Thursday, June 25, 2009
Shipbuilding Plan B: In Case USNavy Screws Up
To carry the human payload into contact with the population, Galrahn depends on the Littoral Combat Ships (LCS) and a notional class of patrol boats. An LCS will act as the command element for its subordinate patrol boats, as well as providing aviation support of helicopters and UAVs. The patrol boats will board and inspect suspect vessels, render assistance as necessary, and gather human intelligence.
The proposal is well thought out and implementable, but the LCS is its weak point. Many people want to kill the LCS to build more DDG-51s or a better armed frigate. What if Congress cut off the LCS project in a few years? What is our shipbuilding Plan B to keep up presence and numbers? As G pointed out in his USNI piece, the US Navy will hit a Warship Gap by the year of 2025 if the US Navy does not come up with a plan to fix shipbuilding.
There are several options for our Shipbuilding Plan B. One possibility is build our 21st Century Spruance Class Destroyer. The Spruance Class was a highly successful ship type because the Navy built it in enough numbers to meet its presence needs. It also had plenty of room inside for future upgrades and technology experiments. By sticking with a minimal weapon system suite, the Navy kept the price tag affordable. Later on, the Navy used the Spruance hull to build the world-famous AEGIS Cruisers.
It turns out that we have a reverse-Spruance class in service right now: the Arleigh Burke Class Destroyers (DDG-51). At $1.5 billion per ship, the Burke is one of the most expensive warship in the world. Maybe we should start planning for a reverse-Spruance. More than 40% of the Burke price tag comes from the electronics and weapons. If we strip off the radars and don't install the Mk 41, we can buy a DD-51 for about $700 million.
Such a Spruanced-Burke will keep the shipyards in business. Its manufacturing cost and process is well known, so we minimize budget and production surprises. After we take out the weapons, we regain all that upgrade room we've lost over the past 20 years. We will have room to park those LCS modules and launch/recover UxVs. Or more helicopters.
We can also update the hull with new technology. For example, we can incorporate LCS's crew automation technology to drive down DD-51's crew requirement. We can incorporate some electric drive systems to increase the power reserve available for later upgrades. (Without the SPY-1, there will be plenty of power). If in the future, we face a higher end threat, we can always upgrade our DD-51 with more missiles and combat systems.
The specific configuration of DD-51 (hangar, sonar tail, boat ramp, etc) will depend on a more detailed requirement analysis and cost-tradeoff. We can even have multiple variants of DD-51. But this will work well as a Plan B. In effect, an Frigate in a Destroyer's body.
Somalia Policy: Trapped in Nation-State Paradigm
We are giving weapons to the Transitional Federal Government because we are bound by the International Traffic in Arms Regulations, a law passed by Congress. ITAR says that we can only give weapons to the official government of a country. We cannot give weapons to a particular tribe in Somalia, for example, because we would be violating the sovereignty of Somalia, nevermind that the TFG does not have any trapping of sovereignty in the first place.
Right now, Somalia is a collection of principalities, with dynamic borders. The TFG of today may very well disappear tomorrow, breaking apart into its component tribes. These tribes stood up the TFG because we can only give money and weapon to an official government. They're sticking together only to milk us out of money and weapons.
We need to cut the TFG loose. As it is, we are backing a lost cause. If we need to recognize anybody, Somaliland and Puntland are more worthy candidates than the fictional TFG. Our goal in Somalia should be supporting the islands of stability in sea of chaos. If we want to support certain tribes in the TFG, we should channel our aid directly to them, instead of going through the middlemen of the TFG. We need to stop imposing our outdated Nation-State Paradigm upon Somalia and start recognizing reality.
Wednesday, June 24, 2009
Health Financing: An Alternative in Expanding Access
Edited: for format and tagging
The Four Components of Healthcare Spending: Thoughts on Healthcare Reform
The American medical system is state of the art, yet we have many systemic problems: MediCare, that legacy of the Great Society, is driving our Federal government into bankruptcy. Healthcare spending is going higher and higher, yet our physical wellness ranking is at the Third-World level. The poor and rich are covered, but the middle class is finding medical care increasingly unaffordable. The United States is facing severe pressures, but we are not alone. Other public health care countries are experiencing greater-than-inflation healthcare increase as well, as a result of an aging, diabetic population.
