As a Boston Globe op-ed put it a few days after his death “He was not a welcome ally to many in America’s civil rights movement of the early 1900s.” And he was even less welcome among those who ran the establishment media outlets that gave short shrift to the question of baseball’s exclusion of black players. But now, nearly twenty years after the fall of the Berlin Wall, it seemed that Lester just might have outlasted the people who didn’t care to mention him.  After all, as he used to say, he was the last sportswriter covering the 1938 Joe Louis – Max Schmeling heavyweight championship fight in Yankee Stadium who was still vertical and by now there weren’t all that many of them around who’d covered the 1955 World Series either.

On the television program, Rodney spoke of October 4, the day that the Brooklyn Dodgers won the seventh game of the World Series against the New York Yankees, the team that had beaten them in five previous meetings. As this Dodger fan recalls it, he said, “They say there’s no cheering in the press box. That day, there was cheering in the press box.”

When I’d first met Rodney more than ten years earlier, I decided that I’d do my bit to try to get him some attention and some of what follows was originally published in the article “Lester Rodney, the Daily Worker, and the Integration of Baseball” in the 1999 edition of the Society for American Baseball Research publication, The National Pastime.  Since that periodical’s circulation has unfortunately never matched its quality, expanding upon the original seemed to the point upon the occasion of Lester’s death.

Lester Rodney in 2007 (photograph by Byron LaGoy)

“The whole history leading up to Jackie Robinson has usually been that an electric light went on in the head of the noble Branch Rickey one morning and he ended baseball discrimination.” As the lean, white-haired Lester Rodney spoke in his living room in Rossmoor, the sprawling retirement community east of San Francisco, these events were now nearly half a century and twenty-five hundred miles removed. Important details now seemed in danger of being lost forever.

Given the power of the pen he once wielded and its influence in baseball’s integration, the former Daily Worker sportswriter might well have written the history himself. But everything in life — no matter how long a life it may be — is a matter of priorities, and in recent years Rodney had switched his from writing about sports to playing them. Had he taken the time to write the book, he might not have stayed in such extraordinary shape and might never have become the first top-ranked tennis player in California’s 85 years-and-over bracket. So, for now, an important chapter in the story was known mostly to those who knew Rodney — and who happened to ask.

Although he scoffed at the notion that Brooklyn’s “Great Mahatma” acted alone, Rodney didn’t mean to minimize the credit due the Dodgers president — some club owner actually had to put a black ballplayer into a major league uniform and Rickey acted while the others mumbled. It’s just that he knew there were a lot of other people generating the electricity that finally turned on that light.

Not the least of them was Rodney himself. In fact, by the time Robinson took his position at first base in Ebbets Field on April 15, 1947, more than a decade had passed since Rodney first took up the cause of integrating baseball as sports editor of the Communist Party’s New York Daily Worker newspaper.

Today the concept of a “communist sportswriter” seems a very strange proposition. In Rodney’s day it was not quite so exotic, but still no one would confuse the Daily Worker’s sports department with the “toy department” of any other newspaper. As Karl Marx might have said, heretofore sportswriters had merely interpreted the world of sports; the point, however, was to change it.

The first thing Rodney tried to change was what the 1923 Sporting News called baseball’s “tacit understanding that a player of Ethiopian descent is ineligible.”  In one respect the cause was a natural for a group that considered itself  “the Party of Negro and White.” The Communists had, after all, distinguished themselves in defense of the nine black “Scottsboro Boys” charged with the 1931 rape of two white women in Alabama when few others would touch the cause. They also supported the right to national self determination for a “Black Belt” in the American south, an idea that did not even occur to very many other people — white or black; and, on occasion, they were known to conduct internal party trials of members accused of racism.

The baseball part did not come so easily, though. The Communists displayed but a tenuous grip on the pulse of the nation, dating back to their early decision to take the party underground, in expectation of treatment similar to what the Bolsheviks faced under the Czar. It took three years for them to conclude that they would not be declared illegal after all, resurface, and set off in search of America. And eventually Lester Rodney took them out to the ballpark.

Jackie Robinson, 1954

The basics of the Jackie Robinson story are, of course, familiar to baseball fans: Rickey signed Robinson — a man whose athletic achievements had already prompted one sportswriter to call him the “Jim Thorpe of his race,” took him from the Kansas City Monarchs of the Negro American League, sent him out of the country for a season of minor league ball in Montreal, and finally put him in Ebbets Field the following year. But, until the 1995 publication of David Falkner’s Great Time Coming: The Life of Jackie Robinson From Baseball to Birmingham, no mainstream publication had ever provided any detail of how in 1936 “the Daily Worker began a steady and unremitting campaign for integration … spearheaded by sports writer and editor Lester Rodney,” or noted that it was not even until “A year or so after the “Worker” began its push,” that “the Pittsburgh Courier, the most widely circulated Negro weekly in the nation, initiated its own campaign.”

Rodney’s method was quite simple. He would ask questions other sportswriters wouldn’t or couldn’t. He recalled, “First we’d go to the top officials and they’d say, ‘There’s nothing written, it’s up to the club owners.’ We’d go to the owners and they’d say, ‘My heart is with you but the players would never stand for it.’ Then you go to the players and shoot that down.”

A typical July 19, 1939 Worker story, “Big Leaguers Rip Jim Crow,” quoted members of the Cincinnati Reds. (The franchise often found its fate intertwined with that of Rodney’s organization: according to one team historian, each “crisis in affairs between the United States and Soviet Russia” brought new demands “that the management change the team’s name” despite the fact that “the Reds have been the Reds since 1869, one year before Nicolai Lenin was born and ten years before Stalin’s birthday.”)  Manager Bill McKechnie claimed, “I’d use negroes if I were given permission.”  Pitcher Bucky Walters declared them “Some of the best players I’ve ever seen” and back-to-back no-hit pitcher Johnny Vandermeer concluded “I don’t see why they’re banned.” ”Sensational stuff in 1939,” Rodney remembered.

