Obama's Profile in Courage, or Cave-In?

"It took a lot of courage on Kennedy's part to defy the Pentagon, defy the military -- and do the right thing," said Col. Larry Wilkerson, USA (ret.), according to Robert Dreyfuss in his recent Rolling Stone article "The Generals' Revolt."

Wilkerson, who was chief of staff at the State Department (2002-2005) and now teaches at George Washington University, was alluding to President John F. Kennedy's courage in 1962, when he faced down his top generals and refused to bomb Cuba and risk nuclear war.

That was as close as we came to nuclear calamity during the entire Cold War.

Despite the urgency of the threat posed by the Russian military buildup in Cuba (we now know the Russians had already placed nuclear weapons on the island), Kennedy's deliberate decision-making style allowed enough time for cooler heads to prevail and yielded a peaceful solution.

A hallmark trait of John Kennedy was his ability to listen and learn. At the same time, he did not hesitate to challenge conventional wisdom.

Call that "dithering," if you wish. I, for one, applaud President Barack Obama for following Kennedy's calm, deliberative style, as Obama faces similar pressure from the military to send tens of thousands more troops to Afghanistan.

Kennedy: Out of Vietnam

The Cuban crisis was not the only time JFK found himself at loggerheads with generals who thought they knew better and who verged on the insubordinate. Kennedy's sustained arm wrestling with his senior generals over whether to send more troops to Vietnam was just as tense, and much more sustained.

In the end, he concluded that they had it wrong and decided against them. In short, he opted to behave like a President -- a "decider" (pardon the odd word). His overruling of the U.S. military brass on Vietnam had huge implications, both short- and long-term. This "real history" is highly relevant today.

The 46th anniversary of John Kennedy's assassination passed by last Sunday virtually unnoticed. The unfortunate thing is this: his legacy on Vietnam is so widely misunderstood that it is easy to miss the relevance of his decision-making in the early Sixties to the dilemma faced by President Obama today as he decides whether to stand up to - or cave in to - the Pentagon's plans for escalating another misbegotten war in Afghanistan.

Faux history has it that President Lyndon Baines Johnson's infusion of hundreds of thousands, up to 536,000, combat troops into Vietnam was a straight-line continuation of a buildup started by his slain predecessor. Kennedy did raise the U.S. troop level there from about 1,000 to 16,500 "advisers" -- a significant increase.

But as he studied the options, cost and likely outcomes, Kennedy came to see U.S. intervention in Vietnam as a fool's errand. Few Americans are aware that, just before he was assassinated, Kennedy had decided to pull all troops out of Vietnam by 1965.

The Pentagon was hell bent on thwarting such plans, and Defense Secretary Robert McNamara found it an uphill struggle to enforce the President's will on the top brass. Senior military officers were experts at "slow-rolling" politicians who favored a course that the Pentagon didn't like.

When in May 1962 Kennedy ordered up a contingency troop-withdrawal plan, it took more than a year for the military brass to draw one up.

As the President encountered continuing resistance, he paid increasing attention to more level-headed military and civilian advisers as well as to his own intuition and instincts. Kennedy asked the Marine Commandant, Gen. David M. Shoup, "to look over the ground in Southeast Asia and counsel him."  Shoup told the President:

"Unless we are prepared to use a million men in a major drive, we should pull out before the war expands beyond control."

Kennedy concluded that there was no responsible course other than to press for a phased withdrawal regardless of the opposition from his senior national security advisers. He decided to pull 1,000 troops out of Vietnam by the end of 1963 and the rest by 1965.

How To Do It

My Irish grandmother called Kennedy "a clever lad" and she was right. 

Realizing that he had to exercise the utmost care in navigating choppy military and political waters, Kennedy employed the artifice of sending Defense Secretary Robert McNamara and Gen. Maxwell Taylor on a "fact-finding" trip to Saigon. At the end of the trip they would "recommend" the course the President had already chosen.

Stopping in Hawaii en route back to Washington, McNamara and Taylor were given "their" report, which had been written by John and Robert Kennedy. It was instantly named the "McNamara-Taylor report" and the two travelers presented it to the President on the morning of Oct. 2, 1963.

