Packer on the peaceniks

slaniel | Assassins' Gate, The;Iraq | Monday, July 9th, 2007

Assassins’ Gate is thus far highly illuminating. Packer is very patiently walking us through the lead-up to the war, and seems to have interviewed most everyone involved in its planning and public justification. I suspect it’s because everyone involved views him as an honest broker. As a hawkish liberal in the days leading up to the invasion, he may have had more credibility than most.

Indeed, the only part I can criticize him for so far is his straw-man depiction of the peace protesters. Packer is probably right when he says that this country is largely divided between those who view all wars in the light of World War II, and those informed by Vietnam. Maybe he knows that most of his readers will be of the dovish variety (though I hope everyone reads it), so he spends a good chunk of his time explaining the ethical justification for the war — that Hussein was a butcher, and that any war which had a 10% chance of ousting him was worth the effort. Packer depicts those of us who opposed the war — including the hundreds of thousands of protesters on First Avenue in New York City, some of whom Packer interviews — as ethically innocent; we never set foot in Iraq, and we can’t imagine the horrors of a brutal dictatorship.

He may well be right about our innocence, but for many of us the issue was unrelated to the brutality. It was that we knew Bush was a liar. We knew that he was inventing reasons to go to war. And we knew that if there actually were good reasons to go to war, he wouldn’t have to lie to sell it to us. It was a matter of trust. I can’t say that I knew the administration would fail to prepare for the postwar cleanup. I also can’t say that I knew how the Iraqi people would greet us. But I did know that the administration couldn’t be trusted, and that colored all of my reactions to their war planning. It was the same for most of the people I knew.

At some level Packer must understand this, because he goes into great detail about all the lies hiding behind the Bushies’ public pronouncements. And, like everyone else, he saw the slow-motion buildup to the war for what it was: elaborate cover for a predetermined outcome. Yet he oddly doesn’t fit this into his model of the doves’ motives. I wonder why he missed that; it’s fairly obvious.

Fitzgerald before the Senate Judiciary Committee?

slaniel | Scooter Libby commutation | Sunday, July 8th, 2007

Chuck Schumer hints that it might happen, but I put my metaphorical money against it. Fitzgerald has tried very hard to be above the partisan fray; his statement on the commutation was as brief and narrow as it could be. I’d be highly surprised if he decided to testify about his interviews with Bush and Cheney.

Packer on totalitarianism

slaniel | Assassins' Gate, The;Iraq;Neoconservative ideology | Sunday, July 8th, 2007

I think I see the structure toward which Packer is patiently building in The Assassins’ Gate. Packer, you may remember, was a hawk in the pages of the New York Times and the New Yorker in the days up to and immediately following the start of the Iraq War. As The Assassins’ Gate gets rolling, Packer doesn’t explicitly mention the articles he wrote, but instead mentions the people with whom he was talking at the time. He mentions the excited intellectual climate in which he was swept up — all the people trying desperately to understand what exactly had happened on September 11, trying to understand what was driving the terrorists, and trying to put the whole conflict on some kind of world-historical plane. These weren’t isolated attacks; this went back at least half a century, to Sayyid Qutb. This was the war of totalitarianism versus democracy. It was a war of ideas.

Packer hints where he’s going with this: “He was responding viscerally to the event  . . .  and also at an extremely high altitude of abstraction, where details become specks.” The Bushies who latched onto this war were the ones who wrapped the world up in their ideas, shoved it out the door with a little money for bus fare, and hoped for the best; these are the people who seem to believe that if they just advance the right ideas, everything else will follow:

We’re an empire now, and when we act, we create our own reality. And while you’re studying that reality — judiciously, as you will — we’ll act again, creating other new realities, which you can study too, and that’s how things will sort out. We’re history’s actors  . . .  and you, all of you, will be left to just study what we do.

Of course there’s truth in that. The powerful do what they will, and the scholars try to make the naked exercise of power look a bit more coherent. And power keeps doing what it wishes.