Robinson and Paige, 1945, Kansas City Monarchs

Two seasons earlier he’d published an interview with Satchel Paige, the most famous Negro League star. Rodney recalled that “At the end of the interview I said to Paige that (Hall of Fame pitcher) Dazzy Vance came to the Dodgers at 29 years of age, which was old for a ballplayer, but that when he was 32 he won 25 games. Paige, who was then 29 himself, says, ‘I don’t think they can keep us out three more years.’ But he was wrong. He had to wait another eleven years. Very tragic and it bothers me that Paige is always portrayed as an egocentric guy, content to be a big fish in a small pond. It’s absolutely false.” (Joe DiMaggio, once told the “Daily Worker” that Paige, whom he’d played against in post-season exhibitions, was “the best pitcher I ever faced.” Paige ultimately became the first player elected to the Baseball Hall of Fame primarily on the basis of a Negro League career.)

In 1941 Rodney and his confederates stepped up the campaign, sending telegrams to every major league team owner asking them to try out black players. ”The only fully positive response we got was from William Benswanger of the Pittsburgh Pirates. The next spring we arranged a tryout for Roy Campanella — who was about 20 then — and two other players.  And then Benswanger came under intense pressure — I’ve never known the exact nature — not to hold the tryouts and he backed out as gracefully as he could.

“I never slammed him for it, because he was the first honest guy who answered, ‘You’re right and I’m willing to give it a try.’ And then he came under all that pressure. So that was the first tryout that never happened.

“Imagine how baseball history would have been changed if Benswanger had told all the other owners to go fuck themselves and hired Campanella, Satchel Paige and maybe three other players from the (Negro National League) Homestead Grays who were the best team in baseball and played in Pittsburgh. Pittsburgh was the heart of black baseball then. The Pirates would have immediately won five straight pennants.”

Invisible Men, Donn Rogosin’s 1983 history of the Negro Leagues, is fairly typical of the brush off usually given to the Communists’ efforts, dismissing the Benswanger affair as a “non-existent tryout,” and concluding that “The black players and the black press were unimpressed by the Communist campaigns.”

Willie Mays and Roy Campanella, 1961

The Communists, however, clearly impressed at least one black player: Roy Campanella’s eponymous 1952 biography acknowledges that the “Daily Worker” had “pounded hard and unceasingly against the color line in organized ball.”  What makes this recognition particularly compelling is the fact that the book’s author, New York Daily News sportswriter Dick Young, was known neither for left wing sympathies nor graciousness. According to Rodney, “Dick Young says to him, ‘We don’t want that stuff in there; you want to keep your skirts clean.’ And Campanella says, ‘What do you mean?  That’s what happened. You want to know my life story?  This is part of it.’

“Campanella believed that baseball was the most important reason why the Supreme Court struck down segregation in 1954. When I heard that I said, ‘Come on, Roy, what are you talking about?’ Campy said, ‘All I know is that the ballclubs going down south traveling together, playing together, living together, were the first all the time, they were the first in hotels; they were the first in trains. Don’t tell me it wasn’t the most important thing.” Indeed, at first Campanella’s conclusion may seem that of a man overestimating the significance of his own corner of the world. But the record shows that Birmingham, Alabama actually ended its prohibition of interracial sports a month before the Court ordered its schools desegregated in the landmark “Brown versus the Board of Education” decision. The reason? To allow Campy, Jackie and the rest of the Dodgers to play a spring training exhibition game there.

And a letter to the August 20, 1939 Daily Worker appears to give the lie to the alleged indifference of black sportswriters to the Communists’ efforts. The letter-writer takes the “opportunity to congratulate you and the Daily Worker for the way you have joined with us in the current series concerning Negro Players in the major leagues, as well as all your past great efforts in this aspect,” and goes on to express the hope for further collaboration. The author was Wendell Smith, sports editor of the Pittsburgh Courier, a black newspaper whose nationwide readership would exceed 400,000 during the following decade.

“You know, Jules Tygiel’s book (Baseball’s Great Experiment: Jackie Robinson and His Legacy) was the first to acknowledge our efforts and that wasn’t until 1983,” Rodney recalled. ”In that Ken Burns series (the nine part 1994 Public Broadcasting System documentary of baseball history) it mentions that (manager) Leo Durocher told a sportswriter that he would use some of the great Negroes in a minute on the Dodgers if he were given permission. I’m the sportswriter he told that to. Burns, of course, had a big corporate-funded series and he did manage to push the role of the Negro to the center, as he did with his Civil War series. But even PBS is not so radical on these things,” he adds with a grin, “as you can tell by how many radicals you’ll see on the McNeil-Lehrer news hour. So you can’t fault Burns for not mentioning the Daily Worker.”

At that point in the conversation the voice of Rodney’s wife Claire interjected from the next room, “I can fault him.” An active Communist herself, Claire was called before the House Un-American Activities Committee when she was teaching elementary school in Lawndale, California. ”They never realized that I was her husband,” Rodney noted.

It’s probably less accurate to say that Rodney and the integration campaign — that eventually included “End Jim Crow in Baseball” petitions with two million signatures gathered by the Young Communist League and labor organizations like the National Maritime Union — were written out of history than that they were just never written into it in the first place.  Some noticed, however – David Falkner’s book notes how “remarkable was the passion and the insistence of the campaign which was generally lost on white America — though not on those in government who were always vigilant on the twin menaces of communist agitation and black unrest.”

Not exactly a friend of Mr. Rodney

Foremost among the vigilant was FBI Director J. Edgar Hoover, who singled Rodney out for individual mention in Masters of Deceit, the central text of anti-communism. “We’re sort of considered folk heroes by many young people now, but things like that created problems for our children in high school in the 1950’s,” Rodney would later say.

