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Health care and national security
A while back I commented on the two imbalances of power that drive American grand strategy. The first is the gap between the United States and the other major powers, which makes Americans think they are responsible for managing much of the world and convinces them that they can do so with near-impunity. The second imbalance is the strength and political clout of a host of different institutions and interest groups whose common agenda is encouraging greater international activism on the part of the United States. In recent decades, the forces in favor of "doing more" have been better-funded and better-organized than those who favor greater restraint, which is one reason why we spend so much on defense and why we find ourselves entangled in intractable conflicts on several continents.
But when I read some early reports about the Obama administration’s health care plans, I began to wonder if the various forces that favor global activism are going to face stiffer opposition in the future. We are likely to have a sluggish economy for some time to come and the U.S. population is getting older. Virtually everyone agrees that serious health care reform is badly needed but will cost a lot. Plus, Obama's various economic recovery measures are going to saddle us all with record deficit levels. Us baby boomers are not exactly noted for our altruism, and my generation is going to put a lot of pressure on politicians to deliver the entitlements we've been promised. All of this means that budget dollars are going to be very tight, and the Pentagon is going to face tougher scrutiny when it brings in gold-plated requests. The Nation and Mother Jones may not be all that formidable a political opponent, but what about the AARP?
One of the great triumphs of Reagan-era conservatism was to convince Americans that paying taxes so that the government could spend the money at home was foolish and wrong, but paying taxes so that the government could spend the money defending other people around the world was patriotic. Ever since Reagan, in short, neoconservatives supported paying taxes to promote a U.S.-dominated world order, while denouncing anyone who wanted to spend the money on roads, bridges, schools, parks, and health care for Americans as a “tax and spend liberal." But if I'm right about the emerging fiscal environment, that situation may be about to change.
TIM SLOAN/AFP/Getty Images
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“The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails.”
Stephen M. Walt is the Robert and Renée Belfer Professor of International Relations at Harvard University.
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All of this means that budget
Hopefully, this will lead to a re-evaluation of the US Grand Strategy in order to build a security policy that doesn't have as high operating costs. That's realistically the only way you'll end up with lower defense costs - the budget follows the commitments we have.
I'm doubtful, though. What I think is more likely is that we'll get a nasty extension of the current situation, where we are actually under-funding our current Grand Strategy and system (basically, US military strategy is based largely around "Flexible Response" and being able to both project power in different arenas worldwide as well as deciding on a flexible amount of military power used in each situation).
It's much easier to under-fund commitments than it is to give them up.
We have publicly funded
We have publicly funded police, fire, school, etc. -- why are we the only industrialized nation to not have health included in this list?
Why not a private fire-dept to those neighborhoods who can afford it only?
Reagan was not the first
Reagan was not the first, I think Woodrow Wilson would be the first that convinced US people of that, being a small-government-jeffersonian who supported the first permanente income tax law which mainly provided the funds for WWI.
Constant nominal defense budget?
"Starve the beast" conservatives have counted on (and strongly promoted) an ever-increasing defense budget to help them eliminate domestic spending. I think you're right and the starving will be applied to military spending before long. What will Grover Norquist do then?
Has anyone heard about calls for a constant nominal defense budget? It's simple to understand, eliminates congressional rear guard actions to restore cut funding to particular programs, and forces the services to compete versus themselves, not the rest of the federal budget.
Health care IS a national
Health care IS a national security issue. A strong system of public health providers, accessible by everyone and networked into a good health information system, is our best defense against epidemics, either natural or man-made. Good health care for first responders, including a number of things we usually don't do now (like monitoring for mood and cognitive effects for at least three years after an acute respiratory distress incident -- what looks like PTSD may actually be, at least in part, a delayed inflammatory response to physical damage), is essential to keeping them functioning well. Timely and effective health care for veterans now lowers the cost of later treatments, keeps more of them active following overseas deployments, and facilitates recruitment of new active duty military personnel. We need universal access to affordable care and a national public-private partnership to evaluate and publicize best treatment practices NOW.
Postwar Conservatism and Intermestic Issues
There was a time when more-or-less principled 'small government' and isolationist Republicans existed. The Great Depression, World War 2 and FDR meant they were in the political wildness for almost a generation. They stuck to their guns until the 1950s, when Republicans like Taft and Hoover gave way or transformed themselves into the McCarthys, the China Bloc and the Nixons..
They found National Security to be an electoral issue with traction. They decided to forget that the National Security state, with its secrecy, permanent semi-war footing and defense budget that swallowed half of every federal tax dollar, was after all the biggest permanent example of big government in American history.
Since then, from Barry Goldwater onwards, they have simply ignored the contradiction, either out of hypocrisy, lies or ignorance: the U.S. Army is an institution apt to bring democracy to Saigon, but the U.S. Federal Government is not within its rights to bring democracy to Birmingham, Alabama. Reagan represented the symbolic and moral triumph of this form of doublethink in the conservative movement: neglect at home, crusade abroad.. and they have never looked back.
The U.S., you rightly point out, will have its resources strained in the coming years. Like all developing and aging countries (Europe, Japan, Taiwan, Russia, even China), there will be less resources and inclination for foreign adventures. And that is probably a good thing.
But there are many reforms which could give the U.S. more resources in general (which might be applied abroad) if the legacy of conservatism and consumerism were partly undone. Everything is an 'intermestic' issue now.
The U.S healthcare system is so wasteful and inefficient that it spends twice as much per head as other developed countries, without achieving better results. This represents several percentiles of GDP.
The U.S. is the only country which considers the only solution to delinquent youth or drug possessors/users to be mass imprisonment. Prison is the college of criminals, this strategy has proven self-defeating, leading the U.S. to have the most prisoners of ANY COUNTRY IN THE WORLD. The U.S. has 5% of the world's population and 25% of its prisoners. Its incarceration rate is about 7 times that of European countries. The U.S. prison-industrial complex costs some $60 billion per year, about 85% of the total defense budget of the People's Republic of China. (Not counting all the social and opportunity costs.)
Finally, there is transportation. The U.S. underinvests massively in public transport. The development of the suburban sprawl since the 1950s practically REQUIRES cars for normal life, this was a mistake. The U.S. also has bad consumption habits, using needlessly monstrously large vehicles (though those habits are slowly spreading to Europe). These are cause and consequence of low gas taxes in the U.S. This transportation system leads to an extremely unhealthy over-reliance on fossil fuels, with all the corresponding ills: vulnerability to the U.S. economy to oil price fluctuations (read: Mideast stability), massive transfers of wealth to dubious agents in the Middle East and elsewhere, perceived need for military adventures in oil-rich areas.
All these are areas we can work at. Obama has only voiced an interest in solving one. But if we were to make progress on all three, reducing our spending on oil, imprisonment and healthcare in line with those of the rest of the developed world, we would be in a good position to offset the new costs related to demographics and the weakening economy.
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