HEALTH CARE REFORM: WHAT A SOLUTION MIGHT LOOK LIKE

There are several truths that must be acknowledged before any realistic discussion on health care reform in the US can even begin:

1) Health insurance and health care are two different things. You can have a health insurance policy potentially worth millions of dollars, but if health care providers won’t accept it, or if your out-of-pocket costs before coverage kicks in are prohibitively high, then in effect you have no insurance.

2) Buying insurance is a sucker’s bet if there is no substantial harm in going without it. The very notion of insurance is predicated on assessing and managing risks. The customer’s risk comes with laying out money for fixed premiums, and the insurer’s risk comes with promising to cover the customer’s medical expenses if and when they arise. For insurance to work, both sides must accept those risks; no matter how cleverly you try, you cannot legislate the dual risk dynamic out of the insurance industry. More to the point, you cannot push all the risk onto the insurer’s side by permitting customers to buy insurance only when they desperately need it. A guy whose house is burning down will be eager to purchase fire insurance—but no insurance company will sell it to him. You buy insurance because you think you’ll eventually need a payout, not because you need the payout now; you may end up forking over more than you ever get back, but that’s the risk you take when you pay your premiums. It’s a form of gambling, like poker. You ante up with your premiums. You ante up before the cards are dealt. You can’t look at your cards, and then decide whether you want to be in the game. No ante, no chance of a payout. That’s the penalty for not anteing up in poker. Likewise, there must be a penalty for not carrying health insurance. In a decent society, however, it can’t be a death penalty.

3) Health care is a commodity, which means, like all other commodities, it is subject to the law of supply and demand. Calling health care a “right,” whatever you think that means, does not exempt it from the law of supply and demand; nor does calling it a “right” alter the fact that in a broadly capitalist economy, people who can afford better stuff tend to get better stuff.

The critical question to ask is what we want a reformed health care system to do. What are we hoping to accomplish by reforming the current mishmash? Here, I think, are a few answers:

1) We want to bring down costs for many, if not most, individuals, and we want at least to rein in costs for the federal, state, and local governments who now subsidize, to a greater or lesser degree, health care expenses.

2) We want to make sure that people with pre-existing conditions are not locked out of the health insurance market altogether, yet we don’t want to create a moral hazard that allows people currently without insurance to wait until they’re sick to buy it. Again, there must be a penalty for not carrying insurance.

3) We want to simplify, insofar as possible, the purchase of insurance and the delivery of health care.

4) We do not want to ration care in such a way as to stifle medical research or thwart new and innovative treatments.

So how do we get started?

Step One: Cap malpractice awards nationwide. I can’t tell you exactly what the cap should be, but it should be as low as possible and pegged to the future earnings of victims. No punitive damages; no money for pain and suffering. If you want to increase the number of providers, you need to lower the overhead expenses for those entering the profession and continuing to practice.

Step Two: Increase the number of providers by lowering the credential requirements to provide primary care. You need a create a vast army of “primary care nurses” empowered to examine patients, recommend treatments, and prescribe medications—who do, in short, the same job primary care physicians now do—but who lack medical degrees. These nurses must be trained and certified above the current level of nurse practitioners but well below the level of licensed physicians. Their compensation will be significantly higher than the former but significantly lower than the latter. They will occupy a middle ground between the two.

Step Three: Establish two networks of primary care providers nationwide, one superior and one inferior. (If you cannot accept that one network will be superior, and one inferior—that two distinct and unequal levels of care are necessary and intentional—and that many people will wind up in the inferior network, you may as well stop reading now.) To underscore this point, and since this is my sketch, I’m going to call the superior tier the Shakespeare Network; the inferior, I’ll call the Shaw Network. Shakespeare will be populated by traditionally-credentialed primary care physicians; Shaw will be populated by primary care nurses. (Ideally, primary care nurses will work in clinics under the supervision of one or two certified physicians—though this will not always be possible in rural areas.) Specialists will not belong to either network.

Step Four: Reform employer-based insurance. If employers want to contribute to their workers’ health care insurance, let them do so. But give the employees a choice of whether to accept the company plan (whether it puts them in the Shakespeare or Shaw Networks), or to take the individual cost of the company plan as an annual bonus designated to buy their own insurance. If the employee can find a cheaper plan that suits his needs, let him pocket the difference…and if he wants a more expensive plan, let him add his own money to the pot. Among the many problems with the current system of employer-based insurance is that fact that employers offer group insurance plans that cover all employees the same way (so, for example, male employees must carry insurance that covers mammograms, and female employees must carry insurance that covers prostate exams).

Step Five: Let people shop anywhere for their policies, and let insurance companies tailor their offerings to narrow demographics. Why, for example, should I be forced to carry a policy that covers mental health care costs if I’m confident I’ll never incur those expenses? How much cheaper would a policy be that omits mental health coverage? Yet many states require that all insurance plans sold within their borders cover mental health care. Ditto acupuncture, erectile dysfunction pills, birth control, etc…if I know I’ll never incur these expenses, why should I be compelled to insure against them? Insurance companies should be free to offer pared down policies at lower premium costs—and to sell those policies to anyone anywhere.

Step Six: Let people further reduce the cost of their insurance by buying plans that restrict their primary care to the Shaw Network. Access to the Shakespeare Network, where primary care is provided by physicians rather than by nurses, should cost more. If you select the cheaper Shaw Network, but grow unhappy with your plan, you can opt into the Shakespeare Network by paying a substantial one-time adjustment penalty (based on your current age, life expectancy, overall health) and higher premiums from that point onward if and only if you are not already sick. If you are already sick—if you have a preexisting condition—you are locked into the Shaw Network. You cannot move up. So, too, if you choose not to carry health insurance for a year or more, you can pay a substantial one-time adjustment penalty and buy into the Shaw Network, but, again, you are locked in. You cannot move up to the Shakespeare Network under any circumstances.

