ShrinkWrapped

Universal Health Care

We will be reading and hearing a great deal about Universal Health Care in the next two years. The Liberal impulse of compassion will tend to promote plans to cover all of the uninsured, with the argument that a country as wealthy as the United States should be ashamed to have so many of its poor without coverage. The more Conservative impulse will be to structure plans, such as President Bush's recent suggestion, in such a way as to minimize the intrusion of the government bureaucracy and preserve aspects of the private system of health care that has worked fairly well but is now being stressed by the combination of the high cost of modern health care and the increasing demands on the system.

Robert Samuelson has an article at Real Clear Politics today in which he addresses some of the issues involved. In Hiding Health Care's Costs, he describes the sleight of hand that has distorted Medical care for a generation:

For decades, Americans have treated health care as if it exists in a separate economic and political world: When people need care, they should get it; costs should remain out of sight. About 60 percent of Americans receive insurance through their employers; to most workers, the full costs are unknown. The 65-and-older population and many poor people receive government insurance. Except for modest Medicare premiums and payroll taxes, costs are largely buried in federal and state budgets.

Samuelson focuses on the costs of health care and the manner in which our current approaches tend to disguise the actual cost of such care:

I don't intend to examine -- at least now -- all the new proposals. Some would do better at some goals (say, protecting the poor) than at others (say, controlling costs). But the Bush proposal does have one huge virtue: It exposes health-care costs to the broad public. By not taxing employer-paid insurance, the government now provides a huge invisible subsidy to workers. Bush wouldn't end the subsidy, but by modifying it with specific deductions for insurance ($15,000 for families, $7,500 for singles), he would force most workers to see the costs. By contrast, some other proposals disguise their costs. Schwarzenegger's plan shifts costs to the federal government, doctors and hospitals. It's clever, but it perpetuates the illusion that health care is cheap.

Within his description lies the root of the problem with our health care system. In point of fact, in America we already have Universal Health Care. The problem is that we cannot afford to offer all the health care everyone desires to everyone who desires it. In other words, we are faced with the problem that every modern state faces: how do we manage access to a limited resource that so many people believe is a "right"?

Saying Whatever Comes to Mind XXIV

This week the Sanity Squad tries to make sense of the growing efforts to strip the Holocaust of its special place in the pantheon of evil.  Multi-culturalism wedded to moral equivalence means that all designated victim classes are equally innocent and free of responsibility and all oppressors are equally evil.  The logic of the position brings Israel's very existence into question.

Please join Neo-neocon, Dr. Sanity, Siggy and me as we try to wend our way through the minefield of deconstructed logic that impedes the progress of men and women of good will.  Listen to or download Multi-culturalism has met the Holocaust and be enlightened.

Psychobabble and the Mis-use of Psychology

Two weeks ago, in The Use and Mis-use of Psychology, I posted about an article in Psychology Today purporting to show that conservatives were motivated by fear.    In my post I pointed out that the use of Psychology to attack one's political opponents was diversionary at best:

Those who are pathologizing Neo-cons believe that at best we are over reacting to a minor threat and at worst are creating the threat out of minimal evidence.

...

If Neo-cons are wrong, rather than paranoid, please explain where we are wrong.  Almost every Neo-con I know would love to be shown a good argument that we are overstating the threat.  However, until you can at least build a cogent argument, even if it leaves many people unconvinced, then do not presume that you are doing anything more than mis-using Psychology to attack those with whom you disagree.

(Cinnamon Stillwell has pointed me to an ongoing discussion of the Psychology Today article and the research upon which it was based at Live Journal, Red Shift or Worldview Defense?)

The current issue of New York magazine takes the pathologizing of one's political opponents to a new and thoroughly sordid level in an attack on President Bush, The Loneliest President: What’s going on in George Bush’s mind? A psychopolitical survey.

New York magazine is a light weight publication which exhibits the vice of an apparent congenital inability to explore any particular issue in any particular psychological depth, and the virtue of having its hand firmly on the pulse of New York Liberal Conventional Wisdom.  The article is only surprising in its viciousness and shallowness.

Culture and Democracy in the Middle East

A great deal of the criticism of our current approach to the War in Iraq and the greater war on global Islamic fascism, hinges on the uncomfortable fact that no one seems to have any very good strategic ideas for how we might proceed in ways that would be likely to enhance our future security and make the world a safer place.  It seems to me that all the current suggestions have extremely problematic flaws and ultimately resolve down to unanswerable questions.

It seems to me that the current options would include:

• The current approach is to imagine our war against both Shia and Sunni versions of the Islamist virus as primarily a military venture.  Since we have no ready answer for Islamic terror, our best approach is to go directly into the heart of the Middle East and attempt to "drain the swamp" and establish a working Muslim democracy in the area.

• An alternative approach, most famously espoused by the Iraq Study Group, would involve opening diplomatic discussions with the Iranians, Syrians, Saudis, and other interested parties, in order to enlist their assistance in stabilizing Iraq.  This is based on the hope that the people who have been most assiduous in fomenting unrest would then develop an interest in Iraqi stability; usually this is coupled with the idea that Iran should agree to stop supporting terrorist groups, like Hizbollah and Hamas, followed by a somewhat more reluctant admission that this is unlikely in the extreme.

