The executive ranch

For a glimpse into the mindset of the Bushies, I offer the example of Dr. Richard Carmona, the man the president chose to be his Surgeon General in 2002. Carmona left that post in July for a new position where I can continue my work as Surgeon General to promote and advance the health of the nation.

Carmona will do this as vice chairman and chief executive of the health division of Canyon Ranch, which features a health resort facility in Tucson, Ariz., which charges $2,340 per person for four nights in a double room. Thats the bargain off-season rate. In season, the rate is $3,280, according to The Wall Street Journal.

Thats the Republican way to promote and advance the health of the nation.

Commission omission

On July 10, 2001, the CIAs George Tenet and Cofer Black gave Condoleezza Rice an urgent warning about al Qaeda, which she ignored during the two months before 9/11. Why wasnt that mentioned in the 9/11 Commission Report? Could it have anything to do with the fact that the commissions executive director, Philip D. Zelikow, was a former colleague of Rices in the Bush I administration, and that he is now serving as one of her top subordinates at the State Department?

Breaking the news

In late September, the number of Americans wounded in Iraq passed 20,000, and at last the shocking story of the wounded reached the front pages, as The Washington Post made it the lead story on Sunday, Oct. 8.

I was heartened because I thought that now the story would receive the attention it deserves from the rest of the media. But later that day, the story was swamped by news of the North Korean nuclear test.

The same fate awaited the estimate of more than 600,000 war-related Iraqi civilian deaths since Bush invaded. The study had been conducted by respected researchers from Johns Hopkins University and Mustansiriya University in Baghdad, funded by M.I.T., and peer-reviewed and published by the British medical journal, The Lancet. But after one day in the sun, that story also disappeared. Ive forgotten what replaced itsurely it was something crucial, like the Madonna adoption news.

Not-so-instant messaging

One detail I hadnt known about how the Republican leadership kept the lid on the Foley scandal was called to my attention by The Charleston Gazettes Scott Finn. He points out that although John Shimkus, chairman of the House page board, knew about the Foley emails months earlier, he did not disclose them to the other members of the committee until Foley resigned. Finns source was not a partisan Democrat, but a Republican congresswoman.

Macro credit for micro credit

Anyone who has ever been involved in the struggle to help developing nations has to love the award of a Nobel Peace Prize to Muhammad Yunus for his program of tiny loans to help poor people start businesses. When I worked for the Peace Corps in the 1960s, it was already clear that the absence of credit for the poor was a major obstacle to their escape from poverty. Most foreign-aid agencies, like the World Bank or the U.S. Agency for International Development, favored large projects that sounded impressive and were bureaucratically more convenientits easier to write one big check than thousands of small ones.

Unfortunately, a large percentage of the big projects were boondoggles that helped only a few in the host countrys ruling elite. What was desperately needed was just what Yunus has done. Bless him and the Nobel committee for recognizing his achievement.

Over for Grover

Several more nails were pounded into the coffin that is Grover Norquists reputation, when a report of the Senate Finance committee found that Norquists Americans for Tax Reform appears to have perpetrated a fraud on taxpayers. The Abramoff scandal has already produced one conviction and seven guilty pleas. Adding Norquist could mean curtains for the total sellout lobbying he has encouraged by insisting on all-Republican lobbying firms.

It is true that few lobbying enterprises have ever been totally innocent. But at least the pre-Norquist custom on K Street, which balanced staffs with Democrats and Republicans, meant that lobbyists understood the importance of listening to the other side. The DeLay-Abramoff-Norquist strategy of riding roughshod over your opponent concedes nothingespecially to the public interest.

Gladwells tipping point

You may recall that in 2000, this magazine published a debate on the Canadian health system between Adam Gopnik and Malcolm Gladwell. The reason I asked the two to debate was that I had learned that Gopnik was the author of an anonymous but very persuasive item in favor of the Canadian system published in The New Yorkers Talk of the Town section. Earlier, I had, over a lunch with Malcolm Gladwell, found that he made the most effective case Id heard against the Canadian system.

Six years later, in a New Yorker article titled The Risk Pool, Gladwell implied that he now found himself in favor of the Canadian system. I wrote asking if my inference was correct. His reply was affirmative:
Why have I changed my mind?…. I woke up one day and realized what much smarter people than me (Adam Gopnik) realized a long time ago, which is that the idea of employer-based health care is just plain stupidand only our familiarity with it and sheer inertia prevent us from rising up in rebellion. I always try to think of a suitable analogy and fail. The closest I can come to is, imagine if we had employer-based subways in New York. You could ride the subway if you had a job. But if you lost your job, you would either have to walk or pay a prohibitively expensive subway surcharge. Of course if you lost your job you would need the subway more than ever because you couldnt afford taxis, and you would need to travel around looking for work.

