The Polluted Health Care Debate

The United States Senate sets to vote on a health-care bill over Christmas this Tuesday after what have been months of fierce political debate. As the opposition warned of “socialized medicine” and “death panels”, public support for “Obamacare” and the president himself understandably plummeted.

Although America’s health care is among the most expensive yet one of the most restricted systems in the world, people began to fear that under the Democrats’ plans, they would face a further decline in quality against ever rising costs. Strangely enough, people also indicated that by majority that health care today is too costly on the whole and that it placed a serious burden on the already fragile American economy. President Obama repeatedly stressed that America’s health care is in desperate need of reform but critics seem to have a point when they say that the Democrats will only make it more expensive.

Unfortunately, Republicans prefer instead to devise little doomsday scenarios and warn people that their elderly will soon be put to death if the Democrats have their way. They point at countries as Canada and the United Kingdom and say, “look how bad things are over there.” In fact, health care in these both countries is far from terrible.

In spite of the rather communist qualities of the British National Health Service, it operates at a lower cost per capita ($2,560, compared to $6,096 for the United States in 2007) while providing better care (PDF). Canada on the other hand, while much cheaper per capita than the American system, provides an approximately similar quality of care. It would appear then that a collectivization of health care doesn’t necessarily make things better or worse. A lot of other factors are in play.

Rather than denouncing “socialized medicine” as being impractical therefore, opponents should point out that it is immoral.

The NHS in Britain was established after the end of World War II, in 1948, with the express purpose of providing health care to all, “regardless of wealth.” Its principles were that the service should “meet the needs of everyone,” “be free at the point of delivery” and “be based on clinical need, not ability to pay.” This gave all Britons a right to proper care, no matter whether they were able to afford it or not. Need, not ability became the standard according to which care would henceforth be distributed.

This is a strange twist of ethics. Imagine that the law were to give people a right to much more basic needs than health care such as food and shelter. No such laws exist of course, for if people indeed are entitled to such rights, others must inevitably provide for them at their own expense.

Granting people a right to health-care demands that others provide such care, for free if necessary. Only a government can allocate care under such conditions for few individual doctors and nurses would go about their work unpaid any more than a supermarket would remain in business for long if it is to meet peoples’ “right to food”.

Even the Republicans, supposedly the champions of the free market, dare not question the alleged right to health care in the United States. Probably because they know how most people would respond to such criticism: “Should we just stand by then and let people die?” they’ll ask

Perhaps proponents of collectivization are only more than willing to pay so that others need not insure themselves but as long as they can’t answer the simple question, “Why shouldn’t we?” to their own charge without speaking of non-existent rights and undeserved charity, no man should be held responsible for the health and care of others against his own choice.

That is what opponents of “Obamacare” should have argued. Because they didn’t, collectivized health care is now likely to become a reality in the United States.

Future Arctic Battleground

Global warming is rapidly changing the Arctic landscape. In the summer of 2008, for the first time in recorded history, the polar icecap retreated far enough to allow shipping north of Eurasia and North America; by 2013, these sea routes are expected to be completely ice free during the summer.

The region promises more than shortcuts for international shipping however. The Arctic is estimated to contain about 13 percent of the world’s undiscovered oil and so much as 30 percent of the world’s undiscovered natural gas. Together this represents 22 percent of all untapped but technically recoverable hydrocarbons. Over 80 percent of these resources lie offshore. No wonder then that nearby countries are only too eager to make the high jump into the cold.

There are some complications: energy prices need to be high enough to make production in such an extreme environment economically viable. To make matters worse, some Arctic coastal states have not settled on the regulatory standards for development yet which is especially hampering Norway.

It isn’t stopping the Russians from more or less trying to annex the Pole for themselves of course. Gazprom has partnered with the Norwegian company StatoilHydro in the Russian Arctic and hopes to bring the enormous Shtokman field in the Barents Sea on stream by 2013. The field holds enough gas to provide the whole of the United States with electricity for six years!

Russia made its designs on the Arctic abundantly clear in August 2007 when it planted its flag on the seafloor of the North Pole. In good Cold War fashion, it subsequently began patrolling the Arctic once again with bombers and warships while Moscow invested more than a billion dollars in the expansion of the port of Murmansk which is supposed to double its capacity by 2015.

