Rethinking War

In 1258 Hulagu Kahn and his Mongols sacked Baghdad, slaughtered its citizens, and destroyed the final remnant of the Abbasid Caliphate. They stacked the heads of their victims in a giant pile and placed their camp upwind to avoid the stench. That was total war and that war was over.

In 2003 an American Army entered Bagdad, deposed its dictator, and spent the next six years trying to keep its citizens from slaughtering each other. That was not total war and it isn't clear it is over.

In 2012 a rag tag band of thugs in Gaza fired hundreds of rockets into Israel, from launchers placed in densely populated areas to ensure maximum civilian casualties in the inevitable retaliation. After a few weeks both sides accepted a fragile cease fire that no one expects to last. That was sort of war and it may never be over.

Not since 1945 has a western nation waged war with a determined commitment to victory. Harry Truman established the precedent in 1951 when he fired Douglas MacArthur and decided to fight China to a stalemate in Korea. In 1972 Richard Nixon, unwilling to fight on indefinitely, essentially sacrificed South Vietnam to the communists rather than risk an invasion of the North. In 1991 George H. W. Bush declined to advance on Baghdad after defeating the Iraqi Army in the first Gulf War, thereby ensuring there would be a second.

I don't mean to second guess any of the post WWII strategic decisions. They all had strong arguments in their favor, and I certainly don't advocate a return to the barbarism of the thirteenth century. But it seems to me we have adopted some dangerous attitudes toward limited warfare that are leaving the world a more dangerous place.  

The Middle East is less stable than it has been in decades, maybe at its most volatile ever. Precipitous pullouts from Iraq and Afghanistan could make matters worse. Our half hearted intervention in Libya may well prove disastrous.

East Asia, calm since Vietnam, has begun to see more and more saber rattling. China is determined to become a maritime power and is showing enough belligerence to make their neighbors nervous. There have been a few skirmishes. Something could easily get out of hand.

The American pivot toward Asia is looking hollow. The events of the Arab Spring demand a sizable military and naval presence in the Mediterranean whether we want one or not and come at a time when budget pressures are crying out for major short and long term cuts in defense spending. It isn't clear where the assets to be repositioned to the Western Pacific are going to come from. 

We can not afford the forces required to overwhelm every threat to our interests wherever they appear in the world. We must become more circumspect in thinking an American military response is the answer to every international political crisis. We should be rethinking the sources and uses of American strength. Some of them are military. Some are cultural. Most are economic.

We are blessed with astounding agricultural capacity. How can we use that to feed and cloth a world growing more prosperous and more populous? It is a moral and strategic imperative.

We have enormous energy reserves and the technology to recover them. How can we apply that to improve economic and physical security, for ourselves and the world?

We are the world's most important trading nation. How do we integrate our economy so closely with friends, and the not so friendly, that to endanger those ties becomes unthinkable?

We are not thirteenth century Mongols. We will not indiscriminately cut off the heads of all our enemies. If we can't make the price of hostility that high, can we offer paths to mutual prosperity instead? 

The Catholic Vote

Most Catholics who attend Mass regularly voted for Mitt Romney. Most nominal Catholics who rarely or never attend Mass voted for Barak Obama. Add them together and it's a near tie, advantage Obama. But let's think about this. About 40% of Mass regulars voted for a man who is so radically pro-abortion he opposes even requirements to provide palliative care for infants who survive a late term abortion, preferring they be allowed to die slowly of asphyxiation. Why would committed Catholics vote for such a man?

Some of them of course are what I would call Joe Biden Catholics, people for whom faith is little more that a public display of ashes on their foreheads at the beginning of Lent. But some of them, and I have some very dear friends in this category, are people who care deeply about their God, their Church, and their fellow man. Why would they vote for a man who supports gay marriage, would force Catholic institutions to pay for employees' birth control pills and abortifacients, attended a blatantly racist church for more than twenty years, has no apparent spiritual values, and has implemented policies that drove millions of Americans from the middle class into poverty? It is a question I hope our Bishops are asking themselves.

It wasn't the economy. Regardless of exit polls indicating the economy was the most important issue, people voted largely along ethnic lines. No one can credibly claim the President has been a good steward of the economy. It wasn't ignorance. A Catholic churchgoer would have to be deaf not to have heard the impassioned protests from the pulpit when the Obamacare birth control mandate was announced. So what was it?

