27 December 2009
How to Support Liu’s Crusade
The U.S. Government and its liberal democratic allies are not the correct institutions to take on the undemocratic ways of the Chinese government. The Chinese people seem to be satisfied, on the whole, with the autocratic rule of the Communist party in Beijing, as long as they are given the opportunity to earn a living and even become rich. Liu Xiaobo has a different idea—one that he is certainly entitled to under the West’s concept of human rights. However, that idea of free expression of political views is certainly not commonly held by Liu’s compatriots.
Liu’s campaign has gotten him into deep trouble with the Chinese government whose suppression of dissent is Liu’s target. Although foreign governments like the U.S. and other liberal democracies are often the tools their citizens wish to use to spread the acceptance of their political values, this is a very high stakes game in current economic conditions. It is a game that should properly be undertaken by private non-governmental organizations and individuals rather than by their official agencies on whom promoting the economic welfare of their nations depends.
Direct governmental pressure on the Chinese Communist regime will only cause it to dig in harder, mainly at the expense of its own populace. Changing the willingness of the Chinese people to demand better human rights treatment from their own government is a private matter. Apparently, Liu’s strategy has been to risk personal imprisonment in order to embarrass likely sympathizers abroad into taking action to help him enlighten, as it were, a number of Chinese citizens sufficient to weaken the tacit acquiescence on which Communist rule rests.
There certainly are potential sources of support for that effort that have as much power, monetary and technological, as most governments to strengthen the hands of Liu, his wife, and their cohorts to convince a majority of their countrymen that life in a free society would be better for them all.
The U.S. Government and its liberal democratic allies are not the correct institutions to take on the undemocratic ways of the Chinese government. The Chinese people seem to be satisfied, on the whole, with the autocratic rule of the Communist party in Beijing, as long as they are given the opportunity to earn a living and even become rich. Liu Xiaobo has a different idea—one that he is certainly entitled to under the West’s concept of human rights. However, that idea of free expression of political views is certainly not commonly held by Liu’s compatriots.
Liu’s campaign has gotten him into deep trouble with the Chinese government whose suppression of dissent is Liu’s target. Although foreign governments like the U.S. and other liberal democracies are often the tools their citizens wish to use to spread the acceptance of their political values, this is a very high stakes game in current economic conditions. It is a game that should properly be undertaken by private non-governmental organizations and individuals rather than by their official agencies on whom promoting the economic welfare of their nations depends.
Direct governmental pressure on the Chinese Communist regime will only cause it to dig in harder, mainly at the expense of its own populace. Changing the willingness of the Chinese people to demand better human rights treatment from their own government is a private matter. Apparently, Liu’s strategy has been to risk personal imprisonment in order to embarrass likely sympathizers abroad into taking action to help him enlighten, as it were, a number of Chinese citizens sufficient to weaken the tacit acquiescence on which Communist rule rests.
There certainly are potential sources of support for that effort that have as much power, monetary and technological, as most governments to strengthen the hands of Liu, his wife, and their cohorts to convince a majority of their countrymen that life in a free society would be better for them all.
16 December 2009
Three Groups of Service Providers Block Healthcare Reform
The health care reform bills in the U.S. Congress have turned out to be, in fact, health care insurance reform bills, despite the charges that the bill’s Democratic drafters have caved to pressure from the insurance industry. As Darcy Burner points out on the December 16, 2009 Alternet website (www.alternet.org), the Senate bill only gets a passing grade for fixing insurance company injustices (like pre-existing conditions, etc.) while failing to bring down the cost of insurance coverage, to raise the effectiveness of health care, or to guarantee an improvement in any of those areas in the next twenty years.
There are three groups of service providers who have an interest in preventing true health care reform:
1) Health care providers who need to cover their expenses and assure a profit on their operations: hospitals and doctors. They all operate within a program of incentives that rewards them for providing services rather than for attaining good healthcare results. One of the most egregious examples of this incentive muddle is the ownership of imaging and other diagnostic laboratories by doctors.
2) Trial lawyers, who are among the smartest and wealthiest contributors to politicians on all sides of the issue. They protect their lucrative medical liability business by convincing consumers, and their representatives in Congress, that an individual’s health is better assured in the courtroom than in consultation with his health care provider.
3) Oh, and insurance companies who must protect their profit if they are to stay in business financing the expense of our totally overpriced and inefficient health care system.
