ShrinkWrapped

Health Care Conundrums

Now that the New York Times is no longer hiding content behind its wall of silence, it is possible to get the current liberal line on issues directly from one of the sources.  In the case of health care, Philip M. Boffey is the go-to person on the editorial board.  In today's Times he introduces what is surely going to be a major Democratic talking point for the upcoming election season, ie, the Democrats are not proposing to socialize health care.  The Democrats will benefit enormously if they can couch the debate over health care as a debate over access and insurance, which is a bit of a smokescreen, and to that end, the arguments as laid out by Boffey have a superficial plausibility that lends itself well to the kind of sound-bite campaigning that our current system seems to reward:

The Socialists Are Coming! The Socialists Are Coming!

The epithet of choice these days for Republicans who oppose any expansion of government’s role in health care programs is “socialized” medicine.

Rudy Giuliani has used the “s-word” to denounce legislation that would enlarge a children’s health insurance program and to besmirch Hillary Clinton’s health plan. Mitt Romney has added a xenophobic twist, calling the Clinton plan “European-style socialized medicine,” while ignoring its similarities to a much-touted health care reform he championed as governor of Massachusetts. Other conservative critics have wielded the “s-word” to deplore efforts to expand government health care programs or regulation over the private health care markets.

Our political discourse is so debased that the term is typically applied where it is least appropriate and never applied where it most fits the case.

The best part follows:

Liberalism & Racism: An Unconscious Marriage

It is a truism that worth repeating: impulses that remain in the unconscious never disappear; they merely remain hidden until they can find ways to express themselves.  When a psychologically healthy resolution to conflicted impulses is established, the outcome is adaptive and ethically and morally acceptable.  For example, it is a commonplace for Surgeons to have sublimated their sadistic tendencies, draining the urgency and erotic charge from them, and direct the impulse toward helping people.  The difference between the knife cut from a sadist and the knife cut from a surgeon is the difference between life and death.

When impulses are defended against with less evolved and mature defenses they are more likely to find expression in ways which facilitate a greater degree of gratification of the original impulse.

One of the more common defenses against unacceptable thoughts, easily seen in young children, is called reaction formation.  A 3 year old with a new sibling often struggles with intense anger at the intruder who has taken his place as first among his mother's loves.  The child quickly learns that open aggression against the newcomer is unacceptable.  An exaggerated and aggressive "love" often replaces the original undisguised hate.  "I don't hate little baby Jimmy (who mommy loves more than me and spends all her time with); in fact I just love him to death!"  In fact, some children "love" their little siblings so much they want nothing more than to show the intensity of their love by hugging their little sibling...intensely... to death.  That is one important reason why wise parents do not leave very young children unattended with newborns.  Eventually the hate is subsumed by affection, attachment, and love but it often persists as part of the core of a sibling rivalry that can last throughout one's lifetime.

Shelby Steele, on the 50th anniversary of the dispatch of American troops to the capital of Arkansas by President Eisenhower, touches on issues related to unveiling the unconscious as he discusses our evolving race relations, in The Legacy of Little Rock.

... Americans watched by the millions and, in this watching, saw something that would change the country fundamentally. Every day for weeks they saw white people so consumed with racial hatred that they looked bestial and subhuman. When white racism was a confident power, it could look like propriety itself, like good manners. But here, in its insecurity, it was grotesque and shocking. Worse, it was there for the entire world to see, and so it broke through the national denial. The Little Rock crisis revealed the evil at the core of segregation, and it launched the stigmatization of white Americans as racists that persists to this day. After Little Rock whites stood permanently accused. They would have to prove a negative--that they were not racist--in order to claim decency. And this need to forever beg one's innocence is the very essence of white guilt. [Emphasis mine-SW]

Once the hatred lurking beneath the gentility was revealed the Nation had to change.  We have come a long way in 50 years but as civilized as we wish to appear, the unconscious persists in its primitive and enduring structure.  What defines our character is how we deal with our unconscious impulses.

