ParisTampaBlog

Thomas Friedman has frequently written about the failure of moderate Muslim leaders to speak out against the Muslim extremists among them. In a recent Times op ed piece, for example, he writes:

“What is really scary is that this violent, Jihadist minority seems to enjoy the most ‘legitimacy’ in the Muslim world today. Few political and religious leaders dare to speak out against them in public. Secular Arab leaders wink at these groups, telling them: ‘We’ll arrest if you do it to us, but if you leave us alone and do it elsewhere, no problem.’”

Well one of those few political and religious leaders in the Muslim world, a former president of the world’s third largest democracy and the country with the largest Muslim population, who did dare to speak out was Abdurrahman Wahid.

Wahid, who died on December 30 of last year, was the first elected president of Indonesia after the resignation of Suharto in 1998, as well as being a long time president of the Nahdlatul Ulama, one of the largest independent Islamic organizations in the world (some 30 million members) whose mission is to make up for the failings of government by funding schools and hospitals, as well as by organizing communities into more coherent groups to combat poverty.

Mr. Wolfowitz, a former U.S. ambassador to Indonesia and assistant secretary of state for East Asia, now a visiting scholar at the American Enterprise Institute, writes in today’s WSJ about his friend, Wahid. Wolfowitz stresses Wahid’s deep humanism, his knowledge of and even acceptance of much in our Western heritage, in particular the Aristotle of the Nichomachean Ethics, and his firm rejection of the writings of Said Qutb and Hasan al Banna, the founders of the Muslim brotherhood and to which as a young man, not unlike Bin Laden, Wahid had been attracted.

Wolfowitz writes, “When I visited Wahid recently he told me of a long-ago visit to a mosque in Morocco where an Arabic translation of Aristotle’s Nichomachean Ethics was on display. Seeing that book had brought tears to his eyes and Wahid explained: ‘If I hadn’t read the Nichomachean Ethics as a young man, I might have joined the Muslim brotherhood.’

“No doubt, what had so impressed Wahid was that Aristotle could arrive at deep truths about matters of right and wrong without the aid of religion, based simply on the belief that ‘the human function is activity of the soul in accord with reason’ (Nichomachean Ethics, Book I). But his tears must have reflected the thought of how close he had come to accepting a cramped and intolerant view of life and humanity.”

Is Atul Gawande on to something in what he asks in a recent New Yorker article, “The health-care bill has no master plan for curbing costs. Is that a bad thing?”

Can we, as he suggests, usefully and justifiably compare the place of health care, in particular the escalating cost of health care today, with the place and high cost of agriculture in the economy some 100 years ago?

And more important can we apply the example of all that we learned from our successful efforts to reform American agriculture in the 20th. century to our present attempts in the 21st century to reform health care?

I think so. What Gawande is saying is both highly interesting in itself and highly relevant to the national debate now going on over health care reform.

What Americans are most afraid of, at least those who work and pay taxes and who are ultimately responsible for providing the revenues that pay for all government programs, are the escalating costs that they now, and later their children and grandchildren, if nothing is done, will have to pay for their health care.

Gawande points out that, ‘Medical care now absorbs eighteen per cent of every dollar we earn, that between 1999 and 2009, the average annual premium for employer-sponsored family insurance coverage rose from $5,800 to $13,400, and the average cost per Medicare beneficiary went from $5,500 to $11,900.”

These numbers ought in themselves to be enough to push our leaders to act. So far they haven’t done so.

Americans are asking if the health care bill, now before Congress, will help to make health care affordable. And more and more they are of the opinion that it won’t. Gawande, however, says there is a good chance that it will, and he bases his argument on the agriculture/health care comparison.

Everyone agrees that sooner or later costs will have to be substantially lowered, that the present health cost trajectory is unsustainable, and that if nothing is done, to cite Gawande’s words: “Health-care spending will essentially devour all our future wage increases and economic growth. State budget costs for health care will more than double, and Medicare will run out of money in just eight years. The cost problem threatens not just our prosperity but our solvency.”

