On a Scandalous and Little-Known Aspect of ‘Obamacare’

Preface

Before discussing the scandal that has motivated this post, we will briefly summarize the New Independent Whig’s editorial position regarding the Patient Protection and Affordable Care Act (PPACA), informally known as Obamacare.  Our position is that PPACA is a seriously flawed program and is worth opposing. The basis for this conclusion does not rest on a categorical objection to the government playing a role in increasing the access of Americans to healthcare. To the contrary, we applaud the successes of Switzerland, Germany and France (to name a few), where universal healthcare is cost effective, satisfactory to patients, of high quality, consistent with a free market approach and relatively robust against the machinations of corrupt politicians and corporatists. 

PPACA has been left in the hands of private, for-profit health insurance companies and is toothless against profiteering by pharmaceutical companies and device makers. PPACA does not set fair prices for treatments, medications, and medical equipment. This is of concern because, in America, these prices are wildly inflated (for example, read this or this). Moreover, in one of the exceedingly few examples of government ever acting to limit its own power, a measure was passed to prohibit federal agencies from using their market power to negotiate lower prices for drugs (source). 

The inflated cost of healthcare means that PPACA premiums are more expensive than necessary. Americans, under this law, are required to either pay a penalty or pay excessive premiums. The result is that more Americans will have health insurance but fewer Americans will have enough money for food or housing. 

The underlying issue here is that the provision of healthcare under PPACA makes it relatively easy for politicians and corporatists to extract economic “rents.” When economists use the word “rent,” it refers to any money that can be obtained simply by possessing a piece of property or a position of authority. PPACA operates by putting healthcare services out to bid and currently, Wellpoint is expecting a $20 billion windfall when the time comes to administer Obamacare in 14 states (source). Wellpoint, as the reader may know, is the cash cow that has made multimillionaires out of folks like Angela Braly.  And one reason why healthcare costs are so high in this country is that companies like Wellpoint make a profit regardless of whether they reimburse expensive or inexpensive claims. These companies make their money by garnering lucrative contracts. 

When the federal government puts contracts out to bid, and bribes and favors are offered to politicians, the contract will not go to the lowest bidder. If contracts are awarded in exchange for bribes and favors, we may expect that the winning bidder is adept at exercising political influence. If a firm decides to trade on its political influence, we may wonder whether this is meant to compensate for deficiencies in terms of the quality or price of the goods or services it provides. And we may suspect that the firm is led by corrupt, self-interested individuals. 

The Scandal

The single largest contract awarded under PPACA has gone to a multinational corporation called the CGI Group. The total amount is just under $100 million dollars (source). The corporation is based in Canada, and as such, the $100 million is being sent outside this country to a corporation that does not pay U.S. taxes. The idea of exporting American taxpayer dollars is scandal enough. But it does not stop there. 

Happy CGI Group Employees

When it is not partnering with Wellpoint to administer PPACA (source), CGI Group pursues another specialty: outsourcing. If a large American company has an IT department run by American workers, CGI Group will likely visit the company to sell the idea of firing American workers and using IT personnel located in Bangalore, India to do the work more cheaply. CGI Group is so adept at selling outsourcing solutions that it won the prestigious National Outsourcing Associations Award in 2012 (source). By awarding a contract to this company, the federal government is financially supporting the outsourcing industry. 

Of course, there may be a method to this madness. By increasing unemployment in America, CGI Group can ensure that a larger number of Americans will be in need of Obamacare. CGI Group has a strong portfolio in the area of electronic health records and will no doubt be pursuing future PPACA contracts (source).

In Canada, CGI Group has been accused of engaging in bid-rigging. The accuser cites evidence to suggest that a government minister involved in awarding the contract had a financial conflict of interest and ought to have recused himself. In addition, the usual oversight activities were not carried out when the bidders were being vetted (source).

CGI Group, as a technology firm, has its hands in businesses other than outsourcing. It is also in line to receive a $6 billion contract from the Department of Homeland Security. If it wins the contract, it will be responsible for conducting surveillance of computer networks, ostensibly to protect the U.S. from “cyberattacks” (source). It has won a $5.3 billion contract from the United States Navy to automate services at naval bases (sources). 

