Ukraine: Time for a Ceasefire?

In an interesting development the Commander in Chief of the Ukrainian Army (the Ukrainian equivalent to the Chairman of the Joint Chiefs of Staff) released an essay last week, just as an interview was published in The Economist. In the essay and interview it was reported that Gen Zaluzhnyi said the war was "at a stalemate." That was later corrected to say that the war was at "a dead end." That was later corrected to say there there was a “technological dead end.”

Whatever he actually said (I don’t read Ukrainian) it was close enough  to “stalemate” that President Zelenskyy felt the need to make a statement that the war was “not at a stalemate,” and added that “Ukraine has no right to even think about giving up,” and insisted there are no secret negotiations.

Some well known analysts also issued an explanation of the General’s paper that sought to explain that what the General really discussing was how to win the war. In a sense he did; Zaluzhnyi talked about the need for a host of improvements, to include:

Modern command and control that has the ability to respond across the entire county while operating in a hostile cyber warfare environment.

Gaining air superiority - in particular improved drones, flooding Russian air defenses, neutralizing Russian attack drones, better anti-drone capabilities, but this also includes manned aircraft (150 F-16s) and surface to air missiles. There has been repeated talk about the ability to defend the entire country from drones and cruise missiles. That would require a nation-wide integrated air defense.

He also mentioned: 

More and better mine clearing as well as integration with drones to allow clearing mine fields while concealed

More effective counter-battery fire - more and better reconnaissance drones, more assets, more artillery, and better integration of artillery with the reconnaissance and command and control

Creating and training reserve forces - a nationwide registry, training facilities to increase the quantity and quality of reserve training

Improving Electronic Warfare - employing complex EW across the front, and a nationwide integrated command and control capability

There is more, to include getting ahead of and staying ahead of Russia in establishing and maintaining situational awareness, and establishing a single, integrated information environment.

He also called on Ukraine to develop its own arms industry.

These are all worthy goals. The problem is that none of them are easy or cheap. Ukraine had a pre-war defense budget of less than $4.5 billion, with total national security spending (to include intelligence and national police) totaling less that $7.5 billion. 

Then consider that a single Patriot battery costs, per Wikipedia, about $1 billion for the US. Exports are more expensive. How many batteries will they need to cover the major cities and industrial facilities (power plants) across Ukraine?

Said differently, the force described above cannot be afforded by Ukraine; NATO and the US would need to pay for it, and sustain it.

And, even with the equipment on hand, the manpower problem is serious. Ukraine has a shrinking population, one that is likely to shrink even more as the war drags on. And the military he describes is one that will require a large cadre of professionals plus a constant churn of reservists. And professional soldiers are expensive to create both in time and money.

He finished with a statement that there’s need for technological breakthroughs - which sounds a lot like “wonder weapons.” 

But Gen Zaluzhnyi isn't stupid, he knows all this; all the pieces that he discussed have been discussed before in the press and by various figures in the Ukrainian government. So, what was the point?

As one of my smart correspondents noted: this is Zaluzhnyi subtly telling the chain of command - President Zelensky and the senior civilians - that the country is hurting and that the country not only may not have enough to win, but it may not have enough to sustain a stalemate.

None of us knows the real casualty counts on either side, both sides have striven mightily to hide their own casualties while spreading rumors about the other side. But there are snippets of data which suggest that the total number of casualties is staggering, with each side losing well over 100,000 killed in action and perhaps 400,000 wounded. It’s worth mentioning that there are some estimates that triple each of those numbers.

Another one of my smart correspondents noted a strange echo from the past: as World War I dragged on, the political leadership in London and Paris began to develop skepticism about the course of the war, while the generals kept saying that “this is not time to stop, we’re going to break through on the next push.” Now the roles might be reversed, but the grind on the front line appears to be very similar.

So, maybe there are no secret negotiations, as President Zelensky insists. But perhaps Gen, Zaluzhnyi is telling him that there should be.

 Ship’s Surgeon

I recall thinking he looked old and frail. I was 14, it was my freshman year in high school and I remember him sitting there, on one of the love seats that my mom and dad had in the den, between the dining room and the living room, in that beautiful house we lived in on Centre Street… He sat facing the windows, I think there might have been a fire in the fireplace to his right, but it had faded, he sat with his hands in his lap and talked, almost no emotion, speaking quietly, in very close control of his emotions, as if to let the littlest hint of his feeling out would be to lose it all, and he would burst. I was only 14 and yet I understood that, it was that clear.

