Duping Americans on Healthcare and War

Exclusive: The American people have been sold a deadly bill of goods both for their lousy healthcare system and for their perpetual war machine – and there’s no end in sight, as Nicolas J S Davies explains.

By Nicolas J S Davies

President Trump and his wealthy friends have just discovered how complicated healthcare is in this country — for the rest of us that is. They will soon find out that U.S. militarism is just as complicated, and for many of the same reasons.

Healthcare is uniquely complicated in the United States because the U.S. is the only wealthy country in the world where for-profit corporate interests have carved out such a dominant role in the sickness and health of its people. The lucrative role of for-profit insurance companies is unique in the entire world; prescription drugs cost many times more than in other countries; and for-profit corporations have taken over 21 percent of U.S. hospitals since 1965.

Every other wealthy country provides universal healthcare to its people mainly through its public sector, with smaller roles for private, usually non-profit entities. Drug prices are contained by the negotiating power of these large public healthcare systems.

These systems all face challenges as they try to maintain the quality of patient care amid the rising costs of new medicines and medical technology, but the basic structure of the healthcare system in each country is well-established and stable.

If people in other wealthy countries pay attention to the U.S. healthcare crisis at all, it must seem that we’re making a meal of this for peculiar cultural reasons. We must enjoy having these huge debates over healthcare every few years for the same reasons that we eat in our cars or play different sports than they do. Outside the U.S., it’s inconceivable that a rich country would really allow tens of thousands of people to die prematurely every year for lack of access to healthcare, or that the public lacks the political power to prevent this from happening.

Race to the Bottom

For the past generation, the U.S. has led a “race to the bottom” among developed countries to ensure that the rewards of advanced technology and increased productivity are allocated to wealthy investors and corporate executives, instead of to the working people actually developing, operating and maintaining these new technologies, in the U.S. and around the world.

A central element in this neoliberal counter-revolution is the expansion of the corporate for-profit sector into areas of life otherwise rooted in the public sector, like health, education, utilities, transportation and criminal justice.

Despite huge imbalances in market power between ordinary people and large corporations, the quasi-religious belief in “markets” as the most efficient mechanism for managing all aspects of society requires that even public services like healthcare and education be privatized and submitted to the “magic of the market.” U.S. political and business leaders are determined to prove that privatized healthcare can work, and then to export it to the rest of the world as part of the relentless expansion of U.S.-based capitalism.

But if public services like healthcare and education cannot be successfully abandoned to the vagaries of “the market,” even in the United States, then the public sector will have proven to be more essential than the architects of neoliberalism have claimed.

When the U.S. finally admits that its brutal experiment in privatized healthcare has failed and it is forced to hand the reins of this critical part of American life over to the public sector, it will be a powerful signal that the neoliberal project has passed its high point – and that the political pendulum has begun to swing back  toward a more rational and democratic future.

Deterrence or Aggression?

Like the privatized U.S. healthcare system, U.S. militarism is also uniquely complicated, in ways that the world is barely coming to grips with after 18 years of U.S.-led wars that have killed about two million people and left half a dozen countries in ruins.

It is hardly a coincidence that our healthcare and warfare crises have some disturbing things in common, since they are products of the same unique political and economic system.

Our dysfunctional medical industry and our murderous war machine are by far the most expensive “healthcare” and “defense” systems in the world. Both are hugely profitable, but neither provides value for money in the form of a healthier or a safer society, the stated missions that justify their existence and their endlessly-expanding demands on our resources.

These are also the two areas of public policy in which bad policy predictably and inevitably leads to massive losses of human life. In terms of keeping people safe from disease and war respectively, U.S. “healthcare” and U.S. “defense” both fail catastrophically despite their ever-growing price tags. In fact, the huge amounts of money involved contribute to their failures by corrupting and distorting the non-commercial purposes they are both supposed to serve.

The Even-Worse War Machine

But U.S. militarism involves complications that dwarf even the ravages of the privatized U.S. healthcare system. While U.S. “news” media provide 24-hour “talking heads” coverage of the CIA and the Democratic Party’s accusations of Russian meddling in the U.S. election, American bombs are killing thousands of Iraqi civilians in Mosul, as they have been doing across Iraq, Syria, Afghanistan and other Muslim countries since 2001.


In contrast to our endless healthcare debate, the contradictions of U.S. militarism have barely been debated at all. Politicians only discuss the purposes of the U.S. military in euphemistic terms, and any objective or honest appraisal of the death, violence and chaos we have unleashed in country after country for the past 18 years is strictly taboo across the political spectrum.

There is an inherent contradiction in trying to use weapons of war to keep the peace. I remember asking my father, a British navy doctor, how he resolved this contradiction, which was more glaring in his case as a doctor committed to “first do no harm.” He told me that he believed a strong defense was the most effective deterrent to aggression.

