Saturday, April 18, 2020

Military Expenditure Toward Healthcare

A quick American history lesson. The 1st Continental Congress met in 1774 to form a colonies-wide protest to the British passage of the Intolerable Acts, which was a response to the Boston Tea Party of 1773. That original Congress produced merely a statement...that no one paid any attention to. But the 2nd Continental Congress met in 1775 and the beginnings of a true organized revolt against the British Crown was pretty well underway. Why the differentiation between the 1st and 2nd? The 2nd Continental Congress included all of the original 13 states and thus can rightly be considered the origins of our current federal gov't, but the 1st only included 12 of those states and so is not exactly the same as the 2nd. That said, the 1st and 2nd were clearly from the same source and built around the same causes, so separating the two isn't really necessary save cosmetic differences. (*)

After the Revolution had been fought and the British were vanquished, the Continental Congress ushered in the Articles of Confederation and from 1781-1789 sorta goes to sleep.  It's there, it's doing stuff, it meets regularly--and yes, there were Congresses and Presidents before 1789--but it is really more of a placeholder for a gov't than an actual gov't. The Constitutional Convention of 1787 is where we got our Constitution, our Congress, our President and our Supreme Court. (**) And in 1789 the 1st United States Congress meets and George Washington is inaugurated as President (***).

Though the time from 1781-1789 was something of a dormant period, it was in 1784 that our modern Army was founded, though initially it was rife with mutiny as the Congress was bankrupt and offered little way by way of regular funding. But actually the Army created by the 2nd Continental Convention in 1775 never went away and though it was re-created in 1784, technically it was still the same Army that was there at the beginning of the Revolution. So the modern Army predates the modern Congress. While the argument could made that Congress goes back to 1774 and the Army goes back to 1775, realistically our Congress goes back to 1789 and in 1789 when the 1st Congress met and the 1st President was inaugurated, the military was already there at the disposal of the gov't.

The military, then, is primary and the construction of our constitution has the military in mind throughout. The President's first order of business, for example, is to be the Commander-in-Chief of the military. Think of it this way: the Military is the wild animal, Congress pays for the cage it lives in, the Commander-in-Chief feeds and waters the animal and tells it what to do, all of which is agreeable to the Military as long as the Congress and President are popularly elected. (****) Add in a Supreme Court (to adjudicate claims between the citizens) and a central bank (to finance it all) and--voila!--you got a political economy that has some real teeth to it. But make no mistake: it is the Military that gives the Congress credence, without it no one would give a shit what a room full of old white men wearing wigs thought about anything. It is the monopoly of force that makes our gov't a gov't--and in our case the force was there before the gov't was.

So the real branches of gov't: 1) Military, 2) Congress, 3) President, 4) Supreme Court, 5) Federal Reserve. Smoothly drip over 50 states with their own legislatures, executives and judiciaries, even their own militias (but no central banks, just not central enough at the State level), then trickle down through the city and county gov'ts and courts (and police forces?) within each State and that's America, buddy.

Why do I bring this up? And why did I put the Military at the top? Is it because I love guns? No. It is that the Military already has all the money and is the only truly bi-partisan supported institution in our nation (*****) and deep down is every bit as much of our makeup as the Presidency or the Congress. If you want the gov't to do something, you're probably gonna need the Military on board. And when you can convince the Military it wants it, too, then you got some sweet action.

Covid-19 has shown us that on occasion we will need emergency procedures and crisis management, above and beyond what the day-to-day gov't itself can (or should) provide. Realistically the Military is going to be the source of all that. You can be queasy about giving the Pentagon too much power or you can embrace the notion that militaries all over the world are on the cusp of the transition from war-making functions to life-saving functions. Medical triage, rapid response, emergency procedures, and search and rescue will be needed to combat floods, earthquakes and hurricanes, too (******). These skills will only be needed occasionally but when we need them, we need them to snap into action pronto. Really only the Military with its national security mandate (and virtually unlimited budget) will be able to perform those tasks.

I'm ready to see the Pentagon move away from weapon development and get back into investing in its citizen assets for the purpose of increasing our capacity for emergency preparedness and to bolster the labor market for a move toward a service-driven healthcare economy. What this virus offers us is the time to do that, as all the other peoples of the world realize that's what they need their militaries to do, too. Developing weapons systems is something we do to outspend our adversaries (yeah, truth be told, we develop ever more expensive weapons solely because we can and our enemies (probably) can't). We can afford systems other countries can't even dream of and that's fine, being dominant in that field is what all the most powerful nations of history possessed. But right now an ethic of life-saving rather than war-making should emerge as nations stagger back into the sunlight.

