Tag: Germany

More Thinking about the Defence Budget and US “Security” – a letter to the editor

Submitted Today to Hudson’s Register Star

Letter to the Editor

May 6, 2011

As our politicians and the media continue the “debate” about our public budgets, Federal and state, we need to continue to ask that they have a debate that includes all aspects of income and expenditures.

I want to focus here on our spending in the Dept. of Defense. Let’s just focus on the more than 750 military bases outside of the US for a moment.  Why do we continue to support military bases throughout Western Europe in nine countries (77,379 personnel in 14,706 buildings with 629 acres of floor space). Germany alone has 167 US military bases. Japan houses 91 US military bases (41,512 personnel in 8,703 buildings with 731 acres of floor space).  The costs are a bit less clear since the Pentagon provides no reports broken down along these lines. But, we can guesstimate. DOD spending last year ( including Iraq and Afghanistan) was $696 billion and the personnel deployed in Europe and Japan are 8% of total active personnel.  You can easily guess that the costs are very big particularly factoring in the support services provided from the US.

Can we say that all of this is really necessary to our security?

While we are thinking about “security”, is our security to be found overseas guarding other countries? Or, should we be thinking about our security as a nation as perhaps better identified by the health of our society. Do we have reasonable access to jobs paying living wages, housing, education, healthcare, and transportation? Are we doing a good job raising our children and insuring that they have opportunities to reach their individual potentials? Are the vast majority of the population living on the same old wages for the past thirty years while a tiny minority become richer to ever more absurd extremes?

This sense of security is obviously a subject of debate and the answers involve us as individuals, families, local government and non-profits as well as state and Federal resources in a complicated mix. But, can we afford to continue the Cold War empire of a vast military? Is our security to be found in such distant places?

Healthcare Crisis

Originally written in 2005

 

The healthcare crisis in the US is growing in severity and yet is not the subject of any real public debate. More than 44 million Americans are without health insurance and almost 65 million will experience a lack of coverage during the year. Emergency rooms are the primary care provider of necessity. All of this despite the fact that, as a nation, we spend more than any other country in the world; 11% more than the next closest country; 90% to 100% more than countries like Germany, Japan, Canada, Australia, and France. Yet the outcomes for our healthcare system are completely second tier and nearly third world.

You may be shocked to see exactly how poorly our phenomenally expensive health system is performing. Just to add some further context, note that Sweden (1st in Infant Mortality to the US 41st position) has a per capita income roughly equal to that of Mississippi (the poorest US state) and spends almost exactly half of what the US does per capita on health care. Examine the Comparative Health System Data in which I have color-coded a few countries for quick comparison.

During our quadrennial presidential personality sweepstakes, neither candidate offered real solutions, really not even a discussion of the issues. We are stuck in a political environment in which neither the Republicans nor the Democrats are offering, and I would argue, are capable of offering real solutions.

Lets make a one basic observation about the situation:

This is not a money problem. As demonstrated by the data on the Comparative Health System Data chart, we clearly are spending enough money in aggregate.

But, this crisis is about money, namely, who gets it and what do they do with it. And, starting from the last serious attempt to tackle the problem during the first year of the Clinton administration, it is very clear that the political system is completely in the pockets of the various interests who have the money now, namely insurance and drug companies, hospitals, and doctors.

It seems obvious to me that we just need to look at any of a number of the top performing countries for the solution. Then, we need to have the political forces in place to tell some of the current participants that the rules have changed.

Central to any solution will be the participation of all US residents in the system. Healthcare is a basic human right and we should not be treated as “risk” factors in insurance company profit calculations. If everyone is part of the healthcare system, then we can effectively share the individual risks and expenses of healthcare across the whole population. Healthcare should not be an actuarial game to derive profit. It should be a system that delivers a reasonable level of service to everyone in the society.

Two players clearly are at the top of the hit list. First, most assuredly the insurance industry, which adds no value to our health care, but consumes by many estimates 15% to 20% of the resources, must go. Second, the drug companies can be brought into reasonable competition for prices that will bring market forces to bear.

Ironically, given the long history of doctors opposing national or single-payer systems in the US, doctors have now been reduced to the status of wage slaves like the rest of us. Many, if not a solid majority of doctors, will support real reforms to the system.

I close here with two basic notions:

  • our healthcare problems are not about a lack of money, and
  • we need to develop political forces that can overcome the control of government (Federal and state) health policies by the current players in the healthcare system.

Given the current Bush administration, I believe the focus of reform must be at the state level. It seems feasible to envision a single-payer system that covers all residents in a state like Massachusetts. We should try it.