Our deaf, schizophrenic uncle S.

William Pfaff, a writer who wrote about European-American relations and the challenges of perceived unchallenged US global leadership well before the Iraq induced and war-blogged “transatlantic rift”, may have indeed listened to Carly Simon when he wrote his not too favorable review of Zbigniew Brzezinski’s election year foreign policy summary “The Choice: Global Domination or Global Leadership” for the latest issue of the New York Review of Books.



His disappointment with the book is primarily caused by its unwillingness to fundamentally challenge some of the myths of rationality of current US foreign policy. Quite to the contrary, Mr Pfaff has no inhibitions to call them all by their name, despite being aware that many of the myths of past and present American foreign policy and politics, particularly the notion of a “unique historical mission ? whether or not divinely commissioned” ? are not open to logical refutation.


That said, I think the last part of his essay is one of the most eloquent descriptions of the communicative disaster that happened particularly between Europe and the US in the last two years.


“Every country has a “story” it tells itself about its place in the contemporary world. We are familiar enough with the American story, beginning with the City on a Hill and progressing through Manifest Destiny toward Woodrow Wilson’s conviction we are “to show the way to the nations of the world how they shall walk in the paths of liberty…. It was of this that we dreamed at our birth.” The current version of the story says that this exalted destiny is fatefully challenged by rogue nations with nuclear weapons, failed states, and the menace of Islamic extremists. Something close to Huntington’s war of civilizations has begun. National mobilization has already taken place. Years of struggle lie ahead.


The “isolation” of the United States today is caused by the fact that its claims about the threat of terrorism seem to others grossly exaggerated, and its reaction, as Brzezinski himself argues, dangerously disproportionate. Most advanced societies have already had, or have, their wars with “terrorism”: the British with the IRA, the Spanish with the Basque separatist ETA, the Germans, Italians, and Japanese with their Red Brigades, the French with Palestinian and Algerian terrorists, Greeks, Latin Americans, and Asians with their own varieties of extremists.


America’s principal allies no longer believe its national “story.” They have tried to believe in it, and have been courteous about it even while skepticism grew. They are alarmed about what has happened to the United States under the Bush administration, and see no good coming from it. They are struck by how impervious Americans seem to be to the notion that our September 11 was not the defining event of the age, after which “nothing could be the same.” They are inclined to think that the international condition, like the human condition, is in fact very much the same as it has always been. It is the United States that has changed. They are disturbed that American leaders seem unable to understand this.


When American officials and policy experts come to Europe saying that “everything has changed,” warning that allied governments must “do something” about the anti-Americanism displayed last year in connection with the Iraq invasion, the Western European reaction is often to marvel at the Americans’ inability to appreciate that the source of the problem lies in how the United States has conducted itself since September 2001. They find this changed United States rather menacing. An Irish international banker recently observed to me that when Europeans suggest to visiting Americans that things have changed in Europe too, as a direct result of America’s policies, “it’s as if the Americans can’t hear.” A French writer has put it this way: it has been like discovering that a respected, even beloved, uncle has slipped into schizophrenia. When you visit him, his words no longer connect with the reality around him. It seems futile to talk about it with him. The family, embarrassed, is even reluctant to talk about it among themselves.”

39 thoughts on “Our deaf, schizophrenic uncle S.

  1. I think this rift will be long term. I have the same feelings when speaking with Europeans. They seem almost pathologically unable to recognize how Western societies have contributed to global instability and the rise of the Islamists. Regarding believing the “American story”; why would Europeans believe an american story when they are so busy trying on construct one of their own to replace the “discredited” American one.

    This is competition not cooperation.

  2. Stacy: agreed. And, I would like to add, that competition is good.

    I’m all for the rift getting wider. Let’s disband NATO, let’s pull out of the UN, let’s go unilateral. Europe is completely on a different trajectory, based on the assumption that social welfare states are the be-all and the end-all of all thriving societies, when they are such obvious failures: they cannot support themselves without being economically tied to free-wheeling, capitalist America.

    Europeans simply don’t understand that, with the collapse of the Twin Towers, multiculturalism, also, came tumbling down. For there clearly are cultures that are inferior, deserving elimination – Wahhabi Islam being the prime candidate. This is anathema to European multicultural sensibilities, to be sure, but then again European sense of cultural security has been artificially supported by the American security umbrella. It was the Americans, after all, that prevented European society from being swallowed up by the monolithic Soviet state that strove to eliminate “differance” (as French Marxists would say).

    If there are “myths” in American foreign policy and politics, there are certainly an equal number, if not more, myths in European politics. The prime myth is that Europe is self-sustaining. It is not. It has allowed itself to become dependent on America, at the cost of the American people. If now America decides to call off the deal, it is up to the Europeans to make the necessary adjustments.

    Of course, one of these adjustments will entail blaming America for the changing circumstances, – for pulling out of the “deal”. But there is no reason whatsoever for maintaining close ties, given the anti-Americanism within Europe today, which actively seeks to pursue policies to the harm and detriment of America.

