Yearly Archives: 2010

Different Paths to National Healthcare

An article I’ve referred to often is “Getting There from Here,” by Atul Gawande, a cancer surgeon in Massachusetts. The article appeared in the January 26, 2009, issue of The New Yorker. Now, don’t go hating on me and calling me a socialist. I’m just conveying information I found interesting.

Gawande discusses how universal healthcare came about in various countries. He says that in every country, the idea is initially derided as “a Bolshevik fantasy.” Sounds familiar.

On both sides are idealists. Hardcore reformers insist that the best thing to do is start from scratch–scrape away the existing system and build the “perfect” system in its place. On the other side are the free market folks, who want to end all public and employer-based insurance, and let people fend for themselves in an open market. If you can afford it–fine; if not–tough.

In the middle are the pragmatists–and in every country, they prevail over the ideologues. Their vision is to start with the existing system, and build from there. It still involves major change, but it’s less traumatic than starting from scratch.

Gawande gives three examples–France, Switzerland, and England. All had a healthcare system in place, and rather than dismantling it, they used it as the starting point. That is pretty much what we’re doing in the US.

England’s system emerged from World War 2, when private hospitals and clinics were overloaded with casualties (or destroyed). The government had to take over…and people liked the result. Their system grew from that point. Their road to national healthcare has absolutely no correlation to the US.

In France, the only organized healthcare involved collective insurance funds financed through payroll deductions by unions and major manufacturers. The French government was too busy with post-war rebuilding to spend much time on healthcare, so they just expanded the system already in place. Now they have more doctors, higher life expectancy, lower infant mortality, and lower costs than the US. The World Health Organization ranks it as the best healthcare system in the world (the US is 37th). And they didn’t even put much effort into it. Not that the French put much effort into anything they do.

In Switzerland, people relied on private insurance. When they passed a universal coverage law in 1994, they required every resident to buy private insurance, and government subsidies restricted the cost to no more than 10% of the person’s income. Some similarities to what we’re doing…or not. Hard to tell what Congress will do, as they keep tweaking the thing to death.

The point is, each country starts at a different place, and each country’s system is a bit different. The wise route is to build on what already exists, rather than start over. That seems to be the route we’re taking.

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A Satellite View of Two Koreas

I had heard about this photo, but recently stumbled across it. This satellite photo shows a night-time view of North and South Korea. North Korea is totally dark, except for its capital, Pyongyang–probably because Beloved Leader Kim Jong Il is up indulging his favorite pastime of watching American movies. China lies north of the border. (Obviously, the country outlines are superimposed.)

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Book: Tears in the Darkness

tears-in-the-darkness200.jpgI remember reading a book about the Bataan Death March back in high school. I was astounded by the cruelty of the Japanese. But “Tears in the Darkness: The Story of the Bataan Death March and Its Aftermath,” published in 2009, takes the horror much further. The Japanese committed terrible atrocities in the Philippines, and that underscores our benevolence as conquerors in rebuilding Japan. We are good people. The Japanese, back then, were decidedly not.

This book’s center is Ben Steele, a US soldier who experiences a little of everything. He fights the Japanese for three months on Bataan. He endures the death march, and then the horrific train ride to the prison camp. We see men dying constantly, and being brutalized and killed for no reason by sadistic Japanese guards. Steele survives a work detail in the far south building a road, then lands in a POW hospital in Manila. After getting well, he and hundreds of other POWs are crammed into the hold of a “hell ship” and taken to Japan as slave laborers. He’s there when Japan surrenders. The book drifts away from Steele, telling the stories of many other soldiers, but keeps coming back to him.

The subtitle is a bit misleading. The death march doesn’t start until 170 pages into the book. Up to that point, it’s all about the battle for Bataan, starting with the Jap invasion the day after Pearl Harbor. I hadn’t read much about that. Our troops, joined by Filipino troops, actually fought very well against the combat-hardened Japanese. They might have even prevailed except for some huge mistakes by General Douglas MacArthur (who doesn’t fare well in the book, at least regarding his command in the Philippines). When our troops on Bataan surrendered–76,000 Americans and Filipinos–it was the largest defeat in American history.

The authors also tell the stories of some Japanese soldiers. The whole culture of the Japanese army was based on cruelty, including to their fellow soldiers. It helped explain their casual brutality toward POWs. We see the Japanese slaughter hundreds and hundreds of Filipino prisoners, bayoneting them. But we also see Japanese soldiers who refused to take part. It reminded me of the German soldiers in “Ordinary Men” who likewise abstained from executing Jews in Poland.