The irony — and this, finally, is where I see Packer heading — is that defining your rule by ideas, and letting the details work themselves out, is part of what defines a totalitarian (apart from, you know, all the killing and stuff). Grab hold of one idea and follow it into the sun. Or as Saul Bellow put it in Mr. Sammler’s Planet:

Perhaps it was the madness of things that affected Sammler most deeply. The persistence, the maniacal push of certain ideas, themselves originally stupid, stupid ideas that had lasted for centuries, this is what drew the most curious reactions from him. The stupid sultanism of a Louis Quatorze reproduced in General de Gaulle — Neo-Charlemagne, someone said. Or the imperial ambition of the Czars in the Mediterranean. They wanted to be the dominant naval power in the Mediterranean, a stupid craving of two centuries, and this, under the “revolutionary” auspices of the Kremlin, was still worked at, in the same way — worked at! Did it make no difference that soon floating dominion by armed ships would be as obsolete as Ashurbanipal, as queer as the dog-headed gods of Egypt? Why, no, it made no difference. No more than the disappearance of Jews from Poland made a difference to the anti-Semitism of the Poles. This was the meaning of historical stupidity. And the Russians also, with their national tenacity. Give them a system, let them grasp some idea, and they would plunge to the depths with it, they would apply it to the end, pave the whole universe with hard idiot material.

Ideas matter, but so do details. You can’t reshape the world in your own image; the world has its own ideas. While I agree to some extent with the New York Times’s “end the war” editorial today, I don’t know that “the wise application of American power and principles” is exactly what the world needs right now. What the world seems to need right now is less principle and more empiricism — more people who understand how policies will work in the real world. We need less philosophy and more science. Abstractions without implementation have had their turn. Of course we need freedom and human rights, and we need people who defend them passionately — defend them against terrorists, and defend them against the United States government. But we need people who will get down in the dirt and pay attention to messy details.

P.S.: The Times’s editorial, linked above, contains this bit:

The United States has the greatest responsibilities, including the admission of many more refugees for permanent resettlement. The most compelling obligation is to the tens of thousands of Iraqis of courage and good will — translators, embassy employees, reconstruction workers — whose lives will be in danger because they believed the promises and cooperated with the Americans.

I’m pretty sure no one other than Packer has written about those translators, embassy employees and reconstruction workers; he described their plight eloquently (as always) in March.

The Assassins’ Gate: America In Iraq

slaniel | Assassins' Gate, The;Blood of the Liberals;Iraq | Sunday, July 8th, 2007

I’ve been looking forward to reading this book for a long time. I loved loved loved Packer’s Blood of the Liberals, I love Packer’s essays in the New Yorker, and I love his blog.

I’m only a short way into Assassins’ Gate. Its first 40 or 50 pages deal with the leadup to the (second) Iraq War, starting back in the Sixties as the neoconservatives scowled at Democrats’ perceived weakness before the Soviets. There followed, according to Packer, 30 years of tension over exactly what role human rights should play in our exercise of military power. I’m now at the point in Assassins’ Gate where the president has inexplicably made up his mind to invade Iraq, under the influence of Wolfowitz and probably Cheney — though, true to form, neither Packer nor anyone else seems to know exactly what Cheney said, to whom, when.

Finished Vampires, Burial, and Death

slaniel | Vampires, Burial and Death | Sunday, July 8th, 2007

Warning: gross discussions of corpses, and the handling thereof, ahead.

It’s good that Paul Barber can take his vampire studies with a bit of humor; I’d be sad if he had forgotten the comical roots of what became a very serious scholarly study of attitudes toward death. Hence in the middle of a very long and interesting section on what, specifically, happens to bodies after death, we have the footnote on page 163 that begins, “While we are dwelling on the unutterably loathsome . . . ” and this one on 176:

That the mouth of the corpse was open and the face red would be quite normal. The stake would presumably rebound because of the elasticity of the (bloated) body cavity. Also, it should not surprise us, by now, that a body moves when it is struck and bleeds when it is cut. I would guess that Giure Grando’s cry resulted from the manipulation of the corpse but can really not say much about the matter, since I almost never have occasion to decapitate a corpse with a shovel.