  3. RSN

    For the most part I agree with you. Why not remain in the UN and Nato? It is always nice to have the thin edge of the wedge available via “old/new” europe.

    I think we need to start putting the Israeli/Palestinian conflict into context. We need to recognize a proxy war when we see it.

    Per a prior post, a Carly Simon enthusiast thinks we are vain. Well, when you are a “hyper-power” a little vanity is to be expected. Ask the French!

  4. RSN,

    did you read what Pfaff says in the quoted article about the self-sufficiency of Europe and the US dependence on NATO?

    European anti-Americanism, if you want to call it that, has always been a cyclical phenomenon. It’s not like it’s the first time. This time, it’s mostly a question about what’s going on over there. Pfaff has put that very well – it’s like a disease a close friend is suffering from yet does not want to admit and face it. Everybody feels the need to straighten things out but you don’t want to hurt the suffering friend by simply being logical and correct.

    The real rift we are looking at is, however, the value rift that goes right through the right center of American politics. That’s independent from the Wilsonianism or Jacksonianism debate, it’s a fundamental social cleavage that does not exist in Europe but, and thus the current transatlantic quarrels simply mirror this inner-American rift.

  5. Stacy,
    Regarding believing the “American story”; why would Europeans believe an american story when they are so busy trying on construct one of their own to replace the “discredited” American one.

    To me, that sounds an awful lot like the scientific process in action; One theory that explained/predicted X has been discredited by empirical evidence Y, it’s only natural reject said theory and to work to come up with a new theory.

    As to Western societies having contributed to global instability and the rise of the Islamists, that’s one theory. But I don’t see what it meaningfully contributes to the question of what to do going forward.

  6. For there clearly are cultures that are inferior, deserving elimination – Wahhabi Islam being the prime candidate. This is anathema to European multicultural sensibilities, to be sure, but then again European sense of cultural security has been artificially supported by the American security umbrella.

    Right. That explains why France, Belgium, and Germany are legislating against the hijab as a sign of female inferiority and subordinate in Muslim minority communities–they’re completely relativistic.

  7. My pathetic attempt at a Fisking…

    “Most advanced societies have already had or have their wars with “terrorism”..Eta..IRA..Red Brigades..”

    Notice any difference between these groups and Al Qaeda? Could it be possible that these groups are all homegrown whereas AQ is a completely foreign entity. Gee, I think the Spanish, British and Germans may have reacted differently to these groups if they were based outside of their countries and were made up of foreigners instead of their own citizens. And why the scare quotes around terrorism? The IRA and Eta don’t qualify as terrorists? I see, the Euros are once again so much more sophisticated them us Americans. They have EXPERIENCE with “terrorists”, we overreact.

    “The belief that the US has a unique historical mission whether or not divinely commissioned is not open to logical refutation. But an American policy that rests on a self-indulgent fiction must be expected to come to a bad end.”

    Not open to logical refutation? Really? He should ask Pat Buchanan and the Jeffersonians about that.

    All nations need a “national story” to articulate your ideals and animate their policy makers. Yes, even the Europeans need one. They simply submerged their old nationalistic ones (they turned out badly in the end) into a larger project.

    Tobias,

    Anti-Americanism is “cyclical phenomenom”?
    Anti-Americanism is a constant (see James Ceaser and Jean-Francois Revel). It is part of the animation within the their new EU story.

    Regarding NATO, If Europe is not dependent on a American military presence why were/are US troops
    in Bosnia/Kosovo? More importantly, why were American F-16’s necessary? Not just because the Europeans don’t have them but because they were unwilling to use any military forces until the British and Americans forcefully urged them to (more British them American).

    Pfaff makes some important points, mainly about American hubris, but he makes the same mistakes he charges Brzezinski with. He uses old assumption to rationalize his position. His piece stinks of EU condescension.

    In my opinion, the rift in American society and politics is reflective of a larger rift in the Western democracies. To be or not to be that is the question.

  8. Notice any difference between these groups and Al Qaeda? Could it be possible that these groups are all homegrown whereas AQ is a completely foreign entity.

    Completely ? I was under the impression that OBL was a Saudi and one of his biggest beefs is that Saudi Arabia is an American satrapy.

    [The belief that the US has a unique historical mission whether or not divinely commissioned is] Not open to logical refutation? Really? He should ask Pat Buchanan and the Jeffersonians about that.

    I don’t think you understood Pfaff’s point: That the belief that the U.S. is and should remain the “leader of the _free_ world” is an article of faith in American Politics, that to suggest otherwise is considered heresy.

    Fact is, the U.S. squandered away much of its moral claim to world leadership in the way it invaded Iraq.

    Prior Good Deeds in Kosovo do nothing to alter that.

  9. The IRA is based in Ireland (North included) and that lays outside Britain. So claiming that the English don’t have experience foreign terrorist is simply wrong.