Gladwell went on to say that the mistake he made in the Monthly debate was, I confused a funding problem with a systemic problem. On a per-capita basis, Canadians now spend on health care something like 60 percent of what Americans spend. If that were increased to say, 65 percent, many of the rationing and wait-time problems would be alleviated. The problem with American health care, by contrast, is systemic. No simple increase in funding fixes the problem.

A good lawsuit

As regular readers know, Im capable of considerable cynicism concerning my former brethren, trial lawyers. Sometimes, however, they are essential to making the system work. Such, I believe, is the case with a suit filed by Randal McCloy Jr. and families of the dead Sago miners against the International Coal Group for its indifference to their safety. A hefty verdict in their favor might cause coal companies to decide that providing safe working conditions is cheaper than their potential liability for not doing so.

Very basic training

From the time that Bushs choice as viceroy, L. Paul Bremer, disbanded the Iraqi army in the spring of 2003, it has been clear that one of the urgent tasks confronting us is to train a new force. Administration officials repeatedly told us that a new Iraqi army would be able to take over. Yet three and a half years have passed, and the Iraqi army is nowhere near ready to take over.

A few months ago, we noted Greg Jaffes report from The Wall Street Journal about how miserably housed the Iraqi troops are. Now comes another Journal story by Jaffe about the quality of training and equipment the United States has provided. He tells of the shock experienced by Lt. Col. Nick Demas, when he learned that he had been assigned inexperienced reservists from Maryland…. to live with, train, and mentor Iraqi troops. Jaffe makes clear the colonels situation was not atypical. One factor: the U.S. army culture that discourages good officers from taking advisory posts.

As for the equipment we give the Iraqi army, the advisors are warned, you will not have all the radios, weapons, night vision devices and field gear issued to a U.S. battalion. This turns out to be a considerable understatement. One advisor told Jaffe, we had to beg for support. It was like pulling teeth.

Overdosed

As you advance through your senior yearsIll be 80 this monthphysicians tend to prescribe more and more drugs to keep you going. A resulting problem is that you tend to have more and more adverse reactions, ranging from irritating rashes to life-threatening conditions. Ive had three in just the last couple of years. And Im not alone. According to the Associated Press Lindsey Tanner, government research shows that each year, more than 700,000 Americans experience reactions serious enough to send them to the emergency room. Doesnt this suggest that physicians and pharmacists should be more careful about prescribing, exploring the likelihood of adverse reactions, and considering the possibility of unhappy interactions with drugs the patient is already taking?

Private plane, public pain

One night in the 1960s, I was flying on a friends private plane from New Haven to Washington. About a third of the way there, I looked out my window on the right and saw the breathtaking spectacle of New Yorks skyscrapers lit up in all their gloryand they were not miles away, but right outside my window. I wondered if this wasnt dangerous. Not because of terrorists, who we werent worried about back then, but because I knew many private pilots had only the most modest training and were fully capable of veering off course and crashing into one of the tall buildings. I was, of course, flying down the East River, just as was Cory Lidle in October.

This was the beginning of a curiosity about the world of private planescalled general aviation. What I learned over the years is that they are under-regulated, because the F.A.A. has been spineless in the face of the lobbying power of private plane owners, many of whom are wealthy and influential. There is no better proof of this lobbying power than the fact that, five years after 9/11, private planes were still able to fly down the East River. Even more worrisome to me is the danger from jets, which, as we all know, are capable of destroying large buildings. Private jets are multiplying rapidly because they make it possible for the wealthy to avoid the hassle of the lengthy security lines involved in regular airline travel. One problem with the jets is that they fly at similar altitudes to the regular airlines, with the resulting increase in the possibility of mid-air crashes, like the one that happened in Brazil.

Health benefits

If you doubt something is radically wrong with our current health-care system, please ponder the case of William McGuire, the departing CEO of one of the nations largest health-care insurers, UnitedHealth Group Inc. McGuire is being forced out because of his participation in a stock options scandal. He could leave the company with as much as $1.1 billion in stock options, retirement payments and other benefits, reports The Wall Street Journal. Think of all the people that much money could cure.

Offensive jets

In case you doubt the damage that could be done by a straying private jet, consider the Brazilian Embraer Legacy private aircraft. It was supposed to fly no higher than 36,000 feet, but it drifted to 37,000 feet, the space occupied by a regular Brazilian passenger plane. The pilot did not tune his radio to the correct frequency to hear ground controllers. Furthermore, his equipment was faulty, with a transponder either switched off or not working that would otherwise have sent a signal to the passenger jet and activated a collision warning device.

All seven people on the private jet survived the crash. All 154 people on the passenger plane did not.

Its Obama time

I was delighted to see that the moderate conservative David Brooks has written a column in The New York Times titled Run, Barack, Run, in which he says that the times will never again so compellingly require the gifts that he possesses. I agree.