The process of decomposition is endlessly fascinating — something I realized vaguely, but not really in detail until I read Barber’s book. For instance, it hadn’t occurred to me that dumping a body in the water — even with a good bit of weight — is often not enough to keep it down; bacteria in the intestines produce a great quantity of methane, which often make the body swell to twice or three times its living volume and float to the surface. Hence if you really want to kill someone and dump his body in the water, you should slice open his stomach and intestines before you dump it; the gases will escape before they have time to puff up the body.

Barber’s introduction suggests that physiological details such as these — fun as they are — weren’t part of his original plan. He wanted to track down the roots of beliefs in vampires, which eventually led him to realize that belief in vampires comes from ignorance of disease. When your brother dies and then your sister, it’s reasonable to think that your brother has come back from the dead to haunt your family, and that the corpse has killed your sister. This belief gains some plausibility if your sister has reported seeing visions of your brother in her sleep in the days immediately after his death. All of these facts may be explained in a purely materialistic way, and a lot of the mystery disappears with a good theory of germs.

Looking back on times of plague, especially, a lot of mysteries disappear if you realize how people are buried and why societies treat corpses the way they do. If many people are dying at once, gravediggers don’t have the time to put the corpse six feet underground; they rush, and the body returns to the surface — maybe because there was a flood, or because the body’s natural bloating pushes the dirt away. It may well seem, then, that the body has “come back to life.” Driving a stake into it can, indeed, solve a lot of problems — bloating in particular. Burning the body is a decisive solution, but it’s also very expensive; one of the more interesting nuggets in Barber’s book is about the difficulty of burning a human body, especially on the scale needed during plague epidemics.

Vampires, Burial and Death rests on many such nuggets — various facts about decomposition and the preparation of corpses. They’re incredibly interesting, and have made me want to go read Coroner (which Barber cites), so long as it’s something more than a potboiler.

Unfortunately, those nuggets don’t hold together for a non-scholarly reader. The quantity of evidence amassed is quite impressive, and builds a convincing story. But it is repetitive in the extreme. I’m sure it contains no more mass than a death-studies scholar would demand, but for the general reader it could profitably lose 50% or 75% of its heft.

Pownce, etc.

slaniel | Pownce | Sunday, July 8th, 2007

Bill Tozier is inviting people to Pownce. Pownce is apparently

a way to send messages, files, links, and events to your friends. You’ll create a network of the people you know and then you can share stuff with all of them, just a few of them, or even just one other person really fast.

I’m sure it’s cool, particularly if Bill is flogging it. But I think I’ve had my fill of social-networking sites. They’re all participating in some kind of n-entity prisoner’s dilemma, where every one of them would be better off if they pooled their resources and built one über social network — maybe a meta social network that allowed us to share whatever we wanted without restraint. Instead they each want a piece of my attention, but my attention is in short supply nowadays. The last entrant loses unless it supersedes all the earlier ones.

I just walked from Roslindale, and boy are my legs tired

slaniel | Roslindale;Walking | Sunday, July 8th, 2007

For future reference, the walk from Taft Hill Terrace to Central Square takes just over two hours. I walked basically due north through the Arboretum and followed the Jamaicaway and the Riverway for most of the rest of the route; I’ll include a Gmaps Pedometer route sometime soon. I was too worried about getting lost, so I stuck closer to the roads than I probably could have. Next time I’ll go with a GPS and head straight through the greenspace.

The Transformers movie

slaniel | The Babe;Transformers | Friday, July 6th, 2007

I saw it the other day with The Babe and children. I don’t know that I’ve ever agreed with Roger Ebert more than I do with his review of this latest Michael Bay pic.

