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We Are All At Risk

I could write an entire paper just documenting numerous cases where people who thought they were well-insured, discovered all too late they weren’t. The following are just a few examples:

1. Patient negotiates fees with surgeon, anesthesiologist, hospital, assuming assistant surgeon, as customary, will be paid by surgeon. Assistant surgeon bills $117,000 for 3-hour surgery and gets it (Rosenthal, 2014).

2. A woman doubled over with pain goes to emergency department at hospital. After multiple tests discovered not appendicitis; but ovarian cyst. Insurance company refused to pay as they determined wasn’t emergency. The person was supposed to diagnose herself, ultimately stuck with $12,596 hospital bill. I guess she could have waited, if appendix burst, well, that’s her bad luck. The policy of not reimbursing emergency room visits if turn out not be an emergency is growing (Kliff, 2018; see also: Abelson, 2018; Chou, 2018).

3. Between 33 percent and 80 percent of cancer survivors exhaust their savings to finance medical expenses. Up to 34 percent borrow money from friends or family to pay for care. For those who fall into debt, the level of debt is substantial. Bankruptcy rates among cancer survivors are 260 percent higher than among similar households without cancer (Ramsay, 2016).

4. “It’s not uncommon for patients who visit an in-network hospital to learn later that they’ve been treated by out-of-network providers, resulting in thousands of dollars in charges. And while the Affordable Care Act generally caps what consumers must spend out of pocket when using providers within their plan’s network, it doesn’t protect consumers from large bills from outside providers. Those providers may be free to charge the consumer for the balance of the bill that the insurer did not pay, known as ‘balance billing’” (Bernard, 2013).

5. “A long night spent struggling with what turned out to be a whooping cough infection left the Encinitas resident so exhausted that he fell and hit his head. He was taken to a hospital emergency department by ambulance. Doctors there recommended that he stay overnight for observation, a precaution to make sure he did not have a more serious injury. After leaving on Feb. 5, everything seemed fine until he received an $18,700 bill in the mail. He learned that, although he had spent the night in a bed at Scripps Memorial Hospital La Jolla, he was never technically admitted as an inpatient. Medicare pays less for observation stays than it does for people who are admitted, and Scripps was billing him for the remainder of the costs he incurred (Sisson, 2016).”

6. And, as a final example, an outrageous one, the treatment of 9/11 First Responders. Most were police or fire department employees, covered by insurance; yet, their insurances didn’t cover much of their care. Finally, Congress passed legislation 10 years later to cover them, though only certain conditions, too little too late for many who had already died and those remaining who had suffered. These were our heroes. If anyone deserved top quality care, it was them (Wikipedia. Health effects arising from the September 11 attacks).

Above is just the tip of the iceberg. Read on.

U.S. Health Care in International Comparisons

Given the power of the health insurance industry we are basically inundated with lies about other nation’s health care systems. International studies rank the U.S. poorly on numerous measures. Not only we rank poorly on infant mortality and life-expectancy; but on chronic conditions. For instance, diabetics do better in the United Kingdom (Mainous, 2006). The list goes on (Chen, 2016; Garrett, 2018; Harrison, 2018; Institute of Medicine, 2013; OECD, 2017; Sawyer, 2017; Schneider, 2017; Tikkanen, 2017). Statistics on cancer ranking the U.S. at the top are deceptive. We do much more screening than other nations, catching cancers at earlier stages, sometimes this is beneficial; but often just involves treatments that are costly and can even lower our quality of life (Wikipedia. Lead time bias; Wikipedia. Length time bias). Pap smears detect cell dysplasias (abnormalities). Most won’t progress to cancer. Prostate cancers are often so indolent that men will die years before they would have had an effect. Early interventions may save some lives; but result in infection, pain, impotence, and incontinence. According to the National Breast Cancer Coalition:

For every 2,000 women invited for screening over a 10 year period, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if they had not been screened, will be treated unnecessarily. The evidence of a mortality reduction from screening is conflicting and continues to be questioned by some advocates, scientists, policy makers and members of the public. In fact, the absolute risk of a woman dying from breast cancer is less than 1% without any screening. Looking at this another way, 995.6 out of 1,000 50-year-old women will not die of breast cancer within the next ten years. This number rises to 996 out of 1,000 with regular mammography screening (National Breast Cancer Coalition, 2013; see also: Houssami, 2017).