While Gawande admits that the Bill doesn’t directly confront the problem of escalating costs (“we crave sweeping transformation [but] all the current bill offers [are] pilot programs, a battery of small-scale experiments”) he strongly suggests that the many small pilot programs in the present Bill, as earlier in the case of agricultural reform, may be the very best way to reform our medical practices.

In 1900 food costs consumed some 40% of the American family’s income, considerably higher than the cost of health care today. At the time agriculture was notoriously inefficient and whereas some might have called for huge federal programs to reform the nation’s farms the government instead went about reform piecemeal, supporting hundreds, perhaps thousands of pilot programs meant to show the farmers how things could be done differently and more efficiently.

At the time it was clear to almost everyone that only by improving the productivity of farming could the living standard be significantly raised, and the U.S. emerge as an industrial power. As Gawande writes, “We had to reduce food costs, so that families could spend money on other goods, and resources could flow to other economic sectors. And we had to make farming less labor-dependent, so that more of the population could enter non-farming occupations and support economic growth and development.”

And that is what we did and what happened, while admittedly “in the attempt to reform how we grew our food there were compromises and concessions and wrong turns, ultimately we were successful because the government agencies leading the reform efforts were allowed to proceed by trial and error, continually adjusting their policies over time in response not to ideology but to hard measurement of the results against societal goals.”

So today it’s clear to everyone that in order to compete successfully in the global economy we have to  reduce the amount of our wealth now consumed by the health care industry. And to do this we ought to follow the agriculture example.

In a section of the Bill, entitled  “Transforming the Health Care Delivery System,” what is offered are, pilot programs, piecemeal efforts to change things locally, or in particular segments of the health industry, such as medical record keeping and the greater use of these records by clinicians. And for Gawande these programs are our best chance of bending the cost curve down to something well within our means to handle.

There are, in fact, as on the millions of small farms earlier, any number of inexpensive improvements that might be made in the way we deliver health care in our hospitals and clinics, and that, if copied nation-wide, as in the case of the earlier agricultural improvements, could result in significantly lower costs, as well as better treatments, just as the agricultural reforms resulted in more and better food at lower costs.

Health professionals, just like agricultural workers, will need to be shown in order to learn, and then, without pressure from without, proceed themselves to make the desired changes and deliver better services at less cost to their patients.

Again, in Gawande’s own words, “The history of American agriculture suggests that you can have transformation without a master plan, without knowing all the answers up front. Government has a crucial role to play here—not running the system but guiding it, by looking for the best strategies and practices and finding ways to get them adopted, county by county. Transforming health care everywhere starts with transforming it somewhere.”

Well over one year ago Michael Porter of the Harvard Business School outlined what he thought were the sources of our country’s exceptional prosperity. The U.S. has prospered, he said, because of a “set of unique competitive strengths.”

These were:

an unparalleled environment for entrepreneurship, for starting new companies.

an entrepreneurship fed by a science, technology, and innovation machine that remains by far the best in the world. (In 2007, American inventors registered about 80,000 patents in the U.S. patent system, where virtually all important technologies developed in any nation are patented. That’s more than the rest of the world combined.)

the world’s best institutions for higher learning

the strongest commitment of all countries to competition and free markets.

an economic policy highly decentralized across states and regions. (think of the entertainment complex in Hollywood or life sciences in Boston)

the deepest and most efficient capital markets of any nation, especially for risk capital.

a  willingness of entrepreneurs to restructure, take their losses, and move on to the “next big thing”

Assuming that our prosperity does stem from these sources, an assumption that most of us would readily make, shouldn’t it be the government’s highest priority to get behind programs in support of these sources?

And yet when one looks at what has most occupied the executive and legislative branches of the government during President Obama’s first year of office one looks in vain for major Congressional or Presidential initiatives to strengthen anyone of these sources.