The American political culture will never achieve needed health care reform if voices, such as Ms. Burner’s or Howard Dean’s, don’t keep harping on the weaknesses of whatever legislation can be adopted by the Congress as an initial step. That should be their role, while the role of those in office and of the President is to get something on the books now. The Burners and Deans must keep the pressure on for improvements in reform to occur in the future. Our democratic system is not easy.
The health care reform bills in the U.S. Congress have turned out to be, in fact, health care insurance reform bills, despite the charges that the bill’s Democratic drafters have caved to pressure from the insurance industry. As Darcy Burner points out on the December 16, 2009 Alternet website (www.alternet.org), the Senate bill only gets a passing grade for fixing insurance company injustices (like pre-existing conditions, etc.) while failing to bring down the cost of insurance coverage, to raise the effectiveness of health care, or to guarantee an improvement in any of those areas in the next twenty years.
There are three groups of service providers who have an interest in preventing true health care reform:
1) Health care providers who need to cover their expenses and assure a profit on their operations: hospitals and doctors. They all operate within a program of incentives that rewards them for providing services rather than for attaining good healthcare results. One of the most egregious examples of this incentive muddle is the ownership of imaging and other diagnostic laboratories by doctors.
2) Trial lawyers, who are among the smartest and wealthiest contributors to politicians on all sides of the issue. They protect their lucrative medical liability business by convincing consumers, and their representatives in Congress, that an individual’s health is better assured in the courtroom than in consultation with his health care provider.
3) Oh, and insurance companies who must protect their profit if they are to stay in business financing the expense of our totally overpriced and inefficient health care system.
The American political culture will never achieve needed health care reform if voices, such as Ms. Burner’s or Howard Dean’s, don’t keep harping on the weaknesses of whatever legislation can be adopted by the Congress as an initial step. That should be their role, while the role of those in office and of the President is to get something on the books now. The Burners and Deans must keep the pressure on for improvements in reform to occur in the future. Our democratic system is not easy.
13 December 2009
Environmental Shakedown?
In his recent commentary online (cf. http://www.realclearpolitics.com/articles/author/charles_krauthammer)
Charles Krauthammer accuses the emerging market countries at the Copenhagen Climate Control summit of ganging up on the Western liberal democracies to get compensation for the cost of adopting carbon emmssion controls. There's no doubt that the economic basis of our advanced Western societies will have eventually to be revolutionized. Do it now or do it under more pressure later. I don't begrudge Obama for playing hardball with Congress by using the EPA card. If Congress wants to control CO2 emissions some other way, let it.
In any case, the industrial democracies have enjoyed rapid economic growth over the last 200 years without restrictions on carbon emissions. The greenhouse gas problem has only been realized lately. It is, however, a universal problem and has raised the cost of economic development generally. Therefore, the same rationale applies to financing the cost of reducing CO2 emissions in the emergent economies as to financing their economic development--wealthier third world partners make better customers and suppliers for the West, and greener third world countries make the planet a healthier environment for the Western societies, too. N.B. The cost of reducing carbon emissions in emergent markets should be financed through long-term bonds of some sort, rather than through grants. Eventually, they will be paid back by all of us, in higher prices and reduced profits--there ain't no such thing as a free lunch.
In his recent commentary online (cf. http://www.realclearpolitics.com/articles/author/charles_krauthammer)
Charles Krauthammer accuses the emerging market countries at the Copenhagen Climate Control summit of ganging up on the Western liberal democracies to get compensation for the cost of adopting carbon emmssion controls. There's no doubt that the economic basis of our advanced Western societies will have eventually to be revolutionized. Do it now or do it under more pressure later. I don't begrudge Obama for playing hardball with Congress by using the EPA card. If Congress wants to control CO2 emissions some other way, let it.
In any case, the industrial democracies have enjoyed rapid economic growth over the last 200 years without restrictions on carbon emissions. The greenhouse gas problem has only been realized lately. It is, however, a universal problem and has raised the cost of economic development generally. Therefore, the same rationale applies to financing the cost of reducing CO2 emissions in the emergent economies as to financing their economic development--wealthier third world partners make better customers and suppliers for the West, and greener third world countries make the planet a healthier environment for the Western societies, too. N.B. The cost of reducing carbon emissions in emergent markets should be financed through long-term bonds of some sort, rather than through grants. Eventually, they will be paid back by all of us, in higher prices and reduced profits--there ain't no such thing as a free lunch.