  10. Pat,

    “Fact is, the U.S. squandered away much of its moral claim to world leadership in the way it invaded Iraq”

    There is no such thing as a “moral claim to world leadership”. There are U.S. interests, French interests, Chinese interests, Ghanaian interests, etc. And there are the resources those polities can bring to bear, collectively or individually, to serve those ends. And there’s cooperation when they see a chance to save assets / increase efficacy by pooling resources when those interests don’t diverge too radically.

    All the rest of it is window-dressing, and always has been. They might all _miscalculate_ where there interests lie or how to best serve them, but make no mistake as to motivation, on all sides at all times.

    Post-WW2 U.S. leadership was not a matter of “moral leadership”, it was a matter of a broke, broken Europe and Japan and a U.S. producing a large proportion of world product all looking askance at a tough looking USSR with interests that diverged radically from everybody else?s. The U.S. led because it had the money and everybody wanted to go in the same basic direction.

    Come 2004, Europe and Japan are no longer broke (if still remarkably weak in power-projection terms) and don’t feel like playing follow-the-leader anymore. I don’t have a problem with that, it’s been on my personal horizon since reading Paul Kennedy’s _Rise & Fall of the Great Powers_ on a trip to Leningrad.

    What I find laughable is the idea that we might want to shift our perception of our interests in order to accommodate them so as to preserve some imaginary ‘moral leadership’. If you’ll pardon my French, screw that. Better a parting of the ways on some issues, if that’s what it must come to. I’m confident that rank self-interest will keep everybody cooperative wherever it’s still appropriate. :^)

    Bernard Guerrero

  11. Carl,
    I think the Ulsters would disagree with you. Northern Ireland is part of Great Britian. That’s why there was an IRA.

  12. Stacy,
    The people of Ulster may disagree, but i doubt the English would. Also Northern Ireland isn’t part of Britain

  13. Bernard,

    That’s a very good Real Politic argument. Unfortunately Real Politic has not served us (USA) well in the past decade. Moral calculus is not always the determining factor but to satisfy the masses it must be part of the equation.

    Patrick,

    When OBL carries an American passport then he’ll be homegrown. My point is AQ represents a new type of terrorism.

    Further, regarding being “the leaders of the free word” I understands Pfaff point, I simply disagree with him. There has always been a strong current within American policy that rejects this position. The Jeffersonians best articulate it.

  14. Carl,

    As long as there are Northern Irish PM’s sitting the House of Commons Northern Ireland will be part of the UK. You are right though, NI is not part of Britain, but it is part of the UK.

  15. “If you’ll pardon my French, screw that. Better a parting of the ways on some issues, if that’s what it must come to. I’m confident that rank self-interest will keep everybody cooperative wherever it’s still appropriate.”

    Judging by the current output of American media and blogs, even the vestigial international credibility of the Bush administration is now open to doubt. On reading this:

    “Later in the [9-12], Secretary Rumsfeld complained that there were no decent targets for bombing in Afghanistan and that we should consider bombing Iraq, which, he said, had better targets.” – quoted from: http://www.j-bradford-delong.net/movable_type/2004_archives/000518.html

    . . more than a few around the world will be expecting men in white coats to be attending Rumsfeld in close proximity wherever he goes.

    OTOH it is reassuring to read assessments from America such as this:

    “The Washinton Post article, ‘Iraq Attacks Blamed on Islamic Extremists,”‘ contains the following revealing paragraph:

    “In the intelligence operations room at the 1st Armored Division?s headquarters (in Baghdad), wall-mounted charts identifying and linking insurgents depict the changing battlefield. Last fall the organizational chart of Baathist fighters and leaders stretched for 10 feet, while charts listing known Islamic radicals took up a few pieces of paper. Now, the chart of Iraqi religious extremists dominates the room, while the poster depicting Baathist activity has shrunk to half of its previous size.” – William Lind at: http://antiwar.com/lind/?articleid=2177

    When dissent and insurgency is so widely distributed, even the most dedicated and maniacal exponents of strategic bombing solutions have a challenging problem with target selection. A reversion to reality suggests that other solutions will likely be more effective. After all, the bombing option didn’t prove especially effective in Vietnam, a prior instance of asymmetric war.

    Besides, looking to the medium to longer term horizons, an extrapolation of economic trends indicates that within a few decades, China and then India will have overtaken America to become the largest national economies in terms of GDP thereby leading to a switch in the capacities for economic leverage:

    “LONDON: India is likely to be the Internet’s new centre of gravity along with China, according to the top official of the body that oversees the Internet.