(Included below)

(more…)

“Human behavior is unmodelable”

slaniel | Darwin's Dangerous Idea;Evolutionary psychology | Friday, July 6th, 2007

More or less implicitly, I’ve heard this claim hundreds of times. I think it’s a bogus claim, even if you make the first-order passes at making it more precise based on everyday experience. Has it ever been made by a serious thinker?

Dan Dennett’s book Darwin’s Dangerous Idea is basically a prolonged attack on the idea that anything in the human mind or human culture is beyond the reach of science. The quality of its evolutionary-psychological evidence is weak and grasping; its ingenuity, and Dennett’s generally, is to open whole lines of argument that might have seemed closed previously. He can’t prove, for instance, that something as complex as the human conscience can be explained by natural selection. But he can surely prove that his argument stands on sturdier grounds than anyone else’s. And his argument fundamentally rests on one very strong tenet: if you’re going to apply natural selection to plants and animals, you have no logical reason to avoid applying it to the human mind or human society — other than your own squeamishness. (Richard Dawkins calls this the Argument From Personal Incredulity. Your inability to imagine that natural selection could do something does not constitute a proof.) Equivalently, if you’re unwilling to apply it to humans, then it’s up to you to explain why you’ll apply it to anything else.

So my predispositions are out on the table. Are there respectable arguments on the other side?

Nationalized health care feeds the terrorists?

I thought that maybe Talking Points Memo was kidding when they advertised a YouTube clip as though that’s what it contained. But that’s exactly what it contains. The Fox News headline, visible below the screen the whole time Neil Cavuto is talking, reads “National Healthcare: Breeding Ground For Terror?”

That’s just amazing. I don’t have the creativity to come up with something like that, even jokingly. And the reasons given in the clip for why this might be a reasonable fear are  . . .  to call them “beneath contempt”  . . .  please, just go watch this thing.

If these are the kind of arguments the other side puts forth, then I see three main possibilities:

  1. We should win in a rout.
  2. The public really can be convinced by such things, and really is that dumb.
  3. We deserve to lose.

Libraries and Google

slaniel | Libraries;Search | Thursday, July 5th, 2007

I’m reading “The Peloponnesian War and the Future of Reference, Cataloging, and Scholarship in Research Libraries” right now. While I don’t think he’s entirely incorrect, I think he’s attaching far too much significance to incidental details of the way the web works today. Anyone who reads this blog knows that I’m a big defender and lover of books, but it’s just not clear to me that the defects he identifies are persistent features of the web. I’m curious whether my readers would agree.

P.S. (5 July 2007): It’s just not clear to me, for one thing, that librarians will be necessary in a world that allows computerized full-text searching. Librarians may well do the job better than Google, but the marginal improvement may not be enough to make a difference. If Google buys you “80% of a librarian,” do you really need the librarian for that last 20%? There’s a decent analogy here with disruptive technologies: initially the technologies only serve your least-valuable customers, and you don’t pay attention to them — indeed, maybe you ignore them. Then they take your middle-tier customers. Eventually they’ve swallowed up all your customers, and by that point it’s too late to change. (Synopsis of disruptive technologies thanks to my coworker John. I picked up The Innovator’s Dilemma, whence this whole discussion springs, but found it too businessy and not economicsy enough.)

Mann’s big claim is that there’s a difference between scholarship and factfinding; Google and its brethren, says Mann, take care of the latter, whereas there will always be a market for the former. Technology, says Mann, can never help real scholars; only people can. That’s either completely bogus or highly questionable; I’m not sure which.

To take just one example: computers seem perfectly capable of finding taxonomies in collections of documents. Mann mentions databases that show you which documents cite the same sources; this is surely something that computers would do extremely well. I have no doubt that cluster analysis could divide up the intellectual world into far better nodes than any librarian could.

My friend James’s “Scan Them All and Let Google Sort Them Out” seems highly relevant here.

