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Politics : Just the Facts, Ma'am: A Compendium of Liberal Fiction -- Ignore unavailable to you. Want to Upgrade?

To: Sully- who wrote (80092)	6/3/2010 11:17:32 PM
From: Sully-	Read Replies (4) \| Respond to of 90947

A Fine Recipe for War By: Mario Loyola National Review Online The government of Turkey seems increasingly bent on a collision course with vital U.S. interests, and the time has come to stop ignoring that fact. Our wayward NATO ally’s recent involvement in the incident of the Gaza flotilla is particularly hurtful to the United States, and demands a particularly sharp response. The U.S. has a vital interest in maintaining the regional stability that is indispensable for the preservation of peace and for any prospect of a two-state solution. Sanctioning an attempt to forcibly breach the Israeli siege of Gaza is among the most destabilizing and dangerous things that Turkey could have done. The Turkish government knew in advance that a Turkish organization with ties to Hamas was launching a flotilla of activists bearing humanitarian aid for Gaza, and chose not to stop it. Turkey knew that the flotilla would put Israel in an impossible dilemma, and that it would be a direct challenge to the Israeli siege of Gaza. Israel reacted precisely as the Turkish government knew it would, with a military response that resulted in bloodshed and in a public-relations disaster for Israel. Because Israel generally defends its internationally understood legal rights, the Turkish government was able to predict what it would do. The Turkish flotilla may well have had a humanitarian purpose. But that does not alter its military significance. The attempt to breach the Israeli siege by a flotilla of eight ships carrying some 800 activists -- and totally unknown cargo -- had obvious military implications for Israel. Israel is on solid legal ground in claiming the right to search cargo approaching Gaza, and that right has been widely confirmed through customary practice. When the flotilla proceeded in disregard of Israel’s offer of docking rights in an Israeli port, and help in transporting all nonmilitary aid overland to Gaza, it turned into a hostile action. And because of the Turkish government’s complicity in the flotilla’s mission, the action can and should be attributed directly to the Turkish government. As an attempt to forcibly breach a military siege, the Turkish flotilla constituted a “use of force” under the United Nations Charter -- of that there is no doubt. The only question is whether that use of force was legitimate. That in turn depends on whether the Israeli siege of Gaza is itself a legitimate use of force. If the siege is illegitimate, then the flotilla was a laudable attempt to bring humanitarian assistance to a beleaguered people. But if the siege is legitimate, then the flotilla was arguably an act of war by Turkey against Israel. The carefully worded presidential statement from the U.N. Security Council took no position on this issue. It condemned “the acts” that resulted in loss of life, which obviously include actions of both Turkey and Israel, and studiously avoided apportioning blame. It called the siege of Gaza “unsustainable,” but stopped short of styling it illegal or illegitimate. The document represents a commendable parry by the State Department, and sustains a longstanding principle of U.S. foreign policy, namely the inviolability of a legitimate naval quarantine. When NATO launched its air campaign against Serbia during the Kosovo crisis of 1999, the U.S. threatened to sink Russian vessels if they entered the Adriatic Sea, the naval theater of NATO operations. Nobody doubted the threat’s legitimacy. When Kennedy threatened to sink Soviet vessels headed for Cuba while still on the high seas, he never had to worry about legitimacy. Military actions that are necessary for enforcing a legitimate military blockade, and are kept clearly within that need, have always stood on firm grounds of international law. The siege of Gaza is a terrible human tragedy. It is sapping Israel’s international standing to a dangerous degree. As an act of self-defense, it may well prove suicidal, just as holding on to the occupied territories for decades after the 1967 war has proven of dubious benefit to Israel’s long-term security. But none of that has any bearing on the legal issue. There is simply no respectable basis for arguing that the siege of Gaza is illegal under international law. The siege is founded on multilateral agreements involving Egypt, the U.S., and even the Palestinian Authority, in the wake of the Israeli withdrawal from Gaza in 2005 and the subsequent Hamas takeover. It is a legitimate military incident to a legitimate state of war, one that will continue to exist so long as no general peace agreement is reached -- and for the moment, neither Hamas nor Hezbollah has any interest in peace. Now Israel’s enemies smell the blood of a real kill, and as a result, they have never been more disinclined to compromise. Meanwhile, Turkey appears bent on challenging key elements of the international legal order on which our Middle East diplomacy