Step Seven: Since specialists (including surgeons) belong to neither network, their services will be available to anyone insured by either network. But scheduling priority will be given to members of the Shakespeare Network…which makes sense, given that provider compensation is greater in the Shakespeare Network. Expect substantially longer waits for specialized services if you are a member of the Shaw Network. Also expect coverage for more expensive specialized services to be occasionally denied to members of the Shaw Network. You pay less, you get less. The medical industry will thus continue to innovate for members of the Shakespeare Network; benefits from the innovations will eventually trickle down to Shaw Network members, but wait times will no doubt be long, and the process of price-dropping will no doubt be slow.

Step Eight: Medicaid funds can only be used to access Shaw Network providers and services.

Step Nine: Medicare should be reconfigured as a lump sum annual payment sufficient to cover the cost of buying private insurance on the Shaw Network. The individual can then supplement that dollar amount to buy into the Shakespeare Network—provided that he has been a Shakespeare Network member for a minimum of (say) 20 years, or that he has no pre-existing conditions to prevent him moving from Shaw to Shakespeare and is willing to pay the cash penalty for such a move.

Review of Walter Laqueur's The Changing Face of Anti-Semitism

The Changing Face of Anti-Semitism, by Walter Laqueur
Oxford University Press, 228 pages, $22.00

Book Review by Mark Goldblatt / first published in the Claremont Review of Books, 2007

The Book of Esther in the Hebrew Bible recounts what is perhaps the world’s first attempted pogrom. The fanciful tale of the persecution and deliverance of the captive Jewish people during the reign of the Persian King Ahasuerus (often identified as Xerxes I, who reigned from 486-465 B.C.) tells the story of Haman, the king’s second-in-command, who plots to kill all the Jews under Persian rule. Haman feels slighted because the Jewish leader Mordecai won’t bow down to him and urges Ahasuerus to authorize genocide: “There is a certain people scattered and separated among the peoples in all the provinces of your kingdom; their laws are different from those of every other people, and they do not keep the king’s laws, so that it is not appropriate for the king to tolerate them. If it pleases the king, let a decree be issued for their destruction…” (Esther 3:8-9). Haman’s plot is eventually foiled by the king’s favorite wife, Esther, herself a Jew and Mordecai’s cousin. Haman is hung on the king’s orders, Mordecai is promoted in his place, and “for the Jews there was light and gladness, joy and honor.”

Rarely since then have things turned out so well for the Jews, as Walter Laqueur recounts in his new book, The Changing Face of Anti-Semitism. Laqueur, a historian and author of Fascism: Past, Present, and Future (1996) and The New Terrorism: Fanaticism and the Arms of Mass Destruction (1999) sets for himself the daunting task of chronicling the long history of anti-Semitism from biblical times to the present. That he mostly succeeds, in just over 200 pages, is a remarkable achievement.

According to Laqueur, the roots of anti-Semitism can be traced, at least in part, to the historical fact of the Diaspora—the scattering of Jewish people throughout the ancient world after the destruction of the state of Judea by the Romans in 73 A.D. Of course, many ethnic and religious groups have been dispersed by calamity and conquest—Laqueur cites the example of the Kurds—but they have tended to remain in roughly contiguous territories, awaiting an opportunity to coalesce again into an autonomous state; Jews, by contrast, actually did disperse, forming recognizable minority communities across the globe—each of which seemed to reinforce, to outsiders, the distinctive nature of Jewish society. Even though Jews often assimilated, they seemed to do so for strictly pragmatic reasons; in matters of the heart, or when push came to shove, they “stuck to their own, isolated themselves, and (so it appeared to outsiders) considered themselves somehow better than others because of being the chosen people and having a special connection with their god.”

If anti-Semitism in the first few centuries after the Diaspora was exceptionally far-flung, it was, as Laqueur notes, only “one of many national and ethnic antagonisms.” Hostility towards Judaism acquires its peculiar status with the ascendance of its rival sect, Christianity—which became, by decree of Theodosius, the official religion of the Roman Empire in 380. Jews, after all, had rejected Jesus and were believed by many Christians to be the main culprits in his death. “There is no doubt,” Laqueur writes, “that the advent of Christianity and…its subsequent interpretation present the turning point in the history of anti-Semitism and the Jews.” Whenever and wherever Christianity reigned during the Middle Ages, anti-Semitism was likely thrive. Even as thoughtful a figure as St. Augustine implores God to slay the Jews so that none would be left to oppose His word. Christian communities were rife with rumors of Jewish treachery; Jews, it was believed, butchered Christian children to bake into their Passover bread, poisoned local wells, and spread disease. Denunciations, persecutions, and forced expulsions became so frequent during this period that it comes as a surprise when Pope Clement VI issues a papal bull in 1348 insisting that the Black Death was not specifically the fault of the Jews but rather a divine punishment against all mankind for its sins.

Jews fared slightly better under Islam after its rise in the 7th century. Though relegated to second-class citizenship under Muslim rule, the Jews were nevertheless spared the relentless suspicion and concerted assaults they suffered in Christian Europe. According to the Koran, Muhammad himself had Jewish friends; Muslims regard Moses, as well as Jesus, as genuine prophets, and both Jews and Christians are ahl al-kitab—People of the Book. On the other hand, the Koran also specifically instructs Muslims to kill Jews and refers to them as “sons of apes and pigs.” A 9th-century hadith (commentary on the Koran) states that the “last hour” will not come until Muslims fight against Jews, until the trees and stones themselves cry out, “O Muslim, there is a Jew hiding behind me. Come and kill him.” The status of Jews under Muslim rule, in short, if slightly more secure than under Christian rule, remained tenuous.