To clarify our thinking and understand our objectives in healthcare reform, I will break up our healthcare spending into four different categories. Each of these four categories have different economic characteristics, which means that we really should devise four different policies to target each of the four sectors.
The four sectors are:
1.) Preventive and Maintenance Cost
2.) Accidents & Infectious Diseases
3.) Chronic Conditions
4.) Pharmaceutical Cost
1.) Preventive and Maintenance Cost: This category covers the general prevention and maintenance treatments we all are supposed to have: Annual Physicals, Vaccinations, Physical Exercises, etc. An ounce of prevention, and all that. This sector is fairly low cost and foreseeable. Public health science has figured out a schedule of vaccinations everyone should get. Everyone should get annual physicals to catch problems while they are cheap to treat. Inexpensive physical exercises will minimize expensive Type II diabetes down the road. This category is where we can group together to exploit monopsonic leverage. We know exactly what we need. Doctors know exactly how to provide the services. We can put primary care providers on a salary to meet this need. This cost category is amenable to a government solution.
2.) Accidents & Infectious Diseases: This category covers trauma medicine/surgery and infectious diseases. Sometimes we catch the flu. Some of us get into car accidents. We cannot drive these probabilities to zero, but actuarial modelling allows us to budget for this cost category well in advance. This category is the "Insurance" part of health insurance. At the same time, we can use risk management techniques to control this cost. For example, enforcing handwashing in schools and airports can vastly decrease the severity of our annual flu outbreaks. The individuals and families opposed to vaccinations can opt out of vaccines, but they should have to pay more money for increasing disease transmission, and hence, our overall financial burden in treating infectious diseases. People who have a history of STDs, for example, should have to pay a higher insurance premium for engaging in risky behavior. Same thing goes for speeding and drunk driving: Reckless driving is the 6th killer in the United States, ahead of firearms and STDs. In addition to stiff traffic tickets, higher insurance premium for risky drivers is only right to responsible drivers everywhere.
This cost sector is not exactly suited to a government solution, because there would be too much political pressure to lower the insurance premiums for the speeding drivers and irresponsible vaccine opponents. A regulated insurance industry is best in this case: You get sick or in an accident, you get paid for the treatment, depending on your insurance coverage. The more responsible you are, the cheaper your premiums. The ones with the Need for Speed and vaccine opponents can opt out of insurance. It is their choice to engage in risky behavior, but we do not have to pay for their resulting medical needs. Actuarial incentives might even encourage responsible behavior, just like car insurance. Universal coverage is not a good policy for this cost category.
3.) Chronic Conditions: This category covers chronic, non-infectious diseases like cardiovascular diseases and diabetes. This cost category is one of the two main drivers for our runaway medical spending in the US [the other being drugs]. I will limit my discussion here to the non-pharmaceutical treatments, because drug is so big it needs its own cost category. So MRI, dialysis, specialty surgeries, etc, fit into this category.
This category is fairly predictable for the ones who suffer from these conditions. The treatment options are fairly standardized; doctors and hospitals are always sharing their best practices. However, our aging population have increased the input into this cost category: old people. Ironically, our success in anti-smoking campaigns have increased our spending on chronic conditions.
Here our course of action is more nebulous. Insurance is not exactly the right model here, because all of us will end up with cancer if we live long enough. Some government subsidy will help people to afford this care: MediCare, for example. Personal savings will help some people to get treatment. We can have government pay for everything here, but we know for sure that Medicare will exceed our federal budget by 2075, if we keep on the current course.
One option is to increase our use of hospice care. For example, this study found that last-year-of-life expenses constitute 22 percent of all our medical expenditures. If we can minimize expenses for terminal patients, we will have that much more money to improve infant mortality. Given the AARP, I don't expect we can take money from old people to give to babies, but that is an option.
4.) Pharmaceutical Cost: Drugs are getting more expensive everyday. We've all received those internet pharmacy emails promising cheap drugs from Canada and Mexico. Here the problem is based on the business model of the pharmaceutical industry: The companies spend years and millions of dollars to shepherd a drug through our regulatory gauntlet. They recoup their investment by holding a high price here during their patent years. In other countries they sell the drug at a lower price to compete with copy-cat drugs and to generate demand.
The pharmaceutical industry raises the valid concern that, if we mess with their business model, we will have many fewer drugs reaching market. The drug companies have been responsible for much of our medical innovations this past century. Despite occassional safety concerns, these drugs have been effective in treating their target conditions.