Rediscovering the Frontier

There is a deep connection in the American psyche between our inception as a frontier nation and our basic freedoms.  The early settlers of necessity were self-sufficient and self-reliant.  It was only with the closing of the frontier, the increasing complexity of modern life, and the development of our tremendous comfort and wealth that we began to cede more and more responsibility for our well being to the State.  Along with such willing surrender of responsibility has been a slow and steady diminution of our freedoms, generally slow enough and modest enough as to be tolerable to most.  This is likely to change.

John Robb, author of Brave New War: The Next Stage of Terrorism and the End of Globalization (which should be on your "must read" list) authored a provocative piece in City Journal yesterday that outlines his contention that the Systems Disruption approach to terrorism and crime is likely to continue and accelerate, increasing its lethality and effectiveness.  This is due to the nature of our increased vulnerability related to our increased connectivity and, of course, the increased complexity of our civilization.  In  The Coming Urban Terror, Robb lays out the case that our cities, once looked upon as fortresses of safety from the forces of chaos and disruption have become targets for, as the subtitle puts it, "Systems disruption, networked gangs, and bioweapons." 

... in the current evolution of warfare, cities are no longer defensive anchors against armored thrusts ranging through the countryside. They have become the main targets of offensive action themselves. Just as the huge militaries of the early twentieth century were vulnerable to supply and communications disruption, cities are now so heavily dependent on a constant flow of services from various centralized systems that even the simplest attacks on those systems can cause massive disruption.

Most of the networks that we rely on for city life—communications, electricity, transportation, water—are overused, interdependent, and extremely complex.

Extreme complexity in and of itself does not imply vulnerability.  However, centralized and extremely complex systems are uniquely vulnerable to system disruption and that is the crux of the problem.

Ramadi, an Instructive Story

Yesterday Michael Totten published “Al Qaeda Lost”, an article documenting the turn of events in Ramadi.  Lieutenant Colonel Mike Silverman offered some very hopeful perspective on Ramadi from the view point of someone on the ground who has been intimately involved with the area and its people.  The article starts with some excerpts from an interview Totten had with Lieutenant Colonel Silverman:

“How long have you been in Ramadi?” I said.

“Since the last week of January, 2007,” he said. “When I first got here my area of operations was the southern half of downtown. It was ugly then, especially for the civilians. We found more than 50 dead in just one grave in the desert. 50,000 – 70,000 people have returned so far since the war ended in April.”

“Describe the progress you’ve seen so far,” I said.

“Sure,” he said, “let’s look at the Abu Bali area for example. 6,000 or so people live there. When I first arrived there were 10 attacks every day just in that small area alone. Since May 1, 2007, we’ve had only one attack total in that area. The people went from having two to three hours of electricity a day to having twelve hours a day. Insurgents kept blowing up the power lines, but now that they’ve been cleared out the government has put them back up. Commerce has really taken off.”

Ramadi is now a stable, peaceful city and the Sunnis there are now important allies of the United States against the terrorists of al Qaeda.  If you have not yet done so you should read the entire article.

I was struck by one particular aspect of the description of Ramadi under al Qaeda.  Within the article was a fascinating bit of discussion which goes a long way toward answering a question I have had meandering through my mind for quite some time:  How many "bad guys" does it take to destroy a civilized society?  The answer may surprise you:

On Words Versus Actions

I have read a great deal and listened to learned commentary and discussion on NPR concerning Mahmoud Ahmadinejad's invitation to give an address at Columbia University.  The discussion tends to focus on two particular points.

First, the invitation is described as a celebration of that quintessential American value, free speech.  In this framework, to rescind the invitation would be to give in to censorship and would be a repudiation of America's core values.  The marketplace of ideas is often invoked as well; one commenter on NPR said he should have the right to speak and if he spouts nonsense it will be obvious to all.

Second, the invitation is offered as an opportunity to put Ahmadinejad on the spot.  He will be asked difficult questions and cornered.  The questioners will make him look foolish by asking, demanding even, that Ahmadinejad support his Holocaust denial with scholarly citations. 