He was a man of “ferocious intellect.” In fact, they were all men of “ferocious intellect.” I steal that line from Richard Dreyfuss, a fantastic actor who used it to describe another fabulous actor: Robert Shaw. I bring them up because the two men are, oddly,  connected to the men I remember. 

As virtually the entire world knows - or at least that part that watches movies - the two men were, along with Roy Scheider - the central figures in one of the great movies: JAWS. It is in one of the most gripping scenes in movie-making history that they connect to the subject I want to write about today. The scene, of course, is the moment when Quint, the cranky and slightly crazy shark-hunter, played to perfection by Shaw, tells Hooper (Dreyfuss) and the Sheriff (Scheider) about the scar on his forearm - where he had removed a tattoo that read: USS INDIANAPOLIS.

The man that I recall is Captain Lewis “Lew” Haynes, who in 1945 was a Lieutenant Commander and ship’s surgeon onboard the USS INDIANAPOLIS.

There is too much to tell the whole story, and much of it has been written down over the years as the survivors were all interviewed, and I encourage you to read the books, search for the stories on line. As it turned out, eventually, Capt. McVay, the commanding officer, court martialed by the Navy, was exonerated, but none of that changes the story itself, and the horror that nearly 900 sailors faced in the sea. 

Capt. Haynes and my dad and a few of their friends were a core of perhaps a dozen surgeons in the Navy, there was another similar group into the Army, who in the the years between the end of WWII and Vietnam helped develop the treatment protocols for burns. They were all men of ferocious intellect.

Three of them served on cruisers as ship’s surgeon during World War II, as lieutenants or lieutenant commanders, though all retired as captains: Ted Starzynski, Lew Haynes and Roger O’Neil. O’Neil also survived a sinking: he was the assistant ship’s surgeon aboard USS JUNEAU and on 13 November 1942, after night action off Guadalcanal, found himself sent by small boat to USS SAN FRANCISCO. SAN FRANCISCO was barely afloat, her keel had been broken, and the bridge had been hit by enemy fire, which had killed Rear Admiral Callaghan and mortally wounded the captain of the ship, Captain Cassin Young, the man O’Neil was operating on in the admiral’s cabin. And at that point JUNEAU was hit by a torpedo and blew up, resulting in the death of all but 10 of the 690 man crew; O’Neil lived.

As for Capt. Haynes and INDIANAPOLIS, they had, as you will recall, just delivered “Little Boy” - the bomb dropped on Hiroshima - to Tinian, and were returning to Leyte in the Philippines when they were torpedoed. The ship was struck by two torpedoes, forward of the bridge, on the starboard side, about 15 minutes past midnight on July 30th. The ship sank in 12 minutes, but still some 900 men, of a crew of 1,196 ended up in the sea, about 720 miles west-south-west of Guam, and 560 miles east-north-east of the Philippines, in about 18,000 feet of water, in 12 foot swells, the moon ducking in and out of clouds, the water they were in covered in several thousand tons of fuel oil.

He had been sleeping when the torpedo hit and it threw him out of his bunk. Fire chased him out of his stateroom, the second torpedo threw him to the floor and he burned his hands. He stumbled around in the smoke and fire, looking for a way out. I recall him saying that he ended up in the wardroom and fell into an easy chair and said that it felt very comfortable and for just an instant he thought about remaining there. He knew he would die but “that was okay.” Then someone fell on him and he “woke up” and stood and began to find his way out. He crawled through a porthole on the starboard side (the ship was listing to starboard and the water was getting closer), climbed a ladder up onto the deck, then as the ship continued to list and sink bow first he simply walked into the water and began to swim away in the darkness.

He ended up as the senior officer in what turned out to be the largest group of men, perhaps 200 or more. Many were wounded, most of those died in the first 24 hours. As he told the story, he went from being a doctor to a coroner, swimming around, testing to see if someone had died - he would gently tap the eyes - if the eyeball itself didn’t respond, the man was dead. He would pull off the dog-tags and slide the chain over his arm. Other men would then pull the life vest off and push the body away.

Eventually, he had so many dog-tags on chains hanging around his arm they began to pull him down. The other sailors had to wrestle them off his arm, and he fought them, trying to keep the dog-tags, and he spoke of the trauma of letting that last little bit of his shipmates slip into the sea.

