioned officers NCOs who suffer from PTSD. An all-volunteer military should have no reason to accept applicants for positions in it who do not display adequate immunity to breaking down under stress.

Unfortunately for the viability of the all-volunteer fighting force, America’s decision to maintain a large military in support of an aggressive foreign policy does not reflect the psychological profile of its population and is not consistent with its willingness to pay the cost of attracting sufficient numbers of suitable individuals to join. PTSD is a tragic consequence of warfare that is avoidable when we choose to use violence to impose our policies on other countries only as long as we limit our imperial goals to those for which we actually have the human psychological resources to pursue them. Our superpower status is situational. It is limited to those situations where we are mentally prepared to act like a superpower.

PTSD may be a true gauge of the congruence of a war policy with the American character. When those of us who choose a military career, or who are impressed into service, believe there are important values at stake in a conflict, it may be easier to repress the overwhelming psychological burdens of its traumatic events. However, when the link is broken between the actions that soldiers are called on to take and the defense of their common beliefs or interests, only a few personalities can modulate the extreme emotions aroused by those actions. In the case of unsuitable persons subjected to such trauma, the result may run the gamut from disturbances to domestic life at one end to violent outbreaks like the Fort Hood massacre at the other. The more commonly military servicemen and servicewomen experience PTSD, the less likely it is that the nation is calling on them to do what it should.

Hubris and Book Titles

How presumptuous for Jonathan Safran Foer to conclude that telling most people that he was writing a book entitled “Eating Animals” would elicit their unprejudiced opinion that vegetarianism is ethically superior to meat-eating. Another word for it is hubris—assuming that one’s choice for a book’s title cannot sway a reader’s perspective on its subject.

After all, humans are still on top of the food chain. That does not keep us from being humane in our treatment of other animals, but we don’t do that in order not to cause them pain. The real reason for making the effort to treat other creatures as gently as possible is to obviate brutalizing ourselves.

Perhaps Elizabeth Kolbert should have suggested another title to Mr. Foer in the November 9, 2009, New Yorker, as she did in the August 31, 2009, issue to Colin Beavan, the equally egotistical author of “No Impact Man.” How about “Denying We’re Animals.”

13 November 2009

PTSD and the All-Volunteer Army

America in the Twenty-first Century is not ready to sustain an all-volunteer military force—not if it expects that force to fight long wars. There are Americans who are psychologically apt to withstand the trauma of the battlefield, even when that battlefield is defined by terrorist attacks that can happen anywhere without warning. However, many of the volunteers who have joined America’s armed forces (37% by one estimate) are ill-suited to combat and suffer from post traumatic stress disorder when exposed to the life-threatening and brutalizing pressures of warfare.

That proportion of America’s fighting force may actually have been higher when the fighting force was assembled by a draft. Although the military is now patently self-selected, it is not correct to assume that voluntary enlistment eliminates those who are not psychologically suited to such a stressful occupation. In fact, the military has been shown to be filled with large numbers of commissioned officers NCOs who suffer from PTSD. An all-volunteer military should have no reason to accept applicants for positions in it who do not display adequate immunity to breaking down under stress.

Unfortunately for the viability of the all-volunteer fighting force, America’s decision to maintain a large military in support of an aggressive foreign policy is not proportionate with the psychological profile of its population or consistent with its willingness to pay the cost of attracting sufficient numbers of suitable individuals to join. PTSD is a tragic consequence of warfare that is avoidable when we choose to use violence to impose our policies on other countries only as long as we limit our imperial goals to those for which we actually have the human psychological resources to pursue them. Superpower status is limited by our mental preparedness to act like a superpower.

PTSD may be a true gauge of the conformity of a war policy with the American character. When those of us who choose a military career, or who are impressed into service, believe there are important values at stake in a conflict, it may be easier to suppress the overwhelming psychological burdens of its traumatic events. However, when the link is broken between the actions that soldiers are called on to take and the defense of their common beliefs or interests, only a few personalities can modulate the extreme emotions aroused by those actions. In the case of unsuitable persons subjected to such trauma, the result may run the gamut from disturbances to domestic life at one end to violent outbreaks like the Fort Hood massacre at the other. The more commonly military servicemen and servicewomen experience PTSD, the less likely it is that the nation is calling on them to do what it should.

11 November 2009

John Muhammad and the Fort Hood Killer

Was the reason for the Fort Hood Killer’s crack-up any different from that of John A. Muhammad, the Beltway Sniper? The Commonwealth of Virginia executed the latter without concern about his presumably Muslim background. His shooting spree was no less terrorizing than Maj. Nidal Malik Hasan’s. They both deserve severe punishment for their brutal crimes.

