Monthly Archives: November 2014

What We Learned form the Report of the 9/11 Commission VI.

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“The modest national effort exerted to contain Serbia and its depredations in the Balkans between 1995 and 1999, for example, was orders of magnitude larger than that devoted to al Qaeda.” (p. 487.) Neither the American public nor American leaders seemed to even notice terrorism as a problem in the post-Cold War environment.

 

Crisis: August 1998.

Immediately after the embassy bombings CIA Director George Tenet knew that there would be a big gathering of terrorist leaders at Khowst in Afghanistan on 20 August 1998, and CentCOM commander Tony Zinni had his cruise missile plan already to go. The responsible decision-makers talked over the issues until 20 May and sent the Vice-Chairman of the JCS to warn the Pakistanis that the cruise missiles flying through their air space were not an Indian attack. Nobody wanted a nuclear war on the sub-continent as an unintended by-product of the strike at Bin Laden, but this probably constituted a serious breach of security. The missiles missed Bin Laden by a few hours and some people think that he was warned off by Pakistan’s intelligence service. (pp. 169-171.)

Clarke wanted the cruise missiles strikes of 20 August 1998 to be the opening act for continuous efforts to kill Bin Laden. It was not to be. (pp. 175-176.)

Although JCS Chairman Hugh Shelton ordered CENTCOM to plan for additional measures, he “did not recommend any of them.” “Shelton felt that the August 1998 attacks had been a waste of good ordnance and thereafter consistently opposed firing expensive Tomahawk missiles merely at ‘jungle gym’ terrorist training infrastructure. In this view, he had complete support from Defense Secretary William Cohen. Shelton was prepared to plan other options, but he was also prepared to make perfectly clear his own strong doubts about the wisdom of any military action that risked U.S. lives unless the intelligence was ‘actionable.’”(pp. 502, 503.)

CENTCOM commander Tony Zinni, who actually had to come up with a possible scheme, believed that a long-term development of relationships with neighboring countries made the most sense. Covert action of any kind would require some kind of local base. Zinni got the feeling that Washington was picky about doing business with dictators merely because they could help out the United States. (p. 197.)

Already haunted by memories of “Desert One” and “Black Hawk Down,” decision-makers probably became even more cautious about using force to solve the Bin Laden problem in the wake of the failed cruise missile strikes of 20 August 1998. (pp. 172-173.)

In addition to missing Bin Laden, there were serious downsides to this attack: international opinion heaped abuse on the US for being “bomb-happy”; the Republicans ridiculed Clinton for “pinpricks.” (pp. 172-173.)

Soon afterward, American diplomatic and military power was being applied in the Balkans against Serbia (October 1998-March 1999) and in the Middle East against Iraq (December 1998). This distracted most of the key people from problem of terrorism.

At the same time it is important to note that people working for Allen Holmes, the Assistant Secretary of Defense for Special Operations and Low-Intensity Conflict, produced a paper calling on the Defense Department to assume the lead in the global fight against terrorism. (pp. 176-177.) This paper did not get very far up the chain of approval during the Clinton Administration, but it may have lain dormant until Rumsfeld came to the Pentagon.

Sore Winners and Sore Losers from Obamacare.

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Medicare provides health insurance for 98 percent of Americans aged 65 and over.

Who lacked/lacks health insurance before/since the Affordable Care Act (ACA)?

Group                                                  Before ACA               Today              Difference.

All Americans under 65                      16.4 percent                11.3 percent    -31 percent.

Hispanic-Mexicans                              26.2 percent                16.5 percent    -37 percent

Blacks                                                             24.1 percent                16.1 percent    -33 percent.

Whites                                                14.1 percent                10.0 percent    -29 percent

Asians                                                             13.6 percent                 9.7 percent    -29 percent

Aged between 18 and 34,                   21.6 percent                14.2 percent    -34 percent[1]

Aged 35 to 44                                     16.4 percent                11.2 percent    -32 percent

Aged 45 to 54                                     15.0 percent                10.6 percent    -29 percent

Aged 55 to 64                                                 12.7 percent.               9.1 percent    -28 percent

Poorest 20 percent of neighborhoods 26.4 percent                17.5 percent    -36 percent

Next poorest 20 percent                      21.6 percent                14.3 percent    -34 percent

Middle 20 percent,                              17.6 percent                11.9 percent   -33 percent

Next highest 20 percent                      13.4 percent                 9.4 percent    -30 percent

Richest 20 percent                               6.5 percent                6.5 percent    ————–

 

Overall and within almost all groups, the ACA has reduced the uninsured by about one-third. Still, two-thirds of those who were uninsured before the ACA remain uninsured today.

Why hasn’t a plan intended to provide almost all Americans with health insurance come anywhere near to achieving that goal? In large measure, the failures of this part of the ACA go back to its design. The ACA originally sought to coerce the states into expanding Medicaid to cover many of those who are uninsured today. In 2012, the Supreme Court rejected that component of the plan. States were left free to expand or not expand Medicaid. So far, twenty-seven states have chosen to expand Medicaid, while twenty-three have rejected it.

Why did many states reject Medicaid expansion? One answer would be Republican wrecking tactics directed against the center-piece of President Obama’s agenda. However, not all Republican-led states rejected expansion and not all Democratic-led states accepted it.

It is possible that rational calculation played a role. The states that rejected expansion had an average uninsured rate of 18.2 percent before the ACA, while those that accepted expansion had an average uninsured rate of 14.9 percent. Federal subsidies for expanded Medicaid are scheduled to be reduced in a few years. States will have to increase their share of the expanded costs. Many of the states that rejected Medicaid expansion pursue a low-tax strategy to attract business. Other parts of the ACA were not completely thought through. Perhaps the failure to make the complete Federal subsidy permanent is another such “glitch.” It will take a Democratic House, Senate, and White House to fix it.

Even in states that expanded Medicare, 9.2 percent of people remain without insurance.   Why? Ignorance? A libertarian resistance to coercive good intentions? Most Republicans have an ideological opposition to an “entitlement” that was forced on them by Democrats. Unlike post-war Europe, there is no consensus on this issue.

Kevin Quealy and Margot Sanger-Katz, “Obama’s Health Law: Who Was Helped Most,” NYT, 29 October 2014.

[1] Understates the gain because it doesn’t include the three million people who are allowed to remain on parents’ insurance.