Sunday, July 30, 2006

ISRAEL AND HEZBOLLAH: THE BIG, SCARY PICTURE

Since my last posting, I've had a daily e-mail exchange with a friend about the situation in Israel-Lebanon. His opinion is that if Israel would give to the Palestinians 100 percent of the West Bank in addition to Gaza, and a corridor connecting the two, all of this fighting in Israel and Lebanon would be over because the Palestinian people would have what they want, and they would not tolerate the terrorists anymore. Unfortunately, I think this proposed solution misses the bigger picture, and ignores a brutal reality about geopolitics and the future.

Look at a map of the midddle East: http://www.uark.edu/depts/globmark/middeastmap.jpg

A few simple facts: Iran and Syria are supporters of Hezbollah and Hamas. Iran is a Shiite-dominated country. In Iraq, a dominant figure is the Shiite cleric Moqtada al-Sadr, an ally of Iran and in solidarity with Hezbollah and Hamas. al-Sadr controls more than 30 seats in the Iraqi parliament and 5 cabinet positions. He is linked to death squads that have acted brazenly to murder Iraqis and Americans since early 2004. The Hezbollah leader, Sheik Hassan Nasrallah, is also a Shiite with close ties to Iran and Syria.

Going back to the map, we can see a large arc of territory either controlled by Shiite extremists or with large and growing elements of Shiite extremism - Iran, Iraq, Syria and Lebanon. This "group of folks" has clearly stated goals that include bringing their brand of Islam to a place of power in larger and larger portions of the world.

This is very scary to think about. We are in a global power struggle between democratic societies and Islamic theocracy. The focal point this week is the no-holds-barred battle between proxies for the United States and Iran - Israel and Hezbollah. I can't help but think that the U.S. first fell into the trap of invading Iraq, under the very wrong theory of the neocons that we could sweep Saddam out and pour in instant democracy. What we have instead is a no-win situation that gets worse by the day for democratic ideals, and just keeps getting better for the Iran-supported extremists. I also think that Israel walked into a set-up. They, too, are in a no-win situation that is getting worse by the day. No matter what Hezbollah does, they will come out the winners, even if they lose (which I now think is not very likely).

Iraq and Lebanon are the battle fields where radical Islam is writting a different history than any of us in the West imagined. They are showing that the United States and it's proxies are over the hill and in decline. They are winning the public relations war, and growing in strength with every day. We can't beat them with our kind of military and our kind of strategies (see the excellent article in the July 30 NY Times about network warfare, or net war, by Thom Shanker).

It's easy to see the Israel-Hezbollah war as just another chapter in the long Middle East conflict over the plight of the Palestinian people. But reality isn't that simple. The goal of Hezbollah/Iran isn't Palestine replacing Israel; the goal is regional dominance, replacing existing governments in Egypt, Saudi Arabia, Jordan and other Arab countries with Iranian-type theocracy. Viewed in this way, Israel is suddenly not just in a battle for its life, but a battle for the future of democracy.

Quite frankly, as I've put this together this week, it has scared the shit out of me. I hope the realization of the stakes in Lebanon scare you too, scare you enough to take a look at the bigger picture and not focus on the minute-by-minute pictures of the pain.

Friday, July 21, 2006

ISRAEL, LEBANON, TERRORISM, THE WORLD

OK, full disclosure first so there are no questions about my potential biases: I am a secular Jew, second generation American, with relatives living in Israel, and I've been to Israel twice. I'm not a knee-jerk "Israel can do no wrong" supporter; I'm often critical of Israeli government policies and actions. I believe strongly that Palestinians should have sovereign lands (Gaza, West Bank) and self-government. I don't like the settlement movement that has taken land in the West Bank. The security wall bothers me, but I understand the need for it.

I also try to look at every situation objectively, searching out different opinions and information that might give me insights into the truth behind an issue.

So, with those caveats out of the way, you can now "read my opinion;" however, I have to warn you, my opinion on this issue is dynamic and changes daily in subtle ways.

I agree that Israel, like any other sovereign nation, has the right to defend itself from attacks. Israel has exercised this right continuously in response to attacks within it's borders by a variety of terrorist groups. (Note: I don't buy the "freedom fighter" tag for terrorist organizations like Hamas, Hezbollah, al Quaida and their ilk - they are murderers and criminals.) Hezbollah has been firing missiles into Northern Israel for several years since Israel withdrew from southern Lebanon in 2000, and I think Israel has shown remarkable restraint during this time. The recent cross-border incursion by Hezbollah militia, and the increased intensity of missile launches into Israel was an escalation by Hezbollah, one that was condemned by a large number of governments, including many Arab states.

Some facts are in order here:
1. U.N. Security Council Resoultion 425 established the "Blue Line," internationally recognized as the border between northern Israel and southern Lebanon.
2. Israel completed it's withdrawal from Lebanon, in respect to the Blue Line, in 2000.
3. U.N. S.C. Resoultion 1559, adopted in September, 2004, called on Syria to withdraw it's forces from Lebanon, and for all Lebanese militias, including Hezbollah, to disband.
4. Syrian troops completed their withdrawal from Lebanon in April, 2005. Hezbollah has not disbanded, and continued to fire missiles into Israel.
5. Hezbollah has an arsenal of at least 10,000 missiles in Lebanon, supplied to them by Iran and Syria.
6. Both Hezbollah and the Lebanese government refer to Israel as "the enemy."
7. A remaining point of contention between Israel and Lebanon - Hezbollah is the Shabaa Farms area that is under the control of Israel. Lebanon claims the area; however, the United Nations, and even Israel agree that the area is part of Syria. (As an aside, Syria does not recognize the independence of Lebanon, Jordan or Israel, by law, considering all of them to be part of "Greater Syria.")

