Following up on my previous article on Mexico, I want to add something else I've been thinking on for the last few days: the cultural landscape of Mexico. Specifically, the mixing of Aztec and Latin culture.
As I've mentioned Prof Carroll Quigley several times, his theory of civilization re-generations have changed my view of events. Spain's colonial period has layered a Latin veneer over Latin America. The Latin-Mediterranean-Spanish culture meshes fairly well with Hispanic sensibilities, so it may sometimes be difficult to detect any leftover signs from the native civilizations like Maya or Aztec. There have been Indian revolts throughout Latin American history, reflecting the continuing undercurrent of native alienation. [Recent examples include FARC, Shining Path, basically all of the land-reform movements.]
Communism had co-opted native discontent during the 20th century, but the ending of the Cold War and the narco economy has fueled an alternative model. The narco economy is serving as the instrument of the society, and the vestiges of the native culture serving as the glues of the society.
The narco death cult, Santa Muerte, may be a synthesis of Aztec death cults and Catholicism. Its veneration of death hearkens back to Aztec times. The narco industry promotes this alternative religion to increase cohesion. This definitely merits a deeper look into the cultural mixing and gestation in Mexico and the rest of Latin America.
One more note on Mexican culture: The Mexican elites (Spanish descendants) have been afraid of the Indian peasants throughout history. The current gun ban (only people with connection or bribes can get a gun permit, to buy guns of NON-military caliber like .380acp) is a symptom of that. The lack of economic reform and exporting of economic refugees into the US is another. [Holding up the status quo for the elites and send the suffering poor to the US.] The on-going Indian revolts in southern Mexico constantly reminds the elites of this problem.
One reason why the drug cartels in Mexico have gotten so powerful is because of elite snobbishness. The drug cartels arose from the Indian peasantry and gray economy. The elites saw the cartels as country bumpkins with more money than they know what to do with. The elites ignored the cartels because they're a Yankee problem, but also because they didn't expect these rednecks to start making trouble in the upper class neighborhoods. Thus they were surprised by the scale of the cartel problem today.
Showing posts with label drugs. Show all posts
Showing posts with label drugs. Show all posts
Friday, May 21, 2010
Thursday, May 20, 2010
Mexican Blame Game Re-Run
Now that Mexican President Calderon is here in the US, the anti-gun lobby and Mexican government are re-newing their calls for American gun prohibition. [I've previously covered the Mexican narco guns blame game here.]
They talk about explosive bullets and full-auto machine guns, implied to be US-origin, deployed by the Mexican narcos. Well, I'd like to have explosive bullets, too. Wish I can buy it from my neighborhood gunshop here in the states.
They talk about explosive bullets and full-auto machine guns, implied to be US-origin, deployed by the Mexican narcos. Well, I'd like to have explosive bullets, too. Wish I can buy it from my neighborhood gunshop here in the states.
The Newsweek article mentioned, at the very end, that the narcos likely got the grenades and machine guns from Mexican military and police inventory, in addition to supplies from China, Europe, and Brazil. Well, great, then why are we talking about the US? And if the Mexican army is a prime weapon supplier of the narco-cartels, then it's intuitively obvious we should limit what we give to them, lest it ending up with the narcos.
Admittedly, the Mexican narcos are probably buying pistols through American dealers, in small quantities. Pistols have always been a prestige weapon worldwide, and their concealability make them both desirable and more smuggle-able. American truck screening on the border would help limit the flow. If Mexican smugglers can still get people and drugs into the US, though, we have little hope of stopping the flow of pistols into Mexico.
Therefore, a border fence is an eminently sensible idea in limiting the flow of weapons. If Mexico is serious about choking off the narco-cartels. That Calderone has not advocated a border fence shows that he cares more about sending people north than stopping drug violence.
PS: Edited for links and tags.