And yet, Dorothy Rabinowitz, in her November 10, 2009, Wall Street Journal Op-Ed article, “Dr. Phil and the Fort Hood Killer,” implies that Maj. Hasan committed a conspicuously dangerous brand of terrorism because it was clearly motivated by “virulent, anti-American, pro-jihadist sentiments.” It rightfully outraged patriotic supporters of the wars on Iraq and Afghanistan, but it was no less inhumane than the sniper terrorism that took place around Washington D.C. eight years ago. Both acts were perpetrated by persons who had lost their sense of social equanimity, if ever they had it, owing to equally mysterious causes.

It is important to understand, however, that as our society becomes more technologically advanced, it is becoming more vulnerable to extreme violence. As we shrink the information intervals between us, our security becomes more fragile. Those with murderous intentions can more easily employ weapons and take opportunities to threaten the safety of innocents. We cannot simply identify this threat with a religion or ideology; the very structure of society must be shored up to withstand the many menaces that technology enables.

05 November 2009

Snubbing Iran’s Democrats

Mariam Memarsadeghi and Akbar Atri, whose OpEd, “The President Snubs Iran’s Democrats,” appears in the November 4, 2009, Wall Street Journal, ought to know better than to characterize the Obama Administration’s refraint from openly supporting opposition groups in Iran like Takhim Vahdat as snubbing democrats. Or perhaps they have deliberately chosen that as their strategy.

It is not the mission of the U.S. to foment democratic revolution abroad. Ms. Memarsadeghi apparently is closely associated with NGOs that seek to promote political change as well as human rights in the Middle East. She should know that only subtle and covert programs are tools that the U.S. government can use, particularly in that region, without abandoning its ability to interact effectively and peacefully with other state governments.

Despite its apparent frustration, Takhim Vahdat must publicly allow the Obama Administration to play that game while encouraging it to support the group’s humanitarian operations. Washington is filled with appropriate channels to seek covert government assistance for political reform in Iran; there also are many private sector sources of such assistance. Using the Wall Street Journal Op-Ed page for that purpose may cause a public opinion stir in Washington, but it won’t go far towards changing the status quo in Tehran.

Honorable Way of Warfare

Terrorism is not an honorable way of warfare. Slaughtering civilians at their workplaces, on the street, in their places of worship, as they commute does not qualify the perpetrators as wagers of classical conflict between states. So I take issue with former Army ranger and writer for the Center for New American Security Andrew Exum, quoted in Jane Mayer’s article in the October 26, 2009 New Yorker, “The Predator War,” who said that “as a classics major. . ., there’s something about pilotless drones that doesn’t strike me as an honorable way of warfare.”

There has been woeful confusion about the causes of the disappearance of safety in the world in recent years, and on the selection of appropriate methods to use to control them. Civil order, which helps assure the personal security of residents of the world’s nations, has traditionally been guaranteed by domestic police forces. Challenges to the authority of nations have been defended by their armed forces. However, the technological advance of communications and means of destruction have allowed extremist religious and ideological groups to become virtual states. Non-state entities now have the power to threaten both civil order and national authority. This has led governments to use their armed forces to take the police actions required to combat non-state law-breakers.

There no longer is an honorable way of warfare—it has become barbaric and unnecessary. There is certainly no honor in choosing to risk innocent life, whether of the police or of bystanders, in order to enforce rules of civil order. If unmanned drones can be used with sufficient surgical precision to avoid “collateral damage,” no classical consideration of honor should prevent their being used to protect innocent life and welfare from the threat of terrorism.

03 November 2009

Afghanistan Has No Nationalist Imperative

Steve Coll has spent a lot of time in Afghanistan and speaks with a lot of authority. However, his comment in the October 26, 2009 New Yorker ignores his own warning not to fall prey to “mirror imaging.” There is no nationalist imperative in the Afghan psyche. When that country has been free of invading foreign armies, civil order has been confined to localities within a political system of practically autonomous fiefdoms. That condition is not chaos; it’s just anarchy.

Certainly anarchy assaults Western liberal democratic (and autocratic, for that matter) sensibilities; but it suits the Afghan temperament. In part, this may owe to the topology of the country: an assemblage of cellular communities divided from each other by hard mountainous shells. The anomaly of Afghanistan has bedeviled Western, Russian, and Asian empire-builders for centuries, not just since the 1979 Soviet invasion.

Mr. Coll’s nation-building agenda (election reform, ethnic integration, political party growth, constitutional and governmental reorganization, eradication of corruption and drug-dealing, and non-violent dispute resolution) might well eliminate security-threatening disorder in a culture that values the rule of law. However, Afghanistan’s culture primarily values family and clan welfare. In this environment the American and Western objective of securing their own safety can best be assured by monitoring a place like Afghanistan, intervening in it when necessary, and letting it behave in its anarchic way the rest of the time.

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