For this cost category, a combination of practices may help control the cost without the unwieldy clubs of government regulation. For example, universal physical training will reduce the incidences of diabetes and cardiovascular diseases, reducing demand for the currently profitable blockbuster drugs. The expansion of hospice care will reduce demand for these drugs as well by decreasing life expectancy. Patients can encourage doctors to prescribe generics where possible [coinsurance would maintain the generics incentive for the patients] .
Some people have pushed for universal drug coverage as part of the universal healthcare reform. However, I fear that the pharmaceutical industry will band up with the AARP and push for ever greater drug subsidies, distorting market incentives and bankrupt the Federal government.
Ob/Gyn & Reproductive Care
The OB/GYN sector has experienced tremendous cost growth this past century, with the increased maternal age causing more complications(twins, etc), spreading popularity of c-sections driving up expenses, and declining fertility (from maternal/paternal aging) demanding more reproductive assistance. This growth in cost has come with an unfortunate increase in infant mortality, due to increased premature births. [Twins and triplets are more likely to be born prematurely. Maternal complications also increase premature births.]
It is important to control our OB/GYN cost because babies are our future. Their productive potential is much higher than the potential of our Retired Persons. At the same time, the OB/GYN cost growth is in part driven by societal changes, not medical advances. Therefore, healthcare reform is not the whole answer to fixing our OB/GYN sector.
If families are postponing births due to career plans, they should increase their savings to account for the cost increase from advanced maternal age. For this particular segment, perhaps a tax-deferred savings plan is the answer. For example, mothers and fathers can draw on their IRAs and 401K's tax-free and penalty free, to pay for birth/reproductive expenses. This will give young men and women a concrete reason to save money, as opposed to that nebulous retirement 40 years away.
The recent rise in twins, triplets, and beyond, is linked to increased maternal age, and correspondingly, IVF practice of multiple implantation. IVF multiple implantation is risky to the mother and disproportionately stressing the OB/GYN sector. Correspondingly, a national healthcare system should not cover multiple implantation on cost concerns. This is a scenario where personal finances, rightly, should be the driver.
Conclusion:
Given the above analysis, the AARP is emerging as a grave threat to our fiscal health. As I am counting on that Army pension to finance my retirement life, I cannot support healthcare reform when the Federal government is already wasting 30% of its Medicare money. I hope that my four categories have helped you understand better our current healthcare reform debate. Please let me know of any improvements we can make to this four component cost model.
PS: See my following post about expanding healthcare access through public financing.
Sunday, June 21, 2009
Intelligence Production
Of course, the implementation of this reform requires the leadership to commit to good intelligence. As COL(ret) Lang has noted repeatedly, the current intelligence system is not interested in producing good intelligence. The focus on failures of intelligence has produced a bureaucracy with all of its worst traits. Our current intelligence vacuum on Iran has only highlighted the incompetence of the Community. Without commitment from the very top, Rasmussen's idea will become just another footnote in our sad intelligence history.
Iran: Preparing for the Aftermath
About the only action we can take right now, is to set up refugee camps for the current-protester, future fugitives, on the run from the authorities. Obviously we cannot invade Iran to set up these camps, but we can do so in Iraqi Kurdistan and in Afghanistan. As Kurdistan has a history of supporting Iranian dissident movements, they are a natural ally. Afghanistan's western provinces have a large Persian population, so that is an ideal site as well.
As the Revolutionary Guards have started fighting the people, we have moved past the opportunity window for enacting the policies I laid out in my previous post. Now we can go on with our democracy talk. A Persian Voice of America should start broadcasting. We should also convince the EU to join our economic embargo against Iran. We can still set up an embassy in Tehran, but the embassy's mission is not to normalize relation with the regime, but rather to provide books and media to the Iranian people through its on-site library and cultural programs.
Arming the dissidents and training them is not an option, though. As I said before, if the 2nd Iranian Revolution is to succeed, it needs the Iranian Army's backing. Our arming the dissidents would erase the maneuvering space for the Iranian Army. Besides, there are plenty of light weapons available in Iraqi markets if the dissidents are looking for guns.
Possible Outcomes of Current Clashes
It is still possible that the Iranian Army will come to the aide of the people. However, the Army cannot openly side against the Guardian Council. The Army could unilaterally move into the cities to "assist" the Basij's riot control efforts. Infantry units could race ahead of the Basij to take control of the streets. Then, they can turn the Basij away and shelter the dissidents.