The evidence is mounting that for those insured in the U.S., both over-diagnosis and over-treatment are often as threatening to our health as under-treatment of those who are underinsured or uninsured (e.g., Brownlee, 2007; Welch, 2011).

However, if the monies wasted on our current system were re-directed to actual treatment, where current interventions for cancer are advantageous, they would be covered. And, as discussed below, the data from a single-payer system has the potential to be used for improving health care.

Extortionist Level Drug Pricing

The recent scandal of raising Epipen prices to $800 is just one example. But even the original $400 for a packet of two Epipens was outrageous given they cost between an estimated $8 – $30 for a two-pack and sell in the UK for $69. In fact, the Epipen was developed for our military (Bloomberg, 2016; Mangan, 2016; Nutting, 2016; Ramsey, 2016; Seipel, 2017; White, 2016). Numerous studies have shown that claims by pharmaceutical companies of the cost of developing new drugs are grossly exaggerated (Light, 2011; Medecins Sans Frontieres, 2014; Prasad, 2017; Public Citizen, 2001; Public Citizen, 2017; Relman, 2002). In fact, over 95% of the basic research is funded by the government and even 50% of new classes of drugs (Light, 2005). The pharmaceutical industry is among the most profitable industries, only equaled by banks; but outdistancing carmakers, oil and gas, and media (Anderson, 2014).

The FDA’s patent of a drug creates a monopoly.

A monopoly exists when a specific person or enterprise is the only supplier of a particular commodity. . . Monopolies are thus characterized by a lack of economic competition to produce the good or service, a lack of viable substitute goods, and the possibility of a high monopoly price well above the seller’s marginal cost that leads to a high monopoly profit(Wikipedia. Monopoly).

The object of patents is to encourage research and innovation in order to benefit the public. The public is certainly does NOT benefited from extortionist level prices and profits. A single-payer health care system will be able to negotiate drug prices, allowing reasonable, not extortion level profits.

In 2003, Congress passed the Medicare Prescription Drug, Improvement, and Modernization Act. Billy Tauzin, as chair of the U.S. House Committee on Energy and Commerce, which oversees the drug industry, played a key role in shepherding the bill through Congress, including prohibiting the government from negotiating lower drug prices and banning the importation of identical, cheaper, drugs from Canada and elsewhere. Even with bargaining the pharmaceutical industry would have increased profits from the addition of a large number of people able to purchase drugs; but greed has no bounds. Tauzin resigned from Congress after the bill was passed and became head of the Pharmaceutical Research and Manufacturers of America at a salary estimated at $2 million per year. Does this raise any red flags (Ludwig, 2015; Wikipedia. Medicare Prescription Drug, Improvement, and Modernization Act)? The VA, Kaiser Permanente, Blue Cross, everyone else pays less for drugs than Medicare because they can negotiate. In fact, some drugs are actually cheaper if purchased directly from a local pharmacists, bypassing the profits and additional administrative costs from the Pharmacy Benefits Managers created by the bill (Ornstein, 2017). Gag orders often prohibit a pharmacist from discussing pricing with customers (Pear, 2018). By negotiating prices the Medicare donut hole could be eliminated (Congressional Budget Office, 2007a; Consumer Union, 2006; Families USA, 2007; Gaffney, 2018; Health Markets, 2018; Light, 2012; Light, 2013).

Complete Coverage, Dental, Home Health Care, Nursing Homes

A non-profit single-payer system will also include dental care, home health care, nursing homes and skilled nursing facilities. Poor painful teeth lead to poor nutrition which affects our diet which affects overall health. It affects our self-image, our ability to concentrate, our productivity, whether as students or workers, and, of course increases the need for health care (CDC, 2018). Quality home health care, allowing people to stay in their homes, is both cheaper than nursing homes and maintains a better quality of life (Ball, 2018; Gerace, 2011; NPR, 2018). With global budgets, nursing homes will have the requisite number of trained health care providers rather than employees in billing offices. Currently new hospitals are being built where each patient will get his/her own room. We could do the same for nursing homes. Just because one is infirm shouldn’t mean the loss of privacy and dignity. We could have such a system given that the monies now going to profits and bloated salaries for administrators, even for non-profit nursing homes, would go to actual care (Zimmerman, 2011).