Vampires, Burial, and Death

slaniel | Vampires, Burial and Death | Wednesday, July 4th, 2007

 . . . is the book I’m reading now. (And yes.) Without even mentioning its content, I think we can agree that that’s an insanely cool title.

I wish I had decided to do something really cool with my life, like studying vampires in a scholarly way. Instead I’m stuck with all this computer bullshit. Man, I suck.

Moving Guantánamo to the mainland

slaniel | Guantánamo | Tuesday, July 3rd, 2007

Gah!

WASHINGTON, July 2 — Seeking a legal path to shutting down the Guantánamo detention facility, senior advisers to President Bush are exploring whether the White House and Congress can agree to legislation that would permit the long-term detention of foreign terrorism suspects on American soil, Pentagon and administration officials say.

The idea of creating a new legal category for some foreign terrorism detainees, which is still in its early stages, faces daunting political, legal and constitutional difficulties. But it is gaining support among some White House and national security officials as the most promising course to allow the president to close the site at Guantánamo Bay, Cuba, that has generated intense criticism at home and abroad.

Essentially, the administration would propose legislation that would result in dividing the estimated 375 Guantánamo detainees into three legal categories. The one that would call for legislative action would include detainees like Khalid Shaikh Mohammed, the mastermind of the September 2001 attacks, and others whose trials would risk exposing intelligence operations. This group, estimated at two dozen to 50, would be placed indefinitely in military brigs on American soil.

There’s so much that’s wrong with this, it’s hard to know where to begin. Most of the objections are obvious, so I’ll spare you. But I’d like to remind the New York Times that we do still have a judicial system in this country, and you are not allowed to call Khalid Shaikh Mohammed “the mastermind of the September 2001 attacks” until he’s been tried and convicted.

I’m going to go fume for a while.

Formal grammars, William Feller, and recurrent events

slaniel | Feller, William;Formal languages | Tuesday, July 3rd, 2007

I would love it if someone could explain this line to me, from “Fine Hall in its golden age”:

We are by now so used to [William] Feller’s ideas that we tend to forget how much mathematics today goes back to his “recurrent events”; the theory of formal grammars is one outlandish example.

I know a little about stochastic processes, which is what the “recurrent events” bit refers to. I know the teensiest bit about formal grammars. I can imagine something like a “stochastic formal grammar,” which would be a set of production rules with associated transition probabilities. I don’t exactly know what the use of that would be, but I can at least see the connection between stochastic processes and formal grammars. But then how would recurrent events be used?

P.S.: Having just started reading the Wikipedia entry on formal grammars, another little thing that really shouldn’t have been confusing to me suddenly became clear. Maybe now would be the time for me to pick up a formal-languages book.

The breadth of Cities and the Wealth of Nations

slaniel | Cities and the Wealth of Nations | Tuesday, July 3rd, 2007

The scope of Jacobs’s book is simply breathtaking. Incorrectly viewing nations as the fundamental economic units, she says, has polluted everything. Even exchange rates turn out to be dangerous in largest part because they send the wrong signals to cities; they indicate the aggregate economic strength of a nation, but cover up its failings in auto parts, software, or agriculture. It thus takes years for Detroit, Silicon Valley, and the Midwest to pick up their individualized warning signs.

In Jacobs’s view, a city-state with its own currency is the ideal size. A city thrives when it is “import-replacing”: constantly learning how to produce the things it imports from other cities, creating new improvised versions of them, and exporting them to other areas — some of which go on to become cities of their own. A city is the basic unit of innovation. Cities of interlocking innovation are the only combined units that matter. These are the only economic units that have ever mattered, at least back to the Roman Empire. All this according to Jacobs. Import-replacing regions thrive and stay constantly alive; Jacobs says that all import-replacing regions become cities, so “import-replacing region” and “city” are basically synonyms. The natural partners of cities are other cities; these are the only other regions that can bring new knowledge and vitality to a city.