I don't pretend to understand it all but I would posit that it is at least partly the result of the Magesterium's diminished and diminishing authority. We just don't listen the way we once did. We hear the Bishops but theirs is not necessarily the last word. We have been taught to challenge authority, even theirs. I would like to say we have learned to think for ourselves but that would be a stretch. I can say we have learned to listen to multiple sides of an argument. We have to be persuaded. We can no longer be told.

Many people, including many Catholics have concluded the Church has become so stridently focused on abortion it trumps everything else. No other social issue really matters. And she clings stubbornly to a quixotic war over birth control she lost half a century ago. Most Catholic couples of child bearing age practice birth control and don't see anything wrong with it. Most of us are strongly pro-life, or at least anti-abortion, but there isn't much we can do about it. Many of us think other issues do matter and see, mistakenly in my view, Democrats as the party that sides with the poor. It is as though Democrats now hold more moral authority for many than the Church.

I don't suggest the Magesterium realign its teaching to conform to popular culture but this isn't working. We might want to consider picking our battles more carefully. It is important that the Church be seen as the champion of the downtrodden, all of them. We aren't. It is crucial that Catholics understand the difference between a handout and true charity. Despite Pope Benedict XVI's best efforts in Caritas in Veritate many of us don't. It is vital that when US Bishops speak to politicians they do so as the heads of a solidly united Church. They don't.

Social justice is one of the Church's most powerful messages. It isn't sinking in. Why?

  

Texas Medicaid

Governor Rick Perry has decided Texas will opt out of the Medicaid expansion proposed under the Affordable Care Act. Dallas Area Interfaith, a community advocacy group I normally support, is campaigning to accept the expansion. I prefer the opt out.

Arguments in support of the expansion boil down to two. It will give health insurance to Texans who are uninsured today, which is partly true and, because it is paid for mostly with federal dollars, it is a bargain for Texas, an argument I reject on its face.

First some facts. Medicaid is paid for partly by the federal government and partly by the state. States are allowed to set eligibility requirements subject to minimums. Texas applies something close to the minimum. ACA sets a uniform eligibility of 133% of Federal Poverty Level, much higher than current Texas rules. The Feds pay all the added costs initially, 90% later on.

In Collin County there about 40,000 people currently covered by Medicaid, about three quarters of them children. It is almost impossible for a childless adult under 65 to qualify. But the County has a program to enroll bonafide residents with incomes up to 100% of FPL who can then get treatment from Primacare at county expense. There is an alternative program called Project Access Collin County which relies on physicians and hospitals to volunteer time and facilities for a limited number of patients. The county pays ancillary expenses for things like drugs, mammograms, and X-rays. PACC also accepts non "county patients" up to 200% of FPL if they don't have other insurance. In essence, in Collin County you can get access to health care if you are poor and uninsured even if you aren't eligible for Medicaid.

If Medicaid coverage is expanded the county program presumably goes away. All the people now covered by the county would be eligible for Medicaid, not necessarily a good thing because very few doctors accept new Medicaid patients. That is because payment levels are so low doctors can't afford more than a few of them and regulatory requirements are onerous. ACA attempts to address this by temporarily (for two years) raising payment levels to the same as Medicare. But what doctor is going to load up his practice with Medicaid patients if they are going to drive him out of business in two years? Insurance isn't much good if doctors won't accept it.

As for PACC they are left serving people with incomes between 133% and 200% of FPL, and those who don't meet Medicaid residency requirements. I'm not sure that is a viable proposition.

It seems to me this is a step backward for Collin County's poor. I don't know about the rest of the state and it may be that Medicaid covers services not provided under current county programs but that is a case I haven't seen anybody make.

Then there is the issue of how this is to be paid for. ACA uses funds saved by reducing Medicare payments to providers and insurance companies over time. But we've been trying to reduce Medicare costs with price controls for years and we know that doesn't work. Every year Congress has to pass a "doc fix", raising rates to prevent a mass exodus of doctors from the program. The only reason I can find a doctor who will accept my Medicare insurance is Medicare has more constituents than Medicaid and can bring enough pressure on Congress to pass the doc fix.

The bargain argument rest on the dubious proposition that Texans will receive better health care (I've already questioned that,) become more productive, and return net economic benefits. I don't see it well supported anywhere. I've even seen it said that it really doesn't matter anyway because the Feds will borrow the money. But just because other states are jumping on this bandwagon doesn't mean we should too. The piper will have to be paid. Obamacare is deeply unpopular and even if Obama is re-elected, we should know in a few days, I question whether congress will fund it. This is a bad idea and it is a loser.