The Protestant Reformation brought with it improved circumstances for the Jews of Europe. Luther, it is true, was rabidly anti-Semitic, and authored a 1543 pamphlet called “The Jews and Their Lies” in which he suggested that synagogues be burned, Jewish homes be destroyed, and the remaining Jews be put under one roof so that “they realize that they are not masters in our land as they boast but miserable captives.” On the contrary, Calvin’s attitude towards Judaism was more enlightened. He noted that the “seed of Abraham” was part of the body of Christ and that God’s divine calling of the Jews could not be rendered null and void, insisting that “our differences with them were purely theological.” Throughout the Reformation, where Calvinism took deepest root—most conspicuously in the Netherlands—Jews fared relatively well.

The idea of Judaism as a foreign entity, a kind of contagion within the body of humanity, rather than merely as a religious sect, began to emerge during the Enlightenment. Speaking of Jews, Voltaire wrote, “I would not be in the least surprised if these people would not some day become deadly to the human race.” Kant and Hegel also held low opinions of Jews, and such sentiments were to acquire the whiff of scientific respectability with the advent of race theory in the late 18th century. Racial categorization was, from the outset, more than just anthropological color coding; each race was assumed to possess innate behavioral characteristics. The Jews, by their very nature, were parasitic. It wasn’t merely their beliefs or traditions that were alien; alienation was their essence. They insinuated themselves into a society like a cancer and began to suck the life out of it.

The term “anti-Semitism” first came into common use in the second half of the 19th century, popularized by Wilhelm Marr, a German journalist, who meant it not as moral critique but as a policy recommendation. Marr argued that it was ignorant, and strategically foolish, to attack Jews as “Christ-killers” or for their alleged ritual murder of Christians. He believed that the real danger posed by Jews lay in their disproportionate influence in upper strata of German society and, related to that, the effects on the national culture of the “Jewish spirit”—a sense of cosmopolitanism (or, if you prefer, statelessness) that undermined traditional notions of German identity. Unless the people could defeat the Jewish spirit—that is, enact anti-Semitism—Marr concluded, they had no future: “Finis Germaniae.”

We are now within sight of the Holocaust. The Holocaust is the shadow that looms over Laqueur’s work; indeed, it is hard to read any narrative of the persecutions of Jews without a sense of dread, of the gathering momentum of collective animus and theoretical justifying which culminates in the hell of Nazi Germany. The singularity of the Holocaust derives not from its body count. What makes the Holocaust unique is the methodology, the step-by-step legal process enacted by the Nazis which identified Jews under their control, isolated them in ghettoes, deported them to concentration camps, and then systematically exterminated them. History is rife with shallow graves. But only in the Holocaust did the blundering ham-fisted brutality of the human species take up a scalpel. This is the first and final truth of the crematoriums. Laqueur’s account of the Third Reich’s campaign of liquidation, though brief, is undoubtedly the highlight of his book.

That said, the book is not without faults, the most glaring of which is a function of its length. This is mostly a mentioning book. It is short on both anecdote and analysis, which makes it a consistently dry read. Indeed, at times it has the feel of an extended encyclopedia article. But like a good encyclopedia article, by the end you sense you’ve gotten a thorough overview of the subject. For that, Laqueur is to be applauded.

Sal Salamone (1948-2012)

[Remarks delivered at KGB Bar, Greenwich Village, October 2012.]

Sal Salamone died, suddenly, on August 28, 2012, during the summer break in the Trumpet Fiction reading series here at KGB. After Jonathan found out that Sal was gone, he suggested that we take a few minutes to remember him, so that’s why I’m up here, behind this podium, tonight. It’s fitting that we should remember Sal. He was part of the Trumpet Fiction family. Apart from Jonathan and Charles and Annie and me, Sal attended more of these readings than anyone else. He bought every book Greenpoint Press published—and just about every book by every author who read at Trumpet Fiction. He was also a writer himself, a serious writer, as disciplined in his process and as determined in his work as any I’ve ever known. But he never asked to read at Trumpet Fiction. For one thing, he didn’t like to be the center of attention. But he also had a weird verbal tic where he would regularly invert the syllables of words. As a friend of ours said after the funeral, Sal had gone to meet the “Gangel Abriel.” So that’s another reason we’re remembering him, and his work, tonight.

The great writing project of Sal’s life’s was a novel called Fate and Other Tyrants. It’s an epic story set in Italy that weaves together politics and religion and love and betrayal across two war-torn generations in the first half of the twentieth century. The novel took him 30 years to finish. For those 30 years, Sal worked full time as a computer analyst at Manufacturers Hanover Trust, which merged into Chemical Bank, which merged into Chase Manhattan Bank, which acquired JP Morgan and became JP Morgan-Chase. His job was to write the computer patches that synched the payroll programs after each merger. He wrote his novel during lunch hours and coffee breaks, at night and on weekends; he even wrote while the mainframes were running tests of his patch programs. He wrote long hand, in green and black composition books. After he finished his first draft, over a decade into the project, he keyboarded the entire thing into something called Leading Edge word processor—revising and editing as he went along. That took another five years. Unfortunately, during those five years, Microsoft Word became the industry standard . . . and it couldn’t convert Leading Edge documents. So Sal had to keyboard in the entire manuscript again—once again, editing and revising as he went along. That took another five years. It was at that point that he printed out a copy for me.

It was 2,822 pages long.