Wasting no time, the President convened a National Security Council meeting that evening to discuss the report.

The senior military saw through the subterfuge and strongly opposed the key recommendations of the report. In his memoir, In Retrospect, McNamara wrote that the NSC meeting saw "heated debate about our recommendation that the Defense Department announce plans to withdraw U.S. military forces by the end of 1965, starting with the withdrawal of 1,000 men by the end of the year."

In McNamara's words, there was "a total lack of consensus." However, there is only one "decider" on the National Security Council -- the President.  Kennedy stepped up to the plate and decided, bypassing the majority opposed.

Thirty-two years later in a Sept. 12, 1995, letter to the New York Times, McNamara took strong issue with a charge in an earlier op-ed that "the groundwork was being laid for our tragic escalation of the war" before President Kennedy was killed.

McNamara described the President's reasoning in deciding to go ahead, despite the lack of consensus:

"[T]he President nonetheless authorized the beginning of withdrawal, believing that either our training and logistical support led to the progress claimed or, if it had not, additional training would not change the situation and, in either case, we should plan to withdraw."

His decision made, Kennedy wasted no time in acting, well, like a President. He told McNamara to announce it immediately in order to "set it in concrete," according to McNamara. 

As the defense secretary was leaving the NSC meeting to tell White House reporters, the President called to him, "And tell them that means all of the helicopter pilots, too," according to Kenneth O'Donnell and David Powers in their book, Johnny, We Hardly Knew Ye.

Action Memo

The President's policy was formalized nine days later in his National Security Action Memorandum Number 263 of Oct. 11, 1963. That document put into effect the McNamara-Taylor recommendations, which provided that:

"A program be established to train Vietnamese so that essential functions now performed by U.S. military personnel can be carried out by Vietnamese by the end of 1965. It should be possible to withdraw the bulk of U.S. personnel by that time ... [and] the Defense Department should announce in the very near future presently prepared plans to withdraw 1,000 U.S. military personnel by the end of 1963."

Whether Kennedy truly believed that the U.S. training program would succeed in helping the South Vietnamese prevail is doubtful. Clearly, he wanted out. He carried around in his conscience and from time to time spoke of the number of American troops already killed. (Eight died under Eisenhower; about 170 during Kennedy's tenure.)

Assistant Press Secretary Malcolm Kilduff, to whom fell the task of announcing President Kennedy's death on Nov. 22, 1963, told James Douglass, author of JFK and the Unspeakable: Why He Died and Why It Matters, that Kennedy's mind was fixed on Vietnam the day before. Instead of rehearsing for a press conference that day, Kennedy told Kilduff:

"I've just been given a list of the most recent casualties in Vietnam. We're losing too damned many people over there. It's time for us to get out. The Vietnamese are not fighting for themselves. We're the ones who are doing the fighting.

"After I come back from Texas, that's going to change. There is no reason for us to lose another man over there. Vietnam is not worth another American life."

A month before, during his last visit to Hyannis Port, Kennedy told his next-door neighbor Larry Newman, "I'm going to get those guys out [of Vietnam] because we're not going to find ourselves in a war it's impossible to win."

Kennedy understood that decisions on Vietnam were far too important to be left to myopic generals. They were still chafing at what they considered Kennedy's failure in 1962 to seize the moment and obliterate Cuba -- and perhaps also the U.S.S.R., while we were at it.

Add Kennedy's clear desire to work closely (often secretly) with Soviet Premier Nikita Khrushchev in a priority effort to prevent another Cuba-type crisis, and then letting generic "Communists" take over Vietnam - with "dominoes" expected to fall all over the place -- and the military brass became convinced they needed to strongly oppose such "appeasement."

'Best and Brightest'

And it was not only the generals. Far from it. The "best and the brightest," first and foremost McGeorge Bundy, Kennedy's national security adviser, were also opposed to Kennedy's decision to pull troops out of Vietnam. 

Bundy strongly disagreed with the recommendations in the McNamara-Taylor report. He also resisted Kennedy's frequently expressed doubts that foreign troops, even in large numbers, could prevail in guerrilla war, and Kennedy's determination never to send combat troops to Vietnam.