Rodney himself was no Red Diaper Baby; he recalled his Republican father displaying a window sign in their Brooklyn house mourning the death of President Warren G. Harding in 1923. But then “in 1931 or 32 — during the depression — three of us rented a cold water flat on McDougal Street in Greenwich Village — ten dollars a month. We were there for the bohemian atmosphere, the cellar clubs, poetry readings.  We were poor as hell but we didn’t know it.

“I wrote some pulp magazine stuff to pay the rent — cheap romances, love stories, just junk. Then we all did our creative writing and critiqued each other. We sold a few stories; I don’t even have them anymore. It all got lost or thrown out when I went into the army.  It was just about life and the torments of youth. It was a very heady New York, Greenwich Villagey atmosphere; the cafeterias were humming with literary discussions and the Communists at that time were impinging on everybody’s consciousness.”

Bohemianism never dulled Rodney’s interest in sports, so one thing that was clear to him about the Communists was that when they addressed sports it was an embarrassment. When he told them so in a letter to the Worker, he was invited in to discuss it and he wound up doing the occasional weekly piece — gratis. By 1936 the Communists were eager to shed strange and foreign identifications in the public mind and entered their “Popular Front” period: “Communism Is Twentieth Century Americanism” replaced “Towards Soviet America” as the party’s slogan. The Daily Worker now wondered whether it should deal with popular concerns like sports on a more regular basis. When a poll of Worker readers came back 6-1 in favor of daily sports coverage, the paper asked Rodney to take it on.

Of course, since this was the Communist party’s newspaper, the question would not be settled as simply as that — there were those who thought the paper should cover “people’s sports” like soccer, not “corporate sports” like baseball. But once the paper decided that a commitment to “Twentieth Century Americanism” required coverage of the “National Pastime,” that coverage would be activist — since this was the Communist party’s newspaper.

It should be noted that even if Ken Burns did not give Rodney his due, Leo Durocher did. In his 1993 book, The Era 1947-1957; When the Yankees, the Giants and the Dodgers Ruled the World, Roger Kahn quotes Durocher telling Rodney, “For a fucking communist, you know your baseball.”  “I was a fan,” Rodney said. ”That’s crucial.  They couldn’t have hired just an ideologue to run the campaign. You had to know baseball.”

The integration campaign was not the limit of the Worker’s innovative baseball coverage. By 1938 the Americanization of the party had progressed sufficiently to allow it to engage New York Yankee third baseman Red (hair, not politics) Rolfe to cover the World Series from a player’s point of view.

“I’d go up to Yankee Stadium after a World Series game and I’d jump in the locker room,” Rodney remembers, “I’m in a hurry. Our deadline is the earliest of any of the papers and so I’d try to speed things up.  I’d say, ‘Red, that was pretty much a key moment when Crosetti decided to go to third instead of going for the doubleplay’ and he’d say, ‘No’ — you couldn’t speed him up — ‘No, no, no.  I wouldn’t say that at all.’ And he painstakingly would go into his own view of the game. This guy was a Dartmouth College graduate; he had just got married and wanted to show his wife that he was more than just a jock. That’s why he agreed to do it for the nominal payment we could afford. He took great pride in these things.”

First hand post-season coverage has now become a commonplace, but “As the Communists used to say, ‘It’s no accident that we did it first.’ A lot of papers didn’t think of ballplayers as having brains. We went to the boxers and the ballplayers themselves and got their feelings. We probably sometimes exaggerated it and added proletarian horseshit about it, but still …”

Joe Louis (by Van Vechten)

Rodney once introduced heavyweight boxing champion Joe Louis to novelist Richard Wright, author of Native Son. “Joe Louis was training at Pompton Lakes, New Jersey. Sportswriters were invited to go to these things as part of the pre-fight publicity, so I told them I had a guest along, a rather well known writer. Louis and Wright had about twenty minutes alone. Apparently Louis had once seen a collection of Wright’s stories, so he knew about him. Richard told me on the way back that although he wasn’t formally educated Joe was no fool and that they’d had a fascinating discussion. Wright wrote about it somewhere, although at this point I don’t remember exactly where.”

Since Rodney usually operated as a one-man sports section it might take him a while to get to every sport, but there wasn’t much he missed. Given that more than three out of every four current National Basketball Association players are black, it may surprise some to know that there ever could have been an issue about letting blacks play the professional game, but there was. And the Worker was in the middle of it.

“Joe Lapchick, who was the center on the original Celtics, coached the Knickerbockers, the first New York professional team, and his son Richard later told me that his father, a devout Catholic, said ‘That damned Daily Worker has done more good helping me to get Sweetwater Clifton (the team’s first black player) on the Knicks.’  This came after Jackie Robinson and it just flowed out of it. There was no big fuss about it. We wrote about it, but not in a scolding way as if the Knicks are the only sinners. There was actually more work done on basketball integration in Boston (where the Celtics signed the first black NBA players) than in New York.”

And, of course, there could be no good communist journalism without an international dimension. The Worker promoted the now largely forgotten Games for Spain, mostly basketball games held in New York’s old St. Nicholas Arena with proceeds going to the Loyalist side in the 1936-39 Spanish Civil War. As Rodney recalled, “Spain was just not a Communist cause. Any decent
person with humane liberal impulses who didn’t think that the government of Spain ran around butchering nuns was for the Loyalists against Franco, Mussolini and Hitler. So we got a lot of top college players who liked the idea and responded to a call to do something beyond just playing for their coach. One game we had a member of the original Celtics, Wee Willie Marron who had become a Communist organizer in New Jersey, put on a shooting exhibition at halftime.”

After several passport rejections and a Washington Post editorial mocking the State Department’s apparent fear of a Communist sportswriter posing a threat to American interests abroad, Rodney was finally cleared to cover the winter games in Cortina d’Ampezzo, Italy, the first Olympics of any kind with athletes from the Soviet Union. Ironically, this trip gave Rodney his first exposure to the events that would cause his resignation from the Daily Worker and the Communist party before the next year was out.