Both of these rationales were advanced by Columbia President Bollinger in his letter to the Columbia community:

In order to have such a University-wide forum, we have insisted that a number of conditions be met, first and foremost that President Ahmadinejad agree to divide his time evenly between delivering remarks and responding to audience questions. I also wanted to be sure the Iranians understood that I would myself introduce the event with a series of sharp challenges to the president on issues including:
the Iranian president’s denial of the Holocaust;
his public call for the destruction of the State of Israel;
his reported support for international terrorism that targets innocent civilians and
American troops; Iran's pursuit of nuclear ambitions in opposition to
international sanction;
his government's widely documented suppression of civil society and particularly of women's rights; and
his government's imprisoning of journalists and scholars, including one of Columbia’s own alumni, Dr. Kian Tajbakhsh (see President Bollinger's prior statement).

I would like to add a few comments on the principles that underlie this event. Columbia, as a community dedicated to learning and scholarship, is committed to confronting ideas—to understand the world as it is and as it might be.

...

And, of course:

It is a critical premise of freedom of speech that we do not honor the dishonorable when we open the public forum to their voices. To hold otherwise would make vigorous debate impossible.

Culminating in the self congratulation that is usually found in direct proportion to the fatuousness of the statements so invested, Bollinger concludes:

That faith in freedom has always been and remains today our nation’s most potent weapon against repressive regimes everywhere in the world.

This is America at its best.

Yaacov ben Moshe does an exemplary job placing Bollinger's letter into context:

You, sir, are also a useful idiot.

Yom Kippur

To all of my Jewish friends and readers, may you have an easy fast and a meaningful Yom Kippur.

Counting Coup

Contrary to popular neo-mythology of the Native American Indian living in a blissful state of nature, in harmony with his fellow man and the environment, the Native American inhabitants of North America prior to the coming of the white man were essentially in a constant state of low level warfare with tribes who competed with them for territory and resources.  A system was developed which allowed for a form of stylized warfare that minimized actual death and injury.  This system worked as during those periods when the competition was most easily managed but broke down under stress. The system was know as Counting Coup and was a reasonable response to pressures for status for young men in an Honor-Shame culture.

In Counting Coup, the goal was for a young brave to sneak up on an  enemy and tap him without being caught.  This gained status for the brave and lost status for the victim.  Wikipedia describes Counting Coup:

Counting coup was a battle practice of Native Americans of the Great Plains. A nonviolent demonstration of bravery, it consisted of touching an enemy warrior, with the hand or with a coup stick, then running away unharmed. Risk of injury or death was involved, should the other warrior respond violently. The phrase "counting coup" can also refer to the recounting of stories about battle exploits.

The term is of French origin from the verb couper, which means literally to cut, hit or strike. The expression can be seen as referring to "counting strikes".

Coups were recorded by notches in the coup stick, or by feathers in the headdress of a warrior who was rewarded with feathers for an act of bravery.

The entire point of the exercise is to manage the competition for status without it constantly degenerating into physical violence.  A corollary to this was that it was in the interests of all parties to avoid open warfare whenever possible.  The concept of Counting Coup would break down if one party saw his accretion of status as legitimizing and facilitating violence.  In other words, if he confused increased status via Counting Coup with increased capability in warfare, it made miscalculation and violence more, not less, likely.

Which brings me to Ahmadinejad, who wants to visit ground zero.

Islam and Marxism and Unmetabolized Rage

In his article in City Journal this week, Theodore Dalrymple commented on the ongoing and evolving alliance between Islam and Marxism:

Islam, the Marxism of Our Time
Some troubling signs in Europe

Two of the men that the German police arrested in early September for plotting a series of huge explosions in the country were young German converts to Islam. It is impossible to know how many such German converts there are, but it is thought to run into tens of thousands, principally men; in the nature of things, it is also uncertain how many of them are attracted to extremism, but few people are so attracted by moderation that they are converted by it.

...

All this suggests that Islam is fast becoming the Marxism of our times. Had Fritz G. and Daniel S. grown up a generation earlier, they would have become members of the Baader-Meinhof Gang rather than Islamic extremists. The dictatorship of the proletariat, it seems, has given way before the establishment of the Caliphate as the transcendent answer to some German youths’ personal angst.

This is good news indeed for Islamists, but not so good for the rest of us.