Apart from one day in June 1954, when his ship’s 6-inch guns “bombarded terrorist positions” on Kedah Peak in Malaya, my father spent his entire career in a shrinking peacetime navy as the sun set on the British Empire. The U.K. stayed out of Vietnam, aside from some covert operations, and no other country attacked the U.K., so my Dad’s view of his naval career as a deterrent to aggression survived largely unscathed.

Even President Trump subscribes to the view that the legitimate role of military power is as a deterrent to aggression by others. On Feb. 27, he declared his intention to add $54 billion per year to the Obama administration’s military budget, which already set a post-WWII record. But in a speech a few days earlier, Trump couched his promise to build a bigger, more expensive war machine strictly in terms of deterrence, as he did regularly throughout his election campaign.

“And, hopefully, we’ll never have to use it, but nobody is going to mess with us,” he said. “Nobody. It will be one of the greatest military build-ups in American history.”

Big-Stick Bullying

My father and our new president were both echoing Teddy Roosevelt’s warning to “speak softly and carry a big stick.” But there is an obvious distinction between carrying a big stick to let others know that you are prepared to defend yourself, and actually threatening and attacking other people with it.

Many Americans keep guns in their homes to protect themselves against crime, but long-standing statistics show that guns in the home are about 20 times more likely to end up injuring or killing someone in a suicide attempt, domestic violence or an accident than in self-defense against a criminal intruder. (My wife and I were once almost shot in our own home when we returned home late at night and startled a house guest who hadn’t even warned us she was armed.) Could we be making a similar mistake on an international scale in our desire to maintain a “strong defense”?

The idea that U.S. diplomacy should be backed up by threats of force has become central to post-Cold War U.S. policy, but it is not long since this was seen as a risky strategy, even in official circles. After catastrophic wars in Korea and Vietnam, U.S. leaders were wary of war, and therefore avoided making threats that would drag the U.S. into new wars.

They did not renounce the use of force altogether, but waged it through proxy forces supported by small deployments of U.S. special forces in Central America and by the CIA in Angola and Afghanistan. These “disguised, quiet, media-free” military operations, as senior officers have called them, were shielded from public scrutiny by layers of secrecy and propaganda, yet they still met with resistance from a war-wary U.S. public and Congress.

The Credible Threat Problem

In heated debates within the Reagan administration, Secretary of State George Schultz argued that U.S. diplomacy should be backed up by the threat of force, while Secretary of Defense Caspar Weinberger warned against threats or uses of force that could lead to another disaster like the war in Vietnam. Weinberger’s view was shared by U.S. military leaders, many of whom had fought as junior officers in Vietnam.

After the bombing of the U.S. Marine barracks in Beirut and the U.S. invasion of Grenada in 1983, Secretary Weinberger publicly laid out a doctrine of limited war in 1984, in which he accepted the thrust of Schultz’s argument, but defined strict limits and conditions on U.S. threats and uses of force. The Weinberger Doctrine declared that the U.S. should threaten or use proportionate force only for clearly defined and achievable objectives, only when “vital” national or allied interests were at stake, and only with the support of the American public and Congress.

But the notion of a credible threat to support diplomacy is a dangerously seductive idea, and the Weinberger Doctrine became “the camel’s nose inside the tent” that was soon followed by the rest of the camel.

As U.S. leaders looked for ways to exploit the post-Cold War “power dividend,” hawkish officials and pundits suggested that General Manuel Noriega in Panama and President Saddam Hussein in Iraq had failed to surrender under threat of U.S. attack because they did not believe that the U.S. would follow through on its threats. The hawks insisted that, if the U.S. would only threaten and use force more readily and consistently, its threats would be “credible” and its enemies would give up without a fight.

The Deceitful Colin Powell

Chairman of the Joint Chiefs General Colin Powell was a former protegé of Weinberger but has made a career of covering up crimes and selling dangerous policies to the public, from his roles in Vietnam, Iran Contra and the First Gulf War to his misleading and treacherous performance at the UN Security Council in 2003. Powell embraced and promoted the “credible threat” theory in a Foreign Affairs article in October 1992, writing that, “threats of military force will work only when U.S. leaders have decided that they are prepared to use force… The president can only persuade an opponent of his seriousness when, indeed, he is serious.”

At about the same time, in what one of his acolytes dubbed the “Ledeen Doctrine,” military-industrial propagandist Michael Ledeen put the “credible threat” theory more bluntly in a speech to the American Enterprise Institute, “Every ten years or so, the United States needs to pick up some small crappy little country and throw it against the wall, just to show the world we mean business.”

Obviously, it is not a legitimate purpose of diplomacy for powerful countries to bully or destroy weaker ones as Ledeen described. In fact it is illegal under the U.N. Charter, which was formulated expressly to try to prevent this kind of international behavior.