Obama has the ability to see the wisdom in conservative and liberal positions that can bring the country together. His speaking ability can inspire. And the fact that he ends up mostly on the liberal side means to me, if not to Brooks, that he will usually lead in the right direction. Reeking electability, he clearly has the potential to be a good president. I pray that he lives up to itand, not so incidentally, that he decides not to pose for more Vogue covers.

Time to go

The Baker-Hamilton commission on Iraq had not reported when we went to press, but I have two worries about it. James A. Baker is too much of a Bush loyalist to admit that the war was a terrible mistake. Lee Hamilton is a very conscientious man, and many conscientious Americanseven those who think that the war was wrong or that we have totally bungled the occupationbelieve we must stay in Iraq until there is a right time to leave.

Unfortunately, there is never a right time. We long ago lost the credibility with most Iraqis that might have enabled us to play a constructive role in their future. Staying much longer wont help. Remember that although the British stayed in India for 104 years, as soon as they left, Hindus and Muslims went into a frenzy of mutual slaughter that cost a million lives. The best we can do is give reasonable noticeIm with John Murtha on six monthsthat will let responsible Iraqis know that now is the time to get their act together, and that will defuse the anger of Iraqis who are killing and maiming our soldiers simply because they want us to go. Finally, we should make orderly provisions for sanctuary, in this country or elsewhere, for the Iraqis who have stuck their necks out on our behalf and who fear reprisal. We must never repeat the horror of Saigon, where we left thousands of Vietnamese clamoring at our embassy gate as the last helicopter departed.

Reach out and gyp someone

Telephone repair time irks clients, was the headline on a recent story by The Charleston Gazette. The Gazette story attributed the problem to Verizons overtime policy. But it did not get at the reason for Verizons reliance on overtime, which is that a few years ago, the company downsized its repair force in an effort to improve profits. The truth is that the breakup of AT&T left everyone with a great gainmuch cheaper long distance ratesbut with much poorer and more expensive local service. Ill never forget my shock when this magazine moved in the late 1980s after the breakup to find that it cost $1,000 to reconnect our phones, while the cost under the AT&T monopoly was so negligible that it did not impress itself on my memory.

Thats why this item is patented

The U.S. patent office is often accused of issuing too many dubious patents. Especially those that are obtained by fly-by-night companies to blackmail legitimate patent holders with the threat of a patent infringement lawsuit. Why would the patent office do this? Im indebted to our alumnus and current New York Times columnist Joseph Nocera for the answer, which is that the patent office gets its funding from the fees it collects when it issues a patent. In case you dont know, the F.D.A.s drug approval process is similarly corrupted.

Another good lawsuit

Another example of the good trial lawyers can accomplish comes from a lawsuit against First Data Bank, which publishes a list of prescription drug prices used as benchmarks for determining what many health plans and state Medicaid programs pay pharmacies for drugs. The Wall Street Journals Barbara Martinez reports that First Data has made the drug companies and pharmacies happy by keeping the prices high. But the lawsuit has produced a settlement requiring the list prices to be lowered enough to result in a predicted saving of $4 billion in 2007 alone.

Thats some harvest

In case you missed The Washington Post article on the crop insurance racket, heres what it disclosed. Last year, crop insurers received $829 million from the government in administrative fees to help run the program. On top of that, taxpayers kicked in $2.3 billion to subsidize the premiums farmers pay for crop insurance.

What did the farmers get from the insurance companies for their losses? Exactly $752 million. What was the annual profit of the insurance companies? $927 million.

Easy there, Norm

Norm Ornstein, in a recent appearance on Bill Moyerss TV show, was eloquent in his denunciation of how corrupt and partisan the U.S. Congress has become. But then he got carried away: If the Founding Fathers were alive today, they would be turning over in their graves.

So much for the Magna Carta

The worst thing about the Military Commissions Actrecently passed by Congress to permit the Bush administration to bring the Guantanamo detainees to trialis that it deprives detainees of the right to habeas corpus. What that right means is that, within a reasonable time after they are detained, their attorney can go before a judge to test the legitimacy of their detention. What can be wrong with that? The only risk is possible exposure of the fact that the government does not have good reason to keep the detainee in prison.

For evidence that the government is capable of making terrible mistakes in who it accuses of terrorism, I recommend you see The Enemy Within, a Frontline special for PBS that tells how the Justice Department totally fabricated the exposure of a supposed al Qaeda cell in Lodi, Calif. At the end of the broadcast, Lowell Bergman, the producer, asks the U.S. attorney who originally brought the case, So if I get this accurately, there has not been, nor is there now, an al Qaeda cell in Lodi, California?

The U.S. attorney: Thats correct.

Charles Peters

Charles Peters is the founding editor of the Washington Monthly.