Good For Business

A non-profit single-payer system will reduce job lock. Currently, many talented individuals are stuck in jobs that are not a good match because they need to maintain health insurance. Imagine some talented individuals wanting to start their own firm, one has a chronic health condition or ill child, the cost of health insurance for individuals or small firms would either be prohibitive or come with high deductibles and copays, not leaving monies for investing in the company, so they stay with their current company (Baker, 2015). Health insurance reduces the competitiveness of American companies in international competition, both upping the overall production costs and devoting time and energy in negotiating yearly insurance contracts for employees. Especially small businesses, the backbone of our economy and largest employer overall, are negatively affected by our current system. If one chooses to ensure its employees, the increased costs put it at a disadvantage against those who choose not to (Johnson, 2012; Leenson, 2017; Reinhardt, 1989).

Why Should Immigrants, including Undocumented, Be Covered?

For those opposed to undocumented aliens receiving health care, numerous studies have found that they contribute significantly to our economy and pay taxes. In fact, an Institute of Medicine study estimated the productivity loss to our economy due to lack of insurance at up to $130 billion in 2000 and if insured the cost of care at up to $69 billion, both would be much higher today (Institute of Medicine, 2003). The Institute of Medicine series of studies on the effects of uninsurance included immigrants, both documented and undocumented (Institute of Medicine, 2009). So, it costs our economy more to not insure everyone. If injured on the job, a job contributing to our economy, shouldn’t they receive care? More importantly, despite President Trump’s push to build a wall, it would be virtually impossible to eliminate them, so, we risk exposure to infectious diseases, e.g., in restaurants, day care centers, in elevators, etc. If not a moral obligation, then enlightened self-interest should prefer they be treated rather than remain contagious (Congressional Budget Office, 2007; Edsall, 2016; Federal Reserve Bank of Dallas, 2003). Not only immigrants use disproportionately less medical care than their representation in the U.S. population would indicate (Goldman, 2006); but they actually contribute to Medicare’s solvency (California Healthline, 2015; Flavin, 2018; Zallman, 2013).

Surveys have shown that the majority of Americans support a non-profit single-payer health care system; but only if it doesn’t include illegal immigrants (Rasmussen, 2009). U.S. law requires providing emergency care to anyone (Wikipedia. Emergency Medical Treatment & Labor Act). Unfortunately, the uninsured “receive fewer needed services, worse quality care, and have a greater risk of dying in the hospital or shortly after discharge,” even from trauma care (Institute of Medicine, 2002).  And as the number of uninsured increases, the quality of health services in a community decrease (Institute of Medicine, 2009).

Besides the fact that they have contributed to the system, besides the risks of infectious diseases, besides the immorality, besides the effects of uninsured on availability of quality care in a community, denying care to anyone lacking proof of insurance could put us all at risk in an emergency. Imagine you suffer a heart attack or an injury and have no proof of insurance. The uninsured get less follow-up care, so their risk of another emergency is high. So, besides the immorality, it isn’t rational to be against a program that will benefit us and our loved ones just to ensure that others don’t benefit as well, enlightened self-interest.

Healthcare Doesn’t Meet the Assumptions of a Market Model

Healthcare DOESN’T fit into a market-based system, regardless of how hard those who profit from it at our expense try to fit a square peg into a round hole (Arrow, 1963). Market economics require “free” access to information and, of course, the ability to evaluate it; but how many of us with cancer understand the basics of medicine, can evaluate peer-reviewed journal articles, know how to search the literature, even have the time or ability to focus when ill? And if in a car accident or suffering a heart attack, how many will be able to call around to various emergency departments to price shop? And how would one even price shop, not knowing once there what will be necessary (e.g., Mehrota, 2017)? And, as explained above, we already pay through our taxes what covers everyone in several other nations with a high level of quality care. It would take a separate article just to explain why health care doesn’t fit in market economics. And how does 65% of health care costs from tax dollars fit into a free market model? One excellent book explains the basic assumptions of a market model and why health care just doesn’t fit into it:

Thomas Rice (2015). “The Economics of Health Reconsidered,” Fourth Edition. Health Administration Press. Used copies of earlier editions are available on Amazon marketplace at reasonable prices. The basics don’t change between editions, just more up-to-date examples, and criticisms of earlier editions are dealt with.