CGI Group also supports the political campaigns of a select handful of United States members of Congress. Take, for example, Representative Jim Moran of Virginia. He was in the news not long ago for demanding that the Washington Metropolitan Area Mass Transit Authority take down an advertisement that was paid for by a group opposing PPACA (source). Mr. Moran has also been outspoken in his defense of PPACA against recent Republican efforts to defund the program (source). CGI Group contributed $7,500 to Mr. Moran’s 2012 campaign (source).

There is some indication that CGI Group’s talent for winning contracts exceeds its ability to provide the services it promises. In setting up network infrastructure for state health exchanges under PPACA, CGI Group has discovered that the price quotes it has been providing consumers for health policies are incorrect (source). It is currently struggling to address the problem and it is entirely possible that, in the near future, it will return to Capitol Hill to request additional funds.

On September 11th

Last year, on observing the anniversary of the events of September 11, I noted that for a brief period of time after the attack, Americans were united by grief and determination. Even though the circumstances were unspeakably tragic, something good came of it: Americans put aside their differences, and experienced what that feels like.

On September 11, firefighters and police officers came to rescue us -- Americans, people that they'd never met -- and were willing to sacrifice their lives in the process. And many did.

A lot is said about Americans' belief in self-reliance. What gets overlooked is that Americans also rely on each other. It takes a lot of trust, but in time -- and not always as quickly as we'd like -- that trust is rewarded.

I was sitting in a secretary's office at the university where I was teaching at the time. A small crowd of us watched the television as the two towers burned. We were all silent. Courage; sacrifice; heroism; rectitude -- the words meant something again, if only for a moment.

In the years since then, our soldiers have been sent overseas to fight and die. Regimes have changed, but really, nothing has changed. The Commander in Chief is still engaged in sabre-rattling. Last month we learned that the banking industry generated a larger profit in the 2nd quarter of 2013 than any on record. We also learned that the salary of hourly workers suffered the greatest drop ever recorded.

When building are burning, the American people know what to do. But the slow-moving disasters do not provoke a response. The foundations of this country are slowly eroding, unseen. Many of the victims haven't the slightest inkling of the disaster that is gathering beneath their feet.

The Politics of War in Syria: Saudi Arabia

During his testimony before Congress, Secretary of State John Kerry revealed that Arab nations (meaning Saudi Arabia and Qatar) have offered to foot the entire cost of an invasion of Syria. 

Secretary of State John Kerry said at Wednesday’s hearing that Arab counties have offered to pay for the entirety of unseating President Bashar al-Assad if the United States took the lead militarily.

“With respect to Arab countries offering to bear costs and to assess, the answer is profoundly yes,” Kerry said. “They have. That offer is on the table.”

Asked by Rep. Ileana Ros-Lehtinen (R-Fla.) about how much those countries would contribute, Kerry said they have offered to pay for all of a full invasion.

“In fact, some of them have said that if the United States is prepared to go do the whole thing the way we’ve done it previously in other places, they’ll carry that cost,” Kerry said. “That’s how dedicated they are at this. That’s not in the cards, and nobody’s talking about it, but they’re talking in serious ways about getting this done (source).”

Although I am loath to admit it, I find myself in agreement with Pat Buchanan when he expresses exasperation on this issue. He writes, “Has it come to this — U.S. soldiers, sailors, Marines and airmen as the mercenaries of sheiks, sultans and emirs … hired out to do the big-time killing for Saudi and Sunni royals (source)?” 

As far as I can tell, the geopolitical situation is this: Syria is an ally of Iran, and Iran is attempting to become the dominant influence in the Middle East. Iran, in turn, is the recipient of military and financial aid coming from Russia. The ties between Iran and Russia extend back into the Cold War era. Russia’s interests are plain: (1) Iran borders Russia, giving Russia a reason to desire influence over the country, (2) Russia wants control of Iranian oil and (3) Russia wishes to be influential in the Middle East. 

The leadership in Saudi Arabia is presently the dominant influence in the Middle East and wishes to retain power. Thus, the Saudis are competing with Iran for hegemony in the region. Just as Iran has the support of Russia, Saudi Arabia has the support of the United States. The most faithful allies of the U.S. – Great Britain and France – back Saudi Arabia.   