    “Paul Twomey, the chief executive of Internet Corp for Assigned Names and Numbers (Icann), says that the pull from the Far East and emerging markets such as India and China was becoming very strong. . . ” – from: http://timesofindia.indiatimes.com/articleshow/559519.cms

  16. Stacy,

    When was the last time that Ulster mp’s were on the goverment benches? I don’t think they were in the last thirty years. In fact i think that the Saudi’s have more power in Washington than Ulster has in London so if you look it that way than Bin Laden is more homegrown than the IRA

  17. Carl,

    The Saudi’s have power every where they can buy it, including Madrid and Paris. Does that make OBL spanish and french? Or is he a citizen of the world? Considering how much influence Saddam and the Iranian Mullahs have with the French maybe they should apply for a passport. Saddam could certainly use one about now.

    My original point that possibly European experience with terrorism, while useful for fighting the War on Terror, was not always comparable to fighting an organization like Al Qaeda. The IRA and Eta have specific political goals and select targets based upon those goals. AQ wants to eliminate the USA. I guess that is a specific goal, but one there can be no compromise with. At least for me there is no compromise, maybe you feel and think differently.

  18. Europe is completely on a different trajectory, based on the assumption that social welfare states are the be-all and the end-all of all thriving societies, when they are such obvious failures

    Yo, RSN: check out this link:

    http://apnews.myway.com/article/20040323/D81G7NOG0.html

    I have no trouble with you lambasting Europe, but please keep things in perspective.

  19. AQ wants to eliminate the USA.

    AQ wants to eliminate Jews and Christians. Americans happen to be their favorite targets (at least in their propaganda) right now. If you are looking for a Nemesis, in the case of AQ, you go and find an instantly recognizable, high profile one.

  20. Stacy,

    The IRA and ETA are both organizations who stated claim is to “liberate” their country and turn it into a communist paradise. OBL wants to “liberate” the world (of us) and let Allah turn it into paradise. I highly doubt that Allah exist but the chance that he can turn the world into paradise is still greater than the zero chance you have with a communists goverment.

  21. Yo, Snarky, check this out:

    http://story.news.yahoo.com/news?tmpl=story&cid=573&e=18&u=/nm/odd_britain_surgeon_dc

    The key line being:

    “…there is a 39-day waiting list for brain operations…”

    Americans are being fed a line of bull when it comes to the viability of European national health care systems.

    What does national health care matter if you can’t get it in time? People are dying in Europe all the time because of overburdened national health care systems.

    But that rarely gets reported in America’s liberal media apparatus.

  22. Tobias:

    Pfaff’s argument about the self-sufficiency of Europe is wholly based on security needs, and not on economic needs. Europe is completely dependent on foreign economic engines for growth, and will be until it solves the question of how to fund growth within its aging welfare states. Because of this, European political self-sufficiency will also be limited.

    As to US dependence on NATO, that is simply not true. There is nothing to prevent the US from dissolving NATO, and making bi-lateral security arrangements with individual nations. For example, having bases in Germany doesn’t make any sense, and a security treaty between the two is irrelevant today and a waste of US resources. However, a treaty with Bulgaria or Romania would certainly make a lot of sense, – and a NATO structure is not needed for that. Not only would the US gain from having bases closer to trouble spots, but the moneys spent on such bases would certainly be of benefit to those economies – making the US presence more appreciated than in Germany. Bulgaria and Romania, certainly, are also aware of the lack of resolve implicit in Western European societies when it comes to crises (Yugoslavia being the prime example), so a treaty with the US is definitely of value over there.

    Most NATO allies are absolutely useless for the US, and a waste of resources. With bilateral treaties, the utility of individual alliances can be monitored more effectively.

    It is true that there is a rift in American society today. But that does not mean that Europe has already grappled with the issues America is grappling with today. On the contrary, Europe is very much behind the learning curve, living a life of illusion, brought on by an excessive trust in the “self-evident” values of multiculturalism. Multiculturalism is not a self-evident value for Arabs or, say, the Chinese. Multiculturalism is seen as a weakness in Western society to be exploited, – a means for less tolerant societies to impose their own hegemonic visions on the world.

    America is beginning to understand this, because America has a more vibrant, boisterous, contentious internal debate going on, compared to Europe. You Europeans may deride this as schizophrenic, but its better than being stuck in a no-growth state of aging sclerosis, only able to absorb events, and never to react, and attempt to change things for the better.

  23. RSN,

    to use the NHS waiting lists as an argument against the welfare state is hardly a fair argument, as they are are a consequence of decade long public underinvestment, esp. under Thatcher but even before. The dismal state of the British public health care system is far less a consequence of wrong incentives in the system than of lack of resources. The British spend around 7% of GDP on health, the US spends more than twice as much, and that is relative to a higher GDP/pc.

    >Pfaff’s argument about the self-sufficiency of >Europe is wholly based on security needs, and >not on economic needs.

    I’m sorry, but this argument strikes me as highly eclectic. Now that there is a counter argument to the claims that the EU depends on US in security terms, you simply reformulate the problem??? I agree on the current growth problems to a certain extent – but problems are far led a conequence of aging than of changing coordination mechanisms – aka transaction costs of transformation processes. Esp. in Germany. This is what costs growth now but what will cause catch-up grwoth rates in the future. As it has happened in the US in the 1990s.