Dr. Sanity, in ISLAM AND MARXISM - A MARRIAGE MADE IN ALLAH'S SOCIALIST PARADISE, picked up on the discussion and added some texture to the argument.  She suggests that the alliance between Marxism and Islam, two ideologies which seem to stand in complete opposition to each other, is more a marriage of convenience than a true alliance of convergent interests.  In this framework, their alliance would be seen as akin to the de facto alliance between al Qaeda's Sunni radicalism and the Persian Shia radicalism of Iran:

I Hope You Know This Means War! ... or Maybe Not

[Update at end]

The Middle East is that area where the needs, passions, and desires of much of the world's population come together in a swirling amalgam of contention.  It is sacred to three great religions, central to the operation of the world economy, and the font of the most destructive passions at play in the world today.  At the moment, many critics of the Bush administration believe that there is an orchestrated campaign afoot, similar to the prodrome to the Iraq War, to prepare the American public and the world for war with Iran.    The usual suspects believe that diplomacy is the only approach to take with Iran, often without recognition that a viable threat of violence is the only avenue with any chance of diplomatic success, while there are other voices calling for immediate attacks on and destruction of the Iranian nuclear program.  Whether or not such attacks would work is uncertain, as is the state of the Iranian program.

Michale Ledeen is prominent among those who believe and have argued that the Iranian Mullahcracy is unstable and ripe for American pressure for regime change.  He believes military force should be a last resort.

The wild card for American policy makers and for the diplomats is Israel.  Since Iran's leadership, not confined to Ahmadinejad, has expressed openly genocidal wishes toward Israel and has spoken of using nuclear weapons to destroy the Jewish state and the Jewish people, Israeli sensitivity to such threats with the memory of the Holocaust indelibly stamped on her people, is understandable.  Even as ineffective a government as that of Ehud Olmert will not long stand by idly while an existential threat grows on the horizon. 

(I do not see the Iranian proxies in Southern Lebanon and the Palestinian Territories as yet having the capacity to represent an existential threat, though they are certainly a threat to the lives and safety of millions of Israelis.)

An Iranian nuclear weapon is unacceptable to the Israelis and those who suggest that we could live with an Iranian nuke are willing to tolerate a level of risk to the lives of Jews much higher than anyone should expect the Jews themselves to tolerate.

Victor Davis Hanson briefly summarizes the state of affairs in the Middle East and points out that the entire region is in flux:

The 60s: Drugs, Sex, and Rock & Roll

The intersection of public events and the internal world has been a primary interest of mine, especially since I have begun blogging.  While I have written a fair amount about the immaturity of the post-war baby boomers and their enhanced narcissism, it is also worth noting that the descent into the "Summer of Love and Psychedelia" of the late 60s was the outcome of a particularly difficult time in America.

The 60s opened with great hopes and idealism.  John Kennedy and his glamorous wife Jackie, were American royalty.  This was before the painful intrusions of reality, when Presidents and other celebrities were better able to manage their image to preserve their function as idealized transference objects.  No one knew about the tawdry and salacious details of JFK's infidelities.  He was the beautiful and wise leader who would usher in a magical time.  Adolescents who came of age in the 60s expected that their magical carpet ride would continue.  The hints of troubles in a distant and unknown Southeast Asian country, Vietnam, were rarely mentioned or noticed.  We were bestride the world and all possibilities were open. 

It is difficult for people who did not live through the event to realize what a visceral blow JFK's assassination was.  Our President was cut down in his prime and it was devastating to the nation's psyche.  Those of us who were the most impressionable, those adolescents who had, developmentally, the greatest tendency to idealization, were crushed.  How could the world be so cruel? 

When idealization collapses, devaluation follows, and it followed with a vengeance.  If the world which we had been brought up to believe owed us everything good (and many, perhaps most, well to do baby boomers grew up in a world with minimal material wants and never experienced material deprivations) had just exchanged light for darkness, we would reject and repudiate that world which had so disappointed us.

What followed was a descent into renunciation.  We would seek salvation in everything that opposed the cruel, sadistic reality that had failed us.