Whence all the fuss? As former Director of the FSB and current secretary of the Russian Security Council Nikolai Patrushev stated last year: “The Arctic must become Russia’s main strategic resource base.” This, perhaps, to compensate for waning influence in Central Asia.

Russia isn’t the only interested Arctic state. In 2008 Canada held its greatest military exercise ever conducted in the region and the country is spending $40 million on scientific research that is meant to bolster its Arctic claims. Together with Denmark, Norway and the United States, Canada in part contests the Russian pretenses but Russia doesn’t shred from threatening with war over ownership of the giant untapped oil and gasfields. Indeed, it has already shown itself quite willing to violate Canadian airspace just to make a point.

The United States remains strangely silent when it comes to the Pole. Earlier this year, in Foreign Policy, Scott G. Borgerson called upon Washington to take on a more active stance in the Arctic but only recently did Secretary of State Hillary Clinton speak on the issue.

With Canadian-Russian aminosity flaring up, the Pole “is an area that we have to pay real attention to,” said to Clinton, “but it’s not an area that I get called about by reporters or have to answer questions about at the White House yet.” Most opinion- and policymakers do not seem to be aware yet of the great possibilities, and the great dangers, that the melting of the Arctic will provide. It’s about time the United States get involved nevertheless, if only to prevent the Arctic from indeed becoming a future battleground.

The End of American Ascendancy

After two decades of almost uncontested American hegemony, the sole superpower of our age is in decline. Or so we are told. The financial meltdown; the rise of China; the failed foreign policies of President Bush or Obama, depending on from which side of the aisle you approach the problem — all seem to indicate that the United States is no longer alone at the game of playing master of the world.

To the right, this is a matter of great concern. Charles Krauthammer writes at The Weekly Standard that “decline is not a condition. Decline is a choice.” He suggests that “America is in the position of deciding whether to abdicate or retain its dominance,” and it’s those wishy-washy, putrid liberals in Congress and the White House that are steering America on a course for decline.

Krauthammer blames President Obama for having gone on world tour and apologize for every wrong ever committed by the United States. The consequence, he writes, is that any moral claim that America might have to world leadership has been effectively undermined. “According to the new dispensation, having forfeited the mandate of heaven — if it ever had one — a newly humbled America now seeks a more modest place among the nations, not above them.” How, without America paramount, is the international system to function?

Henry Kissinger once said that the only way to achieve peace is through hegemony or balance of power. Well, hegemony is out. As Obama said in his General Assembly address, “No one nation can or should try to dominate another nation.” […] And if hegemony is out, so is balance of power: “No balance of power among nations will hold.”

Rather, multipolar arrangements not of nation states but of groups of states acting through multilateral bodies, whether institutional (like the International Atomic Energy Agency) or ad hoc (like the P5+1 Iran negotiators), will set the tone, Krauthammer predicts.

At World Politics Review, Thomas Barnett takes issue with Krauthammer’s gloomy view of the Obama Administration’s foreign policy which, according to him, accepts that “globalization is an inescapable condition of profound interdependency — the destroyer of zero-sum competition.” Republican hawks, on the other hand, think of globalization as “nothing more than the next playing field upon which fierce great-power competition and conflicts will unfold,” in spite of the fact that no great-power war occurred during the last six decades and classic state-on-state war has been virtually eradicated.

Barnett claims globalization and, indeed, the whole postwar “international liberal trade order” for the left and boasts that the “Americanization” has been accomplished. There is no need, he suggests, for American hegemony when culturally and economically, American influence is supreme. Besides — something he doesn’t take into account — militarily, the United States will remain the uncontested superpower for decades to come.

So why is the right so scared? For one thing, the economic and political rise of China worries conservatives. The first cannot be prevented and actually benefits the United States in the shape of trade and hopefully, political change in the near future. The emergence of China unto the world stage in a political and military sense however is where Republicans draw a firm line, “while accusing the Democrats of preemptive surrender in their effort to rebalance America’s global security responsibilities with the domestic need for economic regeneration.”

No matter how you game out America’s current strategic trajectory, the inevitable result is increased Chinese influence over the American economy and the global security situation.