    >As to US dependence on NATO, that is simply not >true. There is nothing to prevent the US from >dissolving NATO, and making bi-lateral security >arrangements with individual nations. For >example, having bases in Germany doesn’t make >any sense, …

    Except that Ramstein is the biggest base outside the US and has infrastructure built over 50 years including a social network that spreads dar beyond the military bases. There is no way to reconstruct this on short notice by paving a runway in Bulgaria. I doubt there would be agreement on bilateral treaties without NATO. What woudl be the point?

    >Most NATO allies are absolutely useless for the >US, and a waste of resources. With bilateral >treaties, the utility of individual alliances >can be monitored more effectively.

    Well, that’s religion. It’s certainly not mine. But you’re clearly entitled to yours.

    >It is true that there is a rift in American >society today. But that does not mean that >Europe has already grappled with the issues >America is grappling with today.

    No, we don’t have this problem. Christian fundamentalism is a fringe activity over here. There is no religious/secular rift within the “western” majorities of European societies. No conservative party in Europe even partly reflects such a social cleavage, even the UK Tories, clearly the most Conservative bunch to find enywhere on this side of the pond think that there is something strange going on in the US.

    >On the contrary, Europe is very much behind the >learning curve, living a life of illusion, >brought on by an excessive trust in the “self->evident” values of multiculturalism.

    To some extent, true. Adjustments are being made. Integration is now clearly the favoured policy all over the continent.

    >Multiculturalism is not a self-evident value >for Arabs or, say, the Chinese. >Multiculturalism is seen as a weakness in >Western society to be exploited, – a means for >less tolerant societies to impose their own >hegemonic visions on the world.

    Well, we gotta find a way to live with our weaknesses – if we think they’re strenghths. The Chinese aren’t particularly keen on Democracy either, yet the last time I checked, the US still thinks that’s a streghth rather than a weakness.

    >America is beginning to understand this, >because America has a more vibrant, boisterous, >contentious internal debate going on, compared >to Europe. You Europeans may deride this as >schizophrenic, but its better than being stuck >in a no-growth state of aging sclerosis, only >able to absorb events, and never to react, and >attempt to change things for the better.

    I think Americans simply like to fight more over opinions. Call that vibrant, if you want. As for the no-growth state, remember your words in five years…

  24. Snarky: “I have no trouble with you lambasting Europe, but please keep things in perspective”

    The flagging economic performance of the Eurozone has not passed unrecognised in Europe – as the links quoted below show [1].

    The basic problem, as diligent followers of European news know, is that the governing parties in France and Germany have been recently punished in regional and local elections. As best they can, both governing parties, the UMP in France and the Social Democrats in Germany, are trying to push through essential reforms of national welfare systems and taxation but without the necessary supporting political consensus for doing so.

    Since the UMP is a centre-right party and the Social Democrats are centre-left, this is not a simple “Left” versus “Right” issue in Europe. The historic roots of state welfare in mainland Europe go back to Bismarck, first Chancellor of the German empire (1871-1890), who introduced a state pension scheme and whose political tendencies were anything but left-wing. The “generosity” of state welfare systems has been a partisan issue in European politics from time to time but the political consensus supporting state welfare systems is deeply embedded. Political parties seeking election are apt to lose out whenever they get tagged as favouring welfare cuts. The inevitable outcome is that the process of reform is slow.

    Part of the political chemistry is the insider-outsider problem, long recognised in many economic commentaries [2]: those with jobs and recipients of state welfare have little personal incentive to want reform even when the result is sluggish performance of national economies. The immediate victims are the unemployed and national electorates to the extent that economies grow slowly with low rates of new job generation. Sad to say, there is nothing new about this problem:

    “While Western Europe reported no net new jobs from 1973 to 1994, the United States generated 38 million net new jobs” [Lester Thurow: The Future of Capitalism (1996), citing the Economic Report of the US President, 1995]

    [1] Links:

    “EUOBSERVER / BRUSSELS – In an interview with the EUobserver, Christoph Leitl, President of business association Eurochambres says the EU has ‘no prospect’ of catching up with the US economy by 2010.

    “Dr. Leitl, whose association represents over 17 million businesses in Europe, said, ‘To speak frankly and clearly, there is no prospect of reaching the 2010 [Lisbon summit] goals. On the contrary, we have a widening gap between the strong economy in the United states … as we are widening the gap, all alarm bells have to sound.'” – from: http://www.euobserver.com/index.phtml?sid=9&aid=14902

    “EUOBSERVER / BRUSSELS – Very few people would argue that the EU?s economic aim to be the most competitive economy in the world by 2010 is going especially well. Some blame the Commission for not providing leadership. Others blame individual EU Member States for not implementing measures agreed at EU levels.