11 December 2009
Peace Prize Is Not Weakness Prize
Alfred Nobel, the inventor of dynamite, would surely have agreed that forcefully demanding adherence to humanitarian principles was consistent with the goal of maintaining peace between the nations of the world. Weakness only invites aggression. Violence, however, is not the only method of using force to convince an adversary to adhere to standards of just behavior. Non-violent compulsion is fully consistent with the aspirations of the Nobel Peace Prize committee when it is used to enforce the principles articulated by President Obama in his acceptance “lecture” on December 10, 2009.
Violence is a loaded term, implying a lack of control over the application of physical force to an intractable adversary or blockage. Strong opposition may be exerted in an orderly way to uncivil elements in society that seek violently to impose patterns of behavior unrelated to the practical needs of life (e.g. religious beliefs). It may involve physical force and still be non-violent. It may even require killing and risk the loss of life. It would, nevertheless, be peaceful.
Although Nobel Laureate Obama eloquently expressed these principles in Oslo, his decision to increase the size and length of the U.S. military occupation of Afghanistan definitely contradicts the objectives of the Peace Prize. True, he is not doing it out of an intention to impose an arbitrary or self-interested new order on a foreign land. Owing to its naiveté, however, the Obama administration has been seduced by the U.S. military, which because it knows how to fight conventional wars, and even conventional insurgencies against established governments, sees every conflict as a conventional one. Even though Afghanistan has not yet established a government that is able to maintain civil order in the country, the U.S. has no business being there.
The U.S. and the rest of the world's liberal democracies only have an interest in preventing the use of Afghanistan as a base for international terrorist groups like Al Qaeda that threaten their own security. This can be done through controlled forceful intervention, short-term as necessary. Now that Al Qaeda appears to have abandoned Afghanistan, the U.S. and its allies should withdraw all forces beyond those necessary for surveillance and pre-emptive action.
Alfred Nobel, the inventor of dynamite, would surely have agreed that forcefully demanding adherence to humanitarian principles was consistent with the goal of maintaining peace between the nations of the world. Weakness only invites aggression. Violence, however, is not the only method of using force to convince an adversary to adhere to standards of just behavior. Non-violent compulsion is fully consistent with the aspirations of the Nobel Peace Prize committee when it is used to enforce the principles articulated by President Obama in his acceptance “lecture” on December 10, 2009.
Violence is a loaded term, implying a lack of control over the application of physical force to an intractable adversary or blockage. Strong opposition may be exerted in an orderly way to uncivil elements in society that seek violently to impose patterns of behavior unrelated to the practical needs of life (e.g. religious beliefs). It may involve physical force and still be non-violent. It may even require killing and risk the loss of life. It would, nevertheless, be peaceful.
Although Nobel Laureate Obama eloquently expressed these principles in Oslo, his decision to increase the size and length of the U.S. military occupation of Afghanistan definitely contradicts the objectives of the Peace Prize. True, he is not doing it out of an intention to impose an arbitrary or self-interested new order on a foreign land. Owing to its naiveté, however, the Obama administration has been seduced by the U.S. military, which because it knows how to fight conventional wars, and even conventional insurgencies against established governments, sees every conflict as a conventional one. Even though Afghanistan has not yet established a government that is able to maintain civil order in the country, the U.S. has no business being there.
The U.S. and the rest of the world's liberal democracies only have an interest in preventing the use of Afghanistan as a base for international terrorist groups like Al Qaeda that threaten their own security. This can be done through controlled forceful intervention, short-term as necessary. Now that Al Qaeda appears to have abandoned Afghanistan, the U.S. and its allies should withdraw all forces beyond those necessary for surveillance and pre-emptive action.
04 December 2009
NATO is the Right Obama Target
His upcoming Nobel Peace Prize acceptance speech gives President Barack Obama an opportunity to direct his persuasive skills towards the entire community of liberal democracies around the world. We no longer live on a globe that is segmented into nation states that can insulate themselves from the disorder that rules other geographies, and sometimes parts of their own lands, behind physical borders. The information technology revolution has provided private ideological groups the tools to organize and implement violent acts against peaceful people anywhere.
As Andrew Bacevich has pointed out (cf. his The Limits of Power: The End of American Exceptionalism (2008)), this is a challenge that the U.S. alone cannot and should not attempt to meet. It is too costly and its threat is to the living standards of the entire modern world. The decision of NATO today to reinforce its contingent in Afghanistan may indicate a willingness to share that burden. Moreover, as the leader of the most powerful of those nation states, President Obama would well serve his own domestic constituency by peristenly enlisting other civil governments into an effective police program that protects the security of all their citizens from the international terrorism that honors no boundaries and respects no civilized behavior code.
