Health Care Reform: A Lesson From the Big 3

US health care reform is the biggest domestic issue facing America today, and action is needed to fix it. But as I was reading about Chrysler’s bankruptcy the other day, it got me thinking about the similarities and differences between the auto industry and the health care industry. As the rhetoric and furor over health care reform gets more and more heated, it might help the debate if we step back and take a look at the failed auto industry and try to learn some lessons about what to do and what not do when reform is needed.

To use an oxymoron, American health care is sick. As many reports have stated, Americans spend twice as much on health care as similar western countries. Half of this cost is paid thanks to the American taxpayer (or the American taxpayer’s children and grandchildren, thanks to budget deficits). But even with all that spending, objective impartial statistics rank America’s health care near the bottom when compared with those same western countries. (See Demockracy article from February 16, 2009, “Health Care in America – A Time for Change” for a full discussion of this issue.) However, even with the groundswell of support from many different corners, this is not a problem which will be fixed at the flip of political switch. This is a problem which has been forty years in the making and will probably be forty years in the fixing.

So, as we watch the plight of the Big 3 automakers, I can’t help but compare their plight to the current situation of the health care industry and compare the position of the auto companies of 1960s to the health care providers of today. For many, many years, the Big 3 automakers were the most celebrated and profitable companies in the world. CEOs, executives, shareholders, unions, and car salesmen all got rich and fat on the profits from the US auto industry. They were the “Masters of the Universe” in the mid 20th century. A national infrastructure was built to support the industry. “What’s good for General Motors is good for America” was the oft-quoted refrain.

GM, Ford, and Chrysler made cars that were the shiniest, biggest, boldest, and the envy of the world. Even if you didn’t need or want rear fins or white side wall tires or big V-8 engines,  you got them because it was the American way to do things. Cars got bigger, more expensive, and more inefficient, and the industry run by the three big oligarchs with almost no other meaningful competition slowly lost touch with the consumer.

And then in the 1970s the car industry had a hiccup. The Japanese (and others) devised a cheaper, more sensible way to make cars which fit the needs of the consumer. These cars were cheaper and on objective criteria, better (sound familiar to an industry we know?). Detroit of course tried to react in the 1970s and 1980s. The industry went through thirty years of pain – a government bailout here, a merger there, a few concessions from the unions. They pared down their product lines to sell mostly SUVs and big cars (cars which people really didn’t need, but old habits die hard). Salesman and marketing programs claimed that the quality statistics comparing the Japanese cars were flawed, and anyway, who wants to drive a small little Japanese car (“I don’t care what the statistics say, the American made car is better”).  And now thirty years later, the Big 3 are on the critical list. Their infrastructures were just too cumbersome to change in the radical ways that were necessary to survive. Chrysler has now died, and GM and Ford are gasping their last breath. It is sort of ironic that one of the biggest problems of the auto industry is the escalating health care costs of the labor force that simply cannot be reduced under the current system.

Saying all that, and even with the Big 3 in their current sad state, I don’t think I know one American who is not a lot happier with the car they drive now compared to what they drove thirty years ago (OK, maybe we need to exclude owners of ’57 Chevys or ’64 Mustangs). All of the trauma and gut-wrenching decisions and layoffs and closures, although obviously difficult for those directly involved, were part of the process required to allow the American consumer to buy the product that was best for him.

So the similarities to the health care industries today and the auto industry of thirty years ago are obvious. The health care infrastructure is bloated and inefficient – it is providing products and services which are too big, expensive, and inefficient to many US citizens. It is more expensive and has less quality than other countries’ health care systems. A huge and complex national infrastructure has been built to support the entire industry. CEOs, executives, and shareholders, along with many powerful physician specialties, are all getting rich on the profits of the health care industry. These constituents do not want to stop the gravy train – but stop it will and stop it must – someday. In the long run, the American consumer will force the change – and it will most likely lead to trauma in the industry. It might take thirty years or longer – but the health care industry will change. In fact, I will make a bold and a rather pessimistic prediction: We will know that health care is “fixed” when one or more of the health care giants of today go bankrupt. The trauma that is necessary to change the system will almost certainly lead to the bankruptcy of a major player in the industry. Just like the Big 3, one or several major health care players will not be able to adapt to changes in the industry, and the result will be predictable. The somewhat tricky issue here is that the bankruptcy that occurs could well be the US Government, which foots nearly 50% of the health care bill in the U.S. – the bankruptcy in the health care industry which occurs might be US.

CHANGING HEALTH CARE IS DIFFERENT – IT’S HARDER

Although there are similarities in the predicaments of the auto and health care industries, there are three major differences worth noting, none of which are going to make reform any easier.

First, there is limited foreign competition to replace and offer alternatives to an inefficient industry. Health care, especially in- patient and primary health care is almost inherently a domestic industry. Japan, India, or China cannot easily begin a strategy of exporting health care to America and provide a competitive hammer to the industry. But this trend can be hard to predict.  If a consultant would have advised the CEOs of the Big 3 in 1960 that they would be brought to their knees by Japanese companies exporting two ton cars from Japan across the Pacific Ocean, he would have been laughed out of the board room. In the high technology world of internet, ipods, blackberrys, and instant data transmission, it is not inconceivable that a cheaper, more efficient health care model could be imported into the US and provide consumers with an alternative. If this does happen, you can be sure the first persons to cry foul will be the doctors, US health care companies, and their lobbyists who, predictably, will complain about low quality, “non-approved” health care, cheaper replacements, job losses, un-American competition, etc. – the mantra that car companies have moaned about for years.

Second, the US government does not just regulate or support the health care industry – it is the health care industry – as mentioned before, approximately 50% of health care spending is through Medicare, Medicaid, and other government programs. Moreover, the rules, regulations, and reimbursement programs developed and administered by the government are incredibly complicated when compared to other private industries. So when we speak of infrastructures that need to change, we are not speaking of a board room in Detroit; we are speaking of the mother of all infrastructures – the US Government. Needless to say, changing the direction of this US battleship will not be an easy task.

Third, the health care industry by its very nature involves life and death situations. The auto industry had to deal with issues like increasing miles per gallon, faster times for 0-60 mph, and how many grocery bags could fit in the trunk. Health care involves more serious issues – which cancer drug is likely to cure a sick child, kidney transplants, strokes, and heart attacks. Health care is emotional and stressful. To affect change within this emotional environment will be much more difficult given the potential side effects if a particular policy is in error.

If anything, then, these three major differences of the health care industry, as compared to the auto industry, will make change harder not easier. The lack of  foreign competition to drive changes and to lower costs, the gargantuan bureaucracy of the US government, and the emotional issues involved all are roadblocks to change. Change will not be easy.

LESSONS TO BE LEARNED

It has been said that he who fails to learn from history will be destined to repeat it. So what can the health care industry learn from the plight of the auto industry?  In my opinion,  there are several important things.

First, what is required to fix the health care system is major surgery. The cost structure and system is fatally flawed. The auto companies cost structure was fatally flawed thirty years ago. Tweaks here and there allowed thirty years of survival for the Big 3, but they did not fix the problem. The health care companies, the insurance companies, and the US government cannot keep forcing their “SUV” solutions when what the consumer needs is a reliable, efficient, quality health care system. If rich people want to pay for big SUVs, then let them, but the average person needs good and efficient, not excessive and gaudy.

We will need to accept that this major surgery to the health care system will be painful and it will take a long time. There will be winners and losers. Jobs will be lost, salaries may be lowered, and mistakes will be made. And given the emotion and seriousness of health care, the mistakes may lead to serious consequences. Let us be prepared for these mistakes and issues. These issues that change brings about cannot reduce our desire and drive to change the system for the better. And as we are going through these painful changes, let’s not let lawyers and tort laws allow even more money to be sucked out of the system by legal confrontation. Tort reform is needed to limit damages and to let providers make the decisions necessary to cut the waste out of the system without worrying about multimillion dollar lawsuits that ultimately just add more costs to an already inefficient system.

Second, good old fashioned competition will ultimately serve the needs of the health care consumer best. Whatever the system looks like in twenty years, it must be a competitive system where individual consumers choose what is best for them. This does not mean that government cannot be involved, but government needs to develop and nurture a system which promotes competition. However, it must be noted that just introducing competition into a system which is broken is not just a cure all. The private and public health care system does have competition now, but it takes place at the wrong levels and on the wrong things. This dysfunctional competition does not focus on delivering value for money to customers, but instead motivates providers to capture more revenue, shift costs to the deep pocket, and restrict services to those who cannot pay. The competition is more about profit and revenues and less about providing value to the patient. Flawed model – flawed competition. The industry needs to develop new business models that reward quality and efficiency, not simply a fee-for-service mentality. Reform should focus on creating a system whereby providers compete directly on the six overarching “Aims for Improvement” (as identified by the Institute of Medicine) for health care. These aims are:

• Safe: Avoid injuries to patients from the care that is intended to help them.
• Effective: Match care to science; avoid overuse of ineffective care and under-use of effective care.
• Patient-Centered: Honor the individual and respect choice.
• Timely: Reduce waiting for both patients and those who give care.
• Efficient: Reduce waste.
• Equitable: Close racial and ethnic gaps in health status.