I’m fascinated by how ordinary people can so easily descend into brutality. “Ordinary Men” showed that, as did “Hitler’s Willing Executioners,” “The Railway Man,” “The Rape of Nanking,” and to bring us to the present, “The Dark Side,” where America embraced torture for a short time after 9/11. (And as a fiction entry, there’s “The Lord of the Flies.”)

The mistreatment of our POWs in “Tears in the Darkness” got me so worked up that I wanted revenge. But then the authors turn a corner with the war crimes trial of the Japanese general who commanded the invasion of the Philippines (and was relieved of command shortly after we surrendered). The circumstances are far too complicated to explain here, but suffice it to say, there was a strong case for not holding him responsible for the atrocities. I’m still conflicted about it. The American military tribunal was pretty much a done deal–they went through the motions of a trial, but he was going to be killed in the end. For the authors to fling 350 pages of atrocities at the reader, and then suddenly make you sympathetic toward the Japanese general…I tell you, it was fascinating.

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Iraqi Eyes on the Example of the American Soldier

Moment-of-truth-in-Iraq.jpgI previously reviewed Michael Yon’s book “Moment of Truth in Iraq,” which tells of his experiences while embedded with US troops in Iraq. The book talks a lot about how American soldiers are viewed by the Iraqi soldiers whom they train and fight alongside.

Yon writes:

“The American soldier is the most dangerous man in the world, and the Iraqis had to learn that before they would trust or respect us. But it was when they understood that these great-hearted warriors, who so enjoyed killing the enemy, are even happier helping to build a school or to make a neighborhood safe that we really got their attention.”

He says that before the invasion, Iraqis looked down on American soldiers. They thought we were soft, hiding behind our technology. Even after conquering the country quickly, they could chalk that up to our superior equipment. But over time, they observed the American willingness to fight and suffer.

“It was only after, when they saw that our people were better street fighters, too, and that American combat soldiers would match or outlast them in the heat, that they began to understand. At this point, the man to man respect was there.”

Not only that, but Iraqi soldiers watched, and tried to copy, their American counterparts. For them, it was a matter of learning from the best. I loved this part:

“Iraqi soldiers and police constantly emulated marines and soldiers. When he got back from missions, SSG Lee worked out. The Iraqis would watch him and start doing their own exercises. Lee was just being himself, and the young Iraqis wanted to be like him….By showing that the strongest soldier is also disciplined, just, and compassionate, soldiers like SSG Lee were winning the moral high ground in Iraq and devastating Al Qaeda. I saw an Iraqi Army lieutenant named Hamid treating prisoners with respect, because he had seen American soldiers do it.”

In the Iraqi army, officers had led from the rear. Now they learned a different type of leadership. “The Iraqis were amazed that American officers and sergeants would lead from the front into the worst situations…..Soon the Iraqi officers who survived and mattered were leading from the front.” He adds, “Iraqi soldiers might be a lot of things, but cowards they are not….Courage is not in short supply in Iraq.”

Yon writes that everywhere he went, Iraqis responded to strong leadership.

“Leading the Iraqis by example worked, but cost us casualties. The American combat soldiers I was with in Mosul in 2005 were not there to play it safe. Their goal was to win. If it cost blood, then blood it would cost. The Iraqis were wild for that sort of leadership.”

The Abu Ghraib and torture abuses left stains which had to be overcome, and which initially deprived us of the moral high ground which is crucial to counter-insurgency. But, Yon writes:

“Even during the outrages of the Fallujah-flattenings and prisoner rape-torture debacles, Iraqis never turned against us the way they would later turn against al Qaeda. We were never completely evil in their eyes. Dumb, overbearing, disrespectful, but not evil….Though Iraqis know we were torturing Iraqi prisoners earlier in the war, overwhelmingly they accept that we have straightened up and that Americans now treat prisoners very well….

“They knew we did a lot of stupid and overbearing things, even brutal and criminal things at times. But they also could not deny that, on the whole, our people had a heart for them, or at least for their kids.”

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Grandpa is Busted

Cameron, my nephew, was out in the garage with Dad, who had been working on Cameron’s bicycle. Cam’s in kindergarten, I think. Maybe first grade. I lose track.

Rick and I were inside, talking to Mom. Suddenly Cam comes running in to Rick, very excited.

“Daddy, Grandpa let me ride my bike on the ROAD!”

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On the Phone with Anthem

Anthem Insurance sent me a letter authorizing my MRI. It said that if the date of the MRI changed, I needed to call them. They gave a number to call.

So I did. I listened to the phone options, and took a wild guess about which one applied to me. A Real Person soon came on the line, and I explained my situation.