Wednesday, June 24, 2009
The Four Components of Healthcare Spending: Thoughts on Healthcare Reform
Yesterday Darshak Sanghavi has a great Slate article about the Massachusetts Health Reform Experiment. Dr. Sanghavi found that people had medical coverage, but the deductible [the part that you pay before insurance kicks in] was so high that the working poor, who are the target of the healthcare reform movement today, ended up right where they were, skipping and skimping on expensive medical services. He fears that we Americans will end up with the same result, lots of money spent with no change in outcome.
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.
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.
Monday, March 2, 2009
Mexico: DoD Leads the Way, Again
It is sad that the media has continued to spread the misconception that Mexico's ongoing civil war is all the fault of the American gun industry. Hello! Why aren't we taking the Mexican border police to task for not clamping down on the gun smuggling?! Is it America's fault that Mexican customs agents are slacking off?
In other news, Dr. Gates said, over the weekend, that the US military will start helping Mexico in fighting its civil war.
It is sad to see that the Obama administration has not learned anything about the post-Cold War world we live in. He spouted some rhetoric about using America's "soft power" to meet our challenges. Yet, with the Second most dangerous threat to American security, [first is Pakistan], Obama has reacted instinctively with the Defense Department, again. "Hope and Change" in the case of US foreign policy is now, "Hope the Military Can Change".
The only "soft power" Obama has done with regard to Mexico is a call to Congress to re-enact the Assault Weapon Ban, a cause for the Brady Campaign. Rahm Emanuel said, "You never want a serious crisis to go to waste." Indeed.
Hat tip to Galrahn for noting this.
PS: updated the tags to include Obama, 30APR2009
In other news, Dr. Gates said, over the weekend, that the US military will start helping Mexico in fighting its civil war.
It is sad to see that the Obama administration has not learned anything about the post-Cold War world we live in. He spouted some rhetoric about using America's "soft power" to meet our challenges. Yet, with the Second most dangerous threat to American security, [first is Pakistan], Obama has reacted instinctively with the Defense Department, again. "Hope and Change" in the case of US foreign policy is now, "Hope the Military Can Change".
The only "soft power" Obama has done with regard to Mexico is a call to Congress to re-enact the Assault Weapon Ban, a cause for the Brady Campaign. Rahm Emanuel said, "You never want a serious crisis to go to waste." Indeed.
Hat tip to Galrahn for noting this.
PS: updated the tags to include Obama, 30APR2009
Wednesday, January 21, 2009
Paradigm Shift: The US Foreign and Security Policies in Flux
This is something I've been meaning to talk about for awhile now. I will just sketch out my idea for now.
The US foreign and security policies/strategies are at a historical moment right now, the moment of paradigm shift. The paradigm is this: Nation-State Centric versus Nation-Tribe Centric.
Failures of Nation-State Centric Paradigm
US policies used to be, and still nominally is, Nation-State centric. Everything the United States does has to be channeled through states and official governments. For example, we know that terrorists reside in, say, Sudan. However, we can't just go in and grab them. We have to petition the Sudanese government for extradition, even though the Sudanese government does not have that much control over the terrorists. Once the terrorists get the wind of an impending extradition, they can use bribes and their contacts in the government to get out of Sudan. And there's nothing we can do about it [except the CIA].
Or, another example, the Iraqi Oil-For-Food program. Right after Gulf War I, we embargoed Iraq's trade. Officially, Iraq was not getting anything through the UN embargo. Unofficially, smugglers moved oil out of Iraq and food/medicine into Iraq. Saddam Hussein and his people were getting a handsome cut of the smuggling trade. But he chose not to give the food and medicine to his people, because he knew that the suffering of his people made great TV. And it did. The UN started the Oil-For-Food program. Iraq now could export as much oil as necessary to feed its people. However, Iraq never came close to its export quota. Saddam chose to sell less oil than he could so that his people would continue to suffer privation. Critical medicine remained short in Iraqi hospitals. On the black market, however, Saddam continued selling oil to line his coffer and buy some weapons.