“This was January and February of 1956. The twentieth Congress [of the Soviet Communist Party] at which Khrushchev threw the book at Stalin wasn’t until later that year. I stopped in Rome on the way to the Olympics and went to the Communists’ paper L’Unita, which was the biggest paper going in Italy. They wined and dined me and I met some party officials. The Italian Communists were always way ahead of us and they said, ‘What do you think about what’s going on in Russia?’ I said, ‘What’s going on in Russia?’  They said, ‘You don’t know what’s going on with Stalin and Khrushchev?’ They had the vibrations. Togliatti, the Italian leader, had been edging away from the hard Stalin line for years. They made us look like the rigid simpletons we were in the United States.

“We had a Communist party convention in 57, the famous convention in which the forces behind [Daily Worker editor] Johnny Gates wanted to transform the party and get the Soviet monkey off our back. That was our last gasp, but the good people were already leaving from despair. It was a psychological jolt to leave, but it wasn’t as painful for us as it was for the unknown heroes who had quietly left earlier. We were going out in a groundswell of popular opinion against what had become evident, so you know we were no great heroes in that sense.

“The real story which has never been investigated at all is the people who discerned all this years earlier and without leaving their ideals or becoming right-wingers or anything, suffered the blows and arrows and had their personal lives ruptured and sometimes their own families broken apart.  The people who left when the Duclos letter came [In 1945 a French Communist, Jacques Duclos, criticized the American party in an article that was widely assumed to indicate Soviet disapproval as well and resulted in the ouster of "twentieth century Americanism" party chairman Earl Browder in favor of hard-liner William Foster] or when the [1939 Nazi-Soviet] Pact was signed – those are the heroes and heroines. I always thought about that. I wished that I’d had the time and the energy and the will to look them up – to tell their story. It’ll never happen now; it’s too far gone.”

Statue of Pee Wee Reese and Jackie Robinson, Coney Island, Brooklyn, NY

But for all his regrets regarding the Communist Party, Rodney never counted among them the goal of social equality that led him to join in the first place. Nor did he have any difficulty finding political relevance in events of half a century ago. He gladly explained his belief that Brooklyn Dodger shortstop Pee Wee Reese articulated the principles behind affirmative action years before anyone had given the theory a name.

“In 1947 when Jackie Robinson had first come up he was taking a lot of punishment because he had promised Rickey not to fight back, no matter what.  And the bad guys were taking advantage of him; Enos Slaughter of the Cardinals came down on his heel at first base; another time some little known shortstop for the Chicago Cubs pretended that Robinson had done something wrong sliding into second and jumped on top of him and began pummeling him and Robinson lay there until the umpires came and pushed the shortstop off. We sportswriters spent time in the dugout before games and knew some of the white players on the Dodgers were really troubled by what was happening. The discussions would go something like this: ‘Democracy means that everybody’s the same, so you treat everybody the same, so that means we don’t do anything special. You treat Jackie the same way as anybody.’

“Pee Wee cut a layer deeper and he scratched his Kentucky head and he said, ‘Yeah, democracy means everybody is the same, but things aren’t the same for Jackie because he’s the only colored guy and he’s catching special hell because of that, so maybe there’s a way we can make things the same for him.’ If that isn’t affirmative action! Here’s a baseball player saying this. That’s the special contribution of Pee Wee Reese.”

In 2007 I approached Rodney again for his thoughts on Robinson as the sixtieth anniversary of his major league debut approached.  He told me: “Today I’m curious as to whether Jackie Robinson means anything to a younger generation. The more I think of what he went through – he was a militant in the Army and at Pasadena Junior College – and he had the agreement not to fight back or even glare back for two years. Here was a 28 year old rookie – and you know that’s quite old for baseball – who had to submerge his personality.  He still won the pennant and the Rookie of the Year award. You know the Dallas Cowboys put red, white, and blue on their uniforms and said they were America’s team, but the Dodgers really were America’s team in those years. They won six pennants in ten years and it could easily have been eight, if Thomson hadn’t hit that home run and Dressen had put a runner in for Abrams. (The Dodgers lost both the 1950 and 51 pennants on the last day of the season.)

“He was an underrated American hero whose statue should be on the Mall in Washington, apart from the kind of ballplayer he was. So you ask why didn’t the Dodgers keep him as a coach? Could you see him coaching base running?  It’s because after the pact was over, he was truculent. He was an Eddie Stanky type. They held him to a double standard. They would have kept Campy after he retired because he was quiet. I was remiss in not doing something at the time.

“My respect for him has grown and grown over the years.  The effect he had on people! Carl Furillo, who wasn’t “going to play with any niggers,” at the end of the year was hugging cheek to cheek with him at the celebration when they won the pennant.  When he was invited to his first Old Timers Day at Yankee Stadium, he said, ‘I must respectfully decline until I see some progress in the front office of baseball.’”

Walter O'Malley, like Lester Rodney, went California Dreamin' in 1958 (picture by Richard Arthur Norton)

Rodney moved to LA in 1958, ironically the same year as Walter O’Malley turned Pee Wee and the rest of the Trolley Dodgers into Freeway Dodgers. “I wound up working for the Santa Monica Outlook for about a year and a half. A dreadful paper – we called it the Santa Monica Outrage. One condition of employment was that you were not a member of the Newspaper Guild. That was the year that [U.S. Senator William]Knowland was running for governor against Pat Brown. The Outlook wouldn’t let you use the company parking lot if you had a bumpersticker for Brown.”