• The third approach, suggested by some of the "bright lights" in the Congress appears to primarily consist of getting American troops out of Iraq and hoping that peace will then break out.

As noted, all of these approaches have serious flaws which suggest they cannot work.

Future Imperfect: Part III

There are a myriad of Worst Case Scenarios possible but all of them start with Iran obtaining nuclear capabilities.  The reason that Iran and nuclear weapons defines the WCS is that almost every branch that follows leads to extremely dangerous outcomes.

Iran's current political system is a metastable construct.  Its economy is non-productive, it is cannibalizing its own oil industry, and it requires the constant infusion of petrodollars to essentially bribe its population into submission.  In other words, once the economy deteriorates to such a point where a significant majority of the population is more threatened by their own economic deprivation than by openly confronting the regime's thugs, open rebellion is inevitable.  The regime is supported by too small a segment of the population to withstand a popular uprising and since they would not voluntarily disappear from the scene quietly, their eschatological beliefs dictate that such a crisis point would be a time of extreme risk of their use of nuclear weapons against their enemies, which since the Khomeini revolution have been most prominently the Great Satan (America) and the Little Satan (Israel), but also include the (near) infidels in Saudi Arabia and the Gulf States. 

On the other hand, if they achieve nuclear capabilities and the regime is thus emboldened and able to extort more from the West and sustain their rule for a longer period before the fall, the temptation to increase the activities of their terror proxies, including the use of nuclear weapons if and when they believe they can do so with relative impunity, will become irresistible.

World opinion, especially  in Europe and the Islamic world, has been carefully prepared by the left and the Islamic fascists and their enablers, for the destruction of Israel.  It would be a disaster of unimaginable proportions for the world to lose one of the beacons of democracy and technological and scientific progress, but if the story ended there, the WCS could, perhaps be manageable.  It would never end there however; the Jews are never the end and are forever the beginning.

Further Digressions

Last week I looked at some poll data that showed that there is a substantial portion of the American public who overtly desire our failure in Iraq (An American Scandal).  I found it puzzling that so many Americans would wish us to fail and questioned their patriotism.  Perhaps that was unfair; it might be more accurate to say that there is a substantial portion of the body politic who believe that what they value in America is more endangered by our presence and our missteps in Iraq than it would be by our failure.  This is a debatable point and I don't think those who espouse the anti-war position make a very persuasive case, nonetheless, this is not the same as being anti-American.  For instance, there are those who have claimed that our efforts to fight the war against terror have increased the danger of our civil liberties being eroded, a point emphasized this morning during a discussion on NPR on the need for more careful attention to the civil liberties of those "capriciously" labeled enemy combatants by the President.  I have suggested that the single greatest threat to our civil liberties would be another successful terrorist attack on America since the political reaction to such an attack would make the ACLU yearn for the days of the Patriot Act.

Be that as it may, the reactions to the President's State of the Union speech on Tuesday night bring up such questions anew.  It was disturbing enough to see the reluctance of the Democrats to applaud the President's call for victory in Iraq; Jim Webb's response is of even greater import, since he was the officially designated responder to the SOTU.

For purposes of clarity, I would like to digress for a moment and describe how I would define victory in Iraq.

A Conscious Digression

In the early days of Psychoanalysis, Freud conceptualized the young science as a "one person" psychology.  The Analyst was a "blank slate" (or unresponsive "wall" as some would claim) and the patient was allowed to project their inner conflicts onto the field where they could be investigated, interpreted, and understood in ways which would allow the patient to change.

Later Psychoanalysts, prominent among them Margaret Mahler in London, soon recognized that Psychoanalysis could not occur without the active emotional involvement of the Analyst; the ideal of a dispassionate, distant blank slate was replaced by the understanding of the analytic situation as involving a "two person" psychology.  You could no more have a patient without an analyst as an infant without a mother. 

Mahler's contributions included her elegant descriptions of the child's sense of self emerging from the undifferentiated mother-infant matrix.  She called the first glimmers of separateness "hatching"; this was followed by the separation-individuation phase later in early childhood (12-18 months).  Along with the establishment of separation, the child developed stable self- and object-representations.

In Science Friday: Differentiating the Self, I described how neuroscience was finally giving us some of the tools and the data we need to understand these concepts and connect them to their physiological substrate.  I used the new research to support the Psychoanalytic understanding of the development of our stable sense of self:

Typically development is a rather complicated journey... but the essential idea that multiple self-representations (ie, different images one has and develops about oneself) must be integrated to form a coherent and consistent sense of oneself has been bolstered by the finding of areas of the brain that appear to do just such integration.