Because of our Nation-State centric paradigm, the United States (and the UN) could not go into Iraq and run the Oil-For-Food program directly. We had to wait for Iraq to sell however much oil it wants to. Give Iraq the food and medicine. And watch the Iraqi government divert food/medicine shipments away from its people, and into the black market. We also ccould do little to stop Iraq's black market oil export, because Saddam was exporting his oil to countries like Syria and Turkey, our putative allies. We had to depend on the grace of the Syrian and Turkish governments to police their own black market activities.
Iraq and Afghanistan
Nation-State paradigm is the main reason our strategies in Iraq and Afghanistan were not working for much of the 21st Century thus far. The paradigm dictates that our policies have to go through the state governments of Iraq and Afghanistan. So for the longest time, we waited for the Iraqi national government to dither about its constitution, then waited some more as they stood up the ministries and carved up patronages. We knew, in the back of our minds, that the Iraqi parties don't have much representation on the ground. That the Iraqi parties were antagonizing the more popularly based insurgencies. However, we could not go against the Iraqi government. If the governing coalition refused to bring more Sunnis into the government, then the most we could do is talk some more.
However, it is also Iraq that has spurred the paradigm shift that we are undergoing. Sometime in early 2006, the US military came to a concensus that we needed to ignore the national parliament and start engaging the local insurgents politically. In the Anbar province, we started negotiating with the sheiks ourselves. We paid the "Sons of Iraq" to provide local security. We paid the sheiks to clean the streets and dig ditches. We dragged the mayors and police chiefs with us to meet the sheiks, sometimes. And everything flowed from that Anbar Awakening.
The difference here is a bottom-up approach versus top-down in imposing security. Before the Awakening, we were recruiting Iraqi soldiers and policemen from a national perspective. We looked at the overall number and depended on the Iraqi ministries to recruit. If the recruiting drive missed, say Fallujah, there was nothing we could do. We gave the ministries Iraqi and US money, and if the ministry bureaucracy does not apportion funds equitably, the most we could do is complain.
In the bottom-up approach, we by-passed the ministries and engage the local level directly. If the recruiting drive missed Fallujah, we could work with the local dignitaries to put security on the street. Americans could hire Fallujan rent-a-cops if there are not enough Fallujan cops.
Because we are in the midst of this paradigm shift, we do not have a clear policy and strategy. The US State Department had always depended on the Host Nation bureaucracy to execute US aid and assistance. Today DoState is trying to stand up Provincial Reconstruction Teams on an ad hoc basis without clear direction. It cannot find enough people to staff these Teams, even though they are a national priority.
Many commentators have commented negatively on the various Awakening movements. They noted the improvements in local security, but always worried that we are undercutting the authority of the Iraqi central government; that we are embracing former Baathists; that we are setting up local warlords. Their concerns generally stem from the Nation-State centric paradigm: if Iraq does not have a strong central government, then the government cannot impose security on its people. Our original policy and strategy was to stand up the central government, able to guarantee internal security, which would allow the US to stand down in Iraq. The Awakenings conflicted with that policy by setting up alternate centers of power. However, the central government had not been able to impose security. The Shiite insurgency and the Sunni insurgency were signs that the Iraqi people did not accept a central government staffed by Iraqi expatriates. We had to grow the local centers of power, co-opting them and steering them in a peaceful direction, thus pressuring the central government to accede to local demands. In embracing the Awakening, the US military adopted a bottom-up tactic when the national policy and strategy remained top-down. The result is strategic confusion, as planners try to reconcile policy with tactic.
The same thing is happening in Afghanistan, tho more slowly. We rushed to set up the central government and the army, without much focus on the local government nor police. The warlords carved up the country and controlled the provinces as they like. Karzai could count on their nominal support, but they always kept high their own interests and those of their constituents. Afghanistan has a more severe problem than Iraq because there are many more factions in Afghanistan, with more regional sponsors. With the "Awakening"-approach, we're again trying to apply bottom-up tactics without seriously reviewing our top-down policy. People like those at Abu Muqawama say that we don't have a clear strategy for Afghanistan. Of course we wouldn't if our tactics and policy conflict with each other.