Bundy thought he knew better, refusing to believe that the President would ever "let South Vietnam go." Years later, Bundy's memoirs defended his views and advice to Kennedy on Vietnam.

However, after McNamara published In Retrospect in 1995, in which he concluded that "we were wrong, terribly wrong" on Vietnam, Bundy went back to the drawing board to rethink his assessment.

Bundy hired a man half his age, Gordon Goldstein, as research assistant to help him on what turned out to be Bundy's personal quest for the roots of his own mistakes which, for the most part, were the result of hubris, pure and simple.

Early this year, author William Pfaff reviewed what started out as the Bundy Memoir Part II (McGeorge Bundy died in 1996), but ended up as Lessons in Disaster: McGeorge Bundy and the Path to War in Vietnam by Goldstein.

In the review, Pfaff highlights Bundy's pedigree: tops at Groton, professor of government at Harvard and youngest dean of faculty; his mother a Boston Brahmin, his father a diplomat. Pfaff is ruthlessly on point in describing Bundy's attitude:

"American had to 'win' in Vietnam because America always wins. America knows better than everyone else because of that intellectual firepower deployed at Harvard and other elite universities. America does not have to know about other people because other people are not worth knowing.

"Goldstein's decisive clue to why Bundy failed came by accident. He found a note written in 1996, when Bundy was asked what had been most surprising about the war. He answered, 'the endurance of the enemy.' Goldstein writes: 'He didn't understand the enemy 'because, frankly, he didn't think they warranted his attention.'"

The good news for today comes from press reporting that top officials of the Obama administration, including the President, have read Goldstein's book. Applying Kennedy's challenge on Vietnam to Obama's on Afghanistan, a Wall Street Journal report of Oct. 7 noted, "For opponents of a major troop increase ... 'Lessons in Disaster' encapsulates their concerns about accepting military advice unchallenged."

Obama Must Decide

There are hints that Obama is more Chicago than Harvard -- and that, like Kennedy, he carries casualty figures around in his conscience. His late-night, early-morning appearance at Dover Air Force Base to salute what the Washington Post calls "transfer cases" coming home from the war is, I believe, a telling sign.

Obama knows they are not just "transfer cases."

This young President, too, is a "clever lad;" he is also a politician. Intellectually, he is surely equipped to understand the March of Folly that would be involved, were he to send substantial additional forces to Afghanistan.

Moreover, Obama is surely aware that the majority of Americans are no longer deceived by the pundits at Fox News. Recent polls show broader and broader popular opposition to sending more troops.

The choice, in my view, is between courage anchored in a determination to do the right thing and cowardice cloaked in the politics of the possible. Let me guess what you're thinking -- "But that's asking too much of a young President; cowardice is too strong a word; Obama cannot possibly face down the entire military establishment."

John Kennedy did. So the question is whether Barack Obama is "no Jack Kennedy," or whether he will summon the courage to stand up to the misguided military brass of today. 

We are talking, after all, about thousands more being killed -- and for what?

I would suggest to the President that he give another close read to Goldstein's Lessons in Disaster and then ponder the lessons that leap out of Barbara Tuchman's The March to Folly: From Troy to Vietnam.

Obama may also wish to ponder the words of W.E.B. Dubois:

"Now is the accepted time, not tomorrow, not some more convenient season. It is today that our best work can be done and not some future day or future year. It is today that we fit ourselves for the greater usefulness of tomorrow."

Ray McGovern works for Tell the Word, the publishing arm of the ecumenical Church of the Saviour in Washington, DC. He was an analyst at the CIA for 27 years, and is on the Steering Group of VIPS.

That it is nothing new is evident in an article in the WSJ in December of last year:

Americans will not put up with such limits, nor will our elected representatives. Mr. Daschle himself proves this. He punts the hard decisions about rationing to an unelected board. Yet his main proposals are not only about expanding subsidized programs to cover more people but about adding the massively expensive benefit categories of mental health, which has a strong lobby behind it, and long-term care, which is important to the broad middle class. http://online.wsj.com/article/SB123060332638041525.html

The article was attacking Senator Daschle who was spear heading the health care reform front for the incoming White House crew. I found this new take on the same crap in a conservative blog today:

For those who are hoping that Congress will deliver health care reform that includes a government run option, be careful what you wish for.