The recent discovery of "mirror neurons" is a Neuropsychological earthquake.  In MIRROR NEURONS and imitation learning as the driving force behind "the great leap forward" in human evolution, V.S. Ramachandran described the existence of such neurons as a paradigm shift:

Saying Whatever Comes to Mind XXIII

Benny Morris’s sobering Jerusalem Post article paints a picture of a Second Holocaust—a nuclear-armed Iran willing to sacrifice the loss of millions of its own people to have the satisfaction of destroying Israel, and an Israel whose own nuclear weapons would be of no real use against an enemy so resistant to deterrence. Is there any way out of this dreadful dilemma? The Sanity Squad discusses paranoia vs. denial, the West as the enabler of its own enemies, and Iran’s vulnerabilities.

Listen or download and be enlightened by Dr. Sanity, Neo-neocon, Siggy, and me as we try to make sense of the senseless.

Future Imperfect: Part II

It  might be helpful to review several points raised by commenters yesterday before going on to describe what I see as the "Best Case Scenario" for the near to moderate term in the War on Islamic Fascism cum terrorism. 

First of all, by any measure "there is (already) a solid and ugly huge army of enemies."  This pool includes the number, ranging into the 6 figures, of all those Jihadis who have trained in terrorist camps, in Afghanistan, Iraq, Iran, Syria, The Palestinian Authority, and the Bekaa Valley, among other locales.  Add to this the vastly larger number of young "wanna-be" Jihadis and you are starting to look at significant numbers.  In addition, the number of Muslims who subscribe to the most radical schools of Islam and/or are sympathetic to the agenda of our enemies number in the millions; even many Muslims who belong to more "moderate" forms of Islam believe that their goal is to bring Shariah law to the entire world, including the West.  This leaves us a very large pool indeed, and since Shariah law is anti-democratic, racist, anti-semitic, homophobic, sexist, and cruel, I consider anyone who desires to change our laws in such a direction to be an enemy.

This does not imply, and I hope my writing did not suggest, "that a military response is the (only) way to go."  A military response is of necessity part of any overall approach to Islamic radicalism, but it is not the only, or even the primary approach, we need to take to what is in reality an ideological war.

Secondly, I am fully aware that our enemies will adopt our technology and use it against us.  I am convinced, and I believe our experiences in Iraq and the Israeli experience in Southern Lebanon, support the idea, that the lag time for adoption of new technology will increase for those who are parasitic to the technology, rather than for those who develop the technology.  Just as one example, our troops have the kind of facility with networks and electronic weapons that comes naturally to those who have spent thousands of hours playing MMRPGs throughout their adolescence.  It will be a very long time before our enemies can approach that level of familiarity with such technology in real time.  This is similar to the edge our fighter pilots have in combat over adversaries who have minimal time in flight training. 

Third, the will to win this war is certainly our weakest spot; it impacts on the will to use our technology and I hope to address this in at least a partial way in this post and perhaps the next.

Fourth, questions of our cultural tendencies toward suicidal behavior via the courts or a reluctance to use force when necessary will be addressed as well, and relate to questions of will, though not always in the ways most obvious.  For example, it is an extremely rare Democratic or Republican Mayor in this country who would eschew the revenue generated by cameras at stop lights; this is a non-partisan adoption of a surveillance society that is already well underway.  Many areas in New York already have cameras on corners (London is even further along) and on the roadways; the surveillance society is already here.  I am merely extrapolating.

Now, as to the Best Case Scenario; the future depends more than anything else on one factor:

Future Imperfect: Part I

The threat of Islamic terrorism is going to be with us for the next 10-15 years at a minimum.  It will persist in attenuated forms for a very long time after that but will no longer represent an existential threat to America.   Our technology will evolve in such a way as to make terrorist activity much less likely to succeed and much easier to combat.  In the first post of a series, Fast Forward: Part I , I wrote:

The Arab world, and perhaps the greater Islamic world, produces nothing except the oil which they can extract from the ground using Western technology.  Considering that technology tends to accelerate at a geometric rate, with new discoveries paving the way for even more new discoveries, the chance of the (radical) Islamic world entering the technological world, except as parasitic users, is negligible, especially in light of their cultural and religious belief that all knowledge has already been revealed. 

Further, as the technology gap increases between the West and Islam, their ability to benefit from the types of asymmetrical warfare that they have perfected diminishes. 

Just one example:  Unmanned surveillance vehicles have become important tools of our military.  They have been armed with  missiles and have been quite effective in killing major terrorist opponents.  In the world of high tech, everything gets smaller, and cheaper, over time.  In 10-15 years, we will have unmanned aerial robots the size of mosquitoes.  Supply them with cameras and other sensors, wireless connections, and drop millions of them in an area of interest.  By developing a real time picture of everyone in an area, their ability to escape detection vanishes.  Now, consider arming our mosquitoes with cyanide or botulism toxin and direct who they "bite."  Terrorists will be dead before they know what happened.  And if others learn from the experience and live under mosquito netting, use the mosquitoes to direct JDAMS or other larger munitions that will do the job.  Pretty soon, hiding in a cave or in the jungle (are you listening, Hugo) won't protect you form the American/Israeli/Australian/English military.

Within our own country, surveillance in real time is already becoming ubiquitous, with cameras on street corners appearing with increasing regularity.  As terrorist incidents continue to occur around the world, the pressure to expand such surveillance will increase.