In 1964 Rodney got a bit luckier, landing a job with the Long Beach Press Telegram, a Knight Ridder paper where he eventually became religion editor. “How did I become religion editor?  How does the real world work? The managing editor is unhappy with the religion pages and comes into the press room and says, ‘One of you guys has got to be able to do a better job. Rodney — you!’ I found it quite interesting; it was the time of the ecumenical movement. I was actually cited by the National Council of Churches for my coverage of churches and the Vietnam War.”

Eventually he caught the attention of the Los Angeles Red Squad who visited the Press Telegram in the hopes of getting him fired. Rodney remembered, “The managing editor, a Republican ex-marine, told them to get lost. By this point he knew me and he didn’t care what they had to say about me.  If they had gotten there when I had just started it might have been another matter” – Religion Editor Exposed as Communist!

But unusual as it was going from Communist sportswriter to religion editor, his 1975 retirement from the Press Telegram gave him the time to do something arguably even more remarkable — pursuing the second career in sports that caused a local newspaper to dub him the “George Burns of tennis.”  He joined the senior circuit at age 65 with mixed results, but reached #7 ranking in Southern California in the 70+ bracket. From then on he just outlasted or maybe outlived the opposition. At age 79 Rodney and his wife Clare moved north to be closer to their children, but he still teamed with a southern partner to become the top ranked doubles combination in Southern California in the 80+ category. As a singles player he reached as high as #2 statewide and #6 nationally.

Rodney kept his hand in journalism with the occasional article for the Rossmoor News, a weekly with a circulation of 8,600. In a 1995 piece he explained the secret of his tennis success: a player’s best chance for attaining high ranking in any five year age bracket comes in the first year when they are still relatively “young” and he predicted that “Come 1996 yours truly will magically metamorphose from a tired old 84 to a frisky young 85.” And sure enough, after winning his first two singles tournaments, Rodney finally achieved the number one spot — at age 85. Although he lived for another thirteen years, Rodney did not make a run at being the first champ in any higher age brackets, dropping out of the tournament scene out of consideration for his (now late) wife’s declining health.

When asked about his current politics at age 85, Rodney said, “That’s a constantly evolving thing. There was a period when I said ‘I don’t know what socialism is any more; they’re going to have to call it something else anyhow, after what the Russians did with it.’  Now I’m ready to say, ‘Why give away a good word?’ Democratic socialism in some form is going to come back. Capitalism keeps creating new radicals. You can talk to a 45 year old conservative who no longer feels secure in his middle-level corporate life and sees his company begin to hire temporary guys or people who’re just short of the hours needed for benefits. And they’ll be making money hand over fist and they’ll downsize to compete for the future – probably in Asia with cheap labor, with no thought about the people, no loyalty to the people. There’s still life in the old boy yet, but some time in the future – and the way history is speeded up it may not be all that far – there’s going to be more people questioning capital than even when the Communist Party was in its heyday or the Socialists or the Wobblies before them.

“There’s got to be a lot of thought as to what replaces it, including individual freedoms and the right to own property – you know, things that we didn’t take into account.  But I have no profound wisdom on the future. If someone asked me how you would most closely describe yourself now, I would say I’m a democratic, bill of rights, American socialist and not only that, I don’t completely say that everything that happened in the name of communism was bad, as some of the Eastern European countries that are reelecting communists are discovering.  They realize, ‘We had a certain certainty to life and a certain humanity toward old people and children and priorities of culture that we don’t even see now – it’s all money.’ Of course, they’re not going to go back to Stalinism.” And he did allow as how there were a few memories that seemed silly decades later: “I used to think there’d be great boulevards named after American Communist leaders, like William Z. Foster Boulevard and Elizabeth Gurley Flynn Street. The closest we came was Jack London Square.”

Since Rodney’s death the press has been all over the story of his role in integrating baseball. Wasn’t much like that when he was alive, though. But if the mass media didn’t pay all that much attention, there were those who did. Rodney recalled, “Nat Holman died in February [1995] at age 98 and his New York Times obituary mentioned the point shaving scandal that occurred when he was basketball coach at City College [of New York]. So I wrote a letter to the Times saying that it should be noted that point shaving didn’t just happen at City College, that it was widespread.  Two days after this appeared, the phone was ringing off the hook from New York … old CCNY guys congratulating me on writing this, saying that they had winced reading Holman’s obituary, as though it was only City College.

“One call was from a guy whose father was in the National Maritime Union and had told him about me. Then there was the guy at Newsday, the big Long Island paper. He was a young man; he didn’t know my name or my past. He said that my letter made him realize that his own paper was still running the point spread on basketball games and he was planning to go into the editorial board tomorrow and raise hell.

“And then I got one – and that’s where I’m going this afternoon –  from a guy who lives in Berkeley and reads the New York Times. He says, ‘Are you the Lester Rodney who was in Mindanao in 1945?’  I said, ‘Yeah.’ ‘52nd Field Hospital?’ – which is amazing because guys who were in the 52nd probably don’t even remember the number of the outfit. ’Yeah.’ And so he says, ‘Well, you were my nurse.’ He was an 18 year old infantryman. The army was still segregated then, but there was one black guy in the ward – this guy tells me – and his bed was positioned out of the way up against the wall and nobody was talking to him.

“I don’t remember the incident, but the guy from Berkeley remembers it clearly. Apparently I told him that I’m going to change the bedding around and he was going to be next to the black guy so he wouldn’t be isolated. It sounded like nothing to me but he said it was so revolutionary to him that someone who had ideals would put them into practice and explain them. And so I became a sort of hero to him and he never thought he’d see my name again. I was 34, a father figure to him.”

This was another point in our conversations when a voice came from the next room. “How do you like that story?” Clare asked, “I was on the upstairs phone; this guy was checking – ‘Are you so and so?  Were you in this place?’ And then there’s a pause and he says, ‘you were my nurse.’  I had goose pimples. I just wish I had a recording of that.”  Lester insisted “It’s not an uncommon story that guys get together many years later.” ”Lester,” Clare retorted, “after 50 years it’s an uncommon story,” at which point Lester attempted to put an end to the debate with the declaration, “Ah, we’re going to do it every 50 years.”