At 275 words per page, that's roughly the same length as the King James Bible. It took me six months to get through it; during that time, the physical weight of the manuscript warped the corner section of my desk. But I did finish it. The story is fast-paced, and the characters are vivid, but the writing is uneven. He needed an editor—he knew it himself. While I was reading it, he began sending out queries to a dozen publishing houses. But, strangely enough, none of them were interested in a 2,822 page novel from an unpublished author. Same for literary agents. He resigned himself to the fact that he was going to have to self-publish the book. But even iUniverse couldn’t deal with 2,822 manuscript pages. He was told he would have to break it up into three sections. The easy thing would have been to break it up chronologically. But writers who do the easy thing don’t write 2,822 page novels. He broke it up thematically: one volume keyed to the rise of Fascism, one keyed to tensions within the Church, one keyed to the struggle of intellectuals and journalists. The process of splitting up and re-editing the novel, then polishing and publishing the three individual volumes, took him another nine years.

Six months into his retirement, he handed me the third and final published volume. That was Thursday afternoon, August 23, 2012, after he and I and John and Kevin finished a round of pitch and putt golf. The following Tuesday, August 28, Sal was out in his backyard playing basketball with his 16 year old nephew. He started to feel sick . . . but he finished the game. Then he walked back into his house, collapsed, and died. He was 64.

Sal knew writing was never going to make him rich. He knew it was never going to make him famous. But he kept writing, decade after decade, for the purest reason of all: He had a story he wanted to tell. He wasn’t the greatest writer I’ve ever known. But he was noblest.

The last thing Sal ever wrote, as far as I can tell, was a group email to the three of us—me, John, and Kevin—apologizing for not getting back to us sooner, and confirming that he could again play pitch and putt the following Thursday. That was the Thursday, as it turned out, after he died:“Guys, I spoke with Mark, and I can definitely make Thursday's golf and lunch. I'm taking August off from writing, so I'm not on the computer everyday. Thanks for remembering me.”

I want to thank Jonathan, and Charles, and Annie, and the rest of you who knew him, for remembering Sal tonight. I know there are a lot of writers in this crowd. Which means there are a lot of people sitting here who understand the effort, and the frustration, and the grief, and, if you’re lucky, the occasional sense of accomplishment that goes with writing. I’d ask that you remember Sal too, even if you didn’t know him. And if you’re so inclined, keep him in your prayers, at least for a while.

The War Against Islamic Totalitarianism: How We Got Here

            (Originally published 8/17/04 in Frontpage Magazine. Edited and expanded.)

        One of the more debilitating cognitive blind spots of progressives is their belief that pathological behavior is always the result of privation: If only people were rescued from poverty, or ignorance, or hopelessness, the progressive mind reasons, they would cease doing terrible things. But in the case of Islamic terrorism, which is a pathological behavior, such an analysis is off the mark. On the contrary, the psychic justifications for Islamic terrorism can be found in an intellectually accessible and, in its own way, profoundly moving philosophy that stands in direct opposition to the liberal democratic institutions and Enlightenment values of the West.

The key figure, according to many scholars of recent Islamic history, is the Egyptian fundamentalist thinker Sayyid Qutb (1906-1966), whose writings form the basis for radical Islam’s struggle against Western ascendancy. Qutb’s signature contribution to Muslim thought was to update the concept of jahiliyya. For centuries, jahiliyya had signified the state of ignorance in the world prior to the advent of Islam; according to Qutb, however, jahiliyya should also be understood as the underlying spirit of decadence and corruption which exists in all times and all places--and which true Muslims are duty-bound to fight against. There can be no compromise with jahiliyya. “The mixing and co-existence of truth and falsehood is impossible,” Qutb wrote. “Command belongs to Allah or else to jahiliyya.” What was required, for Muslims, was to live under the strict Islamic code of laws called the sharia. It was the only way to ensure that they were living the way Allah intended.

Despite the sharia’s rigidity, Qutb argued that it was the sole source of genuine liberation since the sharia came from God. Either human beings were ruled by God, or else they were ruled by other human beings; there was no distinction, on this level, between an absolute dictatorship or a representative democracy. Both amounted to the rule of men over men--which, according to Qutb, was always a form of oppression. (It’s worth noting that Qutb reserved many of his most virulent criticisms for secular-minded Muslims.) Only the rule of God provided people with freedom. Thus, Qutb rejected out of hand the entire Enlightenment project which sought to separate church from state.

Whatever else might be said of Qutb’s worldview, it represents a straightforward, coherent, easily understood system of beliefs--a system which has been vastly influential among Islamic radicals, including Osama bin Laden. (Osama’s mentor and co-jihadist, Ayman Zawahiri, was a student and follower of Qutb; while studying at King Abdulaziz University, Osama attended weekly lectures by Qutb’s brother, and fellow students recall Osama as deeply drawn to Qutb’s thought.) Jihad is legitimized, in the radicals’ eyes, as the struggle against jahiliyya. The only question is how far jihad is aimed. The short-term project would consist of casting out the infidel Jews and Christians from Islamic holy lands and recapturing the holy cities of Mecca and Medina from the jahiliyya-tainted Saudi regime; the long-term project would consist of subjugating the non-Islamic West, which means defeating the United States, in order, first, to keep its corrupting influences out of Islam, and, ultimately, to liberate the West itself from the suffocating darkness of Enlightenment secularism.

It is a totalitarian movement in the truest sense.

The war against Islamic totalitarianism, on a fundamental level, is therefore a struggle between Enlightenment and anti-Enlightenment forces. To overlook this first truth--as progressives are wont to do--is to misapprehend the nature of the entire conflict. To be sure, there are other element involved. Ethnic rivalries. Nationalist movements. Regional and tribal loyalties. Religious schisms. Historical grievances. Natural resources. Global economics. The war is a witches’ brew of divided allegiances and score-settling. But at its bottom, beneath the claims and counter-claims, the war is between two irreconcilable visions for the future of mankind. The forces of liberal Enlightenment, committed to rational inquiry and religious tolerance, manifest in democratic rule, versus the forces of anti-Enlightenment, committed to faithful obedience to a divine will, manifest in sharia rule.