If competition is refocused along these parameters rather than just on profit and revenue, then the competition will bring value to the customer. The book Redefining Health Care: Creating Value Based Competition on Results by Michael Porter and Elizabeth Teisburg is an excellent treatise on how competition can be implemented into health care systems to drive the most efficient solutions to the consumer.

Regarding competition, it would be interesting, indeed, if a foreign competitor could begin importing health care services into the US.  I have traveled and lived extensively overseas and experienced health care in many foreign countries.  I can testify that many, many overseas providers would be more than willing to provide health care to US citizens at a fraction of the cost that is paid in the US (and this is from persons living in Western Europe – the opportunities from a low cost country like India or China must be staggering). And remember, before you get protectionist, these other countries’ health care statistics are better than ours – don’t be fooled like the automakers who claimed that your 1972 Ford Galaxy is really better than the Toyota Corolla.

Finally, the leaders of the health care industry, public and private, must focus on what Detroit did not – the needs of the consumer – what does the average citizen want and how much will he pay for it.  In too many cases, the health care industry has lost touch with its customer – the patient.  Instead, the dysfunctional system we have now has redefined the customer as the payer, which usually is Medicare, Medicaid, or a large insurance company. As a simple illustration of this, let’s assume there are two viable, equally effective procedures available to cure a patient: Medicare pays $100 for Procedure A and $1000 for Procedure B. Guess which procedure will be recommended by the Provider – the Provider will choose the one giving him more revenue (assuming more revenue generally leads to more profit). The patient won’t argue, he just wants the best treatment, and there will be an implied view that the more expensive treatment is the “better” treatment. No one is worse off except the government, and they have lots of money – right? This is a simple example, but this is how it works. There are scores of accountants, lawyers, and clinicians who are employed not to provide better care to patients, but to maximize revenue from the “customer” (Medicare, Medicaid, et al.).

The current system and structures are designed to maximize revenue and profit from the intermediaries – they are not focusing on the needs of the customer. The average person does not need the “Cadillac” of health care; the average person does not need the Mayo Clinic. The average person does not need a multimillion dollar tort settlement. The average person needs and wants good, reliable, quality health care at a reasonable cost. The average consumer knows in his heart that health care bills are too large, but that there are currently no viable alternatives for the average citizen. (There are no inexpensive imports he can turn to!) The industry leaders cannot let their existing infrastructures, inefficient practices of the past, or bloated costs and salaries be the drivers of the decision-making process. The industry cannot survive with a “if we build it, they will come” attitude. The health care industry must give the consumers what they want.

Other countries have health care systems (public and/or private) that give the same or better health care results to its citizens for about half the cost of the US. The Big 3 automakers did not survive such inefficiencies, and neither will the health care industry. Change must come or the health care industry will ultimately face the same crisis as the Big 3. Change is imperative; failure is not an option.

Copernicus and the Search for God

I started my search with hope, but in the end there was nothing, but that’s OK. My search spanned many years, many books, and many miles traveled. It is a journey made in some way by all of humankind, an effort to correlate religious belief within the parameters of authenticated history and science. While I was never a regular Church goer, after a brush with cancer, I decided to explore the options.

Just as man has developed over the centuries, so have religions evolved and developed to mirror man’s progress. In the very beginnings were the worship of the sun, natural phenomena, and the spirits of the animals. With the establishment of city states, so came the idea of King/Gods to give strength and courage to their soldiers in battle, by convincing them that the sacrifice, even of their lives, would be rewarded by their God/Kings. [This theory is explained by Jared Diamond in his best seller Guns, Germs and Steel.] The Gods were depicted as enhanced versions of themselves, living in improved versions of our cities, suspended above us in the sky.

From those early beginnings, education, philosophy, and the sciences emerged. With more knowledge of the known world, the old City Gods seemed primitive, and all encompassing religions with one God became the norm. The first of these monotheist religions that grew around the Indus valley in India was Hinduism. The beginnings of Hinduism in India occurred around 2,000 B.C.E. Much of its beliefs were imported with the Dravidians, who entered India from the North already with many of the basic beliefs of what was to become Hinduism. It retained the old Gods at a base level, but assumed the belief that at a higher level, God was one, but man was too lowly to comprehend the higher complexities. Buddhism, which in many ways is more of a philosophy, was then born with the Buddha in 563 B.C.E . Many devout Hindus claim to this day that Buddhism is really just an offshoot of Hinduism.

The area where all our western monotheisms or one-God beliefs started was the Middle East. There Judaism, Christianity, and Islam all arose with very similar and overlapping histories. Jerusalem is of course central to all of those faiths. It is intriguing that some of the main beliefs of our Abrahamic faiths are taken directly from the pre-Abrahamic Gods.

Validation of the Faith

For as far back as faith has been around, humankind has attempted to validate that faith through the scientific philosophical approach. [Here I am indebted to Karen Armstrong for her amazing book, A History of God.] Thousands have sought over the ages to prove the existence of God. Indeed, probably all of us have at some point. The Greeks were probably the earliest recognizable true philosophers. They rejected mythological answers to solve the basics questions of heaven and earth. Probably the most intense and prolonged questioning occurred in Iberia during the 700 years it was under Arab rule, while Europe was still deeply mired in the Medieval mud. It was there that the sharpest religious minds from Judaism and Islam cooperated closely to try to reach a proof, any proof. From all of this evolved the most elaborate theories, doctrines, and suppositions, all as improvable as the original question. The mystic approach, where students look deeply within their own being, has proven more successful to its adherents. Christian Mystics, Muslim Sufis, and Hindu Sadhus have all turned their focus inward through a variety of modes of contemplation. Sufis whirl in concentric circles; Sadhus contemplate, often in poses for hours or days on end in positions that would be extremely uncomfortable for most of us for even a few seconds. Some Monks go without speaking for years on end in an attempt to hear the small inner voice. Even hippies have tried this approach, perhaps the easy way with Mescaline, LSD, Magic Mushrooms, and other mediums. Unfortunately, these approaches probably reveal more about the complexity of the human neurology than the nature of God.

Religious opinions change almost on a daily basis in an attempt to remain pertinent to societies own changes. For right or wrong, it has been essential to keeping stability in many societies by helping keep a promise of a better life after death for those who live indigent livelihoods and as a mechanism for keeping a people united under a common tribal identity against a common enemy with supposed lesser beliefs.

Should Have Religion Died in 1543?

In 1543 Copernicus’s seminal work, De revolutionibus orbium coelestium (On the Revolutions of the Celestial Spheres), posited that the heavens did not revolve around the earth, but the other way around. Arab and Indian scholars had of course knew that for centuries, but this was the first time it was proven to the Christian world. Before this, everything was about us and our planet. Our earth was the center of the universe, all things revolved around us, and, of course, our God overlooked us, judged us, rewarded us, and helped us out in times of trouble. After 1543 we were an immeasurably tiny part of billions of galaxies that extend outward for millions of light years.

The End of My Journey

So is this the end of this journey that I strangely found very satisfying?  The question then is what drives us to religion, and how it is sometimes used to manipulate us. It is a truism that all of us, from the age where we first have a brush with death, be it the death of a relative, friend, or pet, feel the need for a power that makes it alright. The need for religion makes talented salesmen of religion rich, powerful, and influential in every society around the globe. In areas where religion is strongest, it is essential that our leaders adhere to the true faith. Barack Obama would have stood no chance of election if he had declared himself agnostic, yet reading his autobiographical book Dreams From My Father suggests that he valued the works of the church in their help to the poor in Chicago and the dedication of some of the ministers. However, nowhere is there any statement of his own faith. Although I have no doubt that is he a Christian, the fact that he doesn’t seem to wear it on his sleeve, but rather seems to live it through shared values is probably one of his greatest strengths.

Once we accept that belief can transcend evidence, we are programmed to accept without question what those good Christian, Muslim, Jewish, and Hindu leaders tell us. That is why religion has caused so many conflicts over the ages. Today, of course, medieval tortures have been reinvented to use on those lured into battle by their own deluded religious teachers and leaders.

Religion in one form or another has been with us from the beginning of time and will probably be with us until the end. Einstein himself believed in no formal religion, but thought that their must be some master equation which could be used to harmonize all things. It was this equation which he saw as God’s design. He did not believe that humankind played any role, above being a tiny part in “the equation.” Alas Quantum mechanics, whose theories Einstein opposed vehemently throughout the latter part of his life, with its basis being a lack of any order, has moved physics further from any such unifying equation.

The final question then must be: Has mankind benefited from religion, or has all of it been a chain around our necks. Clearly, as mentioned before, it has been a necessity for stability in many societies. Without this stability, the conditions for economic growth and progress may not have been sufficient. Also, it has been a solace to many in times of great stress or sorrow. It has helped countless people through times of intolerable hardship, famine, plague, and wars. Religion left alone and not seized upon by power hungry individuals, states, or countries, can and has been a power for good. I look on the Dalai Llama, Mahatma Gandhi, and the Aga Khan as shining lights in that respect.

Unfortunately, where religions have evolved into powerful advocacy groups on their own behalf, with their leaders’ power-hungry egos inflated by their own sense of gravitas, they inevitably do more to divide and deride than to resolve, pacify, and heal. Religion will continue to hold sway for many more millennia, so it essential for us to understand in an historical rational way the damage that can be caused by the lack of separation between state and religion. In the end, that was the main lesson of my personal journey.

Journalism: The End or the Beginning?