Paradigm Shift Implications
So it is clear that we are struggling our way through this paradigm shift. Eventually we will have to update our policy to account for bottom-up, non-state approaches. But as the world is full of nationalist feelings and semi-functioning state bureaucracies, we will have a hybrid policy for years to come. We will start with bottom-up, Nation-Tribe approaches toward failed states and semi-failed states (which have nominal state governments).
[In a sense CIA has always practiced a version of this Nation-Tribe approach. However, their shenanigans in the 50s soured the taste of bottom-up paradigm for everyone. A major part of the reluctance to engage in nation-tribe paradigm stems from that historical lesson.]
The Nation-Tribe paradigm is dangerous on the international stage because it directly threatens the governments of the Non-Aligned Movement, namely China, India, and thugs like Mugabe. If the Tibet question comes up for the United States, for example, the nation-state paradigm says, it's an internal problem for China, tho we will protest human rights abuses. The nation-tribe paradigm, on the other hand, can say something like this: We support Tibetan self-determination, and will actively support a process that can lead to Tibetan independence. That is an unlikely outcome of the paradigm, as we need to balance other interests, but that would be foremost on the mind of Chinese leaders as they oppose our paradigm shift. India shares many US strategic goals, but they too have many separatist movements and will oppose a Nation-Tribe paradigm.
A Nation-Tribe paradigm, tho, can lead to a powerful outcome in dealing with humanitarian crisis [edited: crises] like Zimbabwe. For example, we can de-recognize the Mugabe regime as it does not represent all of Zimbabwe. We will carve out a sanctuary on Zimbabwe territory, by force if necessary, internationally preferrably, where the MDC is in charge. We will then provide humanitarian assistance and set out to make the sanctuary self-sufficient in food production. If the MDC decides to raise an army and invade Mugabe territory, we would not intervene. If Mugabe attacks the sanctuary, we will defend. The policy goal is humane governance in Zimbabwe, with the sanctuary as the example and training ground on local governance.
[Yes, this is similar to the Kurdistan model we set up after Gulf War I.]
As we move further into the 21st Century, failed states will proliferate. As John Robb commented, Mexico is sinking inexorably into failed state territory and becoming the US's numero uno security challenge. The nation-tribe paradigm will be essential in dealing with the 21st Century Mexico, as the nation-state pradigm failed in dealing with the 20th Century Mexico. If Iraq is where the US military learned the tactics of bottom-up security, and Afghanistan will be [hopefully] where the US military learns the strategy of bottom-up security/governance, then Mexico will be where the US federal government learns to formulate and execute bottom-up policy in pursuit of US interests. Or we will get to practice COIN tactics on our own soil. Let us hope that we learn fast enough.
Edited to Add: One useful way to think about this shift is on the question of sovereignty: We used to be on the "Theory of Sovereignty", that we assumed every government had full sovereignty, even if reality conflicts with that claim. Now we will operate on "the Test of Sovereignty", where we only acknowledge your sovereignty after you have demonstrated it credibly. To use a dated example, we will acknowledge Indonesia's sovereignty over East Timor only if Indonesia can exercise its sovereign powers over East Timor.
Thanks to Joe for the link.
The US foreign and security policies/strategies are at a historical moment right now, the moment of paradigm shift. The paradigm is this: Nation-State Centric versus Nation-Tribe Centric.
Failures of Nation-State Centric Paradigm
US policies used to be, and still nominally is, Nation-State centric. Everything the United States does has to be channeled through states and official governments. For example, we know that terrorists reside in, say, Sudan. However, we can't just go in and grab them. We have to petition the Sudanese government for extradition, even though the Sudanese government does not have that much control over the terrorists. Once the terrorists get the wind of an impending extradition, they can use bribes and their contacts in the government to get out of Sudan. And there's nothing we can do about it [except the CIA].
