Whither Healthcare?

“Now, I have to tell you, it’s an unbelievably complex subject. Nobody knew health care could be so complicated.”  — President Donald Trump 27 February 2017

And you know what?  He is correct.

As the Senate debates and votes on Trumpcare to repeal and replace Obamacare over the coming days, much will be written and talked about regarding its impact and efficacy.  Some will think it is great and others will think it a travesty.  It all depends on what the goal for the program might be and how one thinks that goal should be attained.  Is Trumpcare, or the American Health Care Act (AHCA) (as it is called in the House of Representatives while the Senate Bill is called the Better Care Reconciliation Act of 2017) designed to help Americans and keep them healthy or is it an attempt to do the bare minimum while saving the government, and ultimately tax payers, money?  One’s view of Trumpcare also depends on whether or not Obamacare, or the Affordable Care Act (ACA), is working for you.

Put more succinctly, is healthcare in the greatest country on earth a right or a privilege?  Should it be open to a free market — those that can afford to pay do, those that can’t need to earn more money — or something that every citizen deserves?  If you happen to think that healthcare is a privilege, you get what you pay for, then you may as well stop reading here because you basically think that the government should have nothing to do with healthcare.  If you think that access to healthcare should be a right, then read on. Be forewarned however, that this is, as the president says, complex. Politicians of every stripe also parse and obfuscate elements of healthcare to their own advantage. It can be difficult to determine where the truth lies — especially since many times two people can both be technically correct while interpreting the meaning in totally different ways.  As I like to say, it is the difference between what things are and what things mean.

Here is the crux of the problem.  The United States does not suffer from poor medical care.  People come from all over the world to have their health problems resolved here in the U.S. — if they can afford it. That is the problem.  It is not the quality of care, but rather having access to good care and being able to afford it. Access and affordability are the reason we need insurance plans which is what both Trumpcare and Obamacare are really about.

The U.S. does not really have a health system.  It has a series of health systems depending on whether the individual is on Medicaid or Medicare (the dreaded by conservatives single payer system), or on the VA or Tricare (military) system (basically socialized medicine), or gets insurance through an employer (where most people get their insurance), or buys it on the open market (usually very expensive).

A pervasive goal in the U.S. should be that no one goes bankrupt due to an unexpected illness or injury. Likewise no one should have to forgo medical treatment because they cannot afford it.  Both happen in the U.S., although by most accounts, Obamacare went a long way in reducing the numbers of people in either situation.

So let’s design a system that helps people get care without using their every last dollar.  Let’s assume we want a system where no one can be turned down — or charged unattainable amounts of money — for a pre-existing condition.  This seems to be one area that most politicians can agree upon and one of the most popular aspects of Obamacare.  How to do that?  It does not take a genius to see that maybe I won’t buy any insurance until I get sick or injured and I will save a lot of money in the meantime.  That leaves only those with pre-existing conditions on the insurance rolls — a situation which will either leave the premiums so high as to be unaffordable, or leave the insurance companies holding the bag and going bankrupt.  To even out the costs and make them more affordable to all, we would then require everyone to have insurance — the dreaded mandate. However, it may not be fair or even affordable for everyone to buy insurance, especially for people that do not receive insurance through their employer, so if we are going to require it, then we should come up with a system to help people pay for it — the other debated aspect, subsidies. Those three elements are the basis for every proposed health care plan concocted by politicians.  If you play around with one of the three, it impacts the other two.  It becomes a very complicated game.  How one plays the game depends on my opening statement — what is the goal for the plan?

On top of that throw in hot button issues such as who can do what (Planned Parenthood anyone?), whether in our proposed system we “punish” young healthy citizens by making them subsidize the old “sick” citizens, should the government have the power to tell people that they “have” to have insurance, and who pays for all this, the wealthy or the poor who are most likely to benefit from a plan like this.  It does indeed get complicated in a hurry, and also very emotional for a lot of people.

In evaluating a planned system, lots of politicians focus on premiums and deductibles — and not always together.  It is possible to devise a plan with very low premiums, lower than Obamacare, but does it cover everything?  Does it have a high deductible?  Does it have annual or lifetime caps? What pre-existing conditions are covered?  Those and other details mute any discussion about premiums.  To coin a phrase, we cannot compare apples with oranges.  Premiums are certainly relevant when discussing the cost of a particular plan, but it is not sufficient to get a true picture of the impact or value of that plan.

To muddy the issue, the president makes unfounded claims about Obamacare.  He says “it is dead.” Except it isn’t.  But the president and the Republican leadership are trying hard to kill it, partly to force through Trumpcare.  Insurance exchanges are drying up and companies are pulling out because of the biggest fear they have — uncertainty.  The Congress has yet to decide if they will provide the money for the aforementioned subsidies to help people afford the mandated insurance.  And they have announced that they will not enforce the mandate.  Two of the legs of our three-legged plan are being distorted, that means the third leg is terribly out of balance which makes it appear the system is not working.  If insurance companies don’t think they are going to get paid — or that they will be left holding the bag for high cost pre-existing conditions which they are required to cover — then there are two choices.  They can raise premiums or leave the market.  Most experts assert that without the uncertainty coming from the White House and Capital Hill, the health insurance system in the U.S. would be stable and hold down costs for most (most — not all) Americans seeking health care.  Many people now have insurance that would not otherwise have it.  The result is “wellness checks” and other preventive health measures now sought out by people that did not seek it before.  Therefore they are healthier and the over all expenditures for larger, more catastrophic care comes down because they are less necessary.  Like it or not, the states that expanded Medicare under Obamacare generally have more small hospitals and clinics serving the poor or rural areas of their states because those hospitals have a known source of income for the care they provide.  Many of those small hospitals and clinics closed in states that did not expand Medicare and there is significant concern over the reduction of those Medicare funds under Trumpcare.  In mostly rural states such as Alaska and Maine, even their Republican Senators are concerned and may vote against the proposed Senate bill.  Senators Murkowski and Collins both realize what the proposed reductions in Medicare mean to their states and are worried, as are others.