The American news media provide regular updates on the brutality of the Assad regime in Syria. However, for reasons that remain inexplicable, the media do not provide an equally in-depth treatment of the brutality of the Saudi monarchy. And hence, in this post, I aim to do my small part in correcting this imbalance, and share with the reader what I have learned about Saudi Arabia’s lamentable human rights record. 

The international organization Human Rights Watch (HRW) has provided a public service by documenting some of these Saudi abuses. First, there is the matter of how the government deals with crime. Suspected criminals do not receive a fair trial. When they are found guilty (and they usually are) they may face beheading or something called “cross-amputation” in which the left foot and right hand are removed. “Detainees, including children, commonly face systematic violations of due process and fair trial rights, including arbitrary arrest and torture and ill-treatment in detention. Saudi judges routinely sentence defendants to thousands of lashes.”

Authorities do not always inform suspects of the crime with which they are charged, nor of supporting evidence. Saudi Arabia has no penal code, so prosecutors and judges largely define criminal offenses at their discretion. Lawyers are not generally allowed to assist suspects during interrogation and face difficulty examining witnesses or presenting evidence at trial.

Courageous citizens who set up human rights organizations within Saudi Arabia, or who call for the release of unjustly convicted individuals, are themselves imprisoned. Freedom of speech, along with the other values enshrined in the American Bill of Rights, is not honored in Saudi Arabia. Practicing any faith other than Islam is a punishable offense. One can be arrested for taking Mohammad lightly, or joining certain Islamic sects that are in disfavor. One can be imprisoned for criticizing the incompetence of government officials.

The Sa'ud family rules Saudi Arabia as an absolute monarchy - there are no national elections and no effective means of popular participation in decision making. In early March, the Interior Ministry and the Council of Senior Religious Scholars, the highest law-interpreting body, reiterated a ban on demonstrations. In February, mabahith officers arrested eight people who announced they were founding what they intended to be the kingdom's first political party, the Islamic Nation Party (source).

Saudis import millions of migrant workers to fulfill clerical, manual, and service jobs, because the Saudis regard these jobs as beneath them. According to HRW, “Over 9 million migrant workers fill manual, clerical, and service jobs, constituting more than half the workforce. Many suffer multiple abuses and labor exploitation, sometimes amounting to slavery-like conditions.” In support of this claim, they add, “In years past, Asian embassies reported thousands of complaints from domestic workers forced to work 15 to 20 hours a day, seven days a week, and denied their salaries. Domestic workers, most of them women, frequently endure forced confinement, food deprivation, and severe psychological, physical, and sexual abuse.” The situation became so bad that the government of the Philippines, Nepal, Kenya, and Indonesia took action to deter their residents from traveling to Saudi Arabia for work.  

Given that tyranny is the gravest offense against American values, American patriots must applaud the courage of dissenters who speak out at great risk to themselves. Prince Khalid Bin Farhan Al-Sa’ud was willing to give up his position of power and defected from Saudi Arabia, declaring: 

“This regime in Saudi Arabia does not stand by God’s rules or even (country’s) established rules and its policies, decisions, and actions are totally based on personal will of its leaders.”

“All that is said in Saudi Arabia about respecting law and religion rules are factitious so that they can lie and pretend that the regime obeys Islamic rules (source).”

The steadfast alliance between the United States and Saudi Arabia is an affront to American values. But we all know why this alliance exists. The United States depends on Saudi oil. And in light of this fact, it is surprisingly to see that when the U.S. has the opportunity to become less dependent on Saudi oil, it does not seize the opportunity. In recent years, vast deposits of domestic oil and gas have been exploited and the plan is to export these precious commodities (source). Why? Because when the choice is between what is in the best interest of the American people and what is in the best interest of a handful of plutocrats, there is no contest.

Syria

The official explanation for going to war with Syria is that a “red line” was crossed when the Syrian government authorized the use of chemical weapons.  The chemical weapons incident in Syria occurred on August 21, 2013. The official explanation is dubious, because leaders in the United States wanted to bring about regime change in Syria well before August 21, 2013. The evolution of the public position of United States leaders on Syria eerily resembles the run-up to the 2^nd Iraq War.  

The itch

5/6/2002. In January 2002's State of the Union speech, G.W. Bush called Iraq, Iran, and North Korea the axis of evil. But in May of that year, evidently proud of the rhetorical turn, new members were added. "The United States has added Cuba, Libya and Syria to the nations it claims are deliberately seeking to obtain chemical or biological weapons (source)."