Perhaps the most remarkable piece of the story was when they were finally picked up, after 4-and-a-half days in open ocean, and they ended up in and around large rubber rafts dropped out by the seaplane. Several dozen men were huddled on and around the rafts. There was a large container of fresh water, but just one small cup to drink from. So, he began passing out drinks, one at a time, passing the water past men who hadn’t had any fresh water for, at that point 110 hours. He noted that each man passed the cup along, waiting his turn, that not one man cheated.

Eventually, 317 men were pulled from the sea, though one sailor died shortly after being rescued. Only 316 survived the ordeal.

The next time you watch JAWS, remember Capt. Haynes, and remember the others, those ferocious intellects; Haynes, Starzynski, O’Neil, Stephen Ryan et al, who went on to save the lives of literally thousands of wounded Sailors and Marines and Soldiers and Airmen…

Pepper and Pirates on Memorial Day 2019

May 25th 2019

Memorial Day; Families will get together, perhaps have the first cookout of the summer: hot dogs, hamburgers, steaks, barbecued ribs, barbecued chicken, corn-on-the-cob, seasoned to taste. But, it is Memorial Day, for remembering those who died in service to the nation. And while we may, from time to time, question the reason Americans find themselves in combat, for the Soldiers and Sailors and Airmen and Marines, they often have found little time to question the precise political motivations that led to the actions they find themselves in; they were, and are, too busy taking care of their buddies.

Since 1775 some 1,355,000 Americans have died in combat in service to this country. The numbers are inexact, and almost assuredly higher, perhaps quite a bit higher. Recent estimates of the number killed in the Civil War suggest the commonly accepted number may be thousands short of reality. (And, while not all of those killed were, strictly speaking, American citizens, they died in defense of the nation and thereby certainly earned the title.) 

We need to remember them all for their service, no matter how we may feel about the particular war, even as we stand around the grill. 

And yet, there’s a connection between Memorial Day and much of what is taking place at the cookout; the political freedom that we celebrate, purchased at the price of a good deal of blood; the free markets and our amazing standard of living; or the access to goods from around the world, guaranteed by our more than 200 years of defense of free and fair trade, particularly from pirates. Consider pepper, for example.

Pepper is the world’s most heavily traded and consumed spice, made from grinding up the seeds of the pepper plant. (Green, white and black pepper all come from the same seeds, but it just depends on whether it is cooked or uncooked, and ripe or unripe when processing starts.) Pepper appears to have originated in southern India, but spread across South East Asia and by at least the 16th century was being cultivated in what is modern Indonesia. (Vietnam is currently the largest single producer of pepper.) 

Following the US War for Independence US merchant ship activity blossomed in certain corners of the world, and between 1790 and the 1850s Salem, Massachusetts was the de facto pepper capital of the world, a lucrative trade that brought a good deal of money into the ship owners of New England, as New England merchantmen moved cargoes of spice from the pepper coast of Sumatra (the island’s north-west coast) to the United States and Europe.

In 1827 the ship “Friendship,” out of Salem, entered into that pepper trade. 

And so, in January 1831, Friendship’s master, Charles Endicott, brought Friendship into the port of Kuala Batu, a port on the West coast of the island of Sumatra, to buy a cargo of pepper. (Kuala Batu is about 100 miles or so south of Banda Aceh, the north-west tip of the great island.) While Captain Endicott was ashore negotiating for a load of pepper, Malay pirates seized his ship, killed three of the crew, looted the ship (to include various high-value goods and $40,000 in gold and silver) and drove her into shallow waters. Endicott immediately appealed to the masters of three other US merchantmen in the port, and they eventually managed to retake his ship. Endicott and Friendship headed back to Boston, arriving in July 1831. The ship's owners then protested to President Jackson. (It didn’t hurt their case that one of the owners of Friendship was Massachusetts Senator Nathaniel Silsbee.)

Jackson responded, and on August 28th USS Potomac, a 44 gun frigate under the command of Captain John Downes (from Canton, Massachusetts), departed New York harbor and headed for Sumatra, with orders to investigate the incident, and if Endicott’s account was correct, to demand restitution, and to insist on justice for the pirates.

Downes and USS Potomac arrived off Kuala Batu on February 5th, 1832 - disguised as a Danish merchantman - and Downes began reconnoitering. A local contact informed Captain Downes that the pirate chief, Raja Po Mohammed (though it may have been Raja Teuku Sarullah), was not likely to negotiate under any circumstances and so, while he had been instructed to negotiate with the local chieftain, based on his intelligence Downes decided to skip negotiations, to immediately put ashore a force of 282 men - Marines and armed Sailors, and assault the four pirate forts. 