It is Thomas Jefferson versus Sayyid Qutb.

***

From our perspective, to be sure, it seems fantastic, even absurd, to talk about the defeat of the United States by the terrorists--which is the only path to the realization of their totalitarian goal. But our perspective is not the perspective of Osama and his ilk, who take a much longer view of history, a view in which even the most devastating setback is merely temporary and in which compromise is, literally, worse than death. Their hearts and minds are fixed against us, their struggle for our destruction is what gives their lives meaning, and they’re not going to be won over to our view . . . any more than you could be won over, say, to abandoning the welfare of your children. Muslim radicals ask nothing of us save our submission to Islam or our extinction. If we take them at their words (and what reason do we have to doubt them?) then they despise America as much for our traditions as for our policies, as much for who we are as for what we do--since we are, in effect, the cultural, intellectual and military vanguard of jahiliyya. Osama himself spelled this out in his November 2002 letter to the American people. After a pro forma rant about alleged wrongs perpetrated by the United States on Muslims worldwide, Osama outlined his demands: “. . . we call on you [Americans] to stop your oppression, lies, immorality and debauchery . . .  we call on you to be a people of manners, principles, honor and purity; to reject the immoral acts of fornication, homosexuality, intoxicants, gambling, and trading with interest.”

Osama’s bullet points follow. They're worth quoting at length:

*You are the nation who, rather than ruling by the Sharia of Allah in its Constitution and Laws, choose to invent your own laws as you will and desire. You separate religion from your policies, contradicting the pure nature which affirms Absolute Authority to the Lord and your Creator. You flee from the embarrassing question posed to you: How is it possible for Allah the Almighty to create His creation, grant them power over all the creatures and land, grant them all the amenities of life, and then deny them that which they are most in need of: knowledge of the laws which govern their lives?

*You are the nation that permits Usury, which has been forbidden by all the religions. Yet you build your economy and investments on Usury. As a result of this, in all its different forms and guises, the Jews have taken control of your economy, through which they have then taken control of your media, and now control all aspects of your life making you their servants and achieving their aims at your expense; precisely what Benjamin Franklin warned you against. 

*You are a nation that permits the production, trading and usage of intoxicants. You also permit drugs, and only forbid the trade of them, even though your nation is the largest consumer of them. 

*You are a nation that permits acts of immorality, and you consider them to be pillars of personal freedom. You have continued to sink down this abyss from level to level until incest has spread amongst you, in the face of which neither your sense of honor nor your laws object.

*Who can forget your President Clinton's immoral acts committed in the official Oval office? After that, you did not even bring him to account, other than that he “made a mistake,” after which everything passed with no punishment. Is there a worse kind of event for which your name will go down in history and be remembered by nations?

*You are a nation that permits gambling in its all forms. The companies practice this as well, resulting in the investments becoming active and the criminals becoming rich.

*You are a nation that exploits women like consumer products or advertising tools calling upon customers to purchase them. You use women to serve passengers, visitors, and strangers to increase your profit margins. You then rant that you support the liberation of women.

*You are a nation that practices the trade of sex in all its forms, directly and indirectly. Giant corporations and establishments are established on this, under the name of art, entertainment, tourism and freedom, and other deceptive names you attribute to it.

*And because of all this, you have been described in history as a nation that spreads diseases that were unknown to man in the past. Go ahead and boast to the nations of man that you brought them AIDS as a Satanic American Invention.

Such were Osama’s grievances. The sum of them is what makes us, in Osama's words, “the worst civilization witnessed by the history of mankind.” Or, in other words, satanic. But Satan, as conservative commentator Dinesh D’Souza has noted, does not conquer. He seduces. America, in the minds of Muslim radicals, is not merely the worst civilization in history but the most seductive because we are jahiliyya, unveiled. And we are up in their faces. In a worse way than the ancient giant statues of Buddha in Bamyan, Afghanistan were up in their faces when radicals dynamited them in March 2001; in a worse way than Paddy’s Pub nightclub in Bali, Indonesia was up in their faces when radicals detonated a suicide bomb inside, and then a car bomb outside, killing 202 civilians and wounding another 200 in October 2002; in a worse way than the Miss World Pageant in Nigeria was up in their faces when radicals rioted to protest the contestants’ immodesty, killing 100 and injuring over 500 in November 2003 . . . on television, radio and the internet, in glossy magazines, news journals and paperback books, on movie screens, home videos and CDs, Americans are absolutely everywhere, defying the sharia, acting out in every conceivable manner to seduce the next generation of Muslims away from the path of righteousness. We are bombarding them with the flotsam and jetsam of our pop media, from Eminem’s potty mouth to Britney Spears’s gyrating pelvis, from the Rock’s arched eyebrow to Brandi Chastain’s sports bra, from the brawling on the Jerry Springer Show to the mincing on Queer Eye for the Straight Guy. Such ephemera are tolerated by us, the lowbrow excretions of our dedication to highbrow ideals like individual liberty, artistic expression and free enterprise. For Muslim radicals, they are the toxic images of a steady spiritual genocide being wrought upon them.

The radicals were striking back at us, albeit with mosquito-like forays, since the era of disco music and leg warmers; on September 11th, 2001, they finally got our attention.

From that morning on, our task in the war against Islamic totalitarianism became axiomatic: Kill or imprison-for-life every Muslim radical in the world. It’s a different kind of war since it cannot end with the surrender of a collective entity; no white flag will ever be respected by our enemies. Prosecuting the war on terror is more like prosecuting hundreds of thousands of miniature wars in which our enemies are individual persons, determined to fight to the death. This is crucial. Even if every Islamic regime in Asia and Africa were to embrace liberal democracy and Enlightenment values, the United States would remain at war with Ahmed, Samir, Abdul, et al.