The matter of "seeking to obtain" such weapons did not take very long, because in 2003, Syria had allegedly acquired, and were testing, these sorts of weapons. 

4/15/2003: Donald Rumsfeld: "We have seen chemical weapons tests in Syria over the past 12, 15 months (source)."

Rumsfeld and G.W. Bush. Those were the days.

President G.W. Bush said, back in 2007, that “These two regimes [Iran and Syria] are allowing terrorists and insurgents to use their territory to move in and out of Iraq,” He added, “Iran is providing material support for attacks on American troops. We will disrupt the attacks on our forces. We’ll interrupt the flow of support from Iran and Syria. And we will seek out and destroy the networks providing advanced weaponry and training to our enemies in Iraq (source).”

Retired General Wesley Clark said, back in 2007, “I just got this memo from the Secretary of Defense’s office. It says we’re going to attack and destroy the governments in 7 countries in five years – we’re going to start with Iraq, and then we’re going to move to Syria, Lebanon, Libya, Somalia, Sudan and Iran (source).” That was 2007. Since then, the Libyan government has been destabilized and President Obama has authorized arms shipments to fuel the civil war in Somalia (source). Earlier this year, a former Bush official wrote an editorial calling for U.S. military intervention against Sudan (source). And Lebanon requires no special attention. Any carnage to will be unleashed in Syria will inevitably spill over the border into Lebanon, as that is where one can find large numbers of Hezbollah troops. 

Ruins of the Roman Empire, Palmyra, Syria

The short-lived romance stage

For a little while, Bashir al-Assad was viewed as a pro-western reformer. He did seem like an improvement over his father Hafez, even if he was a member of the Baathist Party (remember them?). He and his glamorous wife dined with Mr. and Mrs. Kerry. The Queen of England granted him an audience.


The soon-to-be-forgotten voice of reason stage

In January of 2012, a policy expert argued that, “if American and NATO forces were to oust Assad, ‘that could make things worse, and lead to a civil war’ among Syria's religious groups … That would mean ‘a long operation’ for American troops – just as the Iraq war— which stretched on and on due largely to fighting between religious sects (source).”

The “let’s hope for a coup d’etat” stage

On 2/14/2012, the U.S. Ambassador to Syria, Robert Ford, stated, “We are not dithering. We are not hesitating. The US position is that we reject any kind of military intervention in Syria, let's be clear about that (source).”  

On 2/ 24/2012, then Secretary of State Hillary Clinton helpfully suggested that, “With deep divisions preventing forceful international action … security forces long loyal to Bashar Assad and his family could oust the Syrian president and end the bloodshed that is ripping his country apart (source).”

The “accidentally divulging the real reasons for war” stage

On 6/4/12, one neo-conservative wunderkind opined that, “Cutting Iran's link to the Mediterranean Sea is a strategic prize worth the risk (source).” For a bit of context, the reader may remember that, during the presidential campaign between Romney and Obama, the hapless Massachusetts Republican repeatedly asserted that Syria is “Iran’s route to the sea.” Many people found this assertion to be ridiculous, because a substantial portion of Iran borders the Persian Gulf.

However, what Romney meant to say was that Syria could become Iran’s route to the Mediterranean Sea. In January of 2011 it was reported, “Under the new deal between the two countries, a gas pipeline will transfer Iran’s gas to Iraq and Syrian territories feeding their power plants,” and following that, the pipeline will extend “through Southern Lebanon … to [the] Mediterranean Sea and Europe [in particular southern Italy], while Syrian oil minister Sufian Allaw noted that ‘The strategic gas pipeline will transfer gas from Iran to Iraq, Syria, and the Mediterranean Sea and this is connected to the Arab gas pipeline’ (source).”

Also, if Syria were to undergo regime change and a new pro-Western government were installed there would be benefits to Israel. “In Lebanon, Hezbollah would be cut off from its Iranian sponsor, since Syria would no longer be a transit point for Iranian training, assistance, and missiles (source).”