In the meantime, increasing the U.S. and NATO military strength in Afghanistan will only approach making that country into a virtual garrison—a situation that will never be welcomed by the Afghan people, and that will constantly invite rebellious attacks on the occupying armies. If the Afghans wish to live in an outlaw state, let them do it; but keep vigilance over the threat that outlaws there pose to the rest of the world and maintain an ability to intervene forcefully when needed to prevent those outlaws from harming the rest of the world.
His upcoming Nobel Peace Prize acceptance speech gives President Barack Obama an opportunity to direct his persuasive skills towards the entire community of liberal democracies around the world. We no longer live on a globe that is segmented into nation states that can insulate themselves from the disorder that rules other geographies, and sometimes parts of their own lands, behind physical borders. The information technology revolution has provided private ideological groups the tools to organize and implement violent acts against peaceful people anywhere.
As Andrew Bacevich has pointed out (cf. his The Limits of Power: The End of American Exceptionalism (2008)), this is a challenge that the U.S. alone cannot and should not attempt to meet. It is too costly and its threat is to the living standards of the entire modern world. The decision of NATO today to reinforce its contingent in Afghanistan may indicate a willingness to share that burden. Moreover, as the leader of the most powerful of those nation states, President Obama would well serve his own domestic constituency by peristenly enlisting other civil governments into an effective police program that protects the security of all their citizens from the international terrorism that honors no boundaries and respects no civilized behavior code.
In the meantime, increasing the U.S. and NATO military strength in Afghanistan will only approach making that country into a virtual garrison—a situation that will never be welcomed by the Afghan people, and that will constantly invite rebellious attacks on the occupying armies. If the Afghans wish to live in an outlaw state, let them do it; but keep vigilance over the threat that outlaws there pose to the rest of the world and maintain an ability to intervene forcefully when needed to prevent those outlaws from harming the rest of the world.
02 December 2009
What About Somalia & Haiti?
The Afghanistan strategy that President Obama unveiled on December 1, 2009, is too much for the U.S. to undertake alone. It is the security and welfare of the whole community of civilized nations that is at stake, not only in Afghanistan, but in all uncontrolled regions of the world including, for example, Somalia and Haiti. Information technology provides modestly financed outlaws the capability to threaten the safety and prosperity of even the most powerful nation-states.
It is difficult enough for civilized countries to control deranged terrorists within their own borders (viz. Oklahoma City, Madrid, London, Bali, D.C. Beltway, Fort Hood, etc.). When a country demonstrates a willful lack of attention to establishing and maintaining order, then it forfeits its presumptive immunity from intervention by other individual states or governments acting collectively. However, it is more than one government, even the U.S., can afford in lives and treasure to police such a disorderly place as Afghanistan (or other regions of the world) on its own.
Therefore, President Obama’s address at West Point has to be directed to the entire world community of civilized nation states. His message to the people who elected him must be that he will tirelessly seek to enlist a truly international effort behind ridding the globe of havens for violent terrorist movements. This effort will eliminate showpiece rulers in isolated geographies and share the costs of putting order in place until the local population establishes its own means of effective governance.
The Afghanistan strategy that President Obama unveiled on December 1, 2009, is too much for the U.S. to undertake alone. It is the security and welfare of the whole community of civilized nations that is at stake, not only in Afghanistan, but in all uncontrolled regions of the world including, for example, Somalia and Haiti. Information technology provides modestly financed outlaws the capability to threaten the safety and prosperity of even the most powerful nation-states.
It is difficult enough for civilized countries to control deranged terrorists within their own borders (viz. Oklahoma City, Madrid, London, Bali, D.C. Beltway, Fort Hood, etc.). When a country demonstrates a willful lack of attention to establishing and maintaining order, then it forfeits its presumptive immunity from intervention by other individual states or governments acting collectively. However, it is more than one government, even the U.S., can afford in lives and treasure to police such a disorderly place as Afghanistan (or other regions of the world) on its own.
Therefore, President Obama’s address at West Point has to be directed to the entire world community of civilized nation states. His message to the people who elected him must be that he will tirelessly seek to enlist a truly international effort behind ridding the globe of havens for violent terrorist movements. This effort will eliminate showpiece rulers in isolated geographies and share the costs of putting order in place until the local population establishes its own means of effective governance.