Although I actually talked with Lester on the phone only a week or so before he died, our last exchange that touched upon politics was in 2008 when he asked if I recommended buying a copy of Robert Service’s  “Comrades: A History of World Communism,” after I’d sent him a review of the book I’d written for the National Catholic Reporter, shortly before that publication opted for a less secular book review policy. Never too late to learn a thing or two. My favorite memory of him over the last several years is the holiday party where he told me that although he was no longer on the competitive tennis tour, he was still playing friendly doubles twice a week at Rossmoor and described the end of one recent match.

The opposing team and their ways were very familiar to him from past play and he knew that when his team hit the ball to a certain spot this particular opposing player would try to hit it to the alley on the opposite side of the court. “So it’s game point for us and I hit the ball to that spot and immediately starting running to where I know he’s going to try to hit it. He does just that and I get to the spot and flick it over the net and it’s a game winner. By now, my momentum has taken me all the way onto the adjacent court where a woman who’s been playing there has seen the whole thing happening on our court and says to me, ‘You’re not ninety!’ And I went home with a big smile on my face.”

You might call it rationing, but I call it common sense and logical decision making based on costs and benefits for health care procedures.  And I have a perfect example of a person who has experienced rationing in the UK and lived to tell about it – Me.

My Personal Health Care Story

As I have noted in my four previous articles at Demockracy.com, my view on this subject is based on my direct experience with the health systems both in the US and Europe. Unlike most pundits on this subject, I have worked and lived in the UK and the US and experienced both health care systems first hand, as an employee, as an executive,  as a corporate board member, as an owner, and, most importantly, as a patient.  Four years ago, I was diagnosed with cancer while living in the UK and received treatment and advice from both the US and UK systems.  The differences in the way these two systems treated my disease were telling – and at the end of the day the UK’s “rationing” system appeared to do everything the US plan offered at a fraction of the cost. Let me explain the detail.

In 2005, I was diagnosed with tonsil cancer while living in the UK. After my initial diagnoses and shock, I sat down with my UK doctors and discussed the treatment plan offered by the NHS. The proposed plan essentially consisted of the following:

1. A surgery procedure to cut the from my tonsil area and  a major neck dissection that would cut tumor surrounding tissue from the tumor and lymph nodes from my neck and shoulder area.

2.  Four weeks of rest to recuperate from the surgery.

3. Then, I would undergo seven weeks of focused radiotherapy to further eradicate pesky cancer cells in my neck and throat region.

4. And finally, in concert with the radiotherapy, I would receive several doses of chemotherapy over the same seven-week period to further blast away any cancer cells that had invaded my body.

All of that seemed perfectly reasonable to me; but to make doubly sure I was getting the correct treatment, I flew to the US to get a second opinion from a highly respected leading specialty hospital in New York. I was somewhat intrigued that this second opinion and treatment of the cancer were essentially the same as the NHS program.  Intrigued, because I was still under the impression that US health care was better–different, and that I would be offered a different option, perhaps more expensive, but perhaps with better outcomes.  But, no, the diagnosis and treatment plan were almost identical.

I followed the treatment plan in the UK – surgery, chemo, radio, all provided free of charge by the NHS. I have dual citizenship in the UK and the US and had lived in the UK for six years, so this was all perfectly within the rules of the NHS. And after 12 weeks of treatment, I was weakened and tired but satisfied that my doctors and I had done all that I could do to combat the cancer. So up to this point, there was essentially zero difference in the way a US or UK doctor would have treated me.

Now came the aftercare plan. I was told by both US and UK doctors that the tumor had a 50% chance of reappearing – a percentage high enough to cause me and my family many, many sleepless nights. Doctors on both sides of the Atlantic agreed that vigorous aftercare monitoring was needed to check to see if the cancer was to reappear. In the US, the doctors suggested that the best way to monitor a reappearance of the cancer was a series of PET /CT scans; they would use the latest and greatest technology to peer inside my body to see if the cancer had returned. They suggested a PET/CT scan once every six months for two years and then perhaps once per year until year 5.  In all, this would mean 7-8 PET/CT scans, which at about $4,000 per scan would mean a total cost of about $30,000.  That sounded like a lot of money, but, hey, – it was my life we are talking about, and there was a 50% chance of the tumor coming back so it sounded like a no-brainer to spend the money and get my ticket out of Camp Cancer.

I then met with my UK doctor and explained the proposed US treatment plan for aftercare. I still remember my doctor giving a wry smile that suggested there was a simpler way – (the smile also of someone who does not have a bottomless pit of money and funding).  She agreed with the need for close monitoring to see if the cancer reappeared, but then explained her treatment plan to me, which was decidedly low tech.  For the first year, she would have me back in her office every 60 days to perform a thorough physical examination. She explained that if indeed the tumor did recur, that 99 times out of 100 the tumor would reappear in the neck or throat area.  Since this area is relatively exposed and easy to see (down the throat with a scope) or feel (through touching and feeling the neck area), she would be able to see or feel the tumor before it gets to the size of one centimeter (maybe even a bit less, depending on its location) – which is about the same size by which a PET/CT scan can detect a tumor.  Furthermore, she explained, that although the PET/CT scans can be a very useful tool, they often can show false positives (white spots on the scan that turn out not to be malignant tumors), and these false positives will just lead to more aggravation and stress for both the patient and the doctor (and also more costs as the health system has to perform more tests to determine that a false positive is indeed false). Not totally convinced, I asked more questions about PET/CT scans and their use; my UK doctor then told me that if the initial tumor had been on an internal organ (the lung or pancreas for example), then the PET /CT scan would be a very useful tool, because if the tumor reappeared, it would be internal and not be in a place where a doctor’s visual or tactile examination could reveal its presence.