Whatever your own views on healthcare in the U.S. take a good hard look at any plan floated to solve the problem.  I am no expert on this subject.  Not at all.  I recognize that we do not have a bottomless purse to pay increasing costs for social programs.  I get it.  Personally, I think we leave a lot of possible solutions (such as a single payer system which prevails in many modern nations, such as Canada) on the table because of emotional political arguments rather than a factual airing of the pros and cons to different solutions.

It boils down to one’s personal views.  Do you get what you pay for and if you can’t pay you don’t get it? Or should the greatest nation on earth also provide the best healthcare available to its citizens?  If so, how is it paid for?  There are no easy answers, but I think we are making it harder on ourselves than needed.  Democrats and Republicans state that they both have the same goal — to make healthcare available to our citizens and at a cost that is sustainable.  If that is the case, then everything else is politics.

To me, we have a system for providing affordable care through an insurance program called the ACA — Obamacare.  No one thinks that system is perfect.  Democrats affirm that they are willing to work with Republicans to fix what needs to be fixed.  Republicans shout that Democrats are obstructionists while jamming through a bill that even most Republicans did not get a chance to look at.

You can look it up, you don’t have to take my word for it, but in putting together Obamacare the Democrats took nearly a year, held countless hearings, folded Republican amendments into the final bill, and tried to put together a bipartisan bill.  Politics interfered at the end of that process and one could argue that Democrats jammed it through at the end.  But contrary to what you now hear, it was not a secret process and it wasn’t a slap dash final product.  I am not sure what the rush is in the Republican held Congress at this point.  This is major legislation that will impact many Americans and a large chunk of our economy. There is no need to play hurry up ball at this point.  Every piece of legislation has some perverse and unintended consequences.  Obamacare has some.  Trumpcare certainly will if it has not been properly vetted and reviewed.  It is too important to just slam through, whether or not you support the fundamental political and social theories behind it.

This process is not in the best interests of our country.  I hope that cooler heads prevail and that everyone takes a step back.  Take a deep breath.  Let’s regroup and come forward with a bipartisan approach to helping every citizen find effective and affordable healthcare.

I’m not holding my breath.


A Burning Fuse

As you probably heard, on Sunday a U.S. Navy F/A-18E Super Hornet shot down a Syrian SU-22 Fitter ground attack bomber.  This was the first air-to-air destruction of a piloted aircraft by the U.S. since 1999 and the second by a NATO aircraft in the region following the November 2015 shoot down of a Syrian SU-24 by a Turkish Air Force F-16.  Both Syria and their ally Russia immediately protested the action.  In addition, the Russians declared that any U.S. or coalition aircraft flying “west of the Euphrates River” while Russian or Syrian aircraft are in the area “will be considered air targets” and subject to attack. Today, a U.S. F-15 shot down an armed Iranian drone, the second one this month.

While none of the participants in the many-sided Syrian conflict desire to go to war with each other, and certainly the Russians and the U.S. do not war, the conditions are very volatile in a confined geographic area.  This is a dangerous situation that is very susceptible to a mistake or miscalculation by one of the parties leading to a hot war, or at least a serious shooting incident.  In short, it is a burning fuse that needs to be snuffed out before reaching the explosives.  Given the conflicting goals of those involved, that may be difficult.  The situation is exacerbated by the Russian withdrawal from a de-confliction protocol whereby U.S. and coalition aircraft communicate with Russian aircraft to warn and alert each other of their locations and missions.  Negotiations are underway to restore that protocol. This is the second time that the Russians withdrew from it, the first coming after the U.S. Navy cruise missile strikes against a Syrian airfield last April.  The relationship then was shortly restored.

The shoot downs occurred following Syrian and Iranian attacks on U.S. backed anti-Syrian forces fighting the dictatorship of Bashar al-Assad.  Some coalition advisers were near the forces attacked from the air.  Following several warnings, the U.S. says it acted in self-defense.

It is difficult to tell the players without a score card.  In short, the major players in Syria are Russia, the United States, Turkey, Iran, the United Kingdom, and France.  Supplying arms and money to the anti-Assad regime are Saudi Arabia and Qatar.  (Remember also that Saudi Arabia and Qatar are involved in their own dispute which resulted in the isolation of Qatar from the outside world.  Both are allies of the U.S. but the dispute is serious and involves Qatari relations with Iran, which is engaged in a major struggle with Saudi Arabia for dominance in the region.  And, oh by the way, one of the major airfields used by the U.S. in the fight against the Islamic State (ISIS) is in Qatar as is the air control headquarters and the Forward Headquarters for the U.S. Central Command.  It’s complicated.)

U.S. and coalition forces are mainly fighting from the air, with some U.S. Special Forces on the ground training and advising various militias fighting against ISIS and covertly supporting those aligned against the Syrian regime. Russia supports the Bashar regime and both Russia and Syria consider any group inside of Syria fighting against Bashar’s forces as “terrorists.”  This includes those supported by the U.S. coalition.  The Russians claim to be fighting ISIS but in actuality they are going after the “terrorists” that oppose Bashar’s regime, which was the case with the recent aircraft and drone attacks leading to the shoot downs. Turkey also opposes the Bashar regime but also opposes the Kurdish PKK (The Kurdistan Workers Party), a group fighting for a Kurdish state carved from Turkey, Syria and Iran.  The PKK is considered a terrorist group in Turkey, but many of the forces that have liberated parts of Iraq and Syria from ISIS are other Kurdish forces trained by the U.S.  Iran supports the Bashar regime, but also opposes ISIS.  Iranian forces and militias are fighting in Syria in support of the regime and in Iraq, in conjunction with Iraqi troops, to root out ISIS.  Iran also supports Lebanon’s Hezbollah which is fighting in Syria to support Bashar.  In something of a proxy war, Saudi Arabia and Qatar are aiding anti-Bashar forces with money and arms, even as they have their own dispute and Qatar is friendly to Iran.

Got all that?  And the country is about as big as the Middle Atlantic states — roughly Richmond to New York City and Pittsburgh to the west.

U.S. policy in Syria has been and is muddled.  Since taking over in January, the Trump Administration has not articulated a clear policy or strategy towards Syria.  Our focus is primarily on defeating ISIS, an effort that is slowly but steadily eliminating their caliphate in Iraq and Syria.