(See, for example, an astonishing WSJ report on the difficulties, including wait times of at least 12 and sometimes as long as 20 years, that highly skilled and highly talented, and therefore highly desirable, foreign-born professionals encounter when seeking to become permanent U.S. residents.)

Instead of policies to increase our competitiveness, and thereby our economic prosperity in a now global economy, we hear mostly about government  bail-outs of too big to fail banks and car companies, about the 100s of billions of stimulus dollars going to increase consumption rather than production, and hesitant, timid, and certainly inadequate congressional proposals to reform the country’s system of health care.

And if all this wasn’t enough to prevent us from doing the right thing there are a number of other problems and issues, any one of which could almost by itself undue our prosperity and for which no reasonable and obtainable solution is even yet in sight, let alone on the table, a few of the weightiest of these being the wars in Iraq and Afghanistan, immigration, and our system of public education.

The President seems to be all tactics, leading skirmishes, waging battles, but the strategic thinking for which he was known for as a candidate, has not been transformed into particular strategic priorities and initiatives.

Instead, President Obama seems on the one hand to be trying to hold things together (because when he assumed office things did seem to be falling apart) — the economy, the war effort. On the other hand the particular attention he has given to health care and job protection, in the form of new entitlements and tariffs, clearly stems from promises made during the campaign.

Too bad. It does seem to be that our leaders are failing us. The President because he seems unable to break free from the entrenched political, corporate, and military centers of power in the country. Is it because he is without sufficient courage to go it alone, for he does seem to have sufficient knowledge?

And the Congress? It is still subject as much as ever to partisan bickering, its members still unable to put the country’s welfare ahead of their own private interests.

In Michael Porter’s words:

“Republicans keep repeating simplistic free-market thinking, even though the absence of all regulation makes no sense. Self-reliance is preached as if no transitional safety net is needed…. Republicans seem to think business can thrive without healthy social conditions.”

“Democrats, meanwhile, keep talking as if they want to penalize investment and economic success. They defend unions obstructing change in areas like education, cling to cumbersome regulatory approaches, and resist ways to get litigation costs for business in line with other countries. Democrats equivocate on trade in an irreversibly global economy. They seem to think social progress can be achieved only at the expense of business.”

It’s true that the value we give to things doesn’t represent something that we might want to call their “real value.” The best we’re able to do is come up with an appraisal, or market value, what they might be sold for. What is the real value of this country’s production? Is it GDP, or the measure of what gets made in the United States, no matter who makes it, or where it goes after it’s made?

Eric Zencey, a professor of historical and political studies at Empire State College, in an op ed piece in today’s Times, G.D.P. R.I.P., says that GDP is more correctly just a measure of gross domestic transactions (than output, or production, or value), and that it fails miserably to represent our economic reality.

Certainly it’s true, as he says, that GDP doesn’t include a good part of our productive wealth, such as all sorts of volunteer work, such as the huge volume of unpaid domestic services including housework, child rearing, do-it-yourself home improvement etc.

Nor, and this is commonly overlooked, does the GDP at all reflect the huge economic benefit that we get directly from nature. This, nature’s bounty, is as much, or more the wellspring of our country’s growth and development as the successive revolutions in agriculture, industry, information, and communication.

My wife has been telling me for years that clothes left out to dry in the sun is an economic benefit that goes uncounted. Whenever she’s had the opportunity to do so, as now in Tampa, she has never failed to put our clothes out in the sun. What value should we attach to this? Similarly, Zencey asks, what is, or was the real value of the natural services provided by the Louisiana bayous? Was it $82 billion, the cost of Katrina?

Perhaps worst of all the GDP doesn’t distinguish between items that are costs and items that are benefits. Zencey says we need a new, more accurate measure of our wealth production, perhaps something best called net economic welfare [N.E.W.].