    “But this merely detracts from the real issues that Europe needs to face, says Andre Sapir, senior economic advisor to the Commission and a noted expert on the EU economy.” – from: http://www.euobserver.com/index.phtml?sid=9&aid=14916

    ” . . the Netherlands could secure another new EU post, with the likely appointment of Wim Kok as head of a group that will carry out a mid-term review of the so-called Lisbon agenda – the set of reforms designed to make European economies more competitive and catch up on US-style productivity and innovation by 2010.

    “Mr Kok, a former Dutch premier, already headed a taskforce that recently reviewed the EU’s employment strategy. An EU official said yesterday that Mr Kok’s appointment would ‘add political impulse’ and send a much clearer signal of EU leaders’ resolve to raise the trading bloc’s competitiveness than if the mid-term review had been left in the hands of the European Commission.” – from: http://news.ft.com/servlet/ContentServer?pagename=FT.com/StoryFT/FullStory&c=StoryFT&cid=1079419877303&p=1012571727166

    [2] For example: Assar Lindbeck: Unemployment and Macroeconomics, MIT Press (1993).

  25. Tobias,

    “to use the NHS waiting lists as an argument against the welfare state is hardly a fair argument, as they are are a consequence of decade long public underinvestment, esp. under Thatcher but even before. The dismal state of the British public health care system is far less a consequence of wrong incentives in the system than of lack of resources.”

    I have to question the logic of the above statement. The whole point, from a social-welfare PoV, of structures like government agencies or markets is to determine the distribution of resources or the incentives under which others will determine the distribution of resources.

    If the problems with NHS are due to chronic underinvestment that dates back to the pre-Thatcher era, then one has to question whether the NHS model is capable of producing the proper level of investment. This isn’t a stochastic blip, after all, it’s a secular inability to get it right across a wide range of different economic and political conditions. The U.S. system does not draw additional resources as compared to the NHS via some form of magic, its structure is such that pulling additional resources in is nearly inevitable. That’s why the big worry over here isn’t wait-times, it’s the rising proportion of resources dedicated to the whole thing and the distribution of the results.

    If the U.S. spending twice the proportion of GDP on healthcare is the proximate cause of having a shorter wait in the U.S., then one of the main arguments for setting up such a system in the U.S. vanishes. Apparently that extra slice of GDP is not merely going towards duplicative administrative functions, etc.

    This doesn’t make the case cut & dry, by any means, but I don’t think that claiming chronic underinvestment is a valid excuse; it’s an indictment.

    Bernard Guerrero

  26. Tobias,

    Famously, spending in America on healthcare, public and private, as a percentage of GDP, is higher than any other OECD country by far. The really curious thing is, however, that life expectancy at birth is marginally lower in America than in almost all west European countries and the infant mortality rate is marginally higher.

    For all their spending on healthcare, in terms of ultimate outcomes, Americans get a very bad deal for their money spent. There are more acute care beds in hospital per head of population in Britain than in America. Britain’s huge disadvantage is in the relatively low number of physicians per head of population we have compared with America and even more so compared with almost all of the rest of western Europe, a factor for which past governments and the medical profession are largely responsible.

    For a handy access to recent comparative data, try OECD in Figures 2003 at: http://www1.oecd.org/publications/e-book/0103061E.PDF

    About forty years back, browsing in a London bookshop, I came across a collection of essays by Richard Titmuss, a professor of social administration at the London School of Economics and one of the intellectual gurus of the early post-war welfare state in Britain. In essentials, the justification as presented for Britain’s National Health Service was that America’s healthcare system was so awful. Much the same argument is often echoed nowadays. Only in recent years has much research in Britain been directed at making comparisons with what goes on in other west European countries – try here: http://www.civitas.org.uk/pubs/healthMain.php?&MMN_position=6:6

    By World Health Organisation rankings of national heathcare systems, France usually comes out top with Britain fairly well down and America even lower.

  27. You might want to research life expectancy methodologies before you go too far down that explanatory road. Specifically look into how countries count premature birth survival rates. In many European countries a pre-mature birth followed by death within a day is counted as miscarriage. In the US it is counted as a birth for life expectancy purposes. When I last looked that counted for almost half of the difference.

    The other thing is about choices. In the US, people make many poor eating and lifestyle choices. That is not a problem of health care spending inefficency.

  28. Stacy,
    Care to explain how “When OBL carries an American passport then he’ll be homegrown” is qualitatively different from being “almost pathologically unable to recognize how [America] has contributed to global instability and the rise of the Islamists.” ?

  29. Bernard,
    There is no such thing as a “moral claim to world leadership”. There are U.S. interests, French interests, Chinese interests, Ghanaian interests, etc.

    That’s roughly my point. If the U.S. goes around humiliating everybody and their cousins, there isn’t going to be anybody interested in allying itself with the U.S.

    The odd incident might be tolerated for the advantages (rich demented uncle) the rest of the time, but all abuse all the time…not worth it after a while.