The lack of a clear strategy in Syria is reflected in the April cruise missile attacks.  At the time, I applauded President Trump’s decision to express our dissatisfaction over the Syrian use of chemical weapons.  But it was only a one time strike to “send a message” and had no real long-term ramifications or follow-up.  There was no strategy behind the strikes.  (One way to tell the seriousness of such a military attack is the longevity of the action and the targets chosen.  If we really wanted to punish Bashar’s regime the attack would have been centered on Damascus and gone after the Interior Ministry or Ministry of Defense in order to make the decision makers pay a price.  Instead we destroyed some aircraft at a remote air base.  To truly take on a larger military operation — which I am not advocating — it would have been a much more serious decision that could lead to direct military conflict with Syrian forces, and conceivably Russian forces. While we are concerned with the humanitarian conditions in Syria, it is not currently our policy to resolve the Syrian conflict through combat.)

The take-away from all this is that the Middle East continues to be a tinder box that could go from a smoldering problem to a conflagration without much effort.  Despite bluster and name calling, neither the U.S. or Russia want to see the situation escalate — especially against each other.  But both nations need to be very careful as other players in the region could relish such a situation in order for them to meet their own priorities and interests, not the least of which is to diminish the stature of the United States in the region and in the world.

These are dangerous times that must be taken seriously.  While we are focused on our own internal daily struggles and tweets, we also must keep our heads up and our eyes on the ball.  The rest of the world is busy pursuing their own agenda.  If we want to be part of events that shape our future, then we must pay attention and clearly state our own goals.

 


The Battle of Midway Island

Yesterday, 4 June, marked the 75th anniversary of the Battle of Midway Island in 1942 where the U.S. Navy defeated the Imperial Japanese Navy and reversed Allied fortunes in the Pacific campaign. Prior to the battle, the Japanese were on the offensive throughout the Pacific area.  Following the battle, they fought a series of defensive operations and steadily retreated back to the home islands.

In a nutshell, the battle entailed an all-in strategy by the U.S. commanders, Commander-in-Chief Pacific Admiral Chester Nimitz and the tactical commanders Rear Admirals Raymond Spruance and Frank Jack Fletcher.  Thanks to cryptologists that broke the Japanese code, the U.S. was aware of the Japanese plan to attack Midway Island and presumably, remove the U.S. from any further ability to thwart Japanese expansion.  The attack on Midway was accompanied by a nearly simultaneous (due to circumstances the attacks were actually a day apart) on the Aleutian Islands in Alaska — an attempt to remove U.S. Army Air Corps aircraft from being in range of the Japanese home islands.

In the battle four Japanese aircraft carriers went up against three from the U.S. Navy.  In short, all four Japanese carriers — Akagi, Kaga, Hiryu, and Soryu — sank, along with the resulting loss of airplanes, pilots and crews.  They also lost a heavy cruiser, a destroyer, and other ships were badly damaged.  The Japanese Navy was never able to recover from those losses as their industrial capacity simply could not replace what was lost, along with the lack of seasoned pilots.  The U.S. Navy lost one carrier, the USS Yorktown and one destroyer.  Military historians such as John Keegan call the victory “the most stunning and decisive blow in the history of naval warfare.”

Without going into all the details of the battle, it is apparent that there many instances of heroic actions. In our present days of troubled times and divisive political arguments, I find it worthy to focus on a small, but significant portion of the battle.  I trust that today, we can find men (and now women) that hold the same high level of selflessness, courage and devotion as those of the torpedo squadrons of the Douglas TBD Devastators from VT-3 on Yorktown, VT-6 on Enterprise, and VT-8 from the Hornet. These airplanes flew low and slow in order to attack surface ships with torpedoes.  In order to get the torpedo on target, it meant a long, slow, straight approach into the teeth of the Japanese air defenses.

The Devastators were on their own due to inexperience on the part of the American commanders coupled with the desire to strike the Japanese first.  Therefore they launched their aircraft piecemeal which resulted in an uncoordinated attack by the torpedo bombers without fighter escorts.  They were doomed.  Of the forty-one aircraft launched, thirty-five were lost attacking the targets, with no hits against the enemy.  On each of those airplanes, a three-man crew piloted and fought the aircraft.  A heavy loss of life.  The aircraft was never used again in battle in the Pacific.

Their sacrifice secured the victory because while the Japanese were preoccupied with the torpedo bombers, they became confused as to the big picture.  This allowed the Navy’s dive bombers and remaining fighter escorts to arrive over their targets virtually undetected and caught the bulk of the Japanese aircraft on the deck of the carriers while refueling and rearming.  Three Japanese carriers were destroyed in about five minutes and the fourth sank from its damage later in the day.

The pilots and crews of the Devastators did not think that they were on a suicide mission.  No one expects anything bad to happen to them, individually, when on a mission.  Yet, they understood the odds and that they weren’t good.  By the time of the battle, the U.S Navy knew that the aircraft was obsolete and vulnerable, but no replacement aircraft had yet made it to the fleet.  Additionally, once over the Japanese fleet they knew that they were alone, without fighter escort, and had no idea where the dive bombers might be.  They knew that the plan, a coordinated attack with all forms of aircraft striking the Japanese simultaneously was out the window. They were on their own.  And yet, they went forward, alone.

As we argue over less important issues today, it serves us well to remember the sacrifices made by those that went before us.  They knew that they were involved in a cause bigger than their individual lives, and they knew that only true sacrifice would carry the day.  Along with our thoughts as a grateful nation, we should also step back and think of our own lives and ability to follow in their foot steps.

We can all benefit from their selfless example.


We’ll Always Have Pittsburgh

I was elected to represent the citizens of Pittsburgh, not Paris.

— President Donald J. Trump on 1 June 2017

As most of you know, President Trump announced his intention to withdraw from the Paris Climate Accord during a speech in the Rose Garden at the White House.  This announcement fulfills a campaign promise that he continually made in the run-up to the November election.  His base, and several close advisers clearly think that putting the United States in the same company as Syria and Nicaragua (the only other nations not in the agreement), instead of in the company of the other 195 nations that agreed to the Accord in December 2015, is a positive development.  Other advisers, including Secretary of State (and former Exxon-Mobil CEO) Rex Tillerson reportedly did not and advised the president to stay within the boundaries of the agreement. As a consequence, many misstatements were made about what was or was not in the Accord.  Somehow, it got caught up in an argument over whether or not climate change is a hoax, as the president continually claimed on the campaign trail, or is it backed up by a preponderance of evidence that human beings are contributing to the changing climate on Earth.