If Republicans Won’t Play Along on Health Care, Who Cares?

The Republicans bluffed and lost in February when they complained that the stimulus bill wasn’t “bi-partisan” enough. Okay, so House and Senate Democrats acquiesced to some of their demands, including tax cuts for businesses and removing provisions for “family planning” (the euphemism that refers to things like abortion and contraception). The Republicans responded to these concessions by voting against the bill.

Not a single House or Senate Republican voted in favor of the stimulus bill. They apparently believed that this would demonstrate to the American people their opposition to wasteful spending and fiscal irresponsibility. Trouble is, the American people didn’t much care what the Republicans thought; they’re in the midst of a financial crisis, where hundreds of thousands of jobs are being lost each month. Hell, yes, they want a stimulus!

Republicans were using a two-pronged approach to sway the public: (1) tax cuts are superior to government spending when it comes to stimulating the economy; and (2) the government is spending way too much. I won’t go into the merits of the arguments here, but suffice it to say that those were the counter-arguments to the Democratic spending bill (yes, “stimulus” = “spending.” Recall President Obama’s statement: “What do you think a stimulus bill is?”).

The public doesn’t much care for tax cuts when those tax cuts would benefit only the top earners in the country. Now, what does look like a good idea is investment in public works projects that have been long-neglected by Reaganites who believe that the government shouldn’t spend any money on anything that isn’t national defense.

Those four paragraphs were a flashback.

Interior — White House, Present Day.

President Obama is meeting with GOP leaders, reminding them that when they clamored for “bi-partisanship,” they abandoned it just as much as they accused Democrats of abandoning it. Between 2003 and 2009, Republicans were used to getting their way every time. Sure, Democrats have controlled Congress since 2007, but for some reason, Democrats spent those two years perfecting the fine arts of cowering and acquiescing. Whenever Republicans talked about “bi-partisanship,” they meant, “Give us everything we want or we’ll call you names. We’ll say you’re soft on terrorism. We’ll say you’re engaging in pork-barrel spending. And if that doesn’t work, then we’ll call you socialists and say that you hate America and want the terrorists to win. So you’d better give us all the things we demand, and if you ever try to put your own agenda forward, we’ll slap you down so hard you’d think Mike Tyson had taken Trent Lott’s seat.”

Well, the tables have certainly turned. And I’m pleased that Obama is prepared to shut Republicans out if they refuse to play ball. Hypocrisy? Not at all. I believe in universal health care. I think it’s absolutely necessary and I think it’s nothing but good. If Democrats are willing to embrace it and make it law, then I support them. When Republicans tried to stop SCHIP, I disagreed with them. It’s a matter of not only agreement and disagreement, but also of what’s good for this country. Quite honestly, the Republicans are not interested in governance. They’re interested in stalling until 2010. They want the wheels of government to grind to a halt so that they can then go back to their constituents in November, 2010 and say, “Look at what the Democrats have done for you! Nothing, that’s what! Aren’t you sorry that you voted them into office?”

And therein lies the fundamental difference: Democrats, including President Obama, are interested in doing something constructive. I will frequently disagree with the methods they use, but I largely agree with their philosophy that the government is going to need to spend money to improve the country. I agree that the wealthy should pay for the impoverished. And I agree that health care should be our right not only as citizens, but as human beings. I think the Democrats’ approach is superior to the Republicans’ approach, and that is why I believe that if Republicans are unwilling to reach an actual compromise with the Democrats, then they should be left behind. It is not the Democrats who should have to bend to appease the Republicans; the Democrats won, their ideas are better, and if the Republicans don’t want to go along with them, then it’s their own funeral. Congress doesn’t even need the Republicans.

I’m not the only one who believes this. The American people would rather the Democrats get on with their agenda instead of watering it down to please Republicans whose sanction they don’t need and whose contempt they will get in return for their efforts. In the New York Times/CBS poll referenced above, 56% of those surveyed said that they thought Democrats should stick to their policies, but 79% thought that it was Republicans who should be bi-partisan. That says a lot: not only do Americans want Democrats to do whatever it is Democrats want to do, but they simultaneously think that Republicans should do whatever it is the Democrats want to do.

Health care reform is way too important for Democrats to be chicken about. The last significant health care reform we had in this country was the prescription drug bill from 2005, which funneled a lot of money directly from the government into the hands of prescription drug companies. Sure, the bill could have included a provision for the government to use its significant bargaining power to get better deals on drugs — but then, that would hurt the drug companies’ revenue, wouldn’t it? At approximately the same time, Congress passed a bankruptcy bill that offered terrific terms for banks, credit card companies, and the very wealthy, but left middle- and low-income people in the dark.

The relationship between bankruptcy and health care is quite close; President Bush declared, in 2005, that we needed the bankruptcy bill so as to stop people from gaming the system and trying to get the rest of us to pay off their debts. To listen to him, you’d think Americans were going bankrupt after buying too many Faberge eggs. At the time he said that, though, fully half of bankruptcies in American were being caused not by frivolous over-spending, but by health-care spending. People were — and still are! — spending themselves into tremendous debt in order to stay healthy and alive. And since our health care system discourages regular check-ups, people are guaranteed to see a doctor only when the condition is serious, which means that it will cost more money to fix than it would have if a doctor had caught the condition earlier, during a regular check-up.

It shouldn’t be surprising that Republicans see health care as a political issue instead of a humanitarian one. In 1993, Bill Kristol wrote that Republicans couldn’t afford to let the Clinton health care plan survive; if it did, then the Republicans would be finished. Let me re-iterate that: to Bill Kristol, it was more important that heath care get defeated so the Democrats wouldn’t win re-election in 1994 than it was for people to have universal access to health care.

That’s what we’re up against. And that’s why I support the Democrats. And if Republicans don’t want to join, who cares? Let them explain to their constituents in 2010 about how they didn’t want those same constituents to have universal health care, all so that the free market could survive.

North Korea: An Uncertain Future

Last week North Korea conducted a test launch of what it claimed to be a satellite, now successfully orbiting the globe and beaming patriotic, revolutionary music to the masses. South Korea, Japan, the US, and many others assert this was no peaceful satellite launch but a provocative and threatening intercontinental ballistic missile test in violation of UN Resolution 1718, and have found no evidence of a singing revolutionary satellite in orbit. So either this test appears to have been, in actuality, a missile test or it was a failed attempt to put a North Korean satellite into orbit – both scenarios that contradict North Korea’s version of events.

President Obama, South Korea, and Japan quickly came out with withering condemnations of the launch, describing it as “provocative” and “reckless,” and calling for sharp, immediate action from the UN, possibly including further economic sanctions. China and Russia, the other two participants in the Six-Party Talks and closer to North Korea, cautioned against “an emotional knee-jerk reaction” to the test, reminding all parties to remain focused on the main goal of the Six-Party Talks – the denuclearization of the Korean peninsula.

Regardless of what happens in response to this immediate crisis, one has to wonder: What is going on in North Korea? Often described as reclusive and one of the world’s most closed societies, North Korea is something of an enigma – especially to Americans. Of course there was the Korean War of the early 1950s, but fewer and fewer Americans remember it, know much about it, or care about it. And to be honest, it is hard to see how that conflict – over 50 years ago – has much relevance as a way of explaining what is going on today. However, it does frame the current situation, and for that reason I will provide a brief history of the Korean peninsula and the complex and usually vitriol US-North Korean relationship since 1945.

The Cold War

In August of 1945, World War II ended, and Korea was granted independence from its Japanese colonizers. This independence came with a price however. Korea, like Germany, would be split in two – one part, essentially, to be a US puppet state, and the other to be a Soviet one. Exiles Syngman Rhee (who had been living in the US) and Kim Il-Sung (who had been in the USSR) returned to Korea to rule the South and North, respectively. Within five years, North Korea invaded the South in an effort to unify the peninsula under its own rule. Much of South Korea, including its capital Seoul, was captured by the North, prompting a massive military response from the UN – led by the US and South Korea. By the end of the conflict, at least 3 million Koreans, almost 1 million Chinese, and over 50,000 Americans had died. After the conflict was over, Korea remained divided almost exactly as it had been before 1950. Relations between the North and South have remained uneasy ever since, and tens of thousands of US troops and (until 1991) thousands of nuclear warheads have been based in the South. Over the years, clashes along the 4 km wide Demilitarized Zone (DMZ) dividing the two countries have not been uncommon. US spy ships and airplanes have been captured or shot down by the North, the North has often threateningly tunneled beneath the DMZ, and the North was responsible for the hijacking and downing of Korean Airlines flight 858 in 1987. At the same time, for 50 years after the Korean War, the US vigorously supported harsh economic sanctions against the North.

Post-Cold War

With the fall of the USSR in 1991, North Korea lost a significant supporter and has struggled with food shortages and a collapsing economy ever since. Since that time, there has been constant speculation about the North’s developing of a military nuclear program and its sharing of military knowledge and technology with nations such as Pakistan and Syria. In 1993 the International Atomic Energy Agency (IAEA) was disallowed from inspecting North Korean nuclear sites, and the North withdrew from the IAEA the next year. In 1994 Kim Il-Sung died and was replaced as North Korea’s head of state by his son, Kim Jong-Il. While the US and North Korea signed the 1994 Agreed Framework to improve relations, its implementation has been rocky, with both sides failing to fully follow through on their commitments. In 1998 the South’s new president Kim Dae-Jung introduced his sweeping new “Sunshine Policy,” a policy of engagement aimed at spurring improved North-South relations and increased cross-border trade and cooperation. The North continued developing its missile program, but largely within the guidelines agreed upon with the US and the South. At the same time, the US played a role in militarily strengthening Japan and South Korea against the North.