The radicals must be neutralized, one by one.

The difficult question is how to neutralize them without creating more radicals to take their place.

***

The name that has yet to arise in our discussion of the war against Islamic totalitarianism is Saddam Hussein. It is altogether legitimate, given the foregoing, to ask whether George W. Bush’s decision to end Saddam’s regime in Iraq was justified as a response to the September 11^th attacks on the United States--attacks in which Saddam, as any rational observer must now concede, had no part.

The answer is a roundabout yes: President Bush’s decision to oust Saddam was justifiable. But to make sense of it, we have to set aside the strong emotions that decision conjures up even now. For progressives, this means letting go, for a moment or two, their visceral distrust of the Bush Administration. For traditional conservatives, this means letting go their reflexive desire to support the prerogatives of the Commander in Chief during a time of war. Rational inquiry, rather than political passion, is required to draw the connection between the attacks of September 11^th and the decision to oust Saddam. Step one in such an inquiry returns us that miserable Tuesday morning in 2001, that miserable Tuesday morning of warm sunshine and perfect blue skies when the world changed.

From the radicals’ standpoint, the sight of the Twin Towers crumbling to dust, the sight of their ashes rising up to blot out the sun over Manhattan, must surely have seemed like an act of God--an unforgettable, historic blow against jahiliyya. Beyond what the moment meant to the radicals, however, a perilous message went out to the rest of the world. Since the end of World War Two, America’s national security had rested, to a substantial degree, on the belief that a sudden, concerted attack on the United States would be answered by retaliation on a biblical scale. That belief, it turned out, was false. Osama called our bluff. He hit us in a horrific way, and we didn’t lash out in vengeance. We investigated, determined who was behind the attack . . . and even once we knew it was Osama, and that he was operating out of Afghanistan, even then we did not incinerate the Kabul. Rather, we only demanded that the Taliban government hand over Osama “dead or alive.” In doing so, we inadvertently, and unavoidably, provided our international enemies with an easy-to-follow formula for making war against America: Just work your mayhem through non-state surrogates and, after the next 9/11, if America again connects the dots, hand over a few corpses to satisfy Washington’s demand for justice.

Saddam Hussein seemed the most likely candidate to capitalize on that formula.

It’s important to recall that regime change in Iraq had been an official policy of the United States since the Clinton Administration--which was empowered by Congress in 1998 to use any means short of a military invasion to remove Saddam. (Which is the reason President Bush sought and received Congressional authorization to use military force prior to the invasion of Iraq.) The attacks of September 11^th, and our measured response to them in Afghanistan, shifted Saddam from back-burner annoyance to front-burner threat--notwithstanding the fact that his pan-Arabism was hard to square with the radical Islam of Osama’s crowd. Still, Saddam and Osama were both consumed by totalizing visions of the future of Islamic peoples, and both saw the United States as the chief impediment to the realization of their visions. More ominously, if a freelance thug like Osama managed to kill 3,000 Americans, what might a resolute sociopath like Saddam, with the financial resources of an oil-drenched country, accomplish?

Now put yourself in President Bush’s position. Here are the facts as you know them in the immediate aftermath of September 11^th:

1) You’ve got the head of the C.I.A., a holdover from the Clinton Administration, telling you emphatically that Saddam possesses weapons of mass destruction.

2) You’ve got an overwhelming consensus of foreign intelligence agencies concurring that Saddam possesses WMDs.

3) You’ve got documented evidence of Saddam’s willingness to use WMDs on his enemies, both domestic and abroad.

4) You’ve got a decade of Saddam jerking around weapons inspectors, thwarting their inquiries, and intermittently kicking them out--thereby incurring further United Nations sanctions--which makes little sense unless he’s hiding WMDs.

5) You’ve got a British intelligence report that Saddam recently sought to buy uranium from Niger.

6) You’ve got a history of Saddam supporting international terrorism, including, as his own foreign minister has acknowledged, doling out $25,000 “grants” to the families of Palestinian suicide bombers who kill Israeli civilians (and, occasionally, American tourists).

7) You’ve got a possible Saddam-Osama connection cited in a 1998 sealed indictment of Osama from the Clinton Justice Department, which reads in part: “al Qaeda reached an understanding with the government of Iraq that al Qaeda would not work against that government and that on particular projects, specifically including weapons development, al Qaeda would work cooperatively with the government of Iraq.” (The charge, you’re informed, was later dropped from the final version of the indictment for lack of corroborating evidence... but of course you’re aware of it. It’s another piece of the puzzle.)

8) You’ve got a personal warning from Russian President Vladimir Putin, who is in a position to know, and who himself opposes an invasion of Iraq, that Saddam is planning terrorist strikes against the United States. As reported by CNN on June 18, 2004, here are Putin’s own words: “I can confirm that after the events of September 11, 2001, and up to the military operation in Iraq, Russian special services and Russian intelligence several times received . . . information that official organs of Saddam's regime were preparing terrorist acts on the territory of the United States and beyond its borders, at U.S. military and civilian locations.”

9) You’ve got a 1996 report from the World Health Organization of the United Nations claiming that 4,500 Iraqi children under the age of five are dying each month as a consequence of the U.N. sanctions. You know the number is a grotesque exaggeration, based on data provided to the W.H.O. by the oxymoronic Iraqi Ministry of Heath (which hasn’t stopped the W.H.O. from putting out the statistic as gospel truth). But even if the actual figure is one tenth of the W.H.O. number, that’s still 450 children perishing each month under the status quo.