All the more reason to be nice to China. Krauthammer however probably isn’t worried so much about the Middle Kingdom in the first place; it’s rogue states as Iran and North Korea, global terrorism and resurging Russia that should be on his mind when he fears that America is losing its strategic advantage.

In the face of those challenges, the Obama Administration mustn’t waver. But if indeed there is a “New Liberalism” that, as Krauthammer claims, abhors the notion of American exceptionalism and believes American hegemony to be corrupting and unjust, it’s not in the Obama White House that it prevails as of yet.

Can Iran Be Contained?

Washington’s latest approach to the Iranian missile threat seems to be rather an old-fashioned one: isolating the problem (financially for instance) and attempting to destabilize it from within — in other words: containment.

Danielle Pletka, vice president of foreign and defense policy studies at the American Enterprise Institute, writing for The Washington Post, isn’t having any of it. It is wrong, she writes, “to think a nuclear Iran can be contained.”

The theory of containment is a Cold War one, notes Pletka, and applying it to modern-day Iran is false. There is no mutually assured destruction because the Obama Administration is too hesitant to ensure it; there is no clear leadership in Iran, especially after President Mahmoud Ahmadinejad’s heavily contested reelection last June; and there are no allies nearby, for the neighboring Arab states are afraid of Iran. Iran on the other hand, doesn’t lack self-confidence.

Tehran probably sees itself more in the mold of India, a great power whose nuclear weapons are acknowledged and now accepted, than of North Korea, a lunocracy without serious global aspirations or influence.

If Iranian officials ponder withdrawal from the non-proliferation treaty, it’s because they no longer want to be constrained by status-quo powers and their status-quo treaties.

Pletka’s argument doesn’t sound too convincing however. After all, containment worked pretty well in the past. What’s really so different about Iran?

Moreover, Pletka largely ignores the Israeli perspective. She admits that a nuclear Iran will be tempted to use its nukes “as a shield from behind which it can engage in adventurism in Lebanon, Iraq and Israel” and that the latter is unlikely to tolerate that, but Israeli action can harm America’s interests.

Obama administration officials confess that they believe Israeli action will preempt our policy debate, as Israel’s tolerance for an Iranian nuke is significantly lower than our own. But subcontracting American national security to Israel is an appalling notion, and we cannot assume that an Israeli action would not provoke a wider regional conflict into which the United States would be drawn.

Thus America must strike now lest it be drawn into a “wider regional conflict” that Iran is unlikely to instigate in the first place? With troops in Afghanistan and Iraq and supposedly still fighting a Global War on Terror, it appears America is already quite involved in a wider Middle Eastern conflict.

The very reason Iran is developing nuclear weapons and long-range missiles is because it is afraid of Israel and the United States. Pletka believes that Iran is bullying us all into accepting it as a nuclear power while hardly anyone in Washington likes the notion of that — and Israel is unlikely to accept it.

Hillary Clinton Speaks on Human Rights

American secretary of state Hillary Clinton testifies to the House Committee on Foreign Relations in Washington DC, December 2
American secretary of state Hillary Clinton testifies to the House Committee on Foreign Relations in Washington DC, December 2 (DoD/Chad J. McNeeley)

Elaborating on the statement President Obama made when he accepted the Nobel Peace Prize last week — “Only a just peace based upon the inherent rights and dignity of every individual can truly be lasting” — Secretary of State Hillary Clinton spoke at Georgetown University in Washington DC about human rights today.

“We cannot separate our democracy, human rights and development agendas,” she argued. “They are mutually reinforcing and united in service of a common purpose: to create a world where all people have the opportunity to fulfill their God-given potential.” Read more “Hillary Clinton Speaks on Human Rights”

The President’s Men

Who really runs American foreign policy? It is an intriguing question because as much as President Obama is the face of his country to the rest of the world, he is not alone in the decisionmaking process.