Despite the constant drum beat from Barack Obama, Nancy Pelosi, Harry Reid, and other Democrats who declare that a government run health care option would not result in a rationing of services, this notion simply seems to defy logic.

Why would anyone believe that it is possible to provide quality health care coverage to an additional 31 million people, without an increase to the number of doctors and while decreasing the cost of health care? The most logical conclusion that can be reached is that the government must begin to ration services, and the quality of our health care will be impacted in a very negative way. 

In fact, this is exactly what has happened in other countries that have already been down this road. Rationing of health care has been well documented in Great Britain and in Canada. long waits to receive vaccinations and some have even been turned away.

http://www.examiner.com/x-28541-Kissimmee-Conservative-Examiner~y2009m11d19-Health-care-reform-has-not-yet-been-passed-but-has-rationing-already-begun

As the Chicago Tribune put it a couple months ago:

Left unsaid by those who raise fears of rationing by any "government-run" or government-related health care is how much rationing the insurance industry does now.

For decades, experts writing in The New England Journal of Medicine and elsewhere have concluded that we do "ration" health care. We just do it through gross disparities in race, sex, age, regions, income and education. http://archives.chicagotribune.com/2009/aug/09/health/chi-oped0809pageaug09

You can google and discover stories of individuals denied proper medical care after they had paid premiums for health insurance coverage individually or through their employer. http://www.healthreform.gov/reports/denied_coverage/index.html

You can find hundreds upon hundreds of links. Or you can read blogs right here at TPM.

The death panels have been operating in this country forever. Haley Barber or some other repub asshole opined recently that if Congress wanted to get rid of pre-existing condition clauses in insurance contracts the bill would pass 400 to 35 in the House with a similar percentage voting for the provision in the Senate.

This is a goddamn lie and it enrages me because the repubs would have done it nine years ago. It is a statement made that is false and that the speaker knows is false as he makes the statement and it is done with one purpose in mind:  Derail the health care package and help insurance companies make more money than ever.

There have been times in our country when we came close to egalitarianism. But the possibility of a true democratic republic embodying the promises contained in the Declaration of Independence and the Constitution never came as close to becoming a reality as it did during World War II.

It was a time when the American People were looking for fairness.

With the Masters of War making money hands over fists and millionaires like Joe Kennedy strutting in suits that cost as much as a working man could make in a year, Roosevelt actually proposed a 100% tax on all incomes over $25,000.00.  Probably about half a million dollars today.

Many controls were put on the economy. The most important were price controls, imposed on most products and monitored by the Office of Price Administration. Wages were also controlled. In addition, the military imposed priorities that largely shaped industrial production.[1][2] wiki

There has never been enough of anything in this country to 'go around', never.  The percentage of people who have certain commodities available to them shifts depending upon whether or not the repubs are in control or not.

But rationing was instituted in WWII in order to 'equal things out' so to speak:

Rationing is often instituted during wartime for civilians as well. For example, each person may be given "ration coupons" allowing him or her to purchase a certain amount of a product each month. Rationing often includes food and other necessities for which there is a shortage, including materials needed for the war effort such as rubber tires, leather shoes, clothing and gasoline. Towards the end of the First World War, panic buying in the United Kingdom prompted rationing of first sugar, then meat, for the rest of the war. During World War II rationing existed in many countries including the United Kingdom and the United States.

With the onset of World War II, numerous challenges confronted the American people. The government found it necessary to ration food, gas, and even clothing during that time. Americans were asked to conserve on everything. With not a single person unaffected by the war, rationing meant sacrifices for all. In the spring of 1942, the Food Rationing Program was set into motion. Rationing would deeply affect the American way of life for most. The federal government needed to control supply and demand. Rationing was introduced to avoid public anger with shortages and not to allow only the wealthy to purchase commodities

While industry and commerce were affected, individuals felt the effects more intensely. People were often required to give up many material goods, but there also was an increase in employment. Individual efforts evolved into clubs and organizations coming to terms with the immediate circumstances. Joining together to support and maintain supply levels for the troops abroad meant making daily adjustments. Their efforts also included scrap drives, taking factory jobs, goods donations and other similar projects to assist those on the front. Government-sponsored ads, radio shows, posters and pamphlet campaigns urged the American people to comply. With a sense of urgency, the campaigns appealed to America to contribute by whatever means they had, without complaint. The propaganda was a highly effective tool in reaching the masses.