The prima facie evidence of complicated-geopolitics-at-play stage

“In June 2012 Iran announced that it would hold a naval exercise together with Syria and Russia in the eastern Mediterranean (source).” Russia is, of course, a staunch ally of Syria. Russia has always lamented a lack of direct access to the Mediterranean. One observer reminisces, “How many times, throughout the Cold War, did we hear of Russia’s desperate need for a warm-water port (source)?”

The "inconvenient factors are ignored" stage

BEIRUT 6/14/13 — A Syrian rebel group's April pledge of allegiance to al-Qaeda's replacement for Osama bin Laden suggests that the terrorist group's influence is not waning and that it may take a greater role in the Western-backed fight to topple Syrian President Bashar Assad (source).

The “we’ll intervene militarily if we have a good reason” stage

On 8/20/2012 Barack Obama said that “his administration would rethink its opposition to military intervention in the Syrian civil war if President Bashar Assad deploys weapons of mass destruction, calling such action a ‘red line’ for the U.S. (source).”


Mythical Moderates

9/3/13: "The Obama administration is considering putting the Pentagon in charge of arming and training moderate rebel forces in Syria (source)." The neo-cons behind the 2nd Iraq War clung to the idea that there were moderate elements in Iraq who would rise up and stabilize the situation, and make the sensible choice of taking a pro-western stance. Now, there are undoubtedly plenty of moderates in Syria or Iraq, but moderate folks are liable to stay quiet rather than risk a public beheading.

U.S. Military Presence in North Africa

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On Keeping One’s Patriotism in Dark Times

The Founders created a brilliant vision for the United States. The American people, however, haven’t always kept faith with that vision. Like the Israelites during their exodus from Egypt, the American people have succumbed to harmful impulses. And like the Israelites, the American people have been occasionally re-awakened. Just as Moses tore down the Golden Calf, Americans tore down the Gilded Age oligarchy. Prosperity and virtue were restored for a time. Such is the journey of life. Sometimes we stop moving forward. We either give in to our own weakness and fatigue, or are beaten down by powerful enemies. And we are left with a decision: whether to surrender or fight. 

Now we are faced with a new Gilded Age but the circumstances are more desperate than they were at the close of the 19^th century. The oligarchs have erected enormous machinery designed to take jobs out of the hands of Americans and place the jobs in the hands of slave-laborers overseas. They have transformed American education; it is increasingly becoming a profit-center that sucks public money into private coffers, and produces citizens who lack the knowledge of history, ethics, and politics to understand either the times in which they live or the extent of what they have lost. The oligarchs control the levers of government, ensuring that their collaborators are elected and their enemies are defeated. They see to it that the American people pay ever higher taxes in exchange for fewer and fewer services. They keep the public divided, quarreling over trifles even as disaster looms over them. They ensure that the populace continues to groan under the weight of impossible debts, because they are our creditors. They seek to destroy the last safeguards of liberty by gradually and cunningly undermining the freedom of speech and freedom of association.

In light of what this country has become, it is not surprising that many people have lost the spirit of patriotism. But to lose the spirit of patriotism is to surrender. And to keep the spirit of patriotism is to fight. 

Thus, to keep one’s patriotism in dark times such as these, it is necessary to embrace certain values that may seem strike some as either quaint or terrifying. These values began in the age of chivalry. And I will point out that my thoughts on this matter have been crystallized by reading the extraordinary book, Bushido, The Soul of Japan, written by Inazo Nitobe in 1899.

The chivalrous virtues include:

RECTITUDE: Rectitude is simply the firm resolution to continue moving forward, even when fatigued or opposed by others. Rectitude arises from a sense of duty to one’s family, friends, and fellow citizens. The opposite of rectitude is self-indulgence or, in the language of Enlightenment scholars, “self-love.” Self-indulgence is what motivates the desire to surrender. We feel our own weakness and pain, and wish for it to end. And as Montesquieu pointed out, “Self-love, the love of our own preservation, is transformed in so many ways, and acts by such contrary principles, that it leads us to sacrifice our being for the love of our being.” In other words, self-indulgence causes us to remain passive as our liberties, our property, our happiness, our health, and our lives are taken from us.

COURAGE: Courage, according to Confucius, is doing what is right. The emphasis here is on “doing.” It is not enough to know what is right; however, courage is not a virtue unless one knows what is right. So, to have “the courage of one’s convictions” is just as important as the courage to take on an adversary. But it is also a virtue to recognize that rationality takes us only so far. Courage is not rational. It is a matter of faith. 