Another possibility is to send in the medical units to set up mobile hospitals or to beef up the current hospitals. Obviously, because of the dangerous rioters, the Army doctors need their own Army escorts as well, to secure the hospitals. The militarization of the hospitals would also protect the patients from all intruders.
If the Army had a military exercise right outside Tehran, they could create a sanctuary from the Basij.
So these are some possible, low profile ways for the Army to rein in the excesses of the Revolutionary Guards and minimize the bloodshed. Hopefully the Iranian Army has enough bureaucratic latitude to carry them out.
Tuesday, June 16, 2009
Iran: Time for an Embassy
The Iranian people are protesting and counter-protesting over their presidential election results. The unrest is similar to the protests of the Ukrainian Orange Revolution, the Tiananmen Square event, and the Berlin Wall. (Or the Israeli and Indian independence movements.) What happens next will depend very much on the bureaucratic actors in Iran. The American response therefore needs to shape and influence these bureaucratic actors.
As Mao Zedung famously observed, "Political power comes from the barrel of a gun." Political transition cannot occur without military power. It is all fine and good that people are marching in the streets, but they cannot change the government if the military balance is against them. For example, in Ukraine and in East Germany, the military sat out on the protests, neither embracing nor opposing the marchers. The people could march in peace and effect change. In Israel and India, the independence movements attacked the British colonial administration with sabotage and assassinations. The British government decided to stop fighting and withdrew. In Western democracies, the military protects the political transitions of elections. Without a military component, protests will cry unheard.
Therefore we need to look at the military dimension in Iran right now. The military opposition in Iran is very small. For example, Michael Totten visited some Iranian Communist Party militia in Iraqi Kurdistan in 2006 [Correction: 2007], and they numbered in hundreds at most. We hear about ethnic separatist violence in Iran from time to time (Iran is an empire), but they were few in number and limited in effect. The student protesters do not seem to have a military wing, judging by my perception that there have been few assassinations of the secret police officials in Tehran. For the Iranian protest to become an Iranian revolution, we will have to look toward the government bodies.
Iran has several militaries. There are the usual Iranian Army, Navy, and Air Force. There is also the Iranian Revolutionary Guards, which has ships and planes of its own. There is the Iranian National Police, which shares the paramilitary and law enforcement portfolio with the Revolutionary Guards. How will they respond to the protest and possible constitutional crisis?
Ahmadinejad came from the Revolutionary Guards, so the Guards will probably side with Ahmadinejad. More importantly, however, the Guards exists to support the Iranian Guardian Council, so they will do what Khamenei says. The Iranian military, on the other hands, competes with the Revolutionary Guards on military matters, so may be inclined to support the students. On the other hand, the Iranian military probably views the current unrest as an American/Israeli conspiracy. Therefore, we need to give the Iranian military the breathing space to make up its mind.
We need to signal the Iranian military that we are not going to take advantage of their current political weakness. We can employ confidence building measures such as officer exchange programs and military visits. These things take time to set up, but by starting the planning process for them, we demonstrate our intentions to the Iranian military. Further, we should decrease the military tension when possible. Our forces in the Persian Gulf can stand down their tempo of operations, such as decreased patrols and training flights. The US Army can minimize its patrols near the Iraqi-Iranian border.
Furthermore, we need to tell the Iranians what we are doing. President Obama can put his mega-watt smile on TV and tell the Iranians that we are standing down militarily to show them we harbor no ill will toward them. He can make a historic announcement to normalize our diplomatic ties with Iran, such as setting up an embassy in Tehran. He should tell them that, regardless of who ends up being president of Iran, the United States will continue the rapprochement. We need to show respect for Iran's constitutional process so that the Iranian military can stop focusing on us and start focusing on their constitutional crisis.
Many commentators in America are saying that we need to "Show our solidarity with the Iranian people and support their democratic dreams." That, in my opinion, is precisely the wrong thing to do. Our support will only feed the Iranian conspiracy theory that the protest is an American/Israeli plot. Instead, we need to back off on the aggressive democratic talk, and demonstrate our respect for Iran's institutions. We need to do what we can to let the Iranian Army support the students.
Edited: The Stimulist looks at the next step here. Anne Applebaum wants to up the democratic rhetoric. Patrick Lang looks beyond the current protest stage, toward the possibly next stage of armed revolution. Adam Silverman analyzes revolutions in general.