The main effort of the Accord was to reduce green house gas emissions.  These emissions are the root cause of rising global temperatures, which in turn are melting the polar ice cap, shrinking the ice shelves in Antarctica, and eliminating glaciers around the world.  As the world’s ice melts, sea levels increase putting coastal land, and many island nations, in danger of being covered by water. Will this happen tomorrow or even next year?  No.  However, 196 nations (until the U.S. announced its withdrawal) agreed that it was a real and present danger to life as we know it on this planet. Long-term problems need long-term solutions, and that was the aim of the Accord.

In my view we can restate it another way.  Forget about arguments for or against climate change. Put it in terms of being pro or anti pollution.  Who is for more pollution?  Apparently, the president and his key advisers such as the Administrator of the Environmental Protection Agency (EPA) Edward Scott Pruitt and White House Chief Strategist Steve Bannon who reportedly convinced President Trump to leave the Accord.

Rather than looking at the Accord as a positive thing for the citizens of the United States and all living things around the world, the president put his opposition to the agreement in economic terms.  To me, this is a short-sighted vision that provides misleading hope for the future for those struggling in the economy with mining and manufacturing jobs that are disappearing whether or not the U.S. remains in the Paris Accord.  The president also claims his decision is a matter of sovereignty and a chance to keep “others” from telling us what to do in our own country.  Or as the president said, “As of today, the United States will cease all implementation of the non-binding Paris Accord and the draconian financial and economic burdens the agreement imposes on our country.”  Apparently no one told him what “non-binding” means and also forgot to inform him that the agreement does not set any burdens on any country outside those that the individual countries voluntarily agree to for themselves.

This is what makes the president’s announcement extremely puzzling.  Under the Accord, each country sets its own commitments with the common goal of “holding the increase in global average temperature to well below 2 degrees C above pre-industrial levels” which is intended to begin to reduce the long-term warming trend rather than stop it, but more on that in a minute.  The point is that if President Trump did not agree with the goals laid out by the Obama administration, under the terms of the Accord, he could change them.  He did not have to leave the agreement.  This makes his statement that “we’re getting out, but we will start to negotiate, and we will see if we can make a deal that’s fair” even more preposterous.  He is not going to get 195 nations to renegotiate.  And it isn’t necessary, just adjust the commitment under the terms of the existing agreement.  I cannot decide if he is being purposely misleading or if he does not understand what he is talking about.

This is a central point for understanding why it is bad policy for the United States to withdraw and makes me believe that the move was intended as an “in your face” insult to the Europeans (thus the reference to the citizens of Paris) and a purely political decision to appeal to the hard-core base that voted for him in 2016, rather than truly thinking about the long-term needs and welfare of our citizens.

This is also reflected in his claim that the United States could not build new coal plants but China and India can, and will, thus somehow depriving the U.S. of the coal-burning market.  Wrong again.  As has been repeated,  the agreement is non-binding, and also has nothing in it that prohibits the United States from building coal-burning plants and it has nothing in it that “allows” China and India to do so. To so state is purely political demagoguery, or ignorance.  In the United States, coal plants are being replaced not because of EPA regulations or because of the Paris Accord, but because of market forces — mainly, because of the abundance of natural gas at cheaper prices.

Coal jobs currently number about 50,000 according to the Bureau of Labor Statistics.  Nearly universally, economic analysts say that the combination of natural gas and technological advances in mining mean that number will not grow, and is likely to decrease.  As pointed out in an article by Christopher Ingraham that number of coal miners compares to about 80,000 employees at Arby’s restaurants or the approximately 150,00 employed in the car wash industry. 50,000 is a drop in the bucket for our entire economy and not at all near the catastrophic impact that the president implies.

Clearly coal mining jobs are important to the 50,000 so employed, but dropping out of the Paris Accord is not going to help them in the future.  When the Pony Express went out of business because of the telegraph and railroads, those people found new jobs.  And so it goes throughout history — innovation and technological progress cause people to lose jobs, but new jobs are created.  For example, the energy efficiency industry had about 2,700,000 jobs in 2016 of which about 677,000 jobs were in the renewable energy sector (solar, wind, hydro, etc.).  President Trump should be putting effort into retraining and educating miners and others in dying industries to allow them to help themselves and the economy in the future rather than promising them a past in which they cannot long survive.

At the same time, those that find environmental issues important, and a threat to our survival, need to do a much better job at making the case.  When asked to choose between the environment and jobs as our president states it, many Americans will choose jobs every time.  It is important to educate voters and all our citizens about the importance of working towards improving our environment.  It is also important to explain and educate voters that a clean environment and jobs are not mutually exclusive. Indeed, environmentally related jobs are a growth industry and go a long way in reducing unemployment.  Railing and ranting will not convince others.  Education and reasoned arguments as to why we are better off under an agreement such as this one, including how it creates jobs (and not in the government bureaucracy), is important to our long-term goals and well-being.  Use this as a wake up call.

Without going through every portion of President Trump’s speech on departing from the agreement and comparing it with the actual Accord, there is one thing he got right — sort of — although it did not appear that he understood what he was saying.  He said, “Even if the Paris Agreement were implemented in full, with total compliance from all nations, it is estimated it would only produce a 2/10 of one degree – think of that. This much [held his fingers nearly close together] Celsius reduction in global temperature by the year 2100. Tiny tiny amount.”  The size of the reduction is unknown and several experts contend that it will be more significant than the president intimated.  But here’s the point, the signatories of the Accord acknowledge that the limits pledged thus far will not meet the 2 degrees Celsius goal, but the efforts to reach that goal will be better than just letting the pollution continue and allow temperatures to continue to rise unabated.  In other words, the signatories were working on the premise that something is better than nothing and that as technology and developments continue evolving in the coming years, new ways of reaching those goals will become apparent. Time will not stand still and the world and its technology will not always be the same as it was in 2015 or now.  The president seems to miss that point.  He seems to think that the world won’t reach the goal anyway so screw it.