BENEVOLENCE: To show benevolence is to take seriously the needs of others. It implies a feeling of filial solidarity with one’s fellow citizens. Benevolence is a willingness to give one’s food to another, even when hungry. To make such a gesture is to be confident in one’s ability to withstand the pangs of hunger stoically. In the code of chivalry, to be benevolent is to show one’s strength. And, conversely, to show a lack of benevolence is to reveal one’s own weakness.  

The Founders and Chivalry

The elements of Japanese chivalry are also evident in European chivalry. I will suggest that (1) elements of European chivalry may be observed in the ideas of the Founders, (2) patriotism is itself a chivalrous sentiment, comprised of rectitude, courage, and benevolence, and (3) returning to the words of the Founders may offer a tonic to revitalize one's feelings of patriotism in times of despair.

RECTITUDE: 

“A generous parent would have said, ‘if there must be trouble, let it be in my day, that my child may have peace.’”  - Thomas Paine

“A general Dissolution of Principles & Manners will more surely overthrow the Liberties of America than the whole Force of the Common Enemy. While the People are virtuous they cannot be subdued; but when once they lose their Virtue they will be ready to surrender their Liberties to the first external or internal Invader. How necessary then is it for those who are determined to transmit the Blessings of Liberty as a fair Inheritance to Posterity, to associate on publick Principles in Support of publick Virtue.” – Samuel Adams

9/22/1776: Nathan Hale is hanged by the British. He is remembered for his last words, "I only regret that I have but one life to lose for my country."

COURAGE: 

“The time is now near at hand which must probably determine whether Americans are to be freemen or slaves; whether they are to have any property they can call their own; whether their houses and farms are to be pillaged and destroyed, and themselves consigned to a state of wretchedness from which no human efforts will deliver them. The fate of unborn millions will now depend, under God, on the courage and conduct of this army. Our cruel and unrelenting enemy leaves us only the choice of brave resistance, or the most abject submission. We have, therefore, to resolve to conquer or die.” 

 – George Washington

 

BENEVOLENCE: 

“Certain modes of luxury may be a public evil, in the same manner as it is a private one. If there be a nation, for instance, that exports its beef and linen to pay for the importation of claret and porter, while a great part of its people live upon potatoes and wear no shirts, wherein does it differ from the sot, who lets his family starve and sells his clothes to buy drink?” - Benjamin Franklin

“He who is void of virtuous attachments in private life is, or very soon will be, void of all regard for his country. There is seldom an instance of a man guilty of betraying his country, who had not before lost the feeling of moral obligations in his private connections.” – Samuel Adams

“I am conscious that an equal division of property is impracticable. But the consequences of this enormous inequality producing so much misery to the bulk of mankind, legislators cannot invent too many devices for subdividing property… [a] means of silently lessening the inequality of property is to exempt all from taxation below a certain point, and to tax the higher portions of property in geometrical progression as they rise.”  – Thomas Jefferson

What Patriotism is Not

FEAR: “Our government has kept us in a perpetual state of fear — kept us in a continuous stampede of patriotic fervor — with the cry of grave national emergency. Always there has been some terrible evil at home or some monstrous foreign power that was going to gobble us up if we did not blindly rally behind it by furnishing the exorbitant funds demanded. Yet, in retrospect, these disasters seem never to have happened, seem never to have been quite real.” -- General Douglas MacArthur, 1957

EXPEDIENCY: “Necessity is the plea for every infringement of human freedom. It is argument of tyrants. It is the creed of slaves.”  - William Pitt

PASSIVITY: “When the representative body have lost the confidence of their constituents, when they have notoriously made sale of their most valuable rights, when they have assumed to themselves powers which the people never put into their hands, then indeed their continuing in office becomes dangerous to the state, and calls for an exercise of the power of dissolution.”- Thomas Jefferson

CONCEIT: “If we do not learn to sacrifice small differences of opinion, we can never act together. Every man cannot have his way in all things. If his own opinion prevails at some times, he should acquiesce on seeing that of others preponderate at others. Without this mutual disposition we are disjointed individuals, but not a society.” – Thomas Jefferson

BLIND ALLEGIANCE: “The duty of a patriot is to protect his country from its government.”
- Thomas Paine.