Twenty-five years later, we can see clearly that threats of force by the U.S. and its allies, however credible, have not persuaded any of our country’s adversaries to back down, and have served only as pretexts for catastrophic wars, or escalations of them, in country after country: Kosovo, Afghanistan, Iraq, Libya, Yemen, Somalia, Syria and so on.

Dooming Diplomacy

This is not because U.S. threats lack credibility, nor because our war machine is under-funded, as President Trump seems to believe. It is because threats undermine diplomacy by locking both sides into hostile positions that would be politically humiliating to back down from. When the side making the threats is a powerful, heavily armed country like the U.S., this effect is even more pronounced, not less, as the political pressure on both sides is even greater.

To his credit, President Obama stepped back from the brink after threatening a devastating attack on Syria in 2013, because U.S. intelligence agencies doubted that the Syrian government was responsible for the chemical weapons attack in Ghouta, the American public overwhelmingly told Obama and Congress that it was opposed to war, and Russia negotiated a diplomatic resolution.  But Obama’s retreat from the brink was so exceptional that he is still loudly condemned for it by hawkish U.S. officials and pundits.

U.S. leaders still claim that U.S. sanctions and threats “brought Iran to the table” over its nuclear program. But this does not bear serious scrutiny. In fact, during Obama’s first term, his “dual track” approach to Iran, conducting negotiations in parallel with sanctions and threats, was an abysmal failure. This policy only succeeded in spurring Iran to build 20,000 centrifuges to produce its own nuclear material, while sanctions punished the people of Iran for asserting their right to a civilian nuclear program under the terms of the Nuclear Non-Proliferation Treaty (NPT).

All the while, as a senior State Department official (and former U.S. Embassy hostage) explained to author Trita Parsi, it was the U.S. that refused to “take ‘Yes’” for an answer,” not Iran. The dispute was only resolved after John Kerry took over from Hillary Clinton as Secretary of State and began serious negotiations that were not undermined by new threats or sanctions.

The failure of U.S. post-Cold War diplomacy based on the threat and use of force would not surprise the American diplomats who drafted the U.N. Charter and witnessed its signing in San Francisco in 1945.  Article 2:3 of the Charter reads, “All Members shall settle their international disputes by peaceful means in such a manner that international peace and security, and justice, are not endangered.” In the very next clause, they backed this up with a prohibition, not only against the “use of force,” but against “the threat or use of force against the territorial integrity or political independence of any state.”

After the two most deadly and destructive wars in human history, American diplomats of that generation needed no prompting to recognize that the threat of force more often than not sets the stage for the use of force, and that a world order based on the overriding necessity for peace must nip the danger of war in the bud by prohibiting the threat as well as the use of force.

Big Stick or Suicide Vest?

I hope this brief retracing of recent history illustrates what should be obvious, that there is a gaping chasm between the kind of “strong defense” most Americans believe in as a deterrent to war and the aggression of current U.S. war policy. In political rhetoric, there may seem to be a fine line between carrying a “big stick” to deter aggression and building a huge war machine to threaten and attack other countries, but, in practice, the difference is obvious.

Our dangerous post-Cold War strategy of “credible threats” is finally, and predictably, bringing us into confrontation with countries that can defend themselves more effectively than the relatively defenseless countries we have attacked and destroyed since 1999. The U.S. and our allies have failed to decisively defeat lightly armed resistance forces in Iraq, Afghanistan, Yemen, Libya, Somalia, Pakistan, Syria, Palestine or Ukraine. Are we now “credibly threatening” to attack North Korea? Iran? Russia? China?

Like a gun in the home, the credibility of our threats has proved to be a double-edged sword that is ultimately as dangerous to us as to our enemies. We have twisted, “Speak softly and carry a big stick,” into something more like, “Threaten everybody and wear a suicide vest.”

It is time to take off the suicide vest, turn our backs on brinksmanship and war, and return to legitimate diplomacy that is not based on threats, credible or otherwise. The problem with our threats is not that other countries don’t think we really mean them. The more serious problem is that we do, and that this is a prescription for war, not a way to keep the peace.

I deliberately write “war,” not “endless war,” because every war does end, one way or another, and this one will too. But the escalating global war we have unleashed cannot possibly end well for our country or the world unless our leaders make a decisive choice to end it peacefully and diplomatically.

This would be a fundamental paradigm shift in U.S. policy, on a par with providing universal healthcare to all Americans. But the alternative should be unthinkable.

Nicolas J S Davies is the author of Blood On Our Hands: the American Invasion and Destruction of Iraq.  He also wrote the chapters on “Obama at War” in Grading the 44th President: a Report Card on Barack Obama’s First Term as a Progressive Leader.