Non-Profit Single-Payer is NOT Socialized Medicine

A non-profit single-payer system is NOT socialized medicine.  Delivery of health care will be by non-profit hospitals and clinics and private practicing physicians. Rather than choosing an insurance plan, if possible, or taking that offered by ones employer, one will be able to actually choose the hospital, clinic, and health care practitioner, without being locked into any network determined by the profit motive of health insurers. Unfortunately, all too often words like “socialism” are used to arouse emotions that stop people from further investigating a policy. Socialism DOES NOT apply to a non-profit single-payer healthcare system, though, as the saying goes: “A lie told often enough becomes the truth.” I have lived in both Sweden and Canada. Swedish healthcare is socialized medicine. Facilities, hospitals and clinics, are owned and run by the government and medical personnel are salaried, except for dentist who operate private practices. In Canada, hospitals and clinics are privately owned and physicians work in private practices. Dental and long term care are not universally covered; but some Provinces do cover them for specific groups, e.g., dental care for children and seniors and home health care and nursing homes for seniors. International studies show both systems superior to ours; but, given American culture, a non-profit single-payer system would be more acceptable.

Non-Profit Single-Payer is NOT a Ponzi Scheme

A non-profit single-payer system is NOT a Ponzi, pyramid, scheme transferring money from the young to the old and sick. A pyramid scheme is one-way, those at the top benefit and those at the bottom lose (Wikipedia. Ponzi scheme). A single-payer system is more like a revolving door, first one is outside, then inside. All of us will eventually grow old and at some time in our lives suffer injury or illness and none of us can be held responsible for our genetics, a roll of the dice. Young people do suffer injuries, cancer, and other illnesses. If they are uninsured, they still receive at least emergency care and, thus, we pay for it. As discussed above, the level of care will be less. By removing the excess administrative costs and profits, our parents, grandparents, and others are covered as we will be in turn. When I was in elementary school, my father’s taxes paid into the system as did others. Even when he was unemployed I continued with my education. When I became an adult, my taxes paid into the system so that the next generation of children would be educated and I gladly did this despite having no children of my own (Reuss, 2012).

Potential Health Services Research, Improved Care

Despite literally billions of dollars spent on medical and pharmaceutical research, problems still exist, including grandfathered interventions. Questions regarding which interventions for which conditions work still exist. Even with the absolute best clinical trials, the risk of rare but serious side-effects will not be found. Our drug laws allow any drug, once approved by the FDA for one condition, be used “off-label” by physicians for any condition. Sometimes the off-label use of a drug really does work; but often it doesn’t. We don’t know how many physicians prescribe an off-label drug for a specific condition, how many discontinued its use due to lack of efficacy or side-effects, nor even if improvements followed, if one could attribute them to the off-label drug or other factors. Circa 20% of all drug sales involve off-label use which adds to our overall cost of health care (Carr, 2017; GAO, 2008; Orac, 2012; Wikipedia. Off-label use). With a non-profit single-payer system, either one standardized database for entry of all patient demographics, conditions, and treatments or a linking system for several already existing databases, has the potential to improve healthcare by assigning teams to investigate everything from surgeries to drugs, FDA approved usage as well as off-label, and vaccines. Numerous large studies have found that the risk from vaccines is minuscule compared to benefits (CDC, 2017); but having data for literally all children could allow one to look at any rare increased risk from “pre-existing conditions” and assuage the fears of parents reluctant to vaccinate their children. Of course, strong laws and enforcement will need to be developed to protect patient confidentiality; something not well-protected with employer-based health insurance.