Since the president’s speech really did not discuss the issue of global climate change, how to deal with it best, or point out misguided practices, it can only be seen in this light.  It was instead one more example of his belief that some kind of conspiracy — primarily by our closest and most important allies — is holding the United States back and dictating what we do or cannot do.  His belief appears to be that by putting “America First” that he can do, or not do, whatever he feels like, the rest of the world be damned. This is extremely dangerous to the future of the United States and its place on the world stage.


The Korean Dilemma

United States policy for many past presidential administrations firmly states that a nuclear armed North Korea is unacceptable to our national security interests and is a threat to peace around the world. This stance continues with the current administration.  Unfortunately, despite sanctions and diplomatic isolation, North Korea already tested five nuclear weapons between 2006 and 2016. Some intelligence reports, as widely cited in the media, indicate that there may soon be another such test. Meanwhile, the North Koreans continue to test ballistic missiles, ever-increasing their sophistication and range.

The threat of a nuclear armed North Korea becomes real when they reach the capability to mount a nuclear weapon on top of a long-range missile.  Experts differ on that estimate.  Some say it is “years” away and some say it could come as soon as 2018.  No one knows for sure, but they do know that the pace of the Korean progress towards that goal is steadily increasing.

When that day arrives, a clear and present danger will exist for the United States and for our friends and allies in the Pacific area.  Thus the question:  How to implement our stated policy of preventing that danger from becoming real?  There is no easy answer.

The Trump Administration, like those before it, states that “all options” are on the table.  The implied but not so subtle threat is one of military action.  To take such action is not so simple as it may seem to some.  In practical terms, North Korean nuclear sites are underground and the intelligence community is not positive that it knows where all of those sites are located.  Reaching a hardened underground site with a conventional missile or bomb is difficult, if not impossible.  It is possible to destroy such a site with our own nuclear weapons, assuming we have it correctly located, but despite the facile way some people talk about nuclear weapons, no credible official thinks that taking a first strike with nuclear weapons is part of the solution at this point. A bomb without a delivery system is not able to reach the target.  To stop the threat, eliminate the delivery system.

However, further complicating the issue is that part of the North’s missile development includes mobile Inter-Continental Ballistic Missiles (ICBMs) that makes targeting the delivery system before launch that much more difficult. They have also tested submarine launched ballistic missiles, which are even harder to locate without sufficient warning and planning.  So while the military option is and should be on the table, the practical aspects of eliminating the threat without a major conflict are daunting.

The ace in the hole held by North Korea is the fact that Seoul, the capital with a population in the city and suburbs of nearly 24 million, is only about 40 miles from the Demilitarized Zone (DMZ).  The North amassed and maintains large numbers of artillery, rocket, and ballistic missiles along the DMZ, many with a range capable of reaching Seoul.  This is a huge deterrent to unilateral U.S. or allied strikes. Additionally, North Korea already has operational ballistic missiles that can reach Japan, the Philippines, Guam and other locations with U.S. military bases and U.S ex-pats. There are other threats as well, but you get the picture.

The Korean War began in 1950, and technically never ended, although an Armistice was reached in 1953. The war resulted in approximately 2.7 million Korean deaths, with an additional 800,000 Chinese and 33,000 American dead. Since then Civil Defense capabilities in the South have vastly improved and the citizens practice taking shelter. Also new are the preemption plans of the United States and South Korean military that in the early stages of conflict would seek to take out the North’s ability to wreak wide-spread damage in the South. However, despite these plans and practices, the devastation of extended combat would be real and with a lasting impact.

The key to a non-military solution in North Korea is China.  President Trump tried to impart to Chinese President Xi Jinping during his visit to the U.S. in April the importance we place on this issue and the need for Chinese influence to reign in the North Koreans.  Presumably President Xi took the information on board, but China has their own interests on the peninsula.  First and foremost, they do not want a united Korea, especially one allied with the United States.  Secondly, they are unwilling to deal with the economic fallout of a massive refugee and humanitarian crisis on their border should the regime of Kim Jong-un fall.  Kim is the ruthless Chairman of the Worker’s Party of Korea and Supreme Leader of the Democratic People’s Republic of Korea (DPRK), or as we call it, North Korea.

Most of us know of the ruthless leadership of Leader Kim, including having his uncle and half-brother killed.  He does not appear to be “crazy” as some would have it, but he is isolated, inexperienced, and convinced of his infallibility.  For a minute, take a look at the world from his point of view.  Assume that he is committed to his personal and the regime’s survival.  Assume also that he believes his own propaganda and that the world really is out to get him.  Here is what he sees.

Kim knows well of the fate of two previous strongmen, Muammar Mohammed Abu Minyar Gaddafi and Saddam Hussein.  Both had programs to develop Weapons of Mass Destruction (WMD).  Both were pressured by world leaders, diplomatically and militarily, to give up their WMD programs.  We now know that both actually did give them up.  One ended up sexually violated and killed in the desert and the other was hung.  Kim Jong-un is not about to fall prey, as he sees it, to the same trick.  He will not willingly give up his nuclear and missile programs just because the U.S. threatens him or China cajoles him.  Economic sanctions seem to hurt only the North Korean population, Kim and his cronies are immune from the deprivations that seriously impact his citizens.  Rebellion from within is nearly impossible given the total control over the population wielded by the state and the total immersion into a way of life and a propaganda machine that influences the average citizens from the day that they are born.

During the Cold War, the superpowers possessed nuclear weapons and competed for influence and territory for many decades without nuclear war becoming a reality.  There were many reasons for our survival despite some serious crises such as the Cuban Missile Crisis and the lesser known 1973 Arab-Israeli War when the U.S. military world-wide went to DEFCON III (Defense Condition 3), the two closest instances of direct conflict between the U.S. and U.S.S.R.  Foremost among these reasons is the concept of Mutually Assured Destruction (aptly known as MAD) where the chance of total and equal destruction deterred each side from using their nuclear weapons.  (Although in fact, most nuclear war plans did not contemplate an all or nothing use of nuclear weapons.  There were (are?) war fighting plans using nuclear weapons in limited strikes that may or may not escalate based on the war aims.  It also has to do with hitting counter-value or counter-force targets — in over simplified words, hitting cities or military forces.  But I digress, although it useful to remember this concept of counter-value versus counter-force targeting in thinking about North Korea.)