Or, another example, the Iraqi Oil-For-Food program. Right after Gulf War I, we embargoed Iraq's trade. Officially, Iraq was not getting anything through the UN embargo. Unofficially, smugglers moved oil out of Iraq and food/medicine into Iraq. Saddam Hussein and his people were getting a handsome cut of the smuggling trade. But he chose not to give the food and medicine to his people, because he knew that the suffering of his people made great TV. And it did. The UN started the Oil-For-Food program. Iraq now could export as much oil as necessary to feed its people. However, Iraq never came close to its export quota. Saddam chose to sell less oil than he could so that his people would continue to suffer privation. Critical medicine remained short in Iraqi hospitals. On the black market, however, Saddam continued selling oil to line his coffer and buy some weapons.
Because of our Nation-State centric paradigm, the United States (and the UN) could not go into Iraq and run the Oil-For-Food program directly. We had to wait for Iraq to sell however much oil it wants to. Give Iraq the food and medicine. And watch the Iraqi government divert food/medicine shipments away from its people, and into the black market. We also ccould do little to stop Iraq's black market oil export, because Saddam was exporting his oil to countries like Syria and Turkey, our putative allies. We had to depend on the grace of the Syrian and Turkish governments to police their own black market activities.
Iraq and Afghanistan
Nation-State paradigm is the main reason our strategies in Iraq and Afghanistan were not working for much of the 21st Century thus far. The paradigm dictates that our policies have to go through the state governments of Iraq and Afghanistan. So for the longest time, we waited for the Iraqi national government to dither about its constitution, then waited some more as they stood up the ministries and carved up patronages. We knew, in the back of our minds, that the Iraqi parties don't have much representation on the ground. That the Iraqi parties were antagonizing the more popularly based insurgencies. However, we could not go against the Iraqi government. If the governing coalition refused to bring more Sunnis into the government, then the most we could do is talk some more.
However, it is also Iraq that has spurred the paradigm shift that we are undergoing. Sometime in early 2006, the US military came to a concensus that we needed to ignore the national parliament and start engaging the local insurgents politically. In the Anbar province, we started negotiating with the sheiks ourselves. We paid the "Sons of Iraq" to provide local security. We paid the sheiks to clean the streets and dig ditches. We dragged the mayors and police chiefs with us to meet the sheiks, sometimes. And everything flowed from that Anbar Awakening.
The difference here is a bottom-up approach versus top-down in imposing security. Before the Awakening, we were recruiting Iraqi soldiers and policemen from a national perspective. We looked at the overall number and depended on the Iraqi ministries to recruit. If the recruiting drive missed, say Fallujah, there was nothing we could do. We gave the ministries Iraqi and US money, and if the ministry bureaucracy does not apportion funds equitably, the most we could do is complain.
In the bottom-up approach, we by-passed the ministries and engage the local level directly. If the recruiting drive missed Fallujah, we could work with the local dignitaries to put security on the street. Americans could hire Fallujan rent-a-cops if there are not enough Fallujan cops.
Because we are in the midst of this paradigm shift, we do not have a clear policy and strategy. The US State Department had always depended on the Host Nation bureaucracy to execute US aid and assistance. Today DoState is trying to stand up Provincial Reconstruction Teams on an ad hoc basis without clear direction. It cannot find enough people to staff these Teams, even though they are a national priority.
Many commentators have commented negatively on the various Awakening movements. They noted the improvements in local security, but always worried that we are undercutting the authority of the Iraqi central government; that we are embracing former Baathists; that we are setting up local warlords. Their concerns generally stem from the Nation-State centric paradigm: if Iraq does not have a strong central government, then the government cannot impose security on its people. Our original policy and strategy was to stand up the central government, able to guarantee internal security, which would allow the US to stand down in Iraq. The Awakenings conflicted with that policy by setting up alternate centers of power. However, the central government had not been able to impose security. The Shiite insurgency and the Sunni insurgency were signs that the Iraqi people did not accept a central government staffed by Iraqi expatriates. We had to grow the local centers of power, co-opting them and steering them in a peaceful direction, thus pressuring the central government to accede to local demands. In embracing the Awakening, the US military adopted a bottom-up tactic when the national policy and strategy remained top-down. The result is strategic confusion, as planners try to reconcile policy with tactic.