On the morning of the 6th, at 0200, Downes put ashore his landing force without being detected, and just before dawn, under the overall command of LT Irvine Shubrick (Potomac’s Executive Officer), with separate units under LTs A.B. Pickham, Henry Hoff, and Jonathan Ingersoll, USN, and 1stLTs Alvin Edson and George H. Terrett, USMC, assaulted each of the four forts. After several hours of intense, hand-to-hand fighting, the four forts were taken. The leader of the pirates and some 150 of his pirates were killed, along with 2 Sailors and 1 Marine.

By 1000 all were back aboard ship. Downes held a burial at sea for the three men, then, on the morning of the 7th bombarded the town until the new Raja agreed there would be no recurrence of the Friendship incident and that they would stop harassing merchant ships. Potomac headed east and home - becoming just the second US Navy ship to circumnavigate the globe.

When word of his actions reached the US in July 1832 Captain Downes received a good deal of criticism for his actions, the suggestion being that he should have first negotiated.  (Downes and USS Potomac didn’t reach the US until May 1834.) President Jackson’s opponents seized on the incident in an attempt to embarrass the President. Accordingly, President Jackson found himself defending Downes, and suggested that perhaps this action would deter any further interference by Malay pirates. The Secretary of the Navy did, however, privately censure Captain Downes, and while he dodged a court-martial, his career at sea was effectively over.

Interestingly enough, the Daily National Intelligencer, an anti-Jackson newspaper, raised the issue that the President had usurped Congressional authority to declare war, nearly a century and a half before the Korean and later Vietnam Wars raised the same issue.

In any case, the Malay pirates did not remain deterred for long. In December 1838 the merchant ship “Eclipse,” (another ship out of Salem, under Captain Charles F. Wilkins) pulled into the West Sumatran coast to trade for pepper. 24 Malay pirates approached the ship and after handing over their weapons were allowed onto Eclipse. The crew then, to display friendship, returned the weapons to the pirates. The pirates then proceeded to seize control and one at a time massacred the captain and crew, then looted the ship of some $20,000 in gold and silver. 

Word soon reached Commodore George Read, Commander of the East India Squadron, and he proceeded to the Sumatran coast, to Kuala Batu, with the 44 gun frigate USS Columbia and the 12 gun sloop USS John Adams. Read had learned the lesson of Capt. Downes and on December 22nd sent ashore Commander T. W. Wyman (commander of USS John Adams) to demand “the pirates and the property.” The pirates stalled and Read fired on several of their forts on Christmas Day. On the 1st of January 1839 Read landed a 360 man force, under Commander Wyman, that captured and destroyed 5 pirate forts and spiked their guns; he then collected a payment from the Raja. Amazingly, no Sailors or Marines were killed in the action, and only one Malay pirate, the others having all fled. And, the Pirates stopped bothering US merchants on the Sumatran coast; after this action the pepper moved without troubles.

Remember that when you ask someone to “Pass the pepper, Please.”

Of note, 1stLT Edson, who later led a raid into Tabasco during the War with Mexico, was apparently a distant relative of MajGen Merrit “Red” Edson, USMC, of Edson Raiders fame; LT Shubrick rose to the rank of Rear Admiral and commanded the squadron off of the west coast of Mexico during that war; LT Hoff rose to the rank of Rear Admiral and commanded in succession both the Pacific Squadron and the North Atlantic Squadron. Commodore Read (who had served as a lieutenant on USS Constitution during her successful engagement with HMS Guerriere, and later served under Stephen Decatur aboard USS United States), also rose to the rank of Rear Admiral.

Have a great Memorial Day.

HMS Pinafore and the Navy Staff

May 19th, 2019

In Gilbert & Sullivan’s HMS Pinafore Sir Joseph Porter sings that he’s done many things in his career that led to being named First Lord of the Admiralty, but none of them took place at sea, or, for that matter, had anything to do with ships. The Chorus tells us: “Stick close to your desks and never go to sea and you all may be rulers of the Queen’s Navee!”

The US Navy isn’t led by men who’ve never been to sea, but there’s growing room to wonder whether it’s led by men who know more about the Navy than Sir Joseph.