It is unlikely that North Korea can be deterred from using its nuclear force based merely on the concept of MAD.  Kim does not want to die, he wants to survive, but he will not go down without a fight.  If his survival is threatened in a way he finds credible, he may go down swinging.

Diplomatically, it is difficult to know what will bring the North to the table with a credible negotiating team willing to provide a solution to inhibiting or eliminating their nuclear program.  On-site inspections and verification must be part of any solution, but Kim has signaled he will never allow them to occur.  Past U.S. administrations have entered into negotiations with them only to find them unserious and uninterested in a real solution.  They were only interested in finding out how much they could get from the West before opting out of any reciprocal actions.

There may be some value in taking a similar approach to the one that the world took with Iran.  While President Obama is often and furiously “blamed” for “caving” to the Iranians, a few things need to be remembered about the agreement.  First, it was not a bilateral U.S.-Iran agreement.  It was a multi-lateral agreement that includes, among others, France, the United Kingdom, Germany, the European Union, China and Russia.  Second, it in fact did stop Iranian development of nuclear weapons, at least in the short run.  The idea is that eventually Iran will benefit sufficiently economically without a nuclear weapons program that they will forgo it rather than suffer more sanctions in the future.  Third, it did open the country to outside inspectors.  No deal is credible without continued verification. The deal was a result of focused sanctions that hurt the Iranians where it counted.

Using this model may or may not be possible, but it could be a starting point for a meaningful international diplomatic effort to resolve the Kim issue.  However, thus far other world leaders have been content to allow the U.S. and China to solve this problem as they are less threatened by the DPRK. China is the key to any solution, but particularly one involving meaningful sanctions.  To be meaningful, they must hit Kim and his fellow oligarchs where it hurts — in their pocket books and life styles.  So far there is no evidence that current sanctions are having any impact on the leadership, only on the population. Thus China (and others) need to meaningfully and consistently enforce economic sanctions.

For other world leaders that do not seem too concerned, they should consider what may be the biggest threat from the North Korean nuclear program.  Cash strapped and looking for a market, it is conceivable that the DPRK will (and maybe already has) export their knowledge and expertise to the highest bidder.  This may and probably will in the future include terrorist organizations and rogue states. That alone should be enough to get most of the world on board with solving this problem.

Finally, and, as it should be, a last resort, there are a number of military options that may preclude full-scale war.  Cyber attacks that cripple the nuclear infrastructure for example could be carried out. (Remember reports in 2010 that the “Stuxnet” virus crippled the Iranian nuclear centrifuges in what is thought to be a combined U.S.-Israeli operation.)  Other clandestine operations are surely in the U.S. playbook.

Should conventional military force be required, a counter-force strike aimed at limiting the DPRK’s ability to do damage in South Korea could be followed by an offer to negotiate with Kim.

Another option is to specifically target Kim and the senior leadership in a decapitation strike that removes the DPRK leadership and thus limits their ability to retaliate.  This seems to have the biggest chance of success.  If a pre-emptive U.S. military strike could lead to a massive conflict on the peninsula and surrounding areas anyway, then go for the leadership first in the chance that the command and control abilities and the will to fight may be eliminated before the conflict spirals out of control.

While the DPRK is increasing its capabilities, so are the U.S and our regional allies.  While we may not be able to locate and eliminate all of the nuclear sites and mobile launchers on the ground, using increasingly sophisticated Anti-Ballistic Missile (ABM) systems the U.S. can limit the impact of a strike by destroying the missiles in flight.  Current systems include Ground Based Mid-Course Defense (GMD) based in California and Alaska which tested well against ICBM targets, the Navy’s Aegis destroyers and cruisers have proven adept at hitting ballistic missiles and the Army’s Patriot and Terminal High Altitude Area Defense (THAAD) systems have as well, depending on the threat and the environment. You may recall that the U.S. is presently deploying the THAAD system in South Korea, although in April President Trump inexplicably called on the Koreans to pay us one billion dollars for the system unless they terminate or renegotiate a bilateral trade agreement — “a horrible deal.”  For now, the deployment continues.

It does not take a crystal ball to determine that the Trump Administration will face its toughest international challenge in North Korea.  Whether in the coming months, as the DPRK accelerates its testing of missile and weapon systems, or in the coming years, one should expect action in one form or another in the near future.  It will take a confident and realistic combination of diplomatic and economic measures from the international community coupled with unparalleled military readiness.  What is certain is that the problem will not go away on its own.


A Soup Sandwich

With increasing frequency, nearly daily, we as a nation wake up to yet another incredible self-created crisis in the Trump Administration.  People that care that our nation’s leader is becoming something of a punch line around the world debate whether President Trump’s actions, statements, and yes, tweets are part of a larger plan or simply the reflection of a man with little to no intellectual curiosity, the attention span of a young child, and who is in way over his head.  I am increasingly falling into the latter category.

In my day the military term for his administration would be that it is a soup sandwich.  The term means exactly what the imagery suggests, something so confused and messy that it cannot be salvaged.

The litany of recent events are well-known.  Whether it is his casual revelations to the Russians of highly critical intelligence, his thinly veiled threats to former FBI Director Comey, his stated reason for firing Mr. Comey because of the “Russian thing”, or the possibility that he tried to stop the FBI investigation of the Russian meddling and specifically Lt General Michael Flynn’s possible involvement with the Russians, his actions have shown a president and an administration that have lost their way.  Put more bluntly, look in the dictionary for “soup sandwich” and you will see a picture of the president.

Note again that all of the crises that the White House staff have dealt with thus far are all self-created by the president.  This does not bode well for handling the inevitable national security crisis or domestic tragedy on the horizon that will test our ability as a nation to deal with all that comes our way.