10) You’ve got a theory, espoused by several prominent members of your administration, that standing up a liberal democracy in the heart of the Islamic world will encourage Enlightenment values among Muslims and thus blunt the homicidal/suicidal edge of radical Islam; it’s just a theory, and will be devilishly hard to execute, but it represents a hopeful alternative to an endless cycle of Islamic terrorism and ad hoc measures culminating, seemingly inevitably, in a massive WMD attack on the United States and a necessarily disproportionate response.

Are there dissenting voices? Yes, to be sure. Hans Blix, Chief U.N. Weapons Inspector, is telling whoever will listen that Iraq has no WMDs. But his history of evaluating Iraq’s WMD capacity is checkered; as head of the International Atomic Energy Agency during the 1980s, he praised Iraqi cooperation with inspections--at the very moment Saddam was building up his WMD arsenal to its highest levels. Blix’s assessment of Iraq’s WMD capacity is echoed by another U.N. weapons inspector, Scott Ritter. But there are questions of Ritter’s reliability as well. On August 31, 1998, for example, just after he resigned his position as weapons inspector due to what he perceived as lack of support from the U.N. Security Council, he said:

Iraq still has proscribed weapons capability. There needs to be a careful distinction here. Iraq today is challenging the special commission to come up with a weapon and say where is the weapon in Iraq, and yet part of their efforts to conceal their capabilities, I believe, have (sic) been to disassemble weapons into various components and to hide these components throughout Iraq. I think the danger right now is that without effective inspections, without effective monitoring, Iraq can in a very short period of time measured in months, reconstitute chemical biological weapons, long-range ballistic missiles to deliver these weapons, and even certain aspects of their nuclear weaponization program.

Yet almost a year after he had left Iraq, in June of 1999, Ritter told an interviewer:

When you ask the question, “Does Iraq possess militarily viable biological or chemical weapons?” the answer is no! It is a resounding NO. Can Iraq produce today chemical weapons on a meaningful scale? No! Can Iraq produce biological weapons on a meaningful scale? No! Ballistic missiles? No! It is “no” across the board. So from a qualitative standpoint, Iraq has been disarmed. Iraq today possesses no meaningful weapons of mass destruction capability.

So you’re George W. Bush: Are you willing to gamble the collective security of the American people on the erratic track records of Blix and Ritter? Setting aside their dissents, however, you’ve also got more pragmatic concerns. Secretary of State Colin Powell is sounding alarms over the potential hardships of a postwar occupation of Iraq; “You break it, you bought it,” he is saying.

On the other hand, you’ve got a copy of the Presidential Daily Briefing from August 6, 2001 sitting on your desk titled “Bin Laden determined to strike in U.S.” The intelligence it contains is sketchy--sketchier by far than the intelligence you now possess about Saddam’s capabilities and intentions--but the title haunts you nevertheless. If only you had acted preemptively in August 2001, if only you had taken out bin Laden. . .

Again, you’re George W. Bush. What do you do about Iraq?

We know, of course, what the real George W. Bush decided: Saddam had to go. Given the strategic reality that we could no longer depend on the threat of a cataclysmic response to deter him, the decision seems altogether reasonable. Not necessarily right. But, at minimum, reasonable. Ousting Saddam, moreover, would present hostile regimes elsewhere with a show of American force, a signal that they might be next if they provoked us--as deterrents go, not exactly on par with the prospect of sudden annihilation, but in reality the best we could do. The fact that Saddam was in violation of the surrender terms which kept him in power in 1991 provided either a legitimate casus belli or a useful fig leaf, depending on your point of view, acquitting America of the charge of disregarding international law.

If the decision itself was altogether reasonable, and it was, Bush must nevertheless be severely faulted for resting the entire public case for invading Iraq on Saddam’s WMDs. In so doing, Bush retroactively undermined the rationale of the invasion when no stockpiles of WMDs turned up. His error in judgment here is especially egregious when we recall that the more compelling reason to go after Iraq was always the opportunity to stand up a liberal democratic government in the heart of Islam. The fact that Bush shifted emphasis only belatedly, after not finding WMDs, was an unforgivable blunder. From the outset, he needed to make the public case that overthrowing Saddam’s regime was a phase in the greater struggle to spread Enlightenment values throughout the Islamic world.

It’s a transformation which, in the long run, might even point towards an endgame for the war against Islamic totalitarianism.

***

There is no doubt, none whatsoever, about the final outcome of the war against Islamic totalitarianism. The Islamic world will embrace the Enlightenment values of rational inquiry and religious tolerance. Such values are no longer optional, not in the twenty-first century. One hundred years ago, this wasn’t the case. One hundred years ago, a dozen fanatics, armed with a death wish and the latest technology available, could perhaps have razed a village. But in the twenty-first century, a dozen fanatics, armed with a death wish and the latest technology available, could slaughter millions and set off an economic panic that might bring down the governments of powerful nations.

Enlightenment values, again, are no longer optional. Rational inquiry and religious tolerance are the glue of modernity. The Islamic world will either embrace them or perish. Their predicament is sketched, with dire poetic flair, by the essayist and philosopher Lee Harris in book Civilization and Its Enemies:

There is a sense of Greek tragedy, with its dialectic of hubris and nemesis, to what has been unfolding in the Islamic world. If Muslim extremists continue to use terror against the West, their very success will destroy them. If they succeed in terrorizing the West, they will discover that they have in fact only ended by brutalizing it. And if subjected to enough stress, the liberal system [of the West] will be set aside and the Hobbesian world will return, and with its return, the Islamic world will be crushed. Whom the gods would destroy, they first make mad.