Besides the secretaries of state and defense, Hillary Clinton and Robert Gates, Obama is surrounded by his national security advisor, the former Marine Corps General James Jones, and the experts of the National Security Council. Not all of these people are old friends. To the contrary: the president ran against Mrs Clinton in the primaries while both Gates and Jones served previous administration. So how have things played out? Read more “The President’s Men”

The Next Republican Candidate

President Obama has hardly completed his first year in office or speculation about which Republican will run against him in 2012 has surfaced already. With leftovers from the last election as Mike Huckabee and Sarah Palin probably too right wing and therefore unelectable, Mitt Romney remains the most high profile of potential candidates. Another name is being tossed around Washington however: the name of John Thune, the 48 year-old junior senator from South Dakota whose staunchly conservative views and youthfulness might well lure Republicans into electing their own version of Barack Obama.

Some media have been quick to pick up on the news. The New York Times described him as charming while Politics Daily is positively smitten with the man. He is “handsome”, “passionate” and “has gone out of his way to bolster his conservative bona fides,” we learn. For example, Thune called his faith his “anchor” and joined the effort to amend the United States Constitution with a ban on same-sex marriage. He supported the invasion of Iraq as a war of liberation — to bring religious freedom to the country would “open the door, obviously, for the Christian faith there as well,” he said. The Republican base might like to hear things like this, but how will he speak to moderates?

On his website, the senator does some more Republican smoothtalking by defending the Second Amendment right to own and bear arms while writing that “government has a duty to promote and protect the family” and pledging to “continue to fight for the life of the unborn,” meaning: abortion is a no-go unless the mother’s life is threatened.

On the other hand, he talks about the need to protect the environment, promote sustainable energy and reform health care — positions that independent voters might find appealing.

On some of the most important issues that an American president must deal with — the economy, homeland security and foreign policy — Thune volunteers no more than slogans however. “America must have a strong military,” he says. We must reduce the tax burden to promote growth. “Our tax dollars should be spent wisely” and law enforcement officials should have “the tools they need to fight the War on Terror.”

Since Thune isn’t a candidate for the presidency yet, it would perhaps be unfair to demand that he elaborates on these position. Right now though, it’s all the Republican talking points that no one can really disagree with — who doesn’t want America to have a “strong military”? and who doesn’t think that “tax dollars should be spent wisely”? — lacking a vision that anyone contesting Barack Obama in 2012 must be able to display.

Can We Win in Afghanistan?

Writing in July 2008, retired United States Army General Barry McCaffrey, a Gulf War veteran and critic of the initial American strategy in Iraq, assessed the war in Afghanistan and concluded the following.

  1. “Afghanistan is in misery.” Life expectancy is low and violence and crime are rampant. At the time, McCaffrey expected Afghan governance to worsen at least until the summer of 2010.
  2. An enormous majority of the Afghan people reject the Taliban but have little faith in the government’s ability to provide them with security and jobs. They do trust the foreign forces but are suspicious about their long-term commitment.
  3. Afghan and NATO forces are militarily superior to the insurgents but they “cannot win through a war of attrition.”
  4. The war has basically run into a stalemate while Afghanistan’s political elite is “focused more on the struggle for power than governance.”
  5. Additional forces are required to break the deadlock.
  6. There is no “sensible coordination of all political and military elements of the Afghan theater of operations” which is hampering the war effort.

General McCaffrey specifically called on NATO to provide more troops. International cooperation was, and is, of the utmost importance in winning the war, he wrote — more than a year ago.

In a similar finding last November, the general appeared all the more pessimistic. “The Taliban believe they are winning,” he wrote and the Afghan people “do not know who will prevail.” Their trust in the Afghan government has declined further while allied casualties have “gone up dramatically.”

There is some reason to be hopeful though. “The Afghan National Army is a growing success story,” and “ISAF is reinforcing just in time to rescue the deteriorating tactical situation.”

David Betz at Kings of War is skeptical however. He notes that none of McCaffrey’s original six concerns have really been addressed. That seems only partly true.

Yes, Afghanistan is still in a deplorable state. Civilian casualties and unemployment figures remain high while the military and ideological power base of the Taliban might well be gaining strength. They are waging a successful propaganda campaign that portrays the Taliban as a disciplined and truly Islamic alternative to the corrupt and incapable Kabul government and to the Western troops which they claim intend to occupy the country indefinitely.

President Obama attempted to counter this claim when he announced a timetable for the withdrawal of American forces; a decision that General McCaffrey thinks was the wrong one:

Our focus must now not be on an exit strategy — but effective execution of the political, economic, and military measures required to achieve our purpose.