is based. Even if there is a colorable argument that the Israeli siege of Gaza violates international law (which it doesn’t), it is crucial to the Israeli-Palestinian peace process that lifting the siege remain a matter for negotiation. Turkey’s assault on the legal foundations of regional stability has already had serious strategic consequences. Within hours of the flotilla incident, Egypt opened its border with Gaza pending further notice, in violation of legal agreements it reached with the U.S. and Israel in support of the peace process over several years. Tens of thousands of Palestinians have already crossed into Sinai -- but the far worse problem is that the parties to the Israeli-Palestinian process no longer have any real control over the influx of weapons to Gaza from the smuggler’s paradise that is the Egyptian Sinai peninsula. With the unraveling of the regional legal edifice, the situation can only grow more volatile. The siege of Gaza is starting to collapse under international pressure -- and those who think this is good news for the Palestinians are not thinking clearly. In the absence of a negotiated settlement of the Israeli-Palestinian conflict, the collapse of the Gaza siege will bring about an extremely dangerous situation: Missiles will pour into the Hamas arsenal; further devastating Israeli military action against Gaza will become inevitable; all prospects for a two-state solution will disappear; and the collateral effects could make a wider Middle Eastern war more likely than it has been in decades. Alas, our ally Turkey has now joined Iran as one of the two major external influences undermining the prospects for a negotiated peace. It is crucial to appreciate just how destructive Turkey’s flotilla adventure is likely to be for the effort to achieve a two-state solution. The Israeli government has long held that, in light of what happened to Gaza after the unilateral Israeli withdrawal in 2005 (namely, that it became a platform for missile terrorism against Israel), and in light of the continuing existential threats facing Israel, a two-state solution based in the West Bank would require continued Israeli control of the West Bank’s borders, particularly its border with Jordan. In other words, any Israeli withdrawal from the West Bank would be conditioned on what for all practical purposes would be a consensual Israeli siege of the West Bank. Netanyahu was quite clear about this in his AIPAC speech earlier this year, and it seems incredible that commentators have taken almost no notice. No Israeli government of any party would ever allow the uncontrolled influx of weapons into the West Bank from the direction of Jordan. Look at a map. The ensuing problem for Israeli security would vastly dwarf the problem that would result even from a total collapse of the Gaza siege. Israel will withdraw from the West Bank only if it feels safe -- and Turkey has just made that a lot more difficult to achieve. How can Israel feel safe with the Gaza siege collapsing amidst a general increase in hostility towards it? How can anybody think that with Gaza under Hamas control, and arming freely for war, Israel would ever risk withdrawing from the West Bank? Only the U.S. can reassure Israel sufficiently to deliver Israeli concessions to the Palestinians. Hence neither the Israelis nor the Palestinians can get what they ultimately want except from the mediating efforts of the United States. We are not there to arbitrate. We are not there to be even-handed in settling playground fights. Our indispensable role is to underwrite an international transaction of historical significance, by minimizing the risks and costs of a peace settlement for both sides in the Israeli-Palestinian conflict. This has indeed been the overriding aim of U.S. policy in the region for decades -- since 1967 to be exact -- and it is a cause to which we have devoted hundreds of billions dollars and a huge amount of time and effort by our most senior leaders. Forget about Israel. Turkey’s complicity in the aid flotilla is a flagrant offense against the United States. The existing Middle East balance of power must be preserved. And that balance is now tilting dangerously against Israel. In terms of offensive military capability, Israel has never been stronger. But the asymmetrical threat of missile terrorism emanating chiefly from Hezbollah and Hamas -- which Israel has no way to defend against -- has created perhaps the most existentially threatening situation in the history of Israel. Given this reality, and given that Israel is faced increasingly with the impossible choice between security at home and legitimacy abroad, the looming collapse of the Gaza siege has terrifying implications for Israel. If Israel cannot get both peace and security out of negotiations, then it faces an existential choice between them -- and alas neither, by itself, will bring legitimacy or survival for the Jewish state in the long run. Israel can simply surrender the occupied territories to its enemies, without any security guarantees, and pray for mercy -- which is what Iran, Turkey, the Arabs, and Western liberals increasingly want. Or it can get