Consider our newest destroyer class, USS Zumwalt. Zumwalt has been called “the most sophisticated ship ever built,” and perhaps she is, with electric propulsion, a wave-piercing bow, new sensors, etc.; all intended to reduce the “signature” of the ship. The ship, you see, was designed to operate near shore, using its sophisticated guns to provide precision strike to support US forces ashore.

Each ship would carry (per the internet) some 700 rounds for the two guns.

Except for one small problem: the shells (originally expected to cost $35,000 each) were a tad expensive: more than $800,000 per shell. The Navy decided that $800,000 or more per round was too much and cancelled production. So, Zumwalt (and  her two sister-ships) has no rounds for her two guns.

The Navy originally wanted 32 of these ships, but when costs mounted the total number was eventually cut to just three ships, at a total cost of $22 billion. Production of USS Zumwalt began in 2009, the ship’s keel was laid in 2011 and she commissioned in 2016. The second and third ships are now outfitting. Zumwalt has conducted short “operational periods” at sea but has yet to operationally deploy to the Western Pacific and Indian Ocean, and the Navy states the ship will be “operationally delivered” this coming September.

If this were just one ship, albeit a very expensive one, there would be a temptation to say: “oh well, and move on.” But, there’s every reason to believe it’s the way the Navy Staff functions these days.

Consider the statement made by a Vice Admiral last week as he talked about increased readiness:  “We’re also coming to realize what that is going to cost, and how you’re going to sustain today’s fleet while continuing to grow.” The planning process is “much more challenging than anyone realized,” he said, “but we’re much smarter about our business” than just a few years ago.

He added that :“We don’t have the complex modeling to even understand what all of these costs are going to materialize to over the next 20 years,” he said, but the service is “working hard to converge on a model” to sustain the ships over the long haul. 

Really? OPNAV didn’t know? What have they been doing for the past few decades?

The Navy has people who do their jobs well; the sailors at sea now in the Persian Gulf, the sailors, in particular the SEALs, deployed around the world performing their assigned missions quietly and professionally. 

But, meanwhile, back at the farm, the system is breaking down. 

Consider the report several weeks ago that the V-22, which will take over all delivery of cargo to our carriers within a few years, can’t seem to get past 52% readiness - 12 years after becoming operational.

Again, this would be acceptable if it were an isolated incident. But it’s not. F-35 budget woes are - sadly - well documented; $13 billion USS Ford remains non-operational 2 years after her commissioning; and the Littoral Combat Ship (LCS) remains complex and expensive to maintain, too expensive, and, most importantly, unchanged since an Under Secretary of Defense found it would not survive in combat; and the list goes on.

Bad decisions have become systemic at OPNAV.

The Navy recently introduced a new promotion process to allow officers selected for promotion to be additionally re-ranked for “merit.” But, this new system was created and will be implemented by the same officers who’ve brought you this procurement and readiness mess. It’s probable that they’ll accelerate the promotion of the wrong people.

Before we go any further, the DOD needs to take a hard look at the Navy; the Navy needs new leadership, leadership that doesn’t trace its pedigree from the current crop of admirals. Or we’re going to get more Joseph Porters, and USS Zumwalts.

A Letter to Secretary Shanahan

May 12th, 2019

I wish Secretary of Defense Shanahan all the best; by all accounts it’s a thankless job. That said, I offer these thoughts from the cheap seats, things he might want to “take a second look at.”

War Plans - there are multiple OPLANS and CONPLANS (Operations Plans and Contingency Plans); someone needs to start working on War Plans. This isn’t semantics; OPLANS and CONPLANS are the purview of the various combatant commanders. But, before there were combatant commanders, before there was a joint staff, in fact, before World War II, the Navy and the Army worked on something called the Rainbow Plans. While common myth has it that the Army and Navy were top heavy, deadwood-laden messes prior to WWII, the facts are otherwise. The work of the Army and Navy in the 1920s and 1930s, specifically on War Plan Orange and later the Rainbow plans, led to  Rainbow 5; it’s how we fought World War II. Further, the Rainbow plans were responsible for initiating multiple ship, aircraft and weapon development plans well before Pearl Harbor - these efforts allowed the US to go on the offensive in 1942. 

We need an organization that looks at what global war might look like, and what would need to be done to fight and win such a war.

While doing so, review current planning practices and assumptions. We‘ve spent the last 29 years fighting enemies far below our weight class, enemies over whom we had existing, extensive, glaring technological edges, and virtually unlimited intelligence. There are few “lessons learned” from those fights that will apply to global war scenarios.