Rationing regulated the amount of commodities that consumers could obtain. Sugar rationing took effect in May 1943 with the distribution of "Sugar Buying Cards." Registration usually took place in local schools. Each family was asked to send only one member for registration and be prepared to describe all other family members. Coupons were distributed based on family size, and the coupon book allowed the holder to buy a specified amount. Possession of a coupon book did not guarantee that sugar would be available. Americans learned to utilize what they had during rationing time.

http://www.u-s-history.com/pages/h1674.html

The only downside to all of this was the black market. Big deal. The percentages of abuse were small and never compared to say prohibition. 

But there has always been and will always be rationing of health care services in one form or another. That is a fact of life.

If you are in need of a kidney transplant, you are put on a list by the hospital. The death panel decides whether or not you are going to die.

I pointed out before the terrible case of Mickey Mantle when he received a liver transplant. A no good drunk people screamed at the time. He was, after all, put at the top of some list. Personally, I would have put that man at the top of just about any list. The point here is that there will always be arguments, petty or otherwise, that someone received a life giving organ and someone else did not. Priorities are set on the basis of age, relative health, etc.http://www.unos.org/

Right now, insurance companies decide who will live and who will die just considering the needs OF THEIR OWN INSUREDS.

And as the Chicago Tribune article points out, 45 million people are told to do the best they can waiting in line at ER;s across the country.

We were a different country when we fought World War II, fighting two fronts simultaneously. There was no unemployment. There was under employment. Did you know that we actually used POW's to help us take up the slack in parts of our economy including agriculture?

We came together as a country. We sacrificed together. We shared what we had.

Sometimes I do not much like the country I live in today.

Reading the preceding, I realized that Dickday had passed a wealth of wisdom to each of us readers. Yet,he forced me to further consider our health care quandary:

What "IS" rational when we speak of illness or the terminally ill?
For the health insurance provider: It's get well fast or die quickly -- minimize losses.
For hospitals: Treat the patient, utilize as many of the hi-tech medical devices as can be justified and release said patient within the number of days specified by the treatment payee.
Doctors: Must manage the the case and attempt to heal or help the patient plus... do no harm. Follow-up visits to principle physicians are, usually, required. Let us not forget Big Pharma as our patient progresses or digresses, as the case may be.
Every step of the healing process is closely monitored by the payee...Before or after the fact. Each entity is acting in a manner that appears to be rational in relationship to the patient.
Under the microscope, the system is actually a tug-of-war for revenue! In this game there is only one looser -- if those directly involved can not come to an agreement, the patient owes the difference!
I have read that 50% of an individuals' health care costs are spent in the last two years of a persons' life.
Under the present health care system, the patients' recovery is implied to be the ultimate goal. Rationally speaking, the ultimate goal is the desire to maximize profit.
Yes, we do have our death panels. Check into the organ transplant systems. Someone is prioritizing those lists. How many hours do doctors spend writing letters of justification to health insurance companies in order to get authorization for procedures they wish to perform?
One act that can bring some rationality into this health vs. profit fiasco is what the Republicans call the "Kill Grandma" clause...I call it the Living Will. This document should be mandatory for all citizens over the age of 21.