Edited for format and inserted links.
Friday, June 12, 2009
Thanks for Reading!
Thank you for subscribing to this blog. I noticed that many people have subscribed to this blog over this past week. Thank you so much for reading. Y'all have inspired me to further procrastinate at work and write articles!
If I come across biased against India, it is because I don't know much about India, its cities, nor its people. Please let me know anything I got wrong!
Thank you,
Jimmy
The Post-Recession Geopolitics, Trade, and Global Guerrillas
For example, he mentioned that the electric/hybrid car is all the rage in the United States, right now, which is a good thing [Oil and all that.] Electric cars use lots of lithium batteries. 40% of the world's lithium supply comes from Bolivia, and much of the rest in other Latin America countries. Bolivia's president does not like the United States much. He is also facing economic and political unrest in Bolivia. In comes the mining industry. Because the government there is not very effective and plagued by corruption, the mining companies pay bribes and fund private security, company town's utilities, etc. Essentially, the mining companies maintain stability at the mines by exporting instability to the rest of the country, in the form of bribes, prostitution, alcohol problems (of transient miners), resentment of non-accountability, etc.
We then will re-ignite a Maoist movement in the country against foreign domination. We will try to prop up the government there, because lithium is now strategically important to the United States. It will be Banana Republics all over again.
Another big point he made is the bottlenecks in our global supply system. In addition to the physical bottlenecks like the Malacca Strait and Hormuz Strait, there's also the capacity bottlenecks of Ports of Los Angeles and Hong Kong and railroad systems, the information bottlenecks of the undersea fiber optic cables, network-node bottlenecks of our power grids, etc. The Just-In-Time philosophy of capacity over-utilization has taken out the slack in our global economic system. This tautness made our system vulnerable to Global Guerrilla attacks, and magnifies the effect of the attacks on our economies.
The speech is long, and full of interesting reflections. It's a must read for anyone thinking about the future.
Sunday, June 7, 2009
Fictions of the "New Medicare"
Well, some people have already started thinking about how the New Medicare, envisioned by President Obama and Peter Orszag, will look like. This is an on-going story, being posted in a serial fashion. It is an engrossing and sad vision of our future.
People who have faith in a government solution should be careful. They might get what they wish for.
Friday, June 5, 2009
China, India, Brides, and War
One of the commenters brought up the burgeoning mail-order bride industry in China, specifically touring Cambodia and other Southeast Asia countries. His remarks got me thinking about the geopolitical implications of this development.
As many of you know, Southeast Asia has a complex attitude toward China. Vietnam, for example, drove out many ethnic Chinese as “boat people” in the late ‘70s and early ‘80s. Indonesia and Malaysia periodically have anti-Chinese riots. Vietnam and the Phillipines have claims against China on the Spratly Islands. Yet Indonesia is cooperating with China in the defense industry, and Burma is using China to balance against Thailand and India.
As China and India both have a surplus male population (explored in Bare Branches), both are experiencing social stress as men compete for mates. Entrepreneurs are pushing the mail-order bride industry in both countries, with a large target demographic.
I believe that bride importing countries generally provoke resentment among the bride exporting populations, due to increased competition for mates in the exporting populations. I don’t have evidence to back up this claim.
However, this sentiment can easily become coupled to local nativist sentiments in the Southeast Asian states. Thailand and Myanmar have cross-border insurgencies and drug trade problems. Vietnam has disputed territories with Laos and Cambodia. Indonesia has ethnic separatist movements. The region has suffered economically over the past 20 years, from competition with the Chinese and Indian export economies and from the currency crises. These are all factors that can lead to war.
China and India both possess nuclear weapons and thus are unlikely to directly confront each other. However, the Southeast Asian states have many flash points and have been balancing against each other. If a crisis were to erupt, demagogues will drag anti-Chinese and anti-Indian sentiments to the surface. India and China will get dragged into such a crisis because of the complex bilateral defense relationships in the region, and because of domestic responses to the nativist sentiment in the crisis countries. The conflict can quickly widen across the penninsulas. Such a conflict will be difficult to resolve, because the belligerents can easily claim seemingly legitimate causii belli in this environment.
Therefore, the bare branches in China and India may indirectly destabilize Southeast Asia. We need to recognize this and increase our crisis response capability in the region.