Efforts continued to normalize North-South and North-US relations until 2001. At that time new US President George Bush took a much more hawkish position toward the North than President Clinton had, and famously included North Korea in his “Axis of Evil” along with Iran and Iraq. This stance worsened US-North Korean relations considerably, and over the next few years North Korea defiantly expanded its nuclear program and withdrew from the Non-Proliferation Treaty in 2003. New governments in South Korea and Japan treated the North more coolly. Bogged down in Iraq, the Bush administration was compelled to try negotiation through the Six Party Talks – which involved the US, North Korea, South Korea, China, Russia, and Japan. Further bellicose statements by President Bush and disagreements over the terms of the Agreed Framework gave the North excuses to withdraw from the talks, and in October of 2006 North Korea tested a nuclear weapon. Incredibly, talks continued after this test, and were successful enough that some foresaw a breakthrough in US-North Korean relations in 2007; yet by late 2008 talks broke down again. Complicating matters was the reported stroke of North Korea’s “Dear Leader” Kim Jong-Il in August of 2008, creating fears about the North’s immediate future – including the stability of its political system and the fate of its nuclear weapons. However,  the US and the North worked cooperatively during this time to alleviate the effects of famines in the North and to find the remains of American servicemen killed since 1950 in the North, and war was in fact averted through diplomatic channels on many occasions.

Prelude to a Transition?

To the average American observer – myself included – North Korea’s actions are perplexing. Why exactly are they test firing rockets over Japan? Why now? What are their motivations? And more generally, why has North Korea spent so much money and risked so much global animosity on developing its nuclear weapons program? Why has it remained such a closed country? With the fall of the USSR and China’s transformation to free market heavyweight, why has it clung to its rigid form of communism? And this is just the beginning.

Here are a few thoughts, first concerning the immediate situation. Despite Kim Jong-Il’s very public appreciation for the launch, it was the first time since August that he has appeared in public, probably due to his questionable health. If he is in fact in poor health, the North may be facing a rocky transition of power and this launch may be a way of declaring North Korea’s continued military strength and its intention to proceed with a space and military program regardless of whether he continues to rule or not. Indeed, after considerable diplomatic progress in 2008, in recent months the North has been more hostile toward Japan and South Korea, has kicked out US humanitarian aid teams, and has detained two American journalists, indicating an unpredictable government possibly undergoing a significant change.

A Negotiation Tactic?

On the other hand, North Korea has used provocative military tests in the past to extract concessions from the US during the Six-Party Talks, such as having its name dropped from the US’s state sponsors of terrorism list or to procure humanitarian and development aid. So, this week’s action could be a signal that the North’s political regime is weak and in need of assistance, for which it would like to use this test as a bargaining chip.

That the North’s military activities are mainly a tactic to drive a harder bargain with the US is the accepted explanation for North Korean motives. While this is certainly part of the picture, it is hard to believe that this is North Korea’s sole purpose for developing such a large military program. Nearly a quarter of the North’s GNP is devoted to military spending, and it has 1.2 million active duty military personnel, nearly double the South’s standing military. This makes North Korea’s military one of the largest in the world, despite the fact that it is a nation of just 23 million people. So, long before the Six Party Talks, the North has been building a formidable military for its own sake, not just as a bargaining chip. The large and threatening US presence in northeast Asia since 1950 is surely a factor, as is the significant drop in military support from Russia and China in recent decades. It is not surprising that the North feels vulnerable, and its massive military is surely one reason that its government has endured and that it continues to exist at all as a nation.

Game Theory with Obama?

The US is experiencing a transition of power as well, and this launch was perhaps directed at a young, inexperienced President Obama. Before the launch, Obama’s administration indicated a willingness to pursue high-level bilateral talks with North Korea and received no answer from Pyongyang. Perhaps, the launch was an effort by North Korea to get the attention of the new administration, and to engage the US on its own terms. It could also have been, in part, a test just to see what reaction the launch would prompt from the US. Over the past few decades, the North has seemed interested in engaging with the US and the South when given the chance. Some also have argued that the recent launch does not explicitly violate UN Resolution 1718, indicating that the North wants attention, but not to actually break its obligations under 1718. This test may have been a way of gauging the sincerity of the Obama administration’s overtures to the North. If Obama can keep a cool head and avoid Bush’s war-mongering rhetoric even in a sticky situation, the North may take Obama’s offers to engage more seriously. Obama declined to use the US missile defense system to shoot down the North’s rocket, and instead sharply denounced the launch and steered the issue to the UN while working with other members of the Six-Party Talks to come up with a constructive response. Time will tell how much Obama’s strategy will differ from that of former Presidents Bush or Clinton.

Why Isolation?

As for North Korea’s more general isolation from the global community, there seem to be a few compelling explanations. The most obvious and simplistic reason is the desire of a small circle of political and military North Korean elites to retain power at any cost. Life in North Korea is hard, stifling, and unforgiving. The North’s particularly harsh interpretation of communism has propped up a family dynasty and benefited a small group at the expense of most for over 50 years. Yet today’s rulers are not as “beloved” as Kim Il-Sung and the North’s focus on military success seems to be a way of demonstrating its power and bestowing legitimacy on a regime that has few other successes to point to.

Demonizing the North Korean leadership is the easy way to explain its actions, but other factors are in play as well.  As mentioned above, the North received substantial economic and military support from both the Soviet Union and China during the Cold War. With the fall of the Soviet Union in 1991 however, much of the North’s support gave way. In contrast to much of Eastern Europe and the former Soviet republics, North Korea’s leadership has adjusted poorly to a post-Cold War world, prioritizing its own survival over a more holistic concern for North Korea’s people and place in this new world. It has remained largely isolated economically and politically and has suffered devastating famines since the early 1990s. Legitimate and imagined fears have resulted in disproportionate military spending that certainly prevents the North from investing in economic development, improving government services and infrastructure, or providing humanitarian aid to the extent necessary. This inability to adjust effectively to a new world has led to economic and political weakness that military strength has attempted to compensate for.

Additionally, as mentioned above, between 1950 and 2000 the US enforced an economic embargo on the North that isolated it from the capitalist world. That was not much of a problem during the Cold War when the North could count on support from the USSR and China, but afterward the North suffered tremendously. Economic sanctions in various forms have often been the response to the North’s more recent military activities. Intended to punish North Korea’s defiant leaders, limiting trade and aid to the North since the 1950s has contributed to the small country’s international isolation and have been an obstacle to normalized relations with other nations.

What’s Next?

What the future holds for North Korea is anybody’s guess, especially if Kim Jong-Il’s health deteriorates further. Will he remain in power, engaging with the international community in his characteristically bold and theatrical way? Will a smooth transition of power take place? Or does the country face a political upheaval with unpredictable and potentially frightening consequences in the near future? And what of denuclearizing and even reunifying the Korean peninsula? Both the North and the US show signs of wanting to increase engagement and economic cooperation, and this would certainly be preferable to the prickly and potentially disastrous path they are on now. Yet both must work hard to overcome their mutual distrust of one another while saving face and appearing not to give up too much to the other, long-feared side of the 38th parallel.

Springtime for the Taliban: Afghanistan Needs a New Model

Perhaps the biggest disappointment to come out of eight years of American intervention in Afghanistan is the apparent inability of the Afghans themselves to decide what they want to be when they grow up.  Sure, that sounds like an average dose of lip service in this climate unless you consider the UN definition of “a failed state.” Afghanistan currently ranks seventh on the Failed State Index (FSI), a sort of Unfortunate 500 for dysfunctional nations. Somalia and its happy band of pirates is number one. For the purpose of perspective – out of a total of 177 UN recognized countries.

Previous US administrations somehow came upon the idea that the American model of a democratically elected government in a highly secular and tribal chunk of real estate was just the thing “to bring peace and stability to the region.”  Where have we heard this wistful speech before?  Probably somewhere between “winning the hearts and minds,” and if all else fails we’ll carpet bomb the daylights out of them until they come to their senses.  How does a country with a little more than 250 years of civility conclude that one system fits all, that it is the right system, or if it is even that useful of a system?  More importantly, is it exportable?

The US has spent more time in Afghanistan than was invested in all of World War II and Korea combined. To date, the Afghan government has made little progress toward establishing anything close to a stable government.  The country continues along the same path of sectional violence, the US led coalition now morphed into the role of neighborhood cop.  A great unifying tactic if it wasn’t for the body count.  The State Department meanwhile pushes the importance of elections and parliamentary process, which totally ignores the traditional power structures of Afghan society; those that encompass family ties, community obligation, and whichever interpretation of Islam that gets practiced in the neighborhood.   All eyes are told to look to the West.  Perhaps a better answer lies much closer to home:

Today the Turkish nation is called to defend its capacity for civilization, its right to life and independence – its entire future.

–Mustafa Kemal Ataturk, 1920.