Finally, Zencey’s summing up, “In 1934, the economist Simon Kuznets, in his very first report of national income to Congress, warned that ‘the welfare of a nation can … scarcely be inferred from a measure of national income.’… [we need] an indicator that will tell us if we are really and truly gaining ground in the perennial struggle to improve the material conditions of our lives.”

General Wald (U.S. Air Force four-star, retired) in today’s WSJ, There is a Military Option on Iran, defends air and naval strikes against Iran’s nuclear facilities. He says that otherwise, “we risk Iranian domination of the oil-rich Persian Gulf, threats to U.S.-allied Arab regimes, the emboldening of radicals in the region, the creation of an existential threat to Israel, the destabilization of Iraq, the shutdown of the Israel-Palestinian peace process, and a regional nuclear-arms race.”

His words make me think of Bob McNamara and Donald Rumsfeld, who with similar false assumptions as starting points led us into the “bad” (for all those who died in vain, for our neglected social problems at home) wars of Vietnam and Iraq.

Wald’s beliefs are as baseless as those of McNamara and the others who in the sixties touted the domino theory of communist domination of the countries of IndoChina, and as baseless as those of Rumsfeld and others who in the nineties talked only of the non-existent weapons of mass destruction in the possession of Saddam Hussein. Have we learned nothing from these terrible mistakes of our own recent past?

Assuming that Iran does become a nuclear power, why would that mean that they would dominate the oil-rich Persian Gulf? At best being a nuclear power would make them a bit more secure faced with the other nuclear powers in the region, including Israel. It might even make them act more responsibly. Just as home owners who have something to protect are more responsible than those who don’t.

And a threat to our “allied Arab regimes” in the region? Who are these “allies?” Saudi Arabia? Egypt? the Gulf Kingdoms? Wouldn’t in fact we love to see these feudal states disappear, and be replaced by democratic and progressive regimes, more supportive of their own people? A nuclear Iran might help that to happen. There’s no reason to assume it would hurt.

“Emboldening of radicals in the region.” Does he really mean this? That the radicals of the region could be even more emboldened than they already are by our own blunders? Where has he been living? Probably in a plane or ship. In any case he seems to have lost touch with the land.

Is there any need to go on with this? ‘The creation of an existential threat to Israel, the destabilization of Iraq, the shutdown of the Israel-Palestinian peace process, and a regional nuclear-arms race.” Need I comment any further? It’s all laughable, or it should be, would be if we didn’t suspect that there were those who took this General seriously, those who might have the influence and power to have us follow up Vietnam and Iraq with Iran.

An article from the Times, Landowners Still in Exile From Unstable Pakistan Area. Pakistan again. As if in answer to the question, why they’re not returning, this article,

From the BBC  News, Pakistani policeman decapitated, “The headless body of a police constable has been found in Mingora, the main town in Pakistan’s troubled Swat Valley.”

On the inability of the Pakistani military to rid the Valley of Taliban presence, if not control, I take this from the Prairie Pundit: “It’s an insane dream to expect anything different from the Pakistani government,” said Ali Wazir, a South Waziristan native and a politician with the secular Awami National Party. “The Taliban are the brainchildren of the Pakistan army for the last 30 years. They are their own people. Could you kill your own brother?”

There’s a lot going on in the world (always has been) and the newspapers, struggling on paper, are thriving online, and online are bringing us the news. Reporters and now a myriad others, who write about what’s happening, do not lack. And prominent among them are those who continue to venture into the unsafe areas of the Globe and come back, most of them, with their stories.

Other than the foreign correspondents and reporters, who keep us abreast of what’s happening, who are the ones who make things happen? Who are the real movers and shakers in today’s world? According to Bret Stephens in today’s WSJ these are, and still are, the dissidents. And the question Stephens raises in his op ed piece is how much we, meaning in particular President Obama, should support them.

The most dangerous countries this year for journalists were not the three countries, Cuba, China, and Iran, where over one half of the 177 journalists now imprisoned are being held (is it safe in prison?) but the three countries, Iraq, Pakistan, and Somalia where one half of the 27 journalists murdered so far this year have died. Still, there are hundreds, thousands of reporters out there reporting back to us.