There are hundreds of various Advanced  Directive forms available at clinics, hospitals and doctors' offices.  I copied and pasted this information fro the Mayo Clinic informational  URL.

http://www.mayoclinic.com/health/living-wills/HA00014

Advance directives: More than just living wills
Advance directives are written instructions regarding your medical care preferences. Your family and doctors will consult your advance directives if you're unable to make your own health care decisions. Having written instructions can help reduce confusion or disagreement. Anyone age 18 or older may prepare advance directives.
Advance directives include:
· Living will. This written, legal document spells out the types of medical treatments and life-sustaining measures you do and don't want, such as mechanical breathing (respiration and ventilation), tube feeding or resuscitation. In some states, living wills may be called health care declarations or health care directives.
· Medical power of attorney (POA). The medical POA is a legal document that designates an individual -- referred to as your health care agent or proxy -- to make medical decisions for you in the event that you're unable to do so. A medical POA is sometimes called a durable power of attorney for health care. However, it is different from a power of attorney authorizing someone to make financial transactions for you.
· Do not resuscitate (DNR) order. This is a request to not have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing. Advance directives do not have to include a DNR order, and you don't have to have an advance directive to have a DNR order. Your doctor can put a DNR order in your medical chart.
How to plan for end-of-life issues
Injury, illness and death aren't easy subjects to talk about, but by planning ahead you can ensure that you receive the type of medical care you want, to take the burden off your family of trying to guess at what you'd want done. Start by having a conversation with your loved ones. Let them know you're creating advance directives and explain your feelings about medical care and what you'd want done in specific instances.
If you want to encourage parents or other family members to create advance directives, explain that it's important for you and the family to know how they would want to be treated. It's generally best to approach the subject in a matter-of-fact and reassuring manner.
Keep in mind that a living will cannot cover every possible situation. Therefore, you may also want a medical POA to designate someone to be your health care agent. This person will be guided by your living will but has the authority to interpret your wishes in situations that aren't described in your living will. A medical POA may also be a good idea if your family is opposed to some of your wishes or is divided about them.
Choosing a health care agent
Choosing a person to act as your health care agent is possibly the most important part of your planning. You need to trust that this person has your interests at heart, understands your wishes and will act accordingly. He or she should also be mature and levelheaded, and comfortable with candid conversations. Don't pick someone out of feelings of guilt or obligation.
Your health care agent doesn't necessarily have to be a family member. You may want your health care decision maker be different from the person you choose to handle your financial matters. It may be helpful, but it's not necessary, if the person lives in the same city or state as you do.
What treatments would you want?
In determining your wishes, think about your values, such as the importance to you of being independent and self-sufficient, and what you feel would make your life not worth living. Would you want treatment to extend life in any situation? Would you want treatment only if a cure is possible? Would you want palliative care to ease pain and discomfort if you were terminally ill?
Although you can't predict what medical situations will arise, be sure to discuss the following treatments. It may help to talk with your doctor about these, especially if you have questions.
· Resuscitation. Restarts the heart when it has stopped beating (cardiac death). Determine if and when you would want to be resuscitated by cardiopulmonary resuscitation (CPR) or by a device that delivers an electric shock to stimulate the heart.
· Mechanical ventilation. Takes over your breathing if you're unable to do so. Consider if, when and for how long you would want to be placed on a mechanical ventilator.
· Nutritional and hydration assistance. Supplies the body with nutrients and fluids intravenously or via a tube in the stomach. Decide if, when and for how long you would want to be fed in this manner.
· Dialysis. Removes waste from your blood and manages fluid levels if your kidneys no longer function. Determine if, when and for how long you would want to receive this treatment.

On the bluffs overlooking the Mississippi (about 40 miles south of La Crescent) there is a Catholic cemetery. Non-Catholics are included amongst those interred there. My wife and I have purchased a plot so that, one day, we may rest next to our loved ones. The land area of the cemetery would be, approximately, 5 acres. The area is equally divided into quarters with a well-kept drive that delineates the four quarters. The northeast and northwest sections are utilized frequently. The Southeast and southwest quarters are barren except for one distant stone. I can't tell you how many times that, while visiting my loved ones, my eyes have been drawn to that stark monument. I have gone to the monument, but time has made the inscriptions unreadable. When we bought our plot, I queried the cemetery manager about the stone so isolated from all of the others. He replied that it was the grave of a young Catholic man whom had committed suicide. The church would not allow his burial among those who were without sin.

"According to the theology of the Catholic Church, death by suicide is considered a grave or serious sin. The chief Catholic Christian argument is that one's life is the property of God and a gift to the world, and to destroy that life is to wrongly assert dominion over what is God's and is a tragic loss of hope."

The locals don't like to talk about that solitary monument.