security through further and endless projections of military power, while its international legitimacy continues to dwindle. Faced with that choice, Israel is highly likely to continue trying the latter before resigning itself to the former. Dim though the prospects for a two-state solution may be right now, keeping those prospects alive, and protecting the balance of power and legal edifice on which those prospects rest, is the only way to slow the increasingly inescapable spiral toward war. Hence the enormous destructiveness of what Turkey did this week. For many years now, the U.S. has been trying to ignore a disturbing trend in Turkey’s behavior. Turkey has been turning away from traditional allies -- and toward a new role as a dominant regional power, perhaps even hoping for a reprise of the Ottoman Empire’s leadership of the Muslim world. The end of the Cold War, and the near-simultaneous end of Turkey’s prospects for membership in the European Union, have set the stage for Turkey’s drift towards Islamist militancy. But even worse, the Turkish government has both followed and fomented an increasingly anti-American and anti-Israeli trend in Turkish public opinion. This disturbing trend has just taken a significant turn for the worse. In the space of two weeks -- between its attempt to undercut U.S. diplomacy toward Iran and its complicity in the forcible attempt to lift the siege of Gaza -- Turkey has now openly undertaken actions totally incompatible with an alliance relationship. Turkey’s official statements on both the Iranian nuclear crisis and the Gaza incident have been a direct affront to U.S. diplomacy, and -- in the latter case -- have reached a tenor of hostility that is simply unacceptable from an ally. At the very least, the U.S. should quietly remind the Turkish government that losing America’s support can be quite costly. When Britain and France seized military control of the Suez Canal in 1956, President Eisenhower threatened to dump U.S. holdings of British pounds-sterling and French francs, plunging them both into a currency crisis, if they did not withdraw their forces. They promptly withdrew. Turkey has survived more than one imminent currency crisis because of U.S. help. Such assistance may not be so readily available in the future. The United States should make it clear to the Turkish government that its status as an ally depends upon its observance of a certain minimal regard for U.S. interests. Turkey has many concerns that depend upon U.S. support -- in its economy, in the Armenian Genocide resolution before Congress, in Cyprus, in Kurdistan, and elsewhere. We can cause a lot of problems for them, and they should perhaps be reminded of the fact as they stroll about the Middle East causing serious problems for us. -- Mario Loyola is a former counsel for national security affairs to the U.S. Senate Republican Policy Committee.

To: Sully- who wrote (80092)	6/5/2010 7:15:46 PM
From: Sully-	2 Recommendations Read Replies (1) \| Respond to of 90947

True costs of Obamacare By: Jeffrey H. Anderson Special to the Examiner 06/04/10 10:04 AM EDT Much of the focus on Obamacare has rightly been on its fiscal recklessness. But in a New York Times story —the type of story the Times couldn’t seem to find space for prior to Obamacare’s passage — we see a clear glimpse of the kind of care that Obamacare would likely spawn. With the nomination brewing of Dr. Donald Berwick — a gushing admirer of the British National Health Service — to head Medicare and Medicaid and with Americans already clamoring for repeal in ever-greater numbers, the story, although tardy, is an important one. It highlights the very real dangers of having millions of the decisions made by doctors and patients across America replaced by the decisions of government administrators in Washington — who rely on studies they don’t understand and pick studies to rely on that aren’t worth understanding. In this case, the relied-upon study was completed by Dartmouth researchers, who were thrust into the national limelight by an administration searching to find an angle, any angle, to try to sell its unpopular overhaul. As the Times writes, <<< “The debate about the Dartmouth work is important because a growing number of health policy researchers are finding that overhauling the nation’s health care system will be far harder and more painful than the Dartmouth work has long suggested. Cuts, if not made carefully, could cost lives.” >>> The Times piece largely stands on its own, and it provides a disturbing account of how much damage powerful government officials could do to people’s lives if they are allowed to impose their decisions nationally, especially when those decisions aren’t rooted — as they almost always wouldn’t be adequately rooted — in legitimate empirical evidence in, as President Obama likes to say, “what works.” Centralizing this much power in the hands of the few would prove fatal not only to liberty but to the quality of American medicine. The Times writes: <<< In selling the health care overhaul to Congress, the Obama administration cited a once obscure research group at Dartmouth College to claim that it could