Those cities that engage in the “transactions of decline,” on the other hand, will eventually fail. Here a transaction of decline is a transaction that may on its face look like it brings some development to the city, but in reality is killing it. Perhaps surprisingly, Jacobs counts defense contracting as a transaction of decline: defense innovations do not help cities with their own internal needs, and they are never import-replaced. They count as dead weight, absorbing labor and capital that could be going to more productive uses. (I wonder whether the Internet would change her mind at all. Though the Internet doesn’t count as a defense contract in the sense that Jacobs cares about; the Internet was, rather, a civilian innovation paid for by the DoD. I don’t know if this is just senseless hairsplitting.)

Jacobs lumps defense and welfare payments together, along with most other transfer payments, into “transactions of decline.” In all these cases, she says, the money is going out and never coming back as new ideas. In large part all these transfer payments are political toys, meant to fund the declining suburbs and farmlands at the expense of the cities that generate real innovation. Still worse is that once transfer payments start, she says, they’re unlikely to stop.

It may be clear that she is not an optimist. Except in a few cases — she singles out Boston’s Route 128 “miracle,” apparently under the tutelage of a venture capitalist named Ralph Flanders — she finds a city’s decline unstoppable once it’s begun.

I can’t attest to the truth of it, but it does have some inherent plausibility. The whole argument rests on the single basic idea that import replacement is fundamental to the economic life of cities. If that’s true, then most of the rest of her argument follows. And she argues on the basis of an alarming breadth of knowledge, spanning every inhabited continent over several thousand years; if she’s not left out any relevant evidence, then it’s convincingly in her favor.

Of course it’s written throughout with the passion of someone who really, really loves cities and hates to see them die for no good reason; The Death and Life of Great American Cities, written before she moved to Toronto, is a paean to Boston’s North End, Philadelphia’s Rittenhouse Square, and her home of New York City. She loves seeing what innovative people can do when they’re packed together with lots of other innovative people. Contrariwise, the death of cities, and their misunderstanding by clueless but well-meaning bureaucrats, is an unending source of righteous indignation. You couldn’t hope to find more well-aimed intellectual firepower in anyone else’s books.

Jane Jacobs, Cities and the Wealth of Nations

In The Death and Life of American Cities, Jane Jacobs demonstrated with clarity, intelligence and righteous indignation that city planners had for decades — going on a century, in fact — misunderstood the virtues that cities possessed, and hadn’t understood why people wanted to live in them. According to Jacobs, all of orthodox city planning was built around the belief that what city dwellers most wanted was to leave the city and live in a suburb or on a farm. So they bulldozed blighted neighborhood after blighted neighborhood and replaced them with parks. When many of those parks themselves became blighted, filled with the familiar sight of the homeless and drug users, orthodox city planners could only scratch their heads; that simply wasn’t supposed to happen. If anything, this only confirmed cities’ incorrigibility. So they wiped out sizable sections of major American cities and built freeways out; clearly people would prefer to be elsewhere. The millions who continued to live in American cities were an inconvenient datum.

In Boston, the West End was demolished in the Fifties and replaced with architecture of stunning banality. The North End, which is now one of the most desirable and expensive neighborhoods in the city, was cut off from the rest of Boston by the highway at the same time. As Jacobs detailed it in Death and Life, the North End only began to thrive because its own residents lent each other money to improve their properties. Fast-forward fifty years: the highway has moved underground (aka the Big Dig), which finally re-integrates the North End, and Mayor Menino admits that leveling the West End wasn’t the best idea. (I’ll provide a cite later today.) Either we learned what Jacobs was trying to teach us accidentally, or we learned directly from her. I’m inclined to believe the latter.

In Cities and the Wealth of Nations, Jacobs claims that national governments repeat the same misunderstandings of their cities on a larger — and possibly more tragic — scale. At this larger level, they believe that they can produce economic activity just anywhere. Struggling farmland? Dam up their rivers, build schools, give them tax breaks, and invite foreign companies to build factories there. Wait a few years and watch a million economic flowers bloom.