    The U.S. has done much lately to undermine it’s position at the top of the international hierarchy.

  30. Sebastion,

    Fair enough criticisms but even so it is not at all clear just what additional benefits Americans are getting from committing 13.9% of GDP to healthcare, as compared with only 9.5% in France, 10.7% in Germany or 7.6% in Britain on OECD figures.

    Only diehards in Britain and the misinformed claim our National Health Service is a model to emulate. In the mid 1990s, the NHS was distributing promotional literature making the truthful claim that it was the largest single employer in the whole of western Europe as though that was an achievement to boast about.

    The New Labour government in 1997 introduced an array of output targets to improve performance of this giant, Stalinist edifice, apparently unaware of a Soviet literature, going back to the 1950s, on how output targets distorted allocations as actors in the system focused on the easiest way of meeting the official targets to the detriment of outputs not targeted. The range of targets is then increased to address the distortions and administrative resources increased to monitor and enforce the new targets. Last October, the present health minister suddenly announced that a third of the civil servants in the Department of Health were to be made redundant as part of the reforms underway to decentalise decision-making in the health service.

    New Labour’s first health minister had an obsession about avoiding competition among healthcare providers. The implications of that came home to me a couple of years back when my GP recommended a minor hospital test. I asked if I could go to the nearest hospital to where I live. Not now, he said. I would have to go to the approved district hospital, which happens to be further away, requiring two bus journeys, because that is how the boundaries have been drawn. That is absurd, of course.

    Seems to me the constructive way forward is to compare national healthcare systems across a range of countries in Europe to see how they function and with what costs and benefits. As mentioned, research along those lines has only been undertaken in Britain recently. The more usual debate in Britain has been to cheer on the NHS because it is better than how healthcare provision used to be and because the costs to patients and the drawbacks of the American market model have been portrayed as the only feasible alternative – not so.

  31. Berhard,

    >If the problems with NHS are due to chronic
    >underinvestment that dates back to the pre-
    >Thatcher era, then one has to question whether
    >the NHS model is capable of producing the
    >proper level of investment.

    I was more referring to the internal incentives of the NHS (which is the ptedominant the problem in the German case) than to the external problems that lead to underfunding. The latter is indeed very likely a structural problem of British politics.

    And, Bob, I agree, it’s probably true that Europeans get a better deal for their money.
    There is a great recent intl. comparison of health insurance systems, also by an LSE group of researchers. Alas, I couldn’t find it among the 1600 pdfs on my computer, so I can’t link it, sorry.

    With respect to the NHS, I find this OECD study quite interesting – http://www.oecd.org/dataoecd/15/36/1885618.pdf?channelId=34587&homeChannelId=33733&fileTitle=Public+expenditure+reform%3A+the+health+care+sector+in+the+United+Kingdom

    And with respect to the differences of the US and European health care systems, some people over at the NBER have answered the question with some creativity here: http://www.nber.org/papers/w852

    Abstract: “European countries are much more generous to the poor relative to the US level of generosity. Economic models suggest that redistribution is a function of the variance and skewness of the pre-tax income distribution, the volatility of income (perhaps because of trade shocks), the social costs of taxation
    and the expected income mobility of the median voter. None of these factors appear to explain the differences between the US and Europe. Instead, the differences appear to be the result of racial heterogeneity in the US and American political institutions. Racial animosity in the US makes redistribution to the poor, who are disproportionately black, unappealing to many voters. American political institutions limited the growth of a socialist party, and more generally limited the political power of the poor.”

  32. I don’t think that the US and Europe are splitting apart so much as returning to the natural state of affairs that existed in the 19th and early 20th centuries. Events such as WWII,the Cold War, and the connection of the population to the European population pulled us very close together. My grandfather came from Europe and remembered living there. I have never been to Europe.

    I would like to see the US place less emphasis on saving the world (an undertaking bound to fail-people must find their own way) and more on taking care of our own citizens and economy.

  33. Lynne,

    “I would like to see the US place less emphasis on saving the world (an undertaking bound to fail-people must find their own way) and more on taking care of our own citizens and economy.”

    Do you mean something like Bush was when he first took up the Presidency in January 2001?

    “Once he got into the Oval Office, Bush pushed an isolationist agenda. He refused to support the Kyoto Protocol that limits emissions of greenhouse gases by industrialized countries; he unilaterally declared the Nuclear Nonproliferation Treaty a Cold War relic; and he refused to send a U.S. delegation to take part in the World Conference Against Racism.” – from: http://www.usatoday.com/news/opinion/columnists/wickham/2001-11-08-wickham.htm

    Little did we know then but the “Bush administration began planning to use U.S. troops to invade Iraq within days after the former Texas governor entered the White House three years ago, former Treasury Secretary Paul O’Neill told CBS News’ 60 Minutes.” – from:
    http://www.cnn.com/2004/ALLPOLITICS/01/10/oneill.bush/

  34. Lynne, there are only America-hating Euro commies on this site. Except that they camouflage their hatred by saying they’re only critical of Bush.