The United States cannot appear to be “scuttling from Afghanistan,” agrees Betz. “We most definitely should, however, have our eyes on the exit and how to achieve the most seemly passage through it as is possible.” Why, yes, eventually. But right now, foreign troops are all that stand between Afghanistan and the Taliban ruling it once again.

The president’s date for the ‘beginning of the end’ will not see the immediate and complete evacuation of NATO forces. Rather, as Secretaries Hillary Clinton and Robert Gates explained on December 2 while testifying before the Senate Armed Services and House Foreign Affairs Committees, the United States is in Afghanistan for the long run — even though it will be with fewer troops

Throughout his election campaign, President Obama stressed the importance of winning the war in Afghanistan. Afghanistan, he knew, was the ground where the real War on Terror was being waged. He was right. With the recent inclusion of Pakistan in the administration’s approach to the war, the United States has the ability, and must gather the will, to defeat the forces of extremism that operate from the mountainous border region between the two South Asian states and from where they continue to threaten the stability of that entire region.

A Government by the People

Scale model of the United States Capitol
Scale model of the United States Capitol (Andy Castro)

Just a few days ago, President Barack Obama and his staff announced their Open Government Directive. In a memo, beginning with the lines, “My administration is committed to creating an unprecedented level of openness in government,” the White House announced its intentions to work toward a form of “collaborative democracy,” in which citizens would be able to input their ideas and contributions toward governance.

With programs like Peer-to-Patent already around, collaborative government seems closer than ever. Its tool? The Internet. Or, the “tubes,” as disgraced former senator Ted Stevens referred to them.

The directive lays out a specific timetable that can be found online and that orders all executive departments to create “open government” websites within ninety days of December 8, 2009.

It seems quite clear that this is a major change in how citizens will be able to deal with government. What is the nature of the change? As Clay Shirky tells us, “the impulse to share important information is a basic one, but its manifestations have often been clunky.” Read more “A Government by the People”

Obama Last Transatlanticist?

Will Barack Obama turn out to be the last transatlantic American president? Nicholas Kitchen wonders in The Washington Note. Although his wind of change met the approval of nearly all of Europe, a series of diplomatic gaffes and mishaps has strained relations, he claims.

The Obama Administration supposedly downgraded ties with Britain from a “special relationship” to a “special partnership” — whatever the difference there might be. As James Pritchett has argued, such a downgrading is not unnatural: Britain simply isn’t the global power it used to be, not in economic nor in military terms and the United States have little reason to pretend otherwise. Kitchen seems to consider it a failure nonetheless.

And it’s not just Britain that Obama managed to upset. No, Angela Merkel and Nicolas Sarkozy expressed their “annoyance” with his administration’s “attitude toward sensitive historical anniversaries” apparently. According to Kitchen these “diplomatic contretemps” were the products of a serious divide:

[O]ver the best response to the financial crisis and in particular the issue of regulation of complex financial services instruments, with Mirek Topolanek using the Czech Republic’s presidency of the European Union to describe American bailouts and stimulus policies as “the road to hell”.

And what does Obama do? He goes to Asia and declares himself the “Pacific president”.

Outrageous? Not really. Kitchen is fair to note that it’s mostly the Europeans themselves who are to blame:

[T]he truth remains that if Europe wants to be a major player on the world stage it needs to think of its role more strategically and systemically if the United States is not to regard the relationship with China as its most important bilateral tie.

There is probably little that will prevent the Americans from considering the latter relationship of greater significance, however, and for good reason: the Sino-American relationship is bound to define the twenty-first century, one way or another.

At the New Atlanticist, James Joyner defends the Obama Administration’s Pacific orientation. That is not to say Washington has forgotten about Europe, he writes. “Just because other countries now get more attention doesn’t mean the transatlantic relationship isn’t the most important one.”

[I]t’s difficult to imagine an evolution of the international system that would have China — or any other rising power — coming to have more similar values and interests than exists between the United States and Western Europe.

If not for the military and political alliance, that is still strong no matter how little attention President Obama were to pay to it; the cultural and economic ties between both sides of the North Atlantic would suffice to ensure mutual dependence for decades to come. The Obama Administration isn’t neglecting Europe. It simply realizes that there are more partners out there.