Kemal (Ataturk was added later – something like ‘Father of the Turks’) had just made a pretty remarkable set of announcements.  They included:

• The end of the Ottoman Empire.  Well, it was almost dead before World War I anyway.
• The abolishment of the Caliphate.  (Political authority under Islam.)
• The formation of the secular Republic of Turkey.
• The unacceptable state surrounding British occupation.

And the need for the Armenians in the east and the Greeks in the west to relocate elsewhere. There was no place for Orthodox Christianity in the new Republic.

About the Man

Mustafa Kemal was born in Salonika (now part of Greece) in 1881.  Most of his early history has been revised so often that most versions lack credibility. Raised in the Muslim faith, a product of military schools, he later served with great distinction as a Lt. Colonel and division commander at the battle of Gallipoli, orchestrating one of the greater defeats the allied forces suffered in the First World War.  A great fan of the West and particularly The Enlightenment (having been assigned to Paris and the Balkans at varying points), he also fully embraced the potential power of the media, using newspapers (often his own creations) extensively in his nationalist pursuits.  Above all, he believed that the only way to save Turkey from complete partition by the allied powers was to establish a modern, secular republic.  In his words, “Islam and civilization are a contradiction in terms.”

The Background

Things were going badly on the western front for the British and French in World War I.  Russia was taken out by both the Nationalist and Bolshevik revolutions.  Britain’s attack at Gallipoli, (Australian and New Zealand forces, ANZAC) was aimed at knocking the Ottoman Empire out of the war.  Instead it turned into a rout.  Britain then tried to turn the Arabs (with T.E. Lawrence’s deft assistance) against the Turks, promising them an Arab state for their trouble.  Naturally that was a lie, the one apparent constant in British colonial policy.  The Allies won the war, the Ottoman Empire was partitioned by the Treaty of Sevres creating what today are known as Syria, Lebanon, Palestine, Jordan, Saudi Arabia, Yemen and of course, Iraq.  The Sultan was left in Istanbul as a British puppet and Kemal fled to Ankara with plans to turn Anatolia into his new republic. He was able to deceive the British and the Arab world just long enough to consolidate his forces in Anatolia, a process pushed along by his creation of opposing media outlets.  The Arab world believed he was fighting to preserve the Sultan and the Caliphate, the British assumed that his services were already on the colonial payroll.  By the time the British realized his intentions, they were already outgunned, out-manned and out maneuvered. In 1923, they signed the Treaty of Lausanne ending hostilities.  The Republic of Turkey was born.

Much of the internal struggle dividing Islam and adding fuel to sectarian violence seems to surround the Caliphate, which is best described as both a person and a thing. One of the chief splits in Islam, the chasm separating Sunni and Shi’a communities is based on the interpretation of Muhammad’s successor as sole authority on Islamic law. Each side accuses the other of being usurpers in a centuries long dispute over who has the right to read the mind of a dead prophet.  Many political and social issues in Islam today fail to achieve any real clarity while the two camps continue to hold on to conflicting interpretations of religious doctrine.  This is further complicated (or exasperated) by the very notion of Islamic Law, a shadowy domain where the words of the prophet Mohammad somehow hold credence with something as innocuous as the local traffic code. By all accounts it is an archaic system, one reminiscent of The Inquisition, but accepted in many quarters of the Muslim world.  Judging its validity is not the point, accepting its existence is, for the idea of belief is not validated by the structural framework of a society, though it is that very framework that accelerates the rift.  Kemal argued that Islamic Law was part of the “nomadic Bedouin custom,” totally unsuitable in the development of a complex, modern society.  That is difficult to argue against given the global interaction of nations today.  Countries like Egypt and Israel have both found it necessary to operate parallel courts to accommodate issues of marriage and personal conduct, but not civil law.  Religious law as the fundamental tenet of a nation is little more than locking the door and keeping the key.  All social, educational, and political exchange stops. No common ground is allowed to exist on this dogmatic, unilateral dead-end street.  America was founded on the premise of religious persecution elsewhere, that in turn, sanctioned by the state.  The road to modernity through democratic ideals couldn’t traverse the murky ground of theological interpretation. Noted historians, Will and Ariel Durant once stated that “the Bible is a great book, a great tale, but if you had to live by it, you’d go crazy.” Then again, modernity may be our point, not the point.

Constantinople (Istanbul) had been the official seat of the Caliphate since about 1514.  The last recognized Caliph was Abd al Majid II who with his family was exiled to Paris following the establishment of the Republic of Turkey.  Kemal found this action necessary in order to create an Islamic republic based on civil law, not theology.  This was naturally viewed as an extreme form of heresy, particularly in the Sunni Arab world, complicated further by the establishment of language laws that reverted Arabic to second class status in both government and religious proceedings, though some laws were moderated later. In itself, this was an offshoot of his policies on nationalization, but it also played into his desire to create a literate, inclusive society.  Again, in opposition to fundamentalism which he saw as “a way of promoting intellectual stagnation” by authorizing religion to define social progress, including the very function of government itself.  Oddly, the Caliphate seemed to end there.  Saudi Arabia did not attempt to re-establish it at Mecca, undoubtedly since it would threaten their position as an absolute monarchy, and it was only briefly claimed by the Taliban following the Soviet departure from Afghanistan.

Kemal was brilliant in many ways, but he was no saint.  His orchestration of the Armenian exodus was as brutal as any forced deportation.  He stacked the military with believers in his own cause and seemed more than willing to arbitrate disputes at the gallows.  Within Turkey he was seen as both savior and despot; in the fundamentalist world, a Doenmeh (a closet Jew), an alcoholic, a homosexual, a womanizer and a heretic – personal attacks that continue long after his death.  The real truth is as clouded as the newspapers Kemal himself used to create.  Yet today, Turkey remains a somewhat stable republic in the middle of one of the most volatile regions on earth.  Not perfect, but functional.

Lessons for Afghanistan

The opportunity for a more progressive society in Afghanistan was probably lost shortly after the Soviet withdrawal in 1989. In the vacuum that followed, the same Mujahedeen we once funded became the Taliban we now hunt.  Instead of rebuilding schools and infrastructure, promoting education and a sense of inclusion, we simply walked away, leaving the task largely to under-funded NGO’s and a lot of wishful thinking. The Taliban, falsely claiming the right to the Caliphate sought to force an Islamic state on the people of Afghanistan as an alternative to both communist autocracy and western indifference – two models of what they saw as a similar dysfunction.  The United States supplied much of the fodder for the Taliban position by reinforcing beliefs that Islam alone would see to the needs of the Afghan people, faith having been the sole unifying factor over ten years of Soviet occupation.  Education should have been the tool of choice to defeat a return to fundamentalism, not merely the establishment of a western leaning central government, manufactured primarily as a base for US influence in the region. No one seemed interested in the greater investment in literacy, the real slayer of despotism, secular or political, and the one indispensable ingredient in democracy. Afghanistan claims a 28% literacy rate among men, women an even more dismal 12%; Turkey, 87% overall.  The Taliban know this and they fear a literate populous far more than anything our armories can ever produce.  But we can’t export a system if nobody can understand the instructions.

Turkey’s example may be a harsh one by American standards, but it allowed the time necessary to go from a shooting war to the process of nation building in a realistic time frame. That element of time is probably what has always hampered American foreign policy, the impatience inherent in the very system we seek to sell.  Any parent will tell you that it takes twenty years or so to educate and develop a child into an adult.  Americans tire of foreign intrigue as quickly as they tire of presidents.  This lack of continuity is not only a result of the fickle nature of American politics in general, but the bad decisions orchestrated by a system in constant flux.  We don’t even bother to apologize since the person that set the policy is never around to finish it anyway.  When Kemal died in 1938 from chronic liver disease, he left behind a far more literate society than he inherited.  Right or wrong in his methodology, he did bequeath them the tools necessary for choice, the one thing the fundamentalist camp can never accept.

The question for Americans is whether we can endure a long-haul assignment, one that begins with security and ends with an informed society, one that just might decide that our model isn’t their model.  That’s the risk of intervention.  If US policy is confined to simply destroying the Taliban, then we’ve already lost this one.  If something else is on the table, this would be a pretty good time for a new President and a revamped State Department to explain just what that might be.

Slumdog Millionaire and What to Do About Global Poverty

I walked out of Seattle’s old Harvard Exit Theater on a cold Friday night in December. I had just seen the film Slumdog Millionaire and overheard two people talking. One was telling the other how she had seen Bollywood movies before and that all they contained were dance scenes and Jane Austen-like plots. She hesitated, “Actually, maybe what I’ve seen were spoofs of Bollywood movies and this was, like, a real Bollywood movie.” I smiled.

At the time, Slumdog Millionaire hadn’t yet won Best Picture at the Golden Globes. It hadn’t been nominated for the Best Picture Oscar (nor was it running as the heavy favorite to win Best Picture and Best Director), and director Danny Boyle and the movie’s two young lead actors – Dev Patel and Freida Pinto – hadn’t yet been hosted and gushed over by Oprah and Ellen. It was playing at a single, mostly empty theater in Seattle. Contrary to what many American viewers believe, Slumdog Millionaire is no Bollywood movie, but it is certainly a film with plenty of genuine Indian elements. It is based on the novel Q & A by Indian diplomat Vikas Swarup. Most of its music is by Bollywood super-composer AR Rahman, and it even contains a (relatively mediocre) song and dance routine. Lead roles are played by famous Indian actors Irrfan Khan and Anil Kapoor. It was filmed entirely in India and the child actors were all Indian – some of them slum dwellers themselves. There is plenty of melodrama and a love story. While Slumdog Millionaire clearly draws inspiration from Bollywood, it is directed by an Englishman and is mostly in English, leading many Indians to treat it as just another Hollywood movie.