So, with the above facts in mind, one begins to understand the incredible complexity of the situation. Clearly, the intelligence agencies of the U.S. and the European nations knew that thousands of missiles were being shipped into Lebanon to Hezbollah forces by air, ship and road. And yet, everyone seems to have turned a blind eye to these activities. With this understanding, it seems reasonable for Israel to bomb the Beirut airport, port facilities, roads and bridges to stop or slow the resupply of weapons to Hezbollah. It is also understandable that Israel would destroy fuel depots to make it more difficult for Hezbollah to fuel the vehicles that move these weapons around the country. It is also reported in the Western press that Hezbollah has many of their weapons positioned in areas where people live.

The majority opinion from world governments seems to be that, while Israel has the right to defend itself, it should show restraint. While I agree with that in principle, I also understand that on-the-ground reality is very different during war.

One of the things that disturbs me most about this situation is the outpouring of hatred I'm seeing towards Israel by people in the United States, including many of my liberal friends. In my view, too many people are always too ready to blame Israel for every situation because they are "the oppressors," "occupiers," "agressors," etc. Certainly Israel has occupied territory "won" during wars with its neighbors. Many (not all) Israelis have contempt for or hatred of Arab people; even Arab Israelis are in many ways second-class citizens. And a number of the tactics used by the Israeli government and military forces have been questionable. But it is important to put all of this into the context of history and politics, and not rush to judgement unfairly.

I see Israel in a very tenuous position right now in terms of world politics, and in the court of public opinion. When attacked by Hezbollah, Israel did not have the option to appeal to the United Nations for resolving the conflict - just look at places like Darfur where people are still waiting, and dying, for the U.N. to do something. And while the U.S. and the European governments pay lip service to Israel's right of self defense, I think they are more than happy to let Israel deal with Hezbollah, and by proxy Syria and Iran, and take the political and public relations heat for these military actions.

Finally, to those Americans who are so quick to lambast Israel, let me pose a scenario. Let's say that a group of extremist members of a political party in Mexico or Canada, or of an Indian Tribe with sovereign treaty lands inside the U.S., crossed their border and attacked a U.S. Army base, and then started firing missiles into U.S. towns and cities. Would we, the U.S., have the right to defend ourselves? And what would "restraint" look like on our part? If recent history is an example, let's say Afganistan following the attacks on September 11th, I think the U.S. would bomb someone back to the Stone Age - in a heartbeat.

Some key readings for your enjoyment:

Good summary of issues re: UN Resolutions 425 and 1559 in Wikipedia


The Innocent Bystander Myth, by Evelyn Gordon in the Jerusalem Post (jpost.com)


Disastrous Miscalculations, by Alon Ben-Meir in the Turkish newspaper Zamon (online edition)

Thursday, July 20, 2006

THE MEDICAL/INSURANCE COMPLEX(ITY)

I read with interest in the Portland, Oregon newspaper this morning that Legacy Hospitals has agreed to settle a class action suit concerning the higher prices paid for services by the uninsured. As a recent surgery patient, I am witnessing first-hand the intricacies and complexities of the Medical-Insurance Complex.

As a consumer of medical services, I have several problem with the billing procedures of the medical providers and the insurance companies. My three main concerns are the following:

1. Consumers should know the cost of the services they are buying prior to purchase. I have made a point of asking what the cost of a medical procedure or service will be when I check in at the reception desk. I have never gotten an answer, except a couple of times when the receptionist did me a favor and called someone to ask. Medical services might be the only commercial enterprise for which consumers agree to a purchase without knowing the price they will be paying.

2. I won't pay for something without first seeing an itemized bill. The typical process for the expenses related to my surgery has been that I never get a bill from the medical service provider (there have been 1 or 2 exceptions). Instead, I get an Explanation of Benefits from the insurance company showing how much was charged, how much the insurer will accept as a charge for the service (see number 3, below), how much the insurer will pay, and the balance left for me to pay. Then I get a statement from the medical provider for the amount the insurance company didn't pay. In many cases, I have received statements from medical companies (doctor groups or laboratories) that I have never heard of, and I have no idea what they did to or for me. After some investigation, I find that doctor so-and-so read an MRI, doctor such-and-such looked at my freshly removed tumor, and company xyz ran the CT scan. My message to these folks: "Send me an itemized bill so I know what you did and I'll think about paying you."

3. The pricing agreements of the Medical-Insurance Complex are amazing! My understanding is that every insurance company negotiates a price list with the providers on their list. This is truly amazing stuff. Here are some examples gleaned from the Explanation of Benefits documents I have received:
- Legacy Emanuel Hospital semi-private room (2 days, 1 night): $1,171; Great West Insurance "covered expense" (the amount they have negotiated): $175.
- Legacy Emanuel Hospital "hospital extras": $12,872; Great West Insurance covered expense: $1,225.68.
- Oregon Anesthesiology Group "anesth inpatient": $780; Great West Insurance "covered expenses" $572.
- medical supplies and equipment: $156; "covered expense" $69.11

The medical providers list the reduction in price on their bill (if you get one) as a discount or insurance allowance. I assume that patients without insurance pay the full meal deal, hence the class-action lawsuit.

Here is what I would like:
1. When I go for a medical service, I am told prior to receiving the service a) the cost to me of the service, and, b) the names of all providers who will be providing service and then billing me. The cost I want to see is the amount negotiated with my insurance company; this information is certainly in the medical providers computer databases.
2. An itemized bill from every medical service provider who provides services to me, not just a statement of the balance after insurance payments.

These are simple and reasonable requests for a consumer to make, and it would help get the Medical-Insurance Complex into line.

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