“I’ll need to transfer you to the department that deals with that,” Real Person said.

A second later, a phone rang, and a woman said in a tentative voice, “Hello?” As if she’d looked at the caller ID and didn’t recognize the number.

I began explaining my situation. “I had an MRI scheduled last Friday, but it had to be rescheduled, so I’m calling….”

She cut me off. “I’m sorry, but you have the wrong number.”

Anthem had transferred me totally out of their system to a private citizen.

So I tried calling the number on my card. After several transfers, each preceded with me explaining why I was calling, I finally reached someone who told me this:

“There was no need for you to call.”

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Tiger Woods and Opportunity

Ron is one of the better players in the Fort Wayne table tennis club. He also manages a golf course.

Tonight I said to him: “I imagine you’ve heard every opinion possible about Tiger Woods.”

He smiled. Yes he had. Then he said, “Here’s my opinion, if anyone’s interested. One: You don’t really know a person’s character, deep down, until they are tested–until they have opportunity. Two: I hope I never have opportunity.”

That’s a humble, “there but by the grace of God go I” kind of attitude. A good attitude to have.

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Today’s Christian Music is in a Vertical Rut

Most contemporary worship songs are sugary love songs–I adore God, and God adores me. That pretty much sums up every “worship” song I hear anymore. It’s all above love, love, love.

I’ve always liked Lovesong’s simple “Two Hands” song: “With one hand reach out to Jesus, and with the other, bring a friend.” But according to the songs we sing, we’ve decided only the first hand is really important. Our singing is all vertical (from us to God and back), without the horizontal (us to others).

I’ve heard others complain that today’s worship songs are, to be sexist, girly songs. All of these love themes lack testosterone. Where are today’s “Onward Christian Soldiers,” “Stand Up for Jesus,” “Soldiers of Christ Arise,” “The Banner of the Cross,” and “I am Resolved”–songs a guy with hair on his chest can sing?

Worship songs rarely, if ever, talk about:

  • God’s judgment on nonbelievers.
  • Going into the world.
  • Giving up anything (beyond the nebulous “my all”).
  • Ministering to the downtrodden.
  • Experiencing trials and tribulations.
  • Holy living.
  • Suffering for Christ.
  • What Christ suffered for us.

“Sin” seems to be missing from worship songs. We lack a “Whiter than Snow” to talk about holy living. Remember the old hymn, “Yield Not to Temptation”? You won’t find, in contemporary music, lyrics that spell out truths like this:

Yield not to temptation, for yielding is sin,
Each victory will help you, some other to win.
Fight manfully onward, dark passions subdue,
Look ever to Jesus, He’ll carry you through.

And what about reaching the world? In our obsession with the vertical, we rarely sing about the Great Commission. Who is writing the next “We’ve a Story to Tell to the Nations,” “I’ll Go Where You Want Me to Go”, or “Bring Them In”? Would Chris Tomlin ever write a song like “Rescue the Perishing”? Or would the fact that people are perishing be too much of a downer, too unworshipful?

As a keyboardist in a worship band, I do my share of grumbling about hymns–how they’re difficult to play, don’t communicate well with people today, and the lyrics mangle sentence structure in order to rhyme. I think a lot of great music is being written today. A LOT. It’s just too limited subject-wise.

While I don’t like playing most hymns (some I LOVE), I admire the themes you find in a hymnal. They cover the gamut of what the Christian life is about. Sure, you’ll find some lovey-dovey hymns, spiritual pablum, but there’s so much more, too.

But contemporary Christians just don’t feel they are “worshiping” if they are singing about people going to hell, or conquering sin, or sacrificing for other people, or the hardships of the Christian life. Because, in our thinking, “It’s all about God and me and how happy I will be.”

(BTW, I’ve ranted about this stuff before here, here, and here.)

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Book: Fiasco, the Early Years of the Iraq War

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“Fiasco: The American Adventure in Iraq,” tells about the Iraq war from 2002-2005–the pre-war planning through to the darkest period, just before the surge. Thomas Ricks, the author, is a highly-respected reporter who specializes in military affairs. He’s well plugged in to the military, and they speak their mind to him.

In addition to original interviews with military and civilian officials, Ricks draws on a vast amount of source material–countless internal military reports and studies; diaries, letters, and blog posts of soldiers; official combat histories of the military units; and practically anything else that was written about Iraq. The amount of research and reporting is overwhelming. If you want to understand the early years of the Iraq war, this is the book for you. Until somebody writes a better one.