Upon further questioning regarding the benefits of the PET/CT scan, the UK doctor did accept that if in the 1 out of 100 chance that the tumor did reappear in another part of the body (not the neck or throat, but an organ such as the liver, the lung, or the pancreas), her physical inspection of the neck and throat area would not likely find the tumor and the PET / CT would give the patient an earlier indication that trouble had returned.  However, she also noted that if the tumor reappeared via PET/CT scan in the liver or the pancreas, that this early detection does not usually lead to a better outcome for the patient. Unfortunately, if the cancer is found in another organ in the body, this would probably mean the cancer had metastasized and was spreading throughout the body. The sad reality of this situation is that one can run all the tests and scans in the world, but in all probability the patient has terminal cancer, and now the question becomes not if but when – a sad conclusion, but medicine and health care do not always have happy endings.

Now I am generally a skeptic on such matters; and I was still operating under the mindset that the US health care is better than UK health care. But I listened to what the UK doctor said, and I believed her. After all, the UK’s public system had not skimped one bit when it came to the surgery, chemo, and radiotherapy – these are expensive procedures, but the benefit they provide is very demonstrable and intuitive.  But intuitively, the expensive aftercare offered by the US seemed to be a lot of work, effort, and technology for little result.  Indeed, I had “found” the initial tumor when I felt a “lump” on my neck about the size of a pea and it was relatively easy to feel once you knew what you were looking for.

The Costs of Health Care

And, being the accountant that I am, I did the math on the treatment plans.  The US and UK aftercare plans were similar in terms of trips to the doctors. However, to recap,the US plan included 7-8 PET/CT scans which would cost about $30,000. My UK doctor said that 99 times out of 100 a doctor’s visual/physical inspection would find the tumor as soon as the PET/CT scan.  But one time out of 100 the scan would find the tumor that had reappeared at some different part of the body – but even then, in most cases, the likely outcome for the patient was terminal cancer, and the doctors could prolong life for a bit, but the patient would be left with a similar outcome – terminal cancer and death. So for our sample of 100 patients in the US who opt for regular PET/CT scans in their aftercare treatment plan, they and their doctors will certainly feel better about all the money and technology that is being spent to combat the disease. However, these 100 patients in the US will cost the system about $3 million ($30,000 times the 100 patient sample = $3 million); and this extra $3 million will provide little or no benefit when compared with the low tech, low cost approach.

Now let’s go back to the US doctor who is presented with this argument; let’s say he or she agrees with the argument and uses the British, low-tech and low-cost method. Two years later, 50 of his or her 100 patients have cancer (50% recurrence rate in both populations) – of those 50 maybe 2 or 3 or 4 think they have been treated wrongly and decide to sue for malpractice. They engage a lawyer and spend a lot of money on courts and legal proceedings.  And ultimately the doctor has to stand in front of 12 jurors while a litigation lawyer – highly practiced in creating courtroom drama – will try to make the doctor look like a villain.  Undoubtedly, during testimony, the lawyer will pointedly ask the doctor this question: “So you decided not to use the PET/CT, a technologically advanced procedure designed to identify cancer at early stages, and you chose not to perform this test to save the company $3,000 – and because of your penny pinching treatment plan, the patient did not get all the tests available to medical science, and now my client is dying of cancer because you would not allow the PET/CT scan?” These words may not be exactly true, but the lawyer is very good at bending and stating the facts in such a way to garner sympathy for his client. (And who really can blame him; he is simply doing his job.)

So the US doctor contemplates the legal scenario above … and guess what – he or she decides to order the PET/CT scan, and by the way, when he/she orders the scan he/she also gets to charge $500 to the patient to read and interpret the scan report – just another little incentive to do more not less. But who can blame him/her: he/she correctly justifies decisions as helping to save lives, reducing threats of litigation, making patients happier, and making a bit more money.

Back in the UK, the doctor has little or no liability from litigation, for a whole series of reasons. The most relevant is that the NHS has done the cost/benefit analysis and clearly sets treatment protocol based on this logical cost/benefit analysis. The doctor did it by the book, so there is little chance of liability.

And, finally, let’s look at is from the patients point of view. I imagine many may accept the logic of this argument. However, when it comes down to individual decisions on whether to do the PET/CT scans, many will still opt for doing the tests – nothing wrong with that – it’s a  free country.  But what the patient should decide is whether he or she is prepared to spend $30,000 of his or her own money to do these tests. I personally do not want to spend my tax dollars on a government run system that spends this kind of money for tests or programs with little or no benefit.  So the patient can bankroll this $30,000 option by either dipping into his or her savings or opting into a fancy, pay-all, private insurance plan with all the bells and whistles that will pay for such luxuries.  The cost of such an insurance plan will undoubtedly cost several thousand dollars more per year, but you get what you pay for.

Now back to the math and the big picture of US health care. In our little sample of 100 throat cancer patients, the US system spends approximately $3 million more than the low-tech approach. Across the country, in the US, about 30,000 people per year are diagnosed with tonsil/throat cancer. So expanding our sample from 100 to 30,000 means the US spends perhaps $900 million on PET/CT scans for throat and neck cancer patients per year, and this extra money provides little if any benefit in patient outcomes. $900 million is therefore largely unnecessarily spent in the US for this one little disease category. The American doctor often opts for the more expensive, more technical solution, not so much for the welfare of the patient, but so he or she is seen as doing as much as he/she can do when dealing with patients who are ill. This makes the patient happy, the doctor happy, the health care companies rich, and feeds into the common misperception in US medicine that more invasive care equates to better care.

$900 million – almost $1 billion spent with no recognizable benefit for one condition.  And as the saying goes, “a billion here and a billion there–pretty soon we are talking real money.” And this one economic example, repeated over and over for other disease categories is certainly one of the major reasons that the US spends twice as much per capita on health care as most other developed countries with no demonstrable benefit to the population.