01 December 2009
Three Keys to Health Care Reform
The health care reform debate has become an ideological battle defined by those who wish to avoid facing the fact that some things are indeed better done by us collectively through our government. It is those contrarians who have tried to make the matter of providing equal access to the benefits of medical science an issue of equalizing the cost for everyone of a minimum level of health care. The American ideal to assure equal opportunity for becoming and staying wealthy is not incompatible with the ideal of assuring equal care for physical and mental illnesses. Our capitalist system has generated enough wealth to allow all our citizens to eliminate the handicaps on the fulfillment of their dreams caused arbitrarily by poor health. Three systemic changes will be required:
The U.S. health care system needs to cut the tie between the supply of medical service and payment for it. For that to happen, insurers must collect premiums according to subscribers’ ability to pay, regardless of their previous medical condition. The premiums will range from zero to as much as the 16% level that our overall health care industry represents of GDP. Part of this tax will be paid by employers and may alter the compensation plans they offer their workforces. Presumably, the graduated income tax and payroll taxes will be adjusted to reflect a reduction in the government’s responsibility for sharing the health care burden.
Insurers, including the public plan, if there is one, will pay primary care physicians on retainer, at a standard rate for each patient, and pay any specialists designated by the Primary on the basis of “fee for service.” The Primary will also receive an annual bonus based on the medical outcome of each patient, which he may share with associated specialists.
Co-payments will be required; but any patient will have the option to withdraw from the system by forfeiting his insurance premium and purchasing care privately. Insurers will essentially be administrators, for the risk of arbitrary medical afflictions is assumed by the entire system. The insurers compete with each other and with the public plan, if there is one, on the basis of efficiency and ability of their affiliated providers to optimize medical outcomes.
The two goals of health care reform are to improve medical outcomes overall and to control overall costs. As pointed out by Professor Paul Starr in his OpEd article in the November 29, 2009, New York Times, “Public Option,” we have no time to lose if we are to avoid the cost disaster; but he fails to direct his prescription for regulatory reform to the appropriate part of our health care system. It is the providers--doctors, clinics, and hospitals—who need to be relieved from their reliance on the “fee for service” model. Health care reform will only happen when providers are compensated for results rather than for procedures.
The health care reform debate has become an ideological battle defined by those who wish to avoid facing the fact that some things are indeed better done by us collectively through our government. It is those contrarians who have tried to make the matter of providing equal access to the benefits of medical science an issue of equalizing the cost for everyone of a minimum level of health care. The American ideal to assure equal opportunity for becoming and staying wealthy is not incompatible with the ideal of assuring equal care for physical and mental illnesses. Our capitalist system has generated enough wealth to allow all our citizens to eliminate the handicaps on the fulfillment of their dreams caused arbitrarily by poor health. Three systemic changes will be required:
The U.S. health care system needs to cut the tie between the supply of medical service and payment for it. For that to happen, insurers must collect premiums according to subscribers’ ability to pay, regardless of their previous medical condition. The premiums will range from zero to as much as the 16% level that our overall health care industry represents of GDP. Part of this tax will be paid by employers and may alter the compensation plans they offer their workforces. Presumably, the graduated income tax and payroll taxes will be adjusted to reflect a reduction in the government’s responsibility for sharing the health care burden.
Insurers, including the public plan, if there is one, will pay primary care physicians on retainer, at a standard rate for each patient, and pay any specialists designated by the Primary on the basis of “fee for service.” The Primary will also receive an annual bonus based on the medical outcome of each patient, which he may share with associated specialists.
Co-payments will be required; but any patient will have the option to withdraw from the system by forfeiting his insurance premium and purchasing care privately. Insurers will essentially be administrators, for the risk of arbitrary medical afflictions is assumed by the entire system. The insurers compete with each other and with the public plan, if there is one, on the basis of efficiency and ability of their affiliated providers to optimize medical outcomes.
The two goals of health care reform are to improve medical outcomes overall and to control overall costs. As pointed out by Professor Paul Starr in his OpEd article in the November 29, 2009, New York Times, “Public Option,” we have no time to lose if we are to avoid the cost disaster; but he fails to direct his prescription for regulatory reform to the appropriate part of our health care system. It is the providers--doctors, clinics, and hospitals—who need to be relieved from their reliance on the “fee for service” model. Health care reform will only happen when providers are compensated for results rather than for procedures.