The most interesting parts, to me, involved candid, real-time words from troops on the ground. We see their professionalism, their extreme competency as a fighting force (as in the section about the invasion). We also see their frustrations with the inadequate planning, the insufficient resources, and the lack of manpower from Day One.

I hate the title. Way too agendish. And yet, by the time I reached the end, I realized it was a pretty accurate description of the war up to 2005. Things were a royal mess, and Ricks tells why. Almost everything points right back to the lack of planning, and the insistence by Don Rumsfield and his deputies that Iraq would be a walk in the park (despite warnings from the military).

The lead-up to the war was truly a joke. Don Rumsfield continually thwarted the military’s attempts to bring sufficient troops. His agenda was to disprove the Powell Doctrine of overwhelming force, showing that we could conquer Iraq with a relatively small force. The military, looking beyond to the occupation, wanted at least 250,000 troops, but Rumsfield’s initial proposal called for just 10,000 troops. The Generals repeatedly warned him beforehand that we would need a huge presence to occupy the country. And since we didn’t, the country descended into looting and chaos. Rumsfield proved his point, at the expense of years of conflict and thousands of lives.

Ricks documents how a number of Bush Administration people, especially around Cheney and Rumsfield, were determined to get us into a war with Iraq, and readily disregarded any arguments against doing so. The frustrated military got the message that it didn’t matter what they had to say–we were going to invade Iraq one way or the other. And even upon realizing they would be fighting a war, they weren’t allowed to adequately prepare for it.

Ricks goes behind doors to all kinds of meetings, delves into numerous military studies, and eavesdrops on conversations between military men who can’t believe what’s happening.

The military knew what needed to be done. The knowledge was there, not only for taking the country but for occupying it and stamping out any insurgency. Bush himself kept his hands off, fully trusting his generals. But Rumsfield continually over-ruled the military leaders.

We also see how the people around Rumsfield were in love with Ahmed Chalabi, the crooked Iraq ex-pat whose falsehoods propelled us into the war, and whom the CIA always knew was in Iran’s pocket.

We see General Tommy Franks, having conquered the country, become disengaged at a crucial time as he prepares to retire soon after taking Baghdad.

Paul Bremer, the civilian put in charge of the occupation, was a disaster. The Iraqi military consisted of men accustomed to discipline and taking orders. They could have been a huge asset. Instead, Bremer disbanded the military, putting tens of thousands of young men out of work and fueling an insurgency. As if that wasn’t enough, he decided that any members of the Ba’ath party couldn’t hold government jobs. So all the people who knew how to keep the country running–civil servants, school administrators, you name it–were left unemployed and told, “You don’t have a role in Iraq’s future.” More recruits for al Qaeda. Bremer did other stupid, stupid things which had the effect of pushing Iraq further into bloodshed and instability. And yet, GW Bush still awarded him the Medal of Freedom. Go figure.

Ricks deals with the mass detainment of Iraqis, which culminated in Abu Ghraib and torture. We see General David Petraus in the early days of the occupation, when he commanded the 101st Airborne in Mosul. His strategy in pacifying his part of Iraq is contrasted with the brute-force tactics of General Odierno and the 4th Infantry Division, which continually knocked down doors in the middle of the night, violated all kinds of Islamic cultural norms, and indiscriminately rounded up large numbers of Iraqi men of all ages. They didn’t bother trying to sort out the good from the bad, as Petraus did, but just sent them all to Abu Ghraib, flooding the system with lots of innocent people.

I was fascinated by Ricks’ account of the two battles for Fallujah–first in the spring of 2004 (called off by civilian leaders just short of victory), and then again in the fall after insurgents had had a chance to heavily fortify the city. That second battle is regarded as the most fierce combat the US military has experienced since the Vietnam War. The taking of Tal Afar was also fascinating. Brilliant strategic thinking.

You get the impression that we would be much, much better off if the civilian leaders had stayed out of it, had just let the military develop all the plans for conquering and occupying Iraq.

The book ends with the war going badly, with Shiites running rampant in torturing and killing Sunnis, and Sunnis and Al Qaeda killing indiscriminately. The “fiasco” is in full bloom. But changes are on the horizon. We see David Petraus and a new team beginning to take shape, and preparations being made for this thing called “the surge.” Ricks deals with that in his second book, “The Gamble.”

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In Search of a Culprit

From the weird file: In 1995, a South Carolina man named Sonny Graham got a heart transplant, using the heart of a man who had committed suicide. He struck up a relationship with the man’s widow in 1997, and married her in 2004. And now he, too, has committed suicide.

So there are two common elements: the heart, and the woman. Who to blame?

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