By now you’ve probably heard of Slumdog Millionaire. It is the story of three street kids growing up in Mumbai. It is part rags-to-riches fairytale, part love story, and part horrifying look into the difficulties of street life. It has been scooping up awards and critical acclaim in the US and the UK while being dogged by more controversy than other Oscar-nominated films. Most of the debate centers around the poverty shown in the film, and whether a white British male (Boyle) has the right to present Indian society in such a way in a commercially successful feel-good (kind of) film. To tell an Indian story through the lives of impoverished street children embarrasses and enrages much of India’s upper-class who see the film as a stereotypically Western view of India as poor, chaotic, violent and dirty. They see Slumdog Millionaire as a “white man’s imagined India.” Some Hindu organizations accuse the film of denigrating Hindu gods. Some human rights groups in India have condemned the film for its use of the term ‘slumdog’ (a term not commonly used that recalls the days of British colonizers calling Indians ‘dogs’). Others see Boyle’s slick, colorful production of such impoverished settings as “poverty porn” – rendering Indian poverty visually appealing and exciting for a mostly white, Western audience. Finally, the compensation given to the film’s young actors is, with Slumdog Millionaire’s success, seen to be inadequate and a way of exploiting real life slum children. No matter how Slumdog Millionaire does at the Oscars, these controversies are unlikely to die down, even if they fall off the pages of US newspapers.

I do not intend to debate each of these controversies here, though I find some of the accusations frivolous while others have some validity. What is most interesting to me is the way in which Slumdog Millionaire has brought the issue of global poverty into the limelight (literally) and has exposed our collective squeamishness with having images of it thrown in our face by a film. If we middle-class Americans must see poverty, we like to see it portrayed in a particular way – most likely in a low-budget documentary that condemns it and that offers a way out. A movie like Born into Brothels does this very well. But Slumdog Millionaire treats poverty and those who live in poverty differently, not as faceless objects of pity, but as individuals – as a story must – with agency and the capacity to be happy and full of dreams in the midst of often horrifying surroundings. In this way Slumdog Millionaire resembles Rohinton Mistry’s impressive novel A Fine Balance – also set in India, that does not shy away from the poverty that is a given in many people’s lives, but something that need not rob people of their humanity, that need not reduce them to objects to be pitied by the world’s wealthy. With this perspective poverty need not limit the range of human experience and emotions. Those who are poor have a story like everyone else, and in fact, those who are poor make up a huge amount of the world’s population. Confronting middle-class Westerners (and Indians for that matter) with the horrors of poverty and the injustice of their own affluence, while avoiding defining the poor by this label alone is something few films do. Slumdog Millionaire does it well. And if it does well at the box office, all the better.

When discussing global poverty and the political and social attempts to alleviate it, it is easy to be overwhelmed by the numbers and to be numbed to the experiences of individuals who must live in such dire conditions. It is easy to feel guilty that you are not the one living in extreme poverty or to feel that those who are poor deserve it, that they just need to try harder. It is also easy to feel hopeless in the face of such a widespread and complex problem. How exactly should the global community address the problem of poverty? Should we place an emphasis on greater individual incomes and saving and buying power? Or should the emphasis be in developing societal infrastructure to improve quality of life by ensuring better health care, education, access to employment, etc.? Some put their faith in the free market to lift all boats, but then the free market seems to demand that many people remain poor, and it doesn’t provide any plan for improving societal shortcomings that contribute to poverty. Some believe government programs are the answer, but improving education, health care, job training programs and the like can be costly and complicated, and simple welfare schemes may perpetuate poverty. A host of non-governmental organizations and foundations play a growing part in addressing poverty, but can arbitrarily bestow charity that perpetuates cycles of economic dependence. The work of groups like the UN’s Development Program connects these participants and strategies offering a practical and promising way of addressing poverty on a global scale.

But uplifting the poor is not all that is needed. Our relatively new found awareness of the toll we inflict upon the environment requires that the discussion about alleviating poverty must include the using and distributing resources. Ending poverty through growing economies and enabling hundreds of millions of Indians and Chinese to drive gas-guzzling cars and to use energy as recklessly as we in the US do is no longer an environmentally viable option. And neither is telling people in poorer countries that they can’t have what we do, that they can’t live how we do. Rapidly developing countries need to do their part to make their growth politically and environmentally sustainable, no question. In a way, the more difficult task is ours however. If global economic growth continues (a given in most minds before the last six months of economic turbulence) most other people in the world will be increasing their consumption and use of resources. The Brazilian student may move up from a bike to a scooter, the Vietnamese family may upgrade to an oven from a cook top stove. In the US however, unless we plan on aggressively defending our unfair hoarding of resources from the global community, we will need to begin to reduce the amount of resources we use. Drastically. Even if free markets can lift all boats, it will mean environmental disaster. The middle class American lifestyle has never been sustainable. We are realizing this just as the world’s two largest countries are economically booming, and striving for that lifestyle. No longer will the United States – six percent of the world’s population – be able to consume 30% of the world’s resources. That’s a fact.

But, I suspect it is a fact that will go ignored or denied. Sure, we may use compact florescent bulbs instead of incandescents. We may recycle and compost. But most of us probably won’t give up our car (or even our second car). Most of us won’t give up our washer and dryer, or our oven, or our spacious homes. In the end, I suspect that we’re all just a bit too selfish and stuck in our ways to make large personal sacrifices for an abstract common good. We want to end poverty, but we don’t want to give up what we’ve been blessed with, and without this sacrifice on the part of the better-off, poverty will continue no matter how much effort is directed at alleviating it.

Like any movie, Slumdog Millionaire has its shortcomings. Its plot is somewhat thin and its characters are not very well-developed. It is a movie more about image than substance. Its details are easily refuted by Indian audiences. However, its vividly showing audiences who have not faced poverty and hardship the lives that many in this world are compelled to lead allows it to be more than just a film. It gives poverty a face and a story that will open most audiences’ eyes to something new – hopefully bringing tangible benefits to the world’s poor while eliciting an honest introspection about what people often must and can do without.

A Police Officer’s View on Drugs: Part 2

Several months ago, in my first piece as a writer for Demockracy, I talked about my perspective as a Police Officer who is against the War on Drugs. In the months that followed, this article became a very popular piece on this Web site and across the social networks. As such, I’ve had several requests to follow up on this piece and talk more about my career experiences and share my insights on this ill-begotten war on drugs. From these requests, I’ve decided to write a follow-up piece. In this follow-up article, I will explore some of my personal experiences that have led me to many of my current conclusions. I hope you enjoy and please share any comments that you may have.

LEAP

As I’ve shared in the past, I am a retired Policeman from Vancouver B.C., and I represent LEAP, Law Enforcement Against [drug ] Prohibition. We are a worldwide organization of Police Officers, Corrections Personnel, Judges, and many others who work in different areas of law enforcement, both active and retired. We currently number some 8,500 members. Our advisory board is made up of one US Governor, four sitting US Federal District Court Judges, five former police chiefs, the ex-mayor of Vancouver B.C, Senator Larry Campbell, the Former AG of Colombia, and from the UK, a former Chief Constable and the former head of narcotic task forces for all of England. We do not support drug use and realize that in an ideal world we would be better off without it. What we do believe is that “The War on Drugs” has created most of our problems with drugs and addiction today. Addiction is a disease, not a crime.

More On My Experience

With that said, let me tell you a bit more about myself and why I have come to these conclusions. I joined the Vancouver Police Department in 1973 and served for 28 years. The date of my joining is important, as the year before in 1972 a Canadian Parliamentary Committee known as Le Dain concluded that due to the high costs of enforcement and the relatively benign effects of marijuana, that there should be a gradual withdrawal of criminal sanctions over time resulting eventually in legalization of marijuana. All in-depth studies going back to the British India Hemp act of 1895 have come to the same conclusion about marijuana. However, the Canadian Parliament chose to ignore those recommendations.

As I recall, there was little focus on drugs when I went through the Vancouver Police Training Academy. (I did however learn that reasonable force extended to choking a dealer to prevent his swallowing the evidence and that the ponytails favored by so called hippies made a very effective handle to restrain them.) After completing training, I discovered that drug enforcement was mainly left to the individual officer’s discretion. No high level traffickers were ever investigated. Enforcement was done only at the street level. Those, however, who centered their activities on drug enforcement made substantial overtime amounts from court appearances. This policy, however, has never been the policy of the Federal Police, the R.C.M.P. They, unlike municipal departments, receive considerable federal funding to enforce the drug laws and do so enthusiastically.

One individual I worked with during my early years routinely arrested individuals on the basis of a dirty hash pipe or a spoon with enough residual heroin to analyze. It was not unusual to bring in 4 or 5 individuals from a rundown hotel room on the basis of a small baggie of weed. At that time, the hotel clerks would tell us the rooms where they suspected the occupants of drug use and hand us the keys, while we turned a blind eye to the other illegal activities carried out by the hotel managers and staff. (I suspect these hotel managers were probably the largest traffickers in the buildings and, according to more than one source, charged prostitutes a premium for brief hotel stays.) Drug charges in Vancouver often resulted in some officers doubling their wages from the overtime and court time involved. The drawback was that there was less police presence on the streets to handle the ongoing and routine crime of downtown Vancouver.