City planners believed — and maybe still do believe — that a city was just a defective pasture. According to Jacobs, national planners likewise believe that a city could thrive anywhere. So they build cargo-cult cities [*] and pray that the same thing which animates their real cities will turn their farmland into the next New York.

But of course that normally fails. A real city has a good reason for being there; a cargo-cult city does not. People aren’t fooled. They want real cities.

Jacobs wants to recast all of macroeconomics using these insights and others, and has the rhetorical skills to convince at least one non-economist that she’s on to something. All the dynamism in a national economy, says Jacobs, comes from its cities. Even the vaunted “heartland” of the United States only survives because cities have brought industrial technologies to their farms. If you want to understand why a nation succeeds or fails, says Jacobs, look to its cities. The title of her book is no accident: she wants to yank economics off the track that it’s been on ever since Adam Smith. At the very least, counting cities as the fundamental macroeconomic units increases the amount of available data: there are only a couple hundred nations, versus a few thousand cities.

Jacobs started thinking about Cities and the Wealth of Nations in the late Seventies, when stagflation had left orthodox macroeconomists scratching their heads. Unemployment and inflation were not supposed to rise in tandem; higher prices were supposed to lead to lower unemployment. (Prices rise, so companies produce more, so they need more workers, so unemployment goes down.) But that wasn’t happening, and in varying degrees hadn’t been happening for a decade. This led Jacobs to wonder whether economists hadn’t been looking at their world in entirely the wrong way.

Her argument makes intuitive sense. I wonder whether economists, by and large, have come to agree with her.

[*] — I will never tire of using “cargo-cult” as a metaphor.

Finished Sick

(Cover of 'Sick'. Features a rolled-up wad of $100 bills in a prescription bottle) I can’t recommend this book highly enough. At first glance, one might expect its structure to be gimmicky:

  1. Interview someone who suffered because of our country’s health-insurance system.
  2. Zoom out from that person to explain the political and economic background to his or her suffering.
  3. Zoom back in.
  4. Repeat 2) and 3) a few times.
  5. Move on to the next person and repeat from step 1).

Far from being a gimmick, I couldn’t imagine a better narrative device. Jonathan Cohn combines the passion of a muckraking journalist with the erudition of a historian. His delivery is simple, unpretentious, and never cloying.

His conclusion is simple: health insurance as delivered by private companies doesn’t work, because their incentive is always to cut services to the bone; the ideal hospital for an insurer is one that has no patients. The history of health insurance, as Cohn tells it, is the history of nonprofit corporations and idealistic doctors slowly getting replaced by for-profit corporations that destroyed the industry they were ostensibly meant to save.

Of course there’s a way out; it’s the way that every other industrialized nation uses, namely guaranteeing citizens the right to health care as a basic condition of citizenship. They spend far less than 16% of their GDP on health care, which is where the U.S. is today. The main obstacle to universal health care in this country is political and ideological; it’s because this country is so dominated by libertarian political orthodoxy. We overcame that orthodoxy in the Sixties and got Medicare and Medicaid; in Cohn’s telling, they are models of efficient health-care delivery. (He says that surveys of the elderly, who are covered by these programs, find that they’re more satisfied with their coverage than are young people in private insurance programs.) It will take a political change to bring us universal health care, but we’ve come close before. There’s no reason we couldn’t do it again.

American dissatisfaction with government, though, is much greater than it was during the Great Society. And we’ve elected at least two presidents (Reagan and Bush) who’ve proved that government is dysfunctional by staffing their departments with dysfunctional true believers in the virtues of the free market. Most of us seem convinced that government is in fact the problem, because we’ve either never seen it work right, or because we’re trained to look at it as through a glass, darkly. But why should government be any worse now than it was in the Sixties, or for that matter the Forties? I’m not convinced that there’s anything standing in the way of efficient government-funded health care, other than the perception that it can’t work.

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