Rationing of health care services – bring it on.  Let’s stop spending money on health care treatments which do not provide a real benefit.  More money does not always mean better care.

You might call it rationing, but I call it common sense–making logical , informed decisions about health care procedures is an achievable goal that can make health care affordable to all Americans.  So let’s look behind the scare tactics and buzz words and do what is right and allow for Affordable Health Care for all Americans.

As it turns out, the partially read copy I checked out from the library is now long overdue and since I can’t renew it, my intended “book review” must be much more limited than I hoped. More complete reviews and information about the book can be found here, here, and here. I will provide a limited review, but what is even more interesting to me is that much of what played out in China in 1989 looks in certain ways similar to what has been happening in Iran since last month’s disputed presidential elections. Consequently, Zhao words take on a gravity and relevance beyond the events he discusses in his book.

Prisoner of the State

Prisoner of the State is the journal of former Communist Party General Secretary Zhao Ziyang. Zhao was General Secretary at the time of the crackdown at Tiananmen Square and was placed under house arrest for his determined opposition to the violent, repressive action ordered by the Party’s hardliners. While in seclusion, Zhao secretly recorded his journal onto tapes smuggled out of the country after his death in 2005. These tapes were then complied and published as Prisoner of the State.

Zhao’s journal begins with a vivid description of the weeks leading up to the June 4 massacre in Tiananmen Square. He details the political back and forth between himself and other Communist Party leaders as they struggled over how to deal with the unprecedented protests which gained strength daily. The demonstrations began as a chance to mourn the death of a popular reformer within the Communist Party. They quickly became a chance for students, and later all segments of urban Chinese society, to vent their frustration with political corruption and to demand democratizing reforms. Zhao’s position was that by empathizing with the students’ demands, making limited reforms, and treating protesters with a soft touch, the protests were sure to die down and that they did not pose a serious threat to the Chinese state or the Communist Party. Chinese leader Deng Xiaoping was swayed by the party hawks, who saw a show of force as the best way to end the protests, reassert the Party’s power, and strengthen Deng’s standing.

The tragic events of June 4, 1989 resulted in the deaths of hundreds of protesters and the end of Zhao Ziyang’s life as a respected politician. While Zhao endured nearly two decades of confinement, China advanced along the liberalized economic path he had championed. Unfortunately, Zhao’s silencing after Tiananmen Square also meant the silencing of those politicians who had advocated political reforms and the continuing rule of a small political elite within the Communist Party who resolved to remain in power no matter how ruthless the means. By the end of his life, after years under house arrest, Zhao had come to support political ideas far more radical than those he held in 1989. In Prisoner of the State, Zhao argues that China must have a free press, an independent judiciary, additional political parties, and ultimately parliamentary democracy.

Reading Zhao’s words against the backdrop of the popular political unrest roiling Iran made them even more relevant, shedding light on what might currently be going on in Iran. The two situations are similar and quite revealing, though probably not in the ways most Americans think. Most Western media accounts of the recent Iranian protests have interpreted events extremely sympathetically, and as a grassroots uprising against reviled President Mahmoud Ahmadinejad, the religious conservatism of Iran’s Shiite clergy, and the repressive security forces of the Iranian state. The truth is quite a bit more complicated however. Serious political analysis of the crisis has been eschewed for glowing personal narratives and the drama of violent clashes between students and government militias. I would even go so far as to say that the picture painted by the Western media is one that it desperately wants to believe – that wants its own fantasies of a secular, non-threatening, US-friendly Iran sans loud-mouth anti-American leader to be validated by the opinions of the Iranian people.

Another Zhao?

However, what has been happening in Iran, and what happened in China in 1989, is not a full-scale popular revolt aiming to overthrow an existing government. In Iran and China, domestic protesters have had different goals and motivations for opposing their political leadership than outsiders have. Both sets of protests were possible only because there was an existing political split within the ruling powers over how to govern their respective countries. In both cases, the protests began as a show of support for political factions that showed more tolerance for dissent and change within the existing political framework. In China, Zhao represented a moderate, reformist political group of the ruling Communist Party. In Iran, presidential candidate Mir Hossein Mousavi claims to represent a similar reformist, moderate wing of the political elite. However, what is happening in Iran may just be factional fighting with little real ideological change at stake. Mousavi – who appears more interested in fighting for his own political advancement – doesn’t appear to be the reformer Zhao was, and Western hopes that Mousavi would magically give up Iranian nuclear ambitions and live in peace with Israel and the US appear completely misplaced. Mousavi has been strongly supported by certain members of Iran’s ruling Shia clergy (particularly Ayatollah Rafsanjani) who detest Ahmadinejad for his attacks on their corruption and privilege. And though foreign media sources depicted Iran’s protests as massive public outpourings of discontent, it is fairly obvious that the protests were limited to educated upper-class students in Tehran and a handful of larger cities. Their demands are certainly not insignificant, but their point of view doesn’t seem to represent a majority of Iranians. The rural poor seem to have again backed Ahmadinejad at the polls. And, despite Western desires, demonstrators are hardly calling for a toppling of Iran’s religious leadership or an overthrow if the ideals of the 1979 Islamic revolution. Indeed, Mousavi’s strongest backers are certain members of the clergy themselves.

In any case, Prisoner of the State illuminates the hidden political complexities that can exist in any country at any time – be it China, Iran, or the US. It also provides a powerful lesson for those who wish to create simple, moralizing narratives out of events that are vastly more complex than most people know at the time they are occurring. We live in a mediated world, but the story the media tells us is rarely the whole story. Zhao has done us all a great service by smuggling his words out of China. They remain relevant as a challenge to repressive regimes that deny their citizens basic human rights, and as a reminder to each of us to think more critically about the world around us.

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.

Bigger isn't always better

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.

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.

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.

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.

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.

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.