In 1995, I started the Vancouver Police Anti-Fencing Unit. Addicts tend to concentrate in the low rent districts as do pawnshops that often supply the addicts with money. The dealers are normally right outside the pawnshop doors to complete the equation. The average addict at that time was spending between $100-$200 daily on his or her addiction. Unfortunately, pawnshops normally only pay 10 cents on the dollar; therefore to support their habits, the addicts have to steal $1,000-$2,000 worth of property. The evidence of stolen property in these pawnshops was so rife as to be almost ludicrous. I remember at one time entering a pawnshop when an addict came in with an armload of stolen property from London Drugs. While negotiating with the owner, he was ripping the London Drugs labels off CDs with his teeth while negotiating the price with the pawnbroker, as he had no spare hands to do the job.

There are unfortunately a small percentage of people who through nurture or genetics, always seem to fall to the bottom and are unable to survive without their self-medications. They have no time for treatment as their days are filled with theft to support their addiction, finding a dealer, and after purchasing their drug of choice, never knowing the quality of their purchase. We cannot help these individuals by locking them away. We must not kid ourselves; in jails, drugs are readily available. Generally, the prison system tolerates drugs as they tends to calm the inmates. The substance that the jail staff often fear is actually alcohol, which leads to riots and destruction. I was told by numerous prison guard colleagues that alcohol is so valued by some of the old alcoholics in jail that they will often attempt to import considerable quantities of drugs, just to trade for alcohol, which is much harder to find inside.

As a policeman, I attended many untimely drug related deaths in the downtown eastside area of Vancouver where I spent much of my career. Overdoses of various drugs were very common. No one paid much heed, and most were not too traumatic to me, as relatives were usually far away, often in Northern BC or other Provinces, and it was up to the local RCMP detachments to notify them. That area in Vancouver is the poorest area in Canada according to tax returns and acts as a magnet to those who have run away from home due to abuse, sexual and domestic. Few of them had any local support in Vancouver. These individuals rapidly became involved in the drug culture of the area and many died there. It was impossible to determine if the drug deaths were a result of long-term abuse, mixing too many drug cocktails or the strength of the drug being greater than expected, either by deliberation, such as we hear of with a hot cap, or by accident.

It was only when I attended deaths out of the usual pattern that the reality of the horror really set in. A one time partner of mine lost his 16 year old daughter to a drug overdose. Unfortunately, her dealer did not monitor her slide into abuse. He did not offer her counseling or monitor the purity and strength of the drugs he sold. He was probably an addict himself, dealing to support his habit. The outrage is that he and thousands more are still out there still selling their products, everywhere to our children.

Solutions?

Raw opium increases in price by several decimal places from the poppy fields, to the addicts in North America. Coke is not quite as profitable and the other drugs even less so, but anyone can rapidly rise to enjoy the lifestyle of say a successful surgeon or lawyer with no educational requirements, experience, skills, and very little work required. The only way we can break this cycle, ensure a uniform product, help those who request it, and monitor those who need help is to legalize the product, heavily regulate it, and supply it to those in need.

Why don’t we go out and arrest all drug dealers? We could arrest them all and you know what will happen? There will be fights, stabbings, shootings and deaths, AND tomorrow new dealers will be there to carry on business as usual. When you arrest a drug dealer, the only thing you create is a job opportunity. As an example, there was recently an investigation of an individual planning to blow up a city block in Surrey, BC, in order to rid it of all the drug dealers there. Some may believe that his point of view could be justified. The only problem was that he himself was a dealer and hoped to take over all the business with the others gone.

Ask yourself if heroin or cocaine were legal, would you use them? I wouldn’t. No one who is rational and has aspirations for a meaningful life is going to. In fact, 99% of all people tell us that they wouldn’t. The first drug laws were enacted because 1-3% of the population was believed to be addicted to drugs. By addicted I mean unable to hold meaningful work and behave in a socially responsible way. Today, after countless millions have been arrested and billions of dollars spent, the percentage of addicts is still estimated at between 1 to 3 % of the population.

Let’s take the money from the criminals, reduce property crimes, reduce prostitution, reduce disease, and give our social agencies the funds to really have an impact on society. Above all, let’s give that 1-3% a chance of a real life.

Obama, Mexico, and the Drug War

Remember the War on Drugs? Sure you do. It was after the Cold War and before the War on Terror. It continues to be an attempt to crack down on the illegal drug trade into the U.S. It turned out to be little more than an excuse to continue the Cold War in places like Colombia. It also resulted in new domestic judicial rules such as three-strikes-and-you’re-out, and draconian mandatory minimum sentences for drug offenders, over-crowding prisons with disproportionately minority, nonviolent, first-time offenders in possession of small amounts of drugs.

Since September 11, 2001, we haven’t heard much about the War on Drugs. With the attacks of that day, the threat of religiously and ideologically motivated radical Muslim terrorists immediately became more grave than the crime and violence connected to Latin American (mostly) drug cartels. Our collective focus has been on the threat posed by Islamic terrorism since 2001 and we have largely ignored the growing threat posed by increasingly powerful drug cartels on our southern border.

Last year, drug violence and corruption in Mexico surged, especially in towns and cities along the U.S.-Mexico border. In 2008 over 6,000 people were probably killed – that adds up to over 16 people every day – twice as many as in 2007. Many of these killings were particularly gruesome – beheadings and execution style killings. Drug cartels are suspected of downing a plane, killing Mexico’s Interior Minister, and corruption related to drug trafficking has reached the highest levels. The Sinaloa, Gulf, and Tijuana cartels have infiltrated the judiciary, the police, and political parties. The director of Mexico’s Interpol Office and an employee of the U.S. Drug Enforcement Agency were both arrested for collaborating with cartels. Last spring, the Justice Department declared that Mexican drug cartels pose the “largest threat to both citizens and law enforcement agencies in this country and now have gang members in nearly 200 U.S. cities.” And the U.S. Army High Command has determined that due to the violence, corruption and instability caused by drug trafficking in Mexico, its government, along with Pakistan’s, should “bear consideration for rapid and sudden collapse.” Former Drug Czar Barry McCaffrey recently stated that thanks to drug cartels “Mexico is on the edge of the abyss – it could become a narco-state in the coming decade.” Mexico’s foreign minister has had to defend her government against accusations of its being a failed state.

These are damning statements that President Obama’s incoming administration should not take lightly. While I hope the situation in Mexico and U.S.-Mexican relations will be treated with the seriousness they deserve, Obama has not shared his plans concerning Mexico or the Drug War very openly with the American public. Indeed, he appears to have followed Bush’s lead and has focused his foreign policy sights on – you guessed it – Iraq, Afghanistan, Iran, and other problems in the Middle East. Given our country’s complex and numerous entanglements in the region, this is understandable. But with the drug trade destabilizing our southern neighbor and threatening to cross the border and sow violence, corruption, and instability on U.S. soil it is surely necessary to give our attention to all of these situations, however difficult it may be.

The U.S.-led Drug War has always been deeply flawed and arguably ineffective. The U.S. has always been eager to solve the problem by force – instigating violence in other countries (massive military funding to Colombia, Mexico, etc.) and treating the drug trade in the U.S. as essentially a moral and policing problem that can be solved with a zero tolerance approach and enough cops, guns, and jails. The U.S. has been reluctant to pursue cheaper and more effective ways of battling the drug trade – drug treatment for addicts in the U.S., and development aid for farmers in other countries for example. The War on Terror has pushed the War on Drugs to the back burner, and it has pushed ‘soft’ strategies even further back. It seems we have given up trying to reduce the demand or the supply of illegal drugs in the U.S.

So what exactly does Obama plan to do about the threat posed by illegal drug trafficking? He did not mention Mexico or drugs in his inaugural address, and his public statements since being elected haven’t given many clues. The new whitehouse.gov foreign policy agenda page says nothing about Latin America, preoccupied as it is with Middle East concerns. And as a candidate, Obama said little specific about Latin America or drug trafficking, though at least he mentioned Latin America on his campaign website.

It appears President Obama will not be as hands-off as President Bush when it comes to problems in Latin America. He has indicated a desire for closer and improved relations with Mexico. President-elect Obama was visited by President Felipe Calderon in Washington where they discussed economic issues (including Obama’s campaign pledge to renegotiate NAFTA, something Calderon is opposed to), the environment, immigration, and drug trafficking. Neither man gave many details about their discussion, but Obama has indicated support for the Merida Initiative, passed last June, which commits the U.S. to increasing aid to Mexico for equipment and training to combat organized crime. It does nothing to reduce the U.S. demand for drugs, however.

President Obama also envisions an ambitious new Partnership for the Americas”. In a Miami speech during the campaign he declared:

We need an agenda that advances democracy, security, and opportunity from the bottom up. So my policy will be guided by the simple principle that what’s good for the people of the Americas is good for the United States. That means measuring success not just through agreements among governments, but also through the hopes of the child in the favelas of Rio, the security for the policeman in Mexico City, and the shrinking of the distance between Miami and Havana.