Nuclear Forces and Special Operations Forces - both are strategic in the strictest sense of the word; take a hard look at how we’re treating them. Nuclear forces need to be modernized and ready and the personnel well trained and well lead in order to be a creditable deterrence; insist on it. 

Special operations forces have been on a high tempo grind for nearly two decades; they’ve developed exceptional capabilities but at great cost to the personnel. DOD needs a path ahead on how to maintain those capabilities and that performance while also preserving the individuals who are special operations.

Procurement - The Pentagon is fascinated with getting “the very best” thing. And there’s merit to that. But better can be the enemy of good enough. The Navy wanted all electric ships; it led to buying three destroyers for $22 billion, and an aircraft carrier that, while commissioned, is still years away from deploying. Fascinated with high technology, we risk losing sight of the need for overall combat effectiveness.

It’s worth remembering that when WWII started the US did NOT have the best fighter aircraft, the best submarines, the best tanks, the best artillery, etc. When the war ended that was still true. But we had the best intelligence…

Personnel - Look at how we’ve implemented the all volunteer force. There’s more than one way to do it, but we seem to have chosen the most expensive of all possible models. Personnel costs are consuming the DOD. Things to consider might include: “Up-or-Out” sounds good should everyone be trying to be a general - sometimes being simply the best at what you do is more important to both the individual and the organization. Why can you enter the military if you’re already married? Should there be rank limits on marriage? Military housing: why do we have any? The need for military housing developed because we had bases in the middle of nowhere. That’s not true anymore. The free market is much better at managing real estate than DOD; adjust housing allowances and then get DOD out of the real estate business. Have we become too focused on Joint operations and lost sight of service competencies? Lots of issues…

Strategic Thought - And honest appraisals of the enemy and of DOD - You need a real Office of Net Assessment. One hasn’t operated (in fact) since the 90s, when the Pentagon started to ignore Andy Marshall. He remained on the job for another decade, and the office remains open, but they’ve been ignored and their product hasn’t been linked to DOD efforts. Get it linked. Bring in new leadership, some folks you can trust to do hard thinking and to tell you the truth even when it hurts, and get the ONA running again.

Good Luck, Mr. Secretary.

Bismarck and East Asia

February 5th, 2017

The other day I heard someone opine that it’s a crime that the US hadn’t (and wasn’t considering) going into Syria to take down President Assad.

Well, consider this:

While the focus of the US, and much of the rest of the world, has been squarely on the US elections, and ISIS, things have continued at quite a pace in East Asia. In the last 5 years China has moved aggressively into the South China Sea (through which passes some 20% of all international trade), claiming it as their own. Meanwhile, China continues expanding its army, navy and air force.

Elsewhere, Thailand, the Philippines, Malaysia, and Indonesia have drifted away from the US and towards China, a result of both neglect on the part of the US during the same 5 years, and the muscular foreign policy of China.

And, North Korea appears to be on the verge of producing both an intercontinental ballistic missile and a nuclear weapon to fit atop that missile.

A rising, expansive power, with a centralized government and few of the restraints found in a western democracy, has been extending its reach, and a new nuclear power has emerged, while the US has been focused elsewhere.

The question is: What next?

Almost to a certainty there will be confrontations between the US (and certain key allies, Japan and the Republic of Korea) and China. And North Korea. Whether those confrontations are violent, and whether they escalate, is the real question. Our goal, quite obviously, is to keep these confrontations as peaceful as possible and where that isn’t possible, to limit the escalation. And to make sure that, in the end, US aims are achieved.

But in getting there, we need to remember something…

Despite how morally superior we might want to sound, it’s critical in the nuclear age that we recognize that every nation will, and must, weigh the cost of survival against the cost of its other interests.

Any planning must first be bounded by the knowledge that potential enemies have nuclear weapons. It’s for that reason that our nuclear force must be modernized and kept ready, to ensure that any possible enemy understands that our nuclear forces are credible and that they can’t resort to the use of nuclear weapons without paying too high a price. A modern, ready nuclear force therefore acts as a bar to crossing that nuclear threshold.

But long before we get to any nuclear threshold, we as a nation need to consider other thresholds.

Ask yourself this “simple” question: how many American lives would you be willing to trade for peace in Syria? 400,000 Syrians have now died in their civil war. Would you be willing to send in the Marines to bring peace to that country? If so, how many dead Marines would be too many?