How do we make this happen? I dunno. What kind of medical and search-and-rescue programs can the military offer? I dunno. I suggest we find out. Realistically the Military can reshuffle a little here and there in its medical personnel, but the massive outlays of capital I'm suggesting would be better served going to colleges and universities. So how can the Military partner with educational systems to ramp up the sheer amount of Healthcare workers? I dunno. Perhaps the Military designs 2 or 4 year programs whereby the GI bill will cover more medical training or something. I don't know how that shit works, but my instinct is the Military can figure it out, has the need to do so and the funds and mandate to pull it off. It's less about training more doctors (though that's not bad) and more about widening the training of emergency service providers and first responders.

Perhaps even multiple levels of doctoring: it takes 6 years of med school to do x/y/z but perhaps it only takes 2 years to be certified in a/b/c. Perhaps we should establish a series of certifications and qualifications leading up to doctorhood that can employ people (at least in emergencies) who haven't achieved maximum educational status. Perhaps it is in separating the many various functions of care rather than seeing Healthcare as one giant indivisible mass. And, for god's sake, we've got tone down the liability of medical providers. Ladies and gentlemen, you have to give medical workers the opportunity to save your life! Suing for gross negligence or continually bad practices is one thing, but suing an aid worker that made an honest mistake or just wasn't able to save your dying uncle is not what our courts need to be concerned with.

The coming boom of healthcare workers would create more opportunities in the industry as a whole and I don't say that under the thought that the supply will create the demand. In healthcare the demand is universally latent and permanently under served--indeed, that's the whole libertarian argument against nationalized healthcare: the demand curve never goes down and the supply curve can never match it, therefore paying for it is utterly impossible and doomed to fail while bankrupting the nation and in the end providing no worthwhile healthcare and satisfying no one. I'm not talking about a Healthcare system that tries to accomplish that impossible task, I'm talking about a Healthcare system where all citizens receives more square one level of attention (giving the data analyzers more than enough to work with), which will require a lot more people with square one kinda skills. I'm talking about a nationwide resurgence of Boy Scouts and Girl Scouts really but with a Pentagon-size budget behind it.

Do I worry about an oversupply of medical professionals? I do not. And I'd love to see the Pentagon use their massive budget to try and prove me wrong. I bet you a dollar training a shitload of extra medical and emergency personnel will not be a waste of money. How to accomplish this? I don't know but pouring Military money into colleges and universities with the purpose of producing more healthcare workers at every level strikes me as the place to start. Perhaps creating a division within the Defense Department that keeps the practice ongoing is the key.



(*) The Stamp Act Congress of 1765 and the Albany Convention of 1754 could be considered antecedents of our gov't but don't have the same makeup or underlying intentions as what we ended up with, so they are better thought of as examples of the larger evolution toward a general sense of political culture rather than as direct lineage of our current gov't.

(**) It also gave us a central bank but that original bank was drowned in the Potomac during the Jackson administration. Our current Federal Reserve is an altogether different beast from what the founding fathers imagined in 1787, but we did end up with one the way they thought we would, right?

(***) In 1789 everyone ignores the Supreme Court because all through the 1790's it was a shit job that nobody wanted. It isn't until Marbury v Madison of 1803 that the Supreme Court even begins to see a proper role for itself. Under the Chief Justice-ship of John Marshall from 1801-1835, the Court rounds into something that would look familiar to contemporary Americans. But it took a while for that third branch to grow.

(****) As the military possesses its own justice system, the Supreme Court actually has very little oversight in how the military operates and functions, outside of affirming the Congress's power of the purse and the President's standing as commander-in-chief. One could argue that modern courts are just extensions of ancient military tribunals, but in America's case, it was hundreds of years of English common law that formed the backbone of our judicial practices. So though I'm trying to show the primacy of the Military in the Federal Gov't, I don't see that as contributing much to our judicial side.

(*****) Well, maybe college football. Hey, there's a lot more state funding there than you probably ever bothered to notice.

(******) Political rallies (sometimes referred to as "riots"), on the other hand, should be left off of the Military's emergency purview. Amassing troops to keep crowds from performing wanton acts of large-scale destruction might be okay, but anything short of that is something the Military should instinctively avoid. Protecting, say, the POTUS or Supreme Court Justices from physical retribution is not the Military's job and not a task the Military should even consider. I'm okay with the Military protecting buildings (the White House, for example) but not individual people (POTUS has his own security force, he's somebody else's problem).The emergency powers I'm talking about would be reacting to purely act of God-type stuff, nothing political in nature if for no other reason then your Military is made up of normal citizens, their passions and persuasions are not so easily banked upon and keeping their directives as clear as possible is a necessity in the Miliary. The Military should avoid the politics of the people and stick to saving lives and protecting borders. Soldiers firing into a crowd....do you know the story of Christopher Seider? (Personal aside: If a domestic mob can only be stopped by force of arms, then it probably shouldn't be stopped, as the only thing that will stop it is genocide. Thus, pointing your military at your own populace is merely suicidal whether in the long run or short)

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