  35. Tobias,

    “The British spend around 7% of GDP on health, the US spends more than twice as much”

    Of course you conveniently omitted that the US also spends more on medical R&D than Europe, accounting for a significant portion for US health care costs. In fact, it is another example of how Europe gets a free ride…

    “Now that there is a counter argument to the claims that the EU depends on US in security terms, you simply reformulate the problem???”

    Pfaff makes the claim that the EU doesn’t have any major external threats, that is true, so it is “self-sufficient” to a certain extent. Putting aside the fact that Europe was completely inept when confronting a major military crisis a stone’s throw from the EU, – in Yugoslavia – just a few years ago, we can claim that the major threats are gone. But you’re fooling yourself if you don’t think that Europe is economically dependent on export markets in the US.

    “Except that Ramstein is the biggest base outside the US and has infrastructure built over 50 years including a social network that spreads dar beyond the military bases. There is no way to reconstruct this on short notice by paving a runway in Bulgaria. I doubt there would be agreement on bilateral treaties without NATO. What woudl be the point?”

    Ramstein is another example of how Germany freeloads off of America. The US spends billions of dollars to maintain it, but there is no reason such a base cannot be built in a country were maintenance costs are lower. We would be doing a service to the Bulgarian economy, plus rewarding a faithful, willing ally, should we have such a base moved there. But the main point would simply be this: Germany deserves to be punished for being a lousy ally.

    “Christian fundamentalism is a fringe activity over here. There is no religious/secular rift within the “western” majorities of European societies. No conservative party in Europe even partly reflects such a social cleavage, even the UK Tories, clearly the most Conservative bunch to find enywhere on this side of the pond think that there is something strange going on in the US.”

    It’s so typical for Europeans to trot out the Christian fundamentalist issue when discussing American politics. Look, I’m an atheist, with a quite liberal lifestyle, but I would trust a Southern Baptist Christian fundamentalist’s sense of right and wrong any day before I would trust a European’s sense of right and wrong. Europeans have clearly lost their moral compass when they seek to appease terrorists, when they support Arabs who have promised to wipe out the Jews, and when they make all kinds of excuses to support Saddam Hussein, and now the Iranian mullahcracy, all for the sake of gaining an advantage over the US.

    “Well, we gotta find a way to live with our weaknesses – if we think they’re strenghths.”

    You’re already weak if you confuse multiculturalism as a strength. It is not. It is a stance one takes when one can’t decide, only prevaricate.

    “I think Americans simply like to fight more over opinions. Call that vibrant, if you want. As for the no-growth state, remember your words in five years…”

    Wasn’t it Kruschev who said to the US, at the end of yet another five-year-plan, that “we will bury you”? There were several other such predictions from, lessee… Hitler, Stalin, Lenin, etc. etc. And you know what? America is still here… ahead of Europe.

  36. RSN,

    first off, I think we should agree we disagree.

    >But you’re fooling yourself if you don’t think
    >that Europe is economically dependent on export
    >markets in the US.

    And the US is economically dependent on Europeans and Japaneses permanently keeping Dollar assets. One side of this is called free trade, that’s why there are (few) people who believe the other is possibly manageable. Most don’t though. I don’t. But that’s probably another story.

    >Look, I’m an atheist, with a quite liberal
    >lifestyle, but I would trust a Southern
    >Baptist Christian fundamentalist’s sense of
    >right and wrong any day before I would trust a
    >European’s sense of right and wrong.

    The problem is not about being right or wrong. It’s about the complexity of modern societies which cannot be dealt with appropriately by any fundamentalist group. Life is all about the grey area. Quite apart from your dislike of Europeans, which is unfortunate, but apparently chronic, the pre-modern/post-modern cleavage in the US society is a problematic rift that is growing in importance. Europe does not feature this rift.

    >Wasn’t it Kruschev who said to the US, at the
    >end of yet another five-year-plan, that “we
    >will bury you”? There were several other such
    >predictions from, lessee… Hitler, Stalin,
    >Lenin, etc. etc. And you know what? America is
    >still here… ahead of Europe.

    I’m afraid I think the last part is more telling about your perceptual bias than it is about the growth perspective in Europe. Growth in Europe is *good* for everybody, including the US. Growth in Europe is not directed against the US. It is an all too common misconception that there is company-like competition between states/economic areas. This is not the case. If you don’t believe me, I’d recommend a handy collection of essays called “pop internationalism” by the Princeton Economist Paul Krugman (should you not rule out his economic positions based on his political wrinting in the NYT).

  37. Tobias,
    Closing a U.S. military base is not necessarily a negative for the host region. They’ve closed a bunch of the in the U.S. over the past 20 years. If the closing is well-managed, it can trigger economic development greater than what the base was generating.

    It’s one case where “punishment” might actually be good for you.

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