That’s not an easy question, and there are no easy answers.

Otto von Bismarck, the foreign minister of Prussia 1862 - 1890 (and chancellor of Germany 1871 - 1890) is reputed to have said, as to the question of Germany getting involved in the Balkans: "the whole of the Balkans is not worth the bones of a single Pomeranian grenadier."

Bismarck had orchestrated the War of German Unification, the Austro-Prussian War and the Franco-Prussian War. He was an exceptional strategist, probably the best in two centuries, and he understood costs and national interests. He was willing to expend assets – and lives – in defense of those interests. But only in defense of those interests. He understood Germany’s national interests, and he knew where those interests ended.

It’s in this sense that the US must be judicious in where it applies effort, where it commits forces, where it draws “red lines,” and where it lets others do what they will.

SecDef Mattis understands this calculus, he understands US interests, and he understands our approach to China needs to be well thought out and deliberate. 

But there seem to be a fair number of folks who think the US should be rushing here, there and everywhere to defend some other set of interests, the “common interests of mankind” or some such thing. They need to ask themselves exactly what price they’re willing to pay, particularly with other peoples’ lives.

Healing Health Care

January 29th, 2017

The President is looking at unraveling the Affordable Care Act (the ACA, commonly referred to as Obamacare) and replacing it with something that is less expensive and at the same time giving citizens more options in their health care.

Less expensive is key. Since the ACA was passed in 2011, health insurance costs have soared and are heading higher still. As of last November premiums were set to rise an average of 25% in 2017, in the 39 states served by the federal market.

While many will receive subsidies to help pay that increase, subsidies will mean that the taxpayer will ultimately foot the bill. And you can be certain that some of the bill we be dropped into next year by raising the deficit.

Before going any further, it might help to consider a few simple concepts.

When this began, there were some 250 million Americans covered by some form of health insurance. When the ACA was passed, that number jumped. The goal was to reach 280 million, leaving about 10% of the citizens uninsured. Without going into whether ordering people to buy health insurance is Constitutional or ethical, someone should have seen a problem.

The problem is this: if you have a health care system providing care to 250 million, and you add 30 million to it, you have less health care per person when you are done. It doesn’t matter how you get there, you have less per person.

How bad? While the overall ratio of doctors to citizens is staying roughly the same, that trend line appears to be in part due to doctors remaining in practice longer, with more doctors practicing medicine well past age 65. However, there is a trend of more doctors entering into specialized healthcare and fewer into general practice. That translates into fewer doctors providing basic healthcare, meaning more “rationing” of doctors, and higher costs – to be met with higher insurance rates.

Perhaps this shortage can be met by expanding the role of nurses in primary health care?

Certainly, except for one minor point: the shortage of nurses is expected to reach roughly 1 million in the next 5 years, with roughly 2 million nurses in practice in the US  (the need is for roughly 3 million, measured in ‘Full Time Equivalents.’)

In short, no matter what’s happening with the efforts to unravel the mess caused by the ACA, and no matter what steps are taken to address health insurance pricing, none of that is going to matter unless we address the question of supply: the United States needs to expand the “supply” of doctors and nurses.

Practically speaking, that can’t be done in the short term except by “robbing” from someone else. Even as we sit and debate the rules for immigration, the US will need to find ways to attract more doctors and nurses to this country over the next 5 years. Options to provide incentives seem limited: a special tax category perhaps for a medical professional who moves to the US.

To address the long-term problem, any health care program needs to provide some mechanism to expand the “production” of doctors and nurses. What that means is more graduates from medical and nursing schools, but that really translates into more medical and nursing schools. Simply putting more students in any class will in the end dilute the “product.” The real solution requires more schools.

But it doesn’t end there. The other shortage is in residency programs. The residency programs need to be expanded now if we are to meet the needs of a population that will reach 400 to 450 million by 2050. The government needs to identify both incentives for new and expanded medical and nursing schools, and new residency programs, as well as eliminating institutional roadblocks to expansion. And these programs should include planning and sizing to meet the need for that future population growth so that we don’t repeat this problem in another 30 years.

Government planning and interference in health care has been at least partly responsible for the increase in costs over the past decade. The government now has an opportunity to take another look at the health care industry, and working with the industry, academia and the citizenry, chart a different course, one that actually steers us around the problems generated by previous administrations.