Properly understood, the war on terror is less like a war than like a race. On the one hand, it’s certain, even as you read these words, that Islamic radicals are conspiring to stage another assault on the United States to equal, or perhaps surpass, the carnage of September 11^th. On the other hand, it’s certain, even as you read these words, that American intelligence agencies and military services are working to kill or capture as many Islamic radicals as they can get their hands on. The race boils down to this: Can America effectively dismantle al Qaeda and its allied organizations before the terrorists manage to strike again, in a major way, on American soil?

The answer is likely no. Tragically no. The difficulty is that it’s not a fair race. As former Defense Secretary Donald Rumsfeld once pointed out, al Qaeda is actively recruiting Muslims to their cause at least as rapidly as the American military is thinning their leadership ranks. Notwithstanding the heroic efforts of Homeland Security officials and intelligence agencies to thwart another attack, it’s virtually certain--as our elected leaders keep reminding us--that the terrorists will eventually succeed.

We will take another hit.

Harris’s insight is that each al Qaeda success hastens the demise of Islamic terrorism. Not because the United States will eradicate it; that will never happen. The United States will never eradicate Islamic terrorism. Islamic terrorism will end only when the overwhelming majority of Muslims--who currently serve as its psychic enablers, fellow travelers and tacit sympathizers--turn against it. But in several prominent Islamic countries, this will entail their turning against their own governments, which continue to sponsor terrorism. And people do not engage in civil wars just because foreigners, especially despised foreigners, think they should.

There are, in fact, only two conceivable scenarios by which the requisite pan-Islamic upheaval will happen. The more humane scenario is the one initiated by President Bush. That scenario is to establish a liberal democracy in Iraq, in the heart of Islam, and hope that it inspires moderate Muslims in the vicinity to embrace Enlightenment values and reject the radical elements among them. The cost of this more humane scenario, if it eventually succeeds, will surely be hundreds of thousands of Muslim lives.

But what if democracy in Iraq fails outright? Or what if it survives but fails to inspire the overwhelming majority of Muslims to reject the radicals? In that case, Islamic terrorism continues unabated. What follows then is the “Hobbesian” scenario Harris sketches: Sooner or later, the United States will take one hit too many, or one hit too catastrophic, and the American people will set aside their natural aversion to promiscuous bloodshed and demand a disproportionate response. They’ll elect a government which promises to end the threat, permanently, whatever the cost--and the cost will likely be millions, perhaps scores of millions, of Muslim lives. Like the German and Japanese civilians in 1945, Muslim civilians from North Africa through the Persian Gulf and down into Southeast Asia will at last feel their absolute defeat. They’ll accept that the fundamentalist struggle against the West has been lost. They’ll dig out from the ruins of their cities and recognize that they cannot allow the radicals to make martyrs of them all. Then, with our assistance, both military and financial, they’ll set out to purge themselves of the terrorist cancer.

Tragically, the Hobbesian scenario is the more probable of the two. Muslims, collectively, have spent the last five centuries making one disastrous decision after another. That’s the unvarnished truth. The idea that liberal democracy in Iraq, if indeed it takes hold, will inspire Muslims throughout the region to do what needs to be done ranks as a long shot. Still, it’s worth a try.

***

Again: the outcome of the war against Islamic totalitarianism is not in doubt. The forces of Enlightenment will, one way or another, eradicate the forces opposed to Enlightenment. It may take years, or even decades, but Islamic totalitarianism is doomed. Keeping in mind that geopolitical truth, as well as the self-evident truth that all persons are created equal--and that the killing of any person therefore represents an equally irreparable tear in the human fabric--we must ask ourselves one basic question about the war against Islamic totalitarianism: How can we hasten its end with the lowest body count? It’s a gruesome question, but a moral one, haunted by the likelihood that more deaths sooner might mean fewer deaths in the long run. The deadlier the weapons the radicals acquire and use, the more viciously and indiscriminately the war against them will eventually be waged. The scalpel, if necessary, will surely give way to the terrible swift sword. But there is no evidence, none whatsoever, that the blood-drenched currents of history can be managed, any more than they could be managed in the twentieth century, or nineteenth or eighteenth or seventeenth centuries, no evidence that the mass bloodletting by which history baptizes generation after generation, against the wills of even the most powerful leaders, is a thing of the past.

For that reason, it’s crucial not to misunderstand how we wound up here. The war against Islamic totalitarianism is not the result of George Bush’s response to September 11^th, 2001. It’s not the result of Bill Clinton’s decision not to assassinate Osama bin Laden, or his decision to pull out of Somalia after the Mogadishu massacre. It’s not the result of George H. W. Bush’s decision to leave Saddam in power following the first Gulf War. Or Ronald Reagan’s withdrawal of marines from Lebanon when their barracks were bombed. Or Jimmy Carter’s dithering during the Iranian hostage crisis. It’s not even the result of America’s steadfast support for a Jewish state in the heart of the Islamic Middle East.

The war against Islamic totalitarianism, on the contrary, is the culmination of a chain of events set in motion centuries ago, back when the social evolution of humanity hit a fork in the road. Down one path lay the Enlightenment . . . and beyond it the goods and, yes, even the excesses of modernity. That path was taken by predominantly Judeo-Christian peoples. Down the other path lay a return to the Middle Ages, to stagnant theocracies and cultural wastelands in which the only relevant question became Who did this to us? That path was taken by predominantly Islamic peoples. They are history’s abject losers. And they’re not happy about it.

But abject losers are the deadliest enemies to engage since they have so little left to lose. They can face down a much greater military power with the most terrifying of all demands: Either submit to us, or kill us. The war against Islamic totalitarianism, as it’s currently being waged, amounts to an effort by America and its allies to stave off the lunacy of terrorist jihad long enough for moderate Muslims to disassociate themselves from it . . . and then to kill off the terrorists themselves.

There’s still time. But the clock is ticking.