The same thing is happening in Afghanistan, tho more slowly. We rushed to set up the central government and the army, without much focus on the local government nor police. The warlords carved up the country and controlled the provinces as they like. Karzai could count on their nominal support, but they always kept high their own interests and those of their constituents. Afghanistan has a more severe problem than Iraq because there are many more factions in Afghanistan, with more regional sponsors. With the "Awakening"-approach, we're again trying to apply bottom-up tactics without seriously reviewing our top-down policy. People like those at Abu Muqawama say that we don't have a clear strategy for Afghanistan. Of course we wouldn't if our tactics and policy conflict with each other.
Paradigm Shift Implications
So it is clear that we are struggling our way through this paradigm shift. Eventually we will have to update our policy to account for bottom-up, non-state approaches. But as the world is full of nationalist feelings and semi-functioning state bureaucracies, we will have a hybrid policy for years to come. We will start with bottom-up, Nation-Tribe approaches toward failed states and semi-failed states (which have nominal state governments).
[In a sense CIA has always practiced a version of this Nation-Tribe approach. However, their shenanigans in the 50s soured the taste of bottom-up paradigm for everyone. A major part of the reluctance to engage in nation-tribe paradigm stems from that historical lesson.]
The Nation-Tribe paradigm is dangerous on the international stage because it directly threatens the governments of the Non-Aligned Movement, namely China, India, and thugs like Mugabe. If the Tibet question comes up for the United States, for example, the nation-state paradigm says, it's an internal problem for China, tho we will protest human rights abuses. The nation-tribe paradigm, on the other hand, can say something like this: We support Tibetan self-determination, and will actively support a process that can lead to Tibetan independence. That is an unlikely outcome of the paradigm, as we need to balance other interests, but that would be foremost on the mind of Chinese leaders as they oppose our paradigm shift. India shares many US strategic goals, but they too have many separatist movements and will oppose a Nation-Tribe paradigm.
A Nation-Tribe paradigm, tho, can lead to a powerful outcome in dealing with humanitarian crisis [edited: crises] like Zimbabwe. For example, we can de-recognize the Mugabe regime as it does not represent all of Zimbabwe. We will carve out a sanctuary on Zimbabwe territory, by force if necessary, internationally preferrably, where the MDC is in charge. We will then provide humanitarian assistance and set out to make the sanctuary self-sufficient in food production. If the MDC decides to raise an army and invade Mugabe territory, we would not intervene. If Mugabe attacks the sanctuary, we will defend. The policy goal is humane governance in Zimbabwe, with the sanctuary as the example and training ground on local governance.
[Yes, this is similar to the Kurdistan model we set up after Gulf War I.]
As we move further into the 21st Century, failed states will proliferate. As John Robb commented, Mexico is sinking inexorably into failed state territory and becoming the US's numero uno security challenge. The nation-tribe paradigm will be essential in dealing with the 21st Century Mexico, as the nation-state pradigm failed in dealing with the 20th Century Mexico. If Iraq is where the US military learned the tactics of bottom-up security, and Afghanistan will be [hopefully] where the US military learns the strategy of bottom-up security/governance, then Mexico will be where the US federal government learns to formulate and execute bottom-up policy in pursuit of US interests. Or we will get to practice COIN tactics on our own soil. Let us hope that we learn fast enough.
Edited to Add: One useful way to think about this shift is on the question of sovereignty: We used to be on the "Theory of Sovereignty", that we assumed every government had full sovereignty, even if reality conflicts with that claim. Now we will operate on "the Test of Sovereignty", where we only acknowledge your sovereignty after you have demonstrated it credibly. To use a dated example, we will acknowledge Indonesia's sovereignty over East Timor only if Indonesia can exercise its sovereign powers over East Timor.
Thanks to Joe for the link.
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