Most legal scholars and Constitutional law experts point out that nothing that we know about thus far concerning the president’s actions is illegal.  Unethical and/or immoral, perhaps, but not illegal.  This is very troubling.  As Dana Milbank ably points out in a recent opinion piece, just because it is legal, does not mean that it is right.  Or as we used to say, just because you can do something, it doesn’t mean that it is a good idea.  The basic point is that President Trump knows no boundaries, has no self-control and therefore has the ability to do great damage to our nation, whether deliberate or out of ignorance.  As Mr. Milbank points out in his troubling piece, the president is within his rights — legally — to do all of the things that we know about.  But the assumption for all modern presidents is that a president would not do all of those things without the proper justifications and explanations.  In crafting the Constitution, the Founding Fathers assumed that the chief executive would be virtuous , guided by honor, and exhibit self-restraint.  Scholars point out that the Constitution gives many powers to the president, specifically and inherently.  The checks and balances that we rely upon cannot stop the president from wreaking havoc in the short-term.  Although the ultimate power rests with the Congress — impeachment — and the courts — ruling certain presidential actions unconstitutional — it takes time and political capital to bring those counter balancing powers to bear. In the meantime, significant and even irreparable damage can be done to our nation.  With President Trump we have a chief executive that seems to be lacking the knowledge to understand the limits and responsibilities of the presidency combined with unchecked impulsivity that can easily lead to damaging actions and decisions.

Look at President Trump’s background.  His success as a businessman by most accounts was not so much because of his personal knowledge and ability.  It was more about branding.  He sold the Trump Brand to investors and let others actually build the real property.  Recently, few of his Trump buildings were actually Trump projects, he merely sold his name and promotional abilities for use by those doing the work.  He became famous due to his time as a television reality star.  Even today he talks about “ratings” for press conferences and speeches.  The pop psychoanalysis could go on and on, but in every instance, it appears that his personality is ill-suited to lead the greatest nation on earth.  To me, for example, he related the very highly classified information to the Russian Foreign Minister (information that will probably result in lives lost, and certainly the loss of an important avenue of intelligence) not because he wanted to help the Russians. I think he did it because he was showing off and wanted to impress his visitors.  Remember this is the guy that in the midst of the ceremony “celebrating” the House passing Trumpcare, stopped his speech to turn around and ask “How am I doing? Am I doing OK? Hey, I’m president. I’m president. Can you believe it?” Well, no, I can’t believe it.  But it is true.

I hear the “I word” — impeachment — bandied about a lot recently.  From what we know now, we are not there yet.  I also worry that under the current divisive political atmosphere in our country that an impeachment act and subsequent trial would be very bad for our nation.  We might not recover from that trauma for many years.  Therefore any impeachment proceedings must be based on clear violations of the law, should there be any.

The other proposal that floats around from time to time is that the 25th Amendment can be used to remove him from office.  This amendment pertains to the succession to the presidency should the president be unable to fulfill his duties.  The relevant section of the amendment in this case is Section Four which provides a procedure for the Vice President and such other “principal officers of the executive departments” (meaning the Cabinet) to declare the president unfit for duty.  Should the president contest that declaration, it goes to a two-thirds vote in both the House and the Senate.  This too would be a long drawn out procedure that could seriously divide our country should the president resist the take-over attempt.  It seems unlikely in any event that Vice-president Pence and the Trump appointed Cabinet would invoke this avenue of removal, barring some obvious and unassailable problem with the president.

Finally, President Trump could resign.  Many pundits and others think this is the most likely scenario for the current president to leave office.  President Trump himself said that 

“I loved my previous life. I had so many things going. This is more work than in my previous life. I thought it would be easier.  I like to work, so that’s not a problem, but this is actually more work and while I had very little privacy in my old life because, you know, I’ve been famous for a long time, I really, this is – this is much less privacy than I’ve ever seen before.”

None-the-less, I doubt very much that the president has any intention of resigning.  He likes the attention and being on the “inside” — people have to pay attention to him and he likes that.

Potentially compounding President Trump’s negative impact on the nation is the dilemma many of his top advisers are facing.  It is a classic scenario.  The president continually throws good, hard-working and upright people under the bus.  They go out and defend his actions in, I hope, good faith only to have him personally provide a completely different rationale for his actions.  This can only go on for so long before people start to ponder resigning.  This is the dilemma such good people face — resign and save my reputation and integrity or stay and try to change things because they could really be a lot worse if no one of significant knowledge and competence is left to try to hold him in check?

I fear that most people consider the recent events as “typical” Washington politics.  That’s too bad. This is not typical and it is not normal. And it isn’t “sour grapes” that the Democrats lost the presidency.

Many continue to state that as a nation we should give the guy a chance.  He’s only been in office about four months.  Give him time.  I tried.  Sorry, but I do not think that anything is going to cause President Trump to change.

For the Republican majority on Capital Hill I can only say, “Clean up on aisle seven.  Soup sandwich in progress.”  The Republican agenda depends on a functioning presidency.  The deal with the devil is almost gone as more and more of the president’s actions take away from the legislature’s ability to legislate.  Clean up the soup sandwich through comprehensive and bipartisan investigations.  Find out what actually happened, or did not happen, and get it into the public domain.  Use a little Clorox on the clean up of the soup sandwich.

If it turns out there is nothing there involving the Russians or other problems then so much the better. If there is something, hold all involved accountable.  The good news/bad news may be that there is nothing there. The good news is that people will not go to jail and the integrity of the system may be restored. The bad news is that we will still be left with a soup sandwich.

 


Incompetent or Dangerous?

Yesterday, President Donald J. Trump fired James B. Comey Jr., the Director of the Federal Bureau of Investigation (FBI).  This came in the midst of an ever-increasing FBI investigation into known Russian meddling in the 2016 presidential election and the increasing number of revelations of ties between the Trump campaign and the Russians.  Those are actually two different issues, which our president apparently cannot understand.

There is wide-spread consensus based on the truth and, you know, actual facts that the Russians interfered with the election.  Most likely they interfered because, as former Bush Administration Secretary of State Condoleezza Rice explained, Russian President Vladimir Putin is a pay-back kind of guy.  He hated Secretary of State Hillary Clinton, primarily because she called his election a sham, and sought the opportunity to work against her campaign.  According to Secretary Rice’s theory, he relished disrupting the election in and of itself, but to have Secretary Clinton as the recipient only made it sweeter.