not only cut billions in wasteful health care spending but make people healthier by doing so. Wasteful spending — perhaps $700 billion a year — “does nothing to improve patient health but subjects you and me to tests and procedures that aren’t necessary and are potentially harmful,” the president’s budget director, Peter Orszag, wrote in a blog post characteristic of the administration’s argument. Mr. Orszag even displayed maps produced by Dartmouth researchers that appeared to show where the waste in the system could be found. Beige meant hospitals and regions that offered good, efficient care; chocolate meant bad and inefficient…. >>> However, the Times writes, “Measures of the quality of care are not part of the formula.” The Times adds, “For all anyone knows, patients could be dying in far greater numbers in hospitals in the beige regions than hospitals in the brown ones, and Dartmouth’s maps would not pick up that difference. As any shopper knows, cheaper does not always mean better.” For example, there are “big city hospitals like those at the Ronald Reagan UCLA Medical Center and NYU Langone Medical Center — which look profligate by Dartmouth’s measure but may rank much higher by other quality indicators.” As the Times shows, the authors of the study seem to conflate higher-quality care and wasteful spending, failing to distinguish between the two — if not in their study itself, then at least in the rhetoric they have chosen in publicly describing it. The Times writes: <<< “We show where the waste is in medicine,” said Dr. Elliott Fisher, a physician who is one of the principal authors of the Dartmouth work and was a frequent visitor to Washington during the long legislative debate. “If everyone could operate like Oregon, Seattle or the Upper Midwest, there’s huge savings.” But the atlas’s hospital rankings do not take into account care that prolongs or improves lives. If one hospital spends a lot on five patients and manages to keep four of them alive, while another spends less on each but all five die, the hospital that saved patients could rank lower because Dartmouth compares only costs before death. “It may be that some places that are spending more are actually getting better results,” said Dr. Harlan M. Krumholz, a professor of medicine and health policy expert at Yale. Failing to receive credit for better care enrages some hospital administrators. But for the Dartmouth researchers, making these administrators uncomfortable is the point of the rankings. >>> Nevertheless, despite these concerns, the research has its supporters. As the Times observes, <<< “Dr. Donald Berwick, nominated by President Obama to run Medicare, called it the most important research of its kind in the last quarter-century. In March, in response to the Congressional Democrats who would have otherwise withheld their support for the health legislation, the administration made a promise. It said it would ask the Institute of Medicine, a nongovernment advisory group, to consider ways of putting the Dartmouth findings into action by setting payment rates that would punish inefficient hospitals and reward efficient ones.” >>> The Times reports that the Dartmouth researchers posted the following, commonsense-defying passage on their website: <<< “‘The evidence is that higher utilization does not extend life expectancy, and might be correlated with shorter life expectancy, compared with lower utilization. Therefore, sending people with chronic diseases to higher-efficiency, lower-utilization hospitals for their care could result in both lower spending and increased quality and length of life.’” >>> In other words, providing high-quality, low-cost care turns out to be remarkable easy. However, as the Times replies, “[T]here is little evidence to support the widely held view, shaped by the Dartmouth researchers, that the nation’s best hospitals tend to be among the least expensive. Furthermore, “Similar problems arise with Dartmouth’s regional data. In Dartmouth’s rankings, for instance, New Jersey comes in dead last because its costs per Medicare beneficiary are the nation’s highest. And yet, for the quality of care offered in New Jersey, independent of cost, federal health officials rank New Jersey second only to Vermont.” There is a big difference between being ranked #2 and #50. In short, the president’s claims that Obamacare would lower costs have been widely debunked, even from the Medicare chief actuary in President Obama’s own administration. Now his inferences that by lowering costs (which Obamacare wouldn’t do), Obamacare would also increase the quality of care, have similarly been debunked — although one marvels at the insular environment in Washington that allowed them to take hold in the first place. And yet, in Dr. Berwick, President Obama has found a true believer who’s not likely to be persuaded by the Times report. (President Obama is also a true believer — but in the government-expanding ends he’s trying to achieve, not in the reasons he gives for supporting them.) Let the Berwick nomination proceedings begin, and let the push for repeal advance. Read more at the Washington Examiner: washingtonexaminer.com