Thursday, June 4, 2009
A Humane Strategy to Support Our Afghan Policy
The American government appears to be changing our policy direction in Afghanistan. Our stated policy has remained the establishment of a civil, democratic society in Afghanistan. The US Army is planning a "surge" of forces into Afghanistan to drive out the Taliban. However, COL(ret) Lang believes that President Obama is revising our policy aim in Afghanistan away from Nation-Building(tm). Obama's ideological faction is generally opposed to a Big Military solution, more congenial to surgical strikes and commando raids. With the appointment of LTG McChrystal as ISAF Commander, we may be giving up on building a Western society in Afghanistan as a policy goal. Instead, our Afghanistan policy is focusing on destroying the Al-Qaeda leadership.
With this change in policy focus, the special operation forces become our strategic main effort in Operation Enduring Freedom. Our conventional forces and the Afghan National Army/Police become the strategic supporting effort. As the supporting effort, their mission is not to establish central government control in the provinces or other population-centric COIN goals. [Although they may conduct population-centric COIN operations to gather intelligence to support the SOF, for example.]
The Afghan people may lose out under our policy change. Under the original policy, securing the Afghan population was a strategic goal, whereas under the new policy, we may cede the Afghan countryside to the Taliban. Some Afghan tribes and families have risked Taliban retaliation to cooperate with the Coalition forces. Under the new policy, we will reduce our operational support, and maybe logistical as well, to our local allies. The reduced support leaves our local allies vulnerable to Taliban attack. As the Taliban has murdered entire families to make an example of "traitors", our strategic retreat from the country side makes us culpable, to a degree, for their deaths as well.
The families of the ANA and ANP are vulnerable to Taliban reprisal as well. If the Afghan soldiers and policemen worry about their far away families, they are less combat effective. We need to secure the families of the ANA and ANP.
In addition, our new policy means that we will start favoring certain warlords over others. Currently, we are officially supporting some warlords who covertly sponsor the Taliban. Instead, we will starting playing one warlord against another to disrupt Taliban safe heavens. In the renewed Afghan Civil War, civilians will get caught in the crossfire.
We need to do something to protect the Afghan civilians from the coming violence; that is the moral thing to do. We will not station basecamps throughout the country to protect the population, because the resulting cost in blood and treasure outweighs our strategic gain. However, we will have enough spare resources to protect refugees and internally displaced persons. We need to include refugee camps in our campaign plan, to minimize our impact on civilians' lives and livelihood. In addition, the unsupervised refugee population is destabilizing the region and further stressing Pakistan.
Therefore, I am proposing that we set up refugee camps near Kabul, for any civilian that needs a place to go. We should organize these camps on the model of John Robb's Resilient Communities, where the residents will work for a living. Idle refugees are susceptible to extremist propaganda of all stripes. Make it a place where the people can stay and make a new life, or catch their breath then go home, whichever they choose. Keep the place safe from insurgent violence so that the people can get on with their lives.
Such a place is a low cost endeavor. It is centrally located with Kabul, so it is close to military bases. The Afghan National Army can train and protect the settlement at the same time. They can practice patrolling and checkpoint operations at the settlement. The Afghan soldiers and policemen can keep their families at the settlements, where they know they'll be kept safe from reprisals. We will involve the refugees in constructing and operating the settlement. These tasks keep them occupied, and give them a stake in the resulting city. By utilizing refugee labor, we reduce the need of expatriate labor, which is expensive and adds to camp life support needs. By having the refugees organize and govern themselves, we give them the opportunity to practice clean government. We will have a centralized place to teach them advanced agricultural techniques, machine repair skills, and other training that can make their lives back home easier, should they ever leave.
The current Afghan refugee population is impeding our policy goals by stressing the social welfare systems of surrounding countries and providing a fertile recruitment ground to Al-Qaeda. We need to at least try to sway them to our side. The ANA and ANP need a sanctuary where their families will be safe from reprisals. We have a moral obligation to give the civilian an alternative from the Taliban-controlled towns and Pakistani slums. These factor argue for Coalition support to refugee camps near Kabul. Moreover, this is an endeavor in which money is more important than American boots on the ground, and for which donor countries are sympathetic.
Edited to add: This post builds on my earlier statement of policy paradigm change. We cannot depend on the host nation bureaucracy to implement our policy for us. Instead, the US military may have to take on the job of city manager/administrator from time to time. Refugee camp is a prime example of the capability the US military needs in the post-Nation-State World we live in.