Every American should be gravely concerned that a foreign power aggressively and with malice of forethought worked hard to disrupt the very foundation of our Republic.  Every American.  This is not a political issue.  Consequently both the Senate and the House of Representatives are conducting bi-partisan inquiries into what happened and how we can protect against it in the future.

However, President Trump seems to believe this is unnecessary.  If one pays only the mildest of attention to the news, you know that he is constantly calling the fact of the interference a “hoax” and the investigations “a waste of taxpayer money.”  He won and that’s all he cares about.  In his mind, end of story.

Secondarily, as the investigation of the Russian interference deepened, it became apparent that there may have been some interaction between members of the Trump campaign and the Russians.  The who, why and what questions remain unanswered.  This also is considered “fake news” by the president and he constantly tweets about issues he thinks are “ridiculous” in connection with the investigation.

He does so even though his first National Security Adviser Lt. General Michael Flynn USA (ret.) was fired by the president for working with the Russians, being paid by them, and lying about it.  I suppose we should just let that go.  Nothing to see here, folks, just move along.

This is the short version of the context surrounding the firing of Director Comey.  The president showed real class by not notifying Director Comey of his dismissal, rather the Director learned about it on television while giving a speech in Los Angeles.

So the president whose staff members and campaign members are under investigation by the FBI and the Attorney General of the United States who was forced to recuse himself from the Russian investigation because of his own role in the campaign and “forgetting” to reveal his own Russian contacts, are the folks that fired the Director.  It most definitely does not pass the smell test.

Thus the question, is the president incompetent of trying to cover up misdeeds in his administration? Does he not know what he is doing or is he deliberately undermining our Constitutional balance?  I do not know, but either one is dangerous.

The alleged reason for the firing was the mishandling of the investigation of Secretary Hillary Clinton’s emails back in July.  Of 2016.  The investigation that then Candidate Trump applauded.  Hmmm.  The timing is also suspicious.  Remember the Trumpian tactic of changing the headlines whenever something critical of him makes the news?  On Monday former Director of National Intelligence James Clapper and former Acting Attorney General Sally Yates testified before a Senate sub-committee looking into the Russian connections.  Their testimony was less than flattering to the Trump Administration and in some cases directly contradicted statements made by the president and his spokespeople.  On Tuesday, Director Comey is fired, thus changing the headlines.  I’m just sayin’….

From the time Attorney General Yates notified the White House that General Flynn was compromised and a potential agent of the Russians until he was fired — only after it all became public in the Washington Post — was 18 days.

From the time that the current Deputy Attorney General and Attorney General recommended the dismissal to the president and the FBI director was fired — for something that happened in July 2016 — was minutes.

Also remember that the FBI Director is appointed for a 10 year term.  This is to keep politics and partisanship out of law enforcement in the most critical areas of our national security.  Only one other active Director was fired, and that was William Sessions in 1993 by President Bill Clinton for ethics violations, not for investigating anything to do with the administration.

Many people were upset by the way that Director Comey handled the email investigation of Secretary Clinton.  Some even argue that the way he handled it (a news conference about a lack of evidence to prosecute) was unprecedented and unprofessional and effectively handicapped the campaign of Secretary Clinton.  In a larger context, even as one may have no love for Director Comey, his firing is very troubling at this particular point.  It seems that as the investigation gets closer to the truth, the resistance from the White House increases.  Director Comey must have been very close to finding damaging information.  It only takes a cursory look at any newspaper or other news source to see that this has raised significant bi-partisan concern in the Congress as to the meaning, appropriateness and impact of the firing.  Most Republicans and Democrats have expressed serious concern.  It is not right.

Alarm bells should be going off when taken in connection with this quote from White House spokesperson Sarah Huckabee Sanders during an interview last night with Tucker Carlson on Fox News. In the same vein as the president and other spokespeople in the White House, she spoke about the Russian investigations and said:

I think the bigger point on that is, “My gosh, Tucker, when are they gonna let that go?” It’s been going on for nearly a year. Frankly, it’s kinda getting absurd. There’s nothing there. We’ve heard that time and time again. We’ve heard it in the testimonies earlier this week. We’ve heard it for the last 11 months. There is no there there. It’s time to move on.

President Trump wants the investigation to go away.  Countless efforts by the president and his spokespeople to undermine the investigations have not worked.  They pretend, as does Ms. Sanders, that the American people do not care.  We won.  End of story.  Yet, the investigations continue and it does not go away.  Next step — fire the Director of the FBI.

One can only conclude that the president must really be trying to hide something big.  Maybe yuuge. Reporting today indicates that last week Director Comey quietly asked Congress for a significant increase in funding for the Russian investigation.  Another coincidence?

President Trump undoubtedly thought that by making Director Comey go away, his troubles would go away as well.  They are just beginning.  Reportedly, the president has little interest in history or understanding exactly how the government works.  Fine.  But someone should tell him that time and time again the cover-up is what brings folks to their knees, doing more damage than the “crime” ever would have.  Maybe he should read up on it.  He may learn something about it when he appoints his next Director of the FBI and the Senate holds confirmation hearings.  If you think there is a fire in the Senate during the current hearings, you haven’t seen anything yet.

A civics lesson might help as well.  Trying to run the United States as a family business operation does not work so well.  Unless his aim is to make a lot of money, which that part so far is working. But that’s a piece for another day.

The investigations will not go away.  They will be slowed down dramatically in the near term.  The FBI is extremely unlikely to report the results of their investigations without a Director in place.  That will take weeks or more likely, months.  James Comey was a Republican appointed by President Obama. President Trump should appoint a Democrat with an impeccable reputation as the next Director.  I am not holding my breath.  His appointment will tell us a lot about the future integrity of anything that comes out of the Department of Justice.

The investigations will continue in the interim.  However, the integrity of those investigations is now compromised. Only by appointing a special prosecutor — which the White House and Senate Majority Leader Mitch McConnell (R-KY) are mightily resisting — will there be some assurance to the American people that an independent investigation, unencumbered by political and partisan elements, reports believable results.

This is fundamental to our national security.  Stay awake and keep the pressure on.  Silence and “getting tired of it all” will erode our freedom.