But Stephens is not talking about the contribution to a better life for us all made by the journalists, but the even greater contribution made by the dissidents. On a list of the most inspiring figures of the last 50 years, says Stephens, the political dissidents will weigh heavily at the top of it: Alexander Solzhenitsyn, Nelson Mandela, Lech Walesa, to name just a few of the most well known.

Now Russian and Iranian dissidents are active, and being imprisoned and murdered, as just last week Natalya Estemirova was found dead by a roadside with gunshot wounds to her head and chest, and for the most part we don’t even know their names, let alone do we question their governments as to their condition and whereabouts.

Yet if the past is to be listened to the future, our future belongs to these dissidents much more than to their executioners. Should Obama be more outspoken in their behalf? Stephens is asking the question and answering it in the affirmative.

We are sorely troubled by a decapitation in the Swat Valley, by a murder in Chechnya. But, as if to bring us back from the brink, we read in the same publications about “Suds,” scheduled to take place at the White House at 6 pm on Thursday. That’s Happy Hour, and one can only hope that Suds will be a happy time for Barrack, James, and Skip.

One wants to join them with a beer on Thursday evening, and I will, and I’ll try to imagine what they will be saying to one another. They’ve already said in advance that there will be no apologies, but the beer might change all that.

And then, as if to strengthen that movement away from the brink, we read on these same web pages that the good people of the town of Greenville, Michigan, are now at risk of losing their town’s statue of Hans Christian Andersen’s “Little Mermaid,” a symbol of their proud Danish heritage.

Why? Well the copyright on the sculptor’s (that’s Edvard Eriksen, who died in 1959) work is still in force, for a full 70 years from the time of his death. And the good people of Greenville omitted to request permission from sculptor’s family to have their own little mermaid statue and bolt it to a pile of rocks on the muddy banks of the Flat River.

Does anybody want to take the measure of the distance between Hans Christian Anderson’s Little Mermaid story and the surviving members of the sculptor’s family who want to be paid? OK, not at all the distance separating the land owners of the Swat Valley and the Taliban. But what I’ll take away with me from the article is this:

“Annette Andersen, a resident of Kimballton, Iowa, headed a community group that raised the $12,000 needed to restore that town’s mermaid statue a few years ago. “Oh boy, I hope they don’t find us (referring to the ‘art police’),” says Ms. Andersen, when told about the controversy in Michigan.”

A New Yorker article by Nicholson Baker, A New Page, Can the Kindle really improve the book?
His answer is no. He finds a number of faults, the principal one being the screen.

“The problem was not that the screen was in black-and-white; if it had really been black-and-white, that would have been fine. The problem was that the screen was gray. And it wasn’t just gray; it was a greenish, sickly gray. A postmortem gray. The resizable typeface, Monotype Caecilia, appeared as a darker gray. Dark gray on paler greenish gray was the palette of the Amazon Kindle.”

NYTimes Op-Ed Columnist, Roger Cohen, in an op ed piece entitled, A Nation Hard to Short, cites Warren Buffett who on MSNBC said, “It’s hard to short America in the long term.” Why is that? Because of “the enduring belief of millions in America as a transforming power.”

A WSJ column by Matthew Kaminski naming The Five Best Novels on Immigrants in America, in order Vladimir Nabokov’s Pnin, Joseph O’Neill’s Netherland, Henry Roth’s Call It Sleep, Junot Diaz’s The Brief Wondrous Life of Oscar Wao, and Jhumpa Lahiri’s Interpreter of Maladies.

The Profiling Prof, James Taranto entering the Skip Gates James Crowley brouhaha while writing in his WSJ Blog.

And last, Lessons in justice and fairness from a no-nonsense historian, Robert Fisk writing today in the Independent about his friend, the historian Avi Shlaim.