Fire Powell (fwd)

["Clement M. Henry" <chenry@mail.la.utexas.edu>]

Noise from the Far Right against the Wash Post article I posted yesterday
- which reminds me to run to the WP today to pick up the 2nd of the 3-part
Woodward series...

*****************************
Clement M. Henry
Professor of Government
University of Texas at Austin
Austin TX 78712
tel 471-5121, fax 471-1061

---------- Forwarded message ----------
Date: Mon, 18 Nov 2002 09:39:33 -0500
From: Murray Kahl <kahl1@gate.net>
Reply-To: eretz-yisrael@shamash.org
To: Middle East discussion group & Zionist news releases
    <eretz-yisrael@shamash.org>
Subject: Fire Powell


NOV. 18, 2002:
DISSING THE ALAMO
David Frum
National Review

Powell Disses the Alamo: Colin Powell should have been fired yesterday –
literally. The Washington Post yesterday posted its first excerpt from Bob
Woodward’s new book, Bush at War. Like Woodward’s book on the Gulf War, The
Generals, Bush at War is essentially an edited transcript of Powell leaks,
all of them calculated to injure this administration and undermine its
policies on the very eve of military action against Iraq.

For more than a year, we’ve been reading nasty little stories in the papers
about Karl Rove, Paul Wolfowitz, and Donald Rumsfeld and condescending
stories about President Bush, Vice President Cheney, and Condoleezza Rice.
Careful readers have understood that these stories emanated from the State
Department – but until now, Powell has taken care to protect his personal
deniability. Now he has abandoned that polite pretense.

In the Woodward piece, Powell scorns the president for his “Texas, Alamo
macho.” (I guess Powell thinks Col. Travis should have negotiated.) Powell
complains with Senate Democrats that acting against Iraq “would suck the
oxygen” out of the anti-terror campaign. He denigrates Rice, snidely
observing that “she had had difficulties” keeping up with what Bush was
doing. When the president over-rules him, Powell complains that he thought
he had a “deal” – as if cabinet members bargain with their president rather
than taking orders from him. Powell repeatedly praises himself or repeats
the praise of others: We learn from him about a personal call from Rice in
which she compliments one of his presentations as “terrific,” and we hear
via Woodward that Powell is “smooth, upbeat ... eloquent.” Amazingly,
Powell even manages to insert into this long uncontrolled soliloquy of
accusation against his colleagues a complaint that they sometimes leak
against him!

“[Undersecretary of State Richard Armitage] had heard from reliable media
contacts that a barrage was being unloaded on Powell. ... The White House
was going to trim Powell’s sails; he was going to fail. Armitage said he
couldn’t verify who was leaking this, but he had names of senior people in
Defense and in Cheney’s office. ‘That’s unbelievable!’ Powell said.”

There is no sin in a cabinet officer dissenting from the policies of his
president. Nor is it necessarily wrong for him to take his dissent to the
country. But before he makes his dissent public, he should resign – and if
he won’t resign, he should be sacked. Instead of representing the United
States to the world, Powell sees his job as representing the world to the
United States. It’s time for him to go.

Homeland Security: My wife and I took the Acela train from Washington to
New York City on Sunday morning. My wife, who is not quite so convinced of
her personal invulnerability as I am, was more than a little disturbed by
the total absence of any security procedures. The conductors barely glanced
at our tickets; they never asked for any ID – this on the very first
weekend after the FBI announced the threat of massive imminent attacks on
American transportation network and national symbols.

But then, maybe the Amtrack conducts knew what they were doing. Whatever
country Amtrak is a symbol of – it ain’t America. Brazil maybe.

Single Payer, Part Deux: Friday’s post on the merits and demerits of
single-payer health systems like Canada’s provoked an avalanche of e-mail –
far too many to respond to each individually. I’m truly sorry about that.
I’m sorry too about the typographical errors in the post, which concerned a
number of the e-mailers: I write these diary entries very late at night or
very early in the morning, and my fingers do sometimes stumble.

Let me try here to reply to the main criticisms I received.

1. My friends over at the New Republic point out that Canada spends only
about 9% of its GDP on healthcare as against America’s 14%. The long delays
in treatment that Canadians suffer can therefore be blamed – not on the
system itself – but on Canada’s failure to fund the system adequately.

This line of defense is often heard in Canada itself. I sometimes think
that the words, “We need more government funding,” should appear on
Canada’s coins in the spot where the words “E Pluribus Unum” appear on
America’s. Here’s the answer.

a) The gap between America’s spending on patient treatment and Canada’s is
not as big as the raw percentages might suggest. For example, America’s 14%
figure includes the cost of the vast American medical research program. The
budget of the National Institutes of Health alone - $27 billion in fiscal
2003 – is larger than the total healthcare expenditures of the provinces of
Ontario and Quebec combined. (The provinces are the main funders of
Canadian healthcare; Ontario and Quebec are the two biggest provinces, home
between them to more than half of Canada’s population.) Canada does little
medical research. In healthcare as in defense, Canada piggybacks for free
on America’s costly efforts.

b) Much of the differential between the cost of the Canadian and American
systems is achieved by the brutal squeezing of the incomes of doctors and
nurses. While this may have some impact on staff morale and may contribute
to a reduction in the skill level of medical staff, it has little relevance
to the issue of waiting times.

c) The Canadian population is demographically different from America’s in
important ways. The average age of the Canadian population is lower than
that of the United States. There is less obesity in Canada, fewer premature
births, fewer victims of assault and attempted homicide. Canadians also
drive fewer miles per year than Americans. These differences impose costs
on the United States that the Canadian system does not bear. Even under
exactly identical health-care policy regimes, one would expect health-care
expenditure in the United States to be significantly higher than in Canada.

d) Advocates of single payer often cite Canada’s lower expenditure on
healthcare as an argument in favor of the Canadian system. Then, when
confronted with the evidence of the Canadian system’s failure, they admit
that America’s 14% is not all frittered away on advertising and obscene HMO
profits – that it does indeed buy superior care. But if the American system
is not riddled with waste that single-payer will squeeze out, then
extending a single-payer system to cover the entire U.S. population will be
just as hugely expensive as conservative critics fear.

2. Many readers have pointed to Canada’s high average life expectancy as
proof that its healthcare system can’t be all bad. But (see point c above)
there’s much more to public health than a healthcare system. Hike cigarette
taxes and life expectancy will rise, no matter how lousy the hospitals are.
The test of a healthcare system is not life expectancy of the population as
a whole – it’s the life expectancy of people once they get sick. Here
Canada’s record is not so good.

3. Some cosmopolitan readers note that other single-payer systems,
Germany’s usually, deliver more satisfactory results than do Canada’s and
Britain’s. That’s true – precisely because the German system is much more
decentralized and offers more choice (and demands more responsibility) than
do Canadian Medicare or Britain’s NHS. Some socialized healthcare systems
are more socialized than others, and the more socialized they are, the
worse they do.

4. Yes, yes, yes, America’s healthcare system is flawed. It’s overly
litigious, it discourages people from changing jobs, it is often wasteful,
and it abandons too many people to charity medicine. Yes, yes, yes,
America’s healthcare system – which probably should not be called a
“system” at all – is in need of reform. The question is not, “Is America
perfect?” The question is, “Would single-payer be an improvement?” And the
answer to that question – despite Al Gore – is no, no, no.


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