This soaring rhetoric is unfortunately not, as far as I can tell, matched by detailed or original strategies for combating the drug trade along the U.S.-Mexico border. Increased cooperation between the U.S. and other Latin American countries will surely be helpful and appreciated, but in the midst of so many other problems, the U.S. may not have the resources or the political will to see these changes through. Yet there are glimmers of hope – commitments to improve cross border partnerships between U.S. and Mexican states and pledges to increase drug treatment programs in the U.S.

It is also instructive to examine the recent decisions Obama and his inner circle have made regarding the Drug War. As a candidate, Obama promised to end DEA raids on medical marijuana dispensaries in California, but since his assuming office raids have continued. Obama’s staff has said that as soon as new Department of Justice officials are appointed the raids will end, heartening news for those who support medical marijuana laws – and a difficult promise to avoid making good on. Obama does not support legalizing drugs – not surprising for a U.S. president – while at the same time advocating more treatment than incarceration for users, a significant shift from previous presidents. He has suggested ending mandatory minimum sentences for non-violent first-time offenders, and ending a federal ban on funding needle exchange programs reversing years of federal drug policy.

This appears promising, yet Obama’s coterie does not have a history of breaking ranks with the War on Drugs consensus. Joe Biden has been a strong supporter of law enforcement solutions, toughening sentencing rules for drug users, and criminalizing drug use. He played a significant part in creating the position of Drug Czar. He has made more moderate decisions in recent years, but many Drug War opponents remain skeptical of him. Rahm Emanuel has been a vocal supporter of the Drug War, at least when it fits his political agenda, and has a mixed record on issues like medical marijuana. Incoming Attorney General Eric Holder also vigorously supported harsher Drug War policies during his years under President Clinton and as U.S. Attorney for the District of Columbia. Obama’s interim Drug Czar – Ed Jurith, a longtime lawyer for the White House Office of National Drug Control Policy, and former Clinton Drug Czar – has been described as “civil and thoughtful” in the ongoing debate over drug policy though he has by-and-large supported the Drug War. It is rumored that Obama’s permanent Drug Czar pick is Republican Jim Ramstad, who has opposed needle exchange programs, a crucial tool in decreasing the spread of HIV and other fatal diseases amongst addicts. While Drug War opponents may not be thrilled with these selections by Obama, many are taking a wait-and-see approach and acknowledging that these individuals are at least politically open to making policy changes.

And in Mexico? Will Obama put forward drug policies innovative and intelligent enough to effectively curb the violence and corruption flourishing along the U.S.-Mexico border? Will he be able to create a new, smarter mix of drug fighting strategies that reduces the violence and corruption that has accompanied drug trafficking in the U.S. and Mexico? While Mexico and the U.S. border states (dealing with the threat of the same drug-related problems) are committed to effectively managing and limiting, if not stopping, the drug trade, it remains to be seen how committed the Obama administration in far-off Washington will be. Inspirational rhetoric is one thing, but confronting difficult societal problems and defeating organized gangs of unrepentant killers is another – just ask former President Bush.

Epoch’s End

I should start by stating that I am a novice in the fields of economics and finance. My career was as a law enforcement officer. I do, however, believe that I have a firm grasp of world history, human nature, and a sense of how much the human spirit can endure until endless mass frustration leads to a chain of events that explodes into actions which can result in regime change and major shifts in worldwide belief systems.

After the First World War, communism and socialism emerged to duke it out with Hitler’s fascism and other conservative regimes for the balance of power in Europe. After the Second World War, unfettered missionary capitalism emerged in the US, bolstered by evangelic Christianity. Liberalism and socialism tended to dominate in old Europe where the relative place of religion diminished, and today is virtually non-existent in many such secular states. Into this mix, multinational corporations emerged, with no allegiance to anyone except their shareholders. Their power enabled them to shape government policies, and their financial weight enabled them to implicitly blackmail governments into giving them sweetheart deals, which were often to no ones benefit except theirs and the richly rewarded politicians who supported them. From this standpoint, I do suspect that the shock waves radiating around the world from the stock market meltdown were not entirely created by a few bad apples running amok in Wall Street, but were rather a symptom of the basic dishonesty that seems ensconced in most stock markets around the world.

Events of the past decade and the past year in particular have convinced me that we are at Epoch’s End and that the current worldwide geopolitical and economic system is so broken that it can never be completely fixed. What will emerge I cannot venture to guess, but it will likely take many years to reach this yet unknown new global equilibrium. In this new equilibrium, the standard of living that many in the western world have taken for granted in recent generations may not be seen again.

Certainly many have been expecting Epoch’s End, through global warming, plagues or famines, but its tipping point appears to have occurred not through those venues, but through economic breakdown. As life has proceeded happily upward for us in the developed world since the Second World War, we have long forgotten that this uninterrupted growth was unprecedented in recent world history. World history suggests that the past fifty or sixty years are more likely to be seen as an outlier rather than as a permanent new paradigm. In the past, plagues have wiped out the working forces, old industries closed down and new ones developed, and populations followed the jobs. Crop failures caused those who wanted to survive to move on to new areas or even to new continents. Growth has been followed by stagnation. Fifty or sixty years may seem like a long time in the scope of a human lifetime. However, it is all but a footnote in world history.

Over the last 50 or 60 years we have come to expect that things will always improve–we will have better cars, holidays, and medical care, and our incomes will continue to provide more of these things. Many companies have based their development on a policy of increasing their revenues as much as 10% a year. Most of these companies have psychologists study shoppers brain waves to use exactly the right words in their sales promotions and to find the best place to put certain items in the store to trigger the buying impulse. We have all happily shopped and shopped for more and more things we don’t need. Products we really need require no advertising. How many television commercials do you see for bread and milk? If the whole world were to enjoy the standard of living that we currently enjoy in North America, we would need three worlds just to keep up. Perhaps most selfish of all, most people now expect to live longer without giving any thought to the potential consequences of this like increasing the world’s population, all the problems of pollution, global warming, polluted water ways, etc. With the world’s population approaching 8 billion plus people, it is close to cardiac arrest. We can’t expect to live forever and have growth forever; death and cyclical stagnation of populations and civilizations are a part of the natural balance of our planet.

As you probably expected, I am nothing of an expert in the ways of the multinational corporation. However, what I do know is that there are many Chinese workers, working at monotonous, dangerous jobs for $5 a day or less, with unpaid overtime expected. They produce cheap quality goods for us that we really don’t need. Who then is the net gainer? At least in the short run, it is a few wealthy shareholders. In order for this situation to flourish, our wage levels must remain 20 times higher, for the same or less effort, than a Chinese worker. The whole approach is broke.

As I write, more and more western governments are announcing huge spending plans to stimulate the economy, using vast amounts of borrowed money. That money is all coming from the sale of our bonds to China. If it works, perhaps we can put off Epoch’s End for a few years, as we attempt to pay the huge debts. Certainly our wages will take a huge hit, and lifestyles will need to readjust. But what if it doesn’t work, what if our spending doesn’t pick up enough to reopen the factories in China? What if China were to ever demand repayment of those bonds to assist their own citizens? We will be bankrupt, there will be no wages for any civil servants, no military wages, no police wages, and no pensions or benefits of any kind will be paid.

Further, as a people, many of us have become lethargic and ignorant. How is it possible to consider people for the highest offices in the land without demanding that they have the knowledge, stability, and honesty to do the job? When you visit your doctor you know that his or her certificate represents years of study, tested time and again by exams and practicum. Yet we are prepared to accept persons for the highest offices because they look good, string a fine line of BS and are just like you and me. Well I have news for you, I don’t want a person like me running a country.

In Canada from where I write, we had a recent Federal Election. The Liberal leader Stephan Dion was put down continually because he didn’t speak perfectly in his second language of English. He didn’t look good in front of the cameras, and he was often filmed from the wrong angles. The saddest thing was that nobody seemed to have the slightest interest in hearing the substance of what he actually was saying. We could save enormous amounts of money and time if we simply gave the job to the best actor and provided a good speech writer. Perhaps getting precisely that for many years has resulted in all our difficulties today. Franklin D. Roosevelt would probably never have been elected today, wheelchair bound as he was. Winston Churchill, similarly, was drunk too often to be electable today. At that time we paid attention to what was said, not the carefully buffed images we see presented today.

In the last U.S. election, most were too polite to state publicly that the election of Sarah Palin as vice president could potentially place every citizen of the US one 72-year old heart beat away from danger. Yes, thankfully Ms. Palin did not become vice president. However, for one of the two major parties of the world’s leading nuclear superpower to even nominate her for vice president should be scary enough. In the case of Mr. Obama and Mr. Dion, being an intellectual was seen as a negative by many. We call this civilization? Thankfully, after eight years of George W. Bush, the America people took a chance on an intellectual. New Canadian Liberal leader and respected Harvard intellectual, Michael Ignatieff, may get a chance in the next few years as well.

If we are indeed at Epoch’s End, we will have all caused this through greed, but most of all because we have failed to keep our eyes on what has really been going on, failed to keep people honest, and preferred to switch on the football game rather than take a glimpse at the foreign-affairs columns or use our computers to access the mass of information which is availably so readily today, yet ignored by most. If we are at an Epoch’s End, it is indeed our own damn fault.

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