Conclusion

Sooner or later all of us will face injury or illness. No system is perfect and there will always be anecdotes of one or a few cases where failures occurred. Unfortunately, as with the red flag of labeling something as “socialist,” anecdotes play on our emotions and we fail to ask the question: “Compared to what?” For every anecdote about a case example of poor care in a Western technologically advanced nation offering universal health care, whether single-payer or socialist, one can find a far greater number in the U.S. A non-profit single-payer health care system ensures that we will be able to choose our doctors and hospitals, get the highest quality of care, without fighting with insurance companies, without being inundated with paperwork, and without worrying about finances. In addition, regardless of our employment, our families will be covered.

The choice is simple: Do we continue to fund through our taxes a system to enrich a few or adopt a non-profit single-payer system that numerous international studies have shown to cover everyone at a high level of care?

Joel A. Harrison, Ph.D., M.P.H., a native San Diegan, is a retired epidemiologist. Dr. Harrison has lived and studied in both Canada and Sweden. Dr. Harrison has been a long-time supporter of a non-profit single-payer health care system and a strong supporter of vaccinations wherein he has, as a volunteer, been writing articles for Every Child by Two, a nonprofit founded in 1991 to promote vaccinations. You can find his articles here and here.

References

Note that I use Wikipedia in the references. I only do this if the Wikipedia article includes references that I have checked out. Thus, rather than listing even more references, this supplies a convenient shorthand.

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The Warm War: Russiamania at the Boiling Point 

by Jim Kavanagh

Photo by Balkan Photos | CC BY 2.0

Is it war yet?

Yes, in too many respects.

It’s a relentless economic, diplomatic, and ideological war, spiced with (so far) just a dash of military war, and the strong scent of more to come.

I mean war with Russia, of course, although Russia is the point target for a constellation of emerging adversaries the US is desperate to entame before any one or combination of them becomes too strong to defeat.  These include countries like Iran and China, which are developing forces capable of resisting American military aggression against their own territory and on a regional level, and have shown quite too much uppitiness about staying in their previously-assigned geopolitical cages.

But Russia is the only country that has put its military forces in the way of a U.S. program of regime change—indirectly in Ukraine, where Russia would not get out of the way, and directly in Syria, where Russia actively got inthe way. So Russia is the focus of attack, the prime target for an exemplary comeuppance.

Is it, then, a new Cold War, even more dangerous than the old one, as Stephen F. Cohen says?

That terminology was apt even a few months ago, but the speed, ferocity, and coordinationof the West/NATO’s reaction to the alleged nerve-agent poisoning of the Skripals, as well as the formation of a War Cabinet in Washington, indicates to me that we’ve moved to another level of aggression.

It’s beyond Cold. Call it the Warm War. And the temperature’s rising.

...

For the past couple of years, we’ve been told by Hillary Clinton, John McCain, Marco Rubio, and Boris Johnsonthat Putin is the new Hitler. That’s a particularly galling analogy for the Russians. Soviet Russia, after all, was Hitler’s main enemy, that defeated the Nazi army at the cost of 20+ million of its people—while the British Royal Family was not un-smitten with the charms of Hitlerian fascism, and British footballers had a poignant moment in 1938 Berlin saluting the Fuhre.:

“War” is what they seem to want it to be. For the past 18 to 24 months, we’ve also been inundated with Morgan Freeman and Rob Reiner’s ominous “We have been attacked. We are at war,” video, as well as the bipartisan (Hillary Clinton, John McCain) insistence that alleged Russian election meddling should be considered an “act of war” equivalent to Pearl Harbor. Indeed, Trump’s new National Security advisor, the warmongering lunatic John Bolton, calls it, explicitly “a casus belli, a true act of war.”

Even the military is getting in on the act. The nerve-agent accusation has been followed up byGeneral John Nicholson, the commander of U.S. Forces in Afghanistan, accusing Russia of arming the Taliban! It’s noteworthy that this senior American military general casually refers to Russia as “the enemy”: “We’ve had stories written by the Taliban that have appeared in the media about financial support provided by the enemy.”

Which is strange, because, since the Taliban emerged from the American-jihadi war against Soviet forces in Afghanistan, and the Taliban and Russia have “enduring enmity” towards each other, as Kate Clark of the Afghanistan Analysts Network puts it. Furthermore, the sixteen-year-long American war against the Taliban has depended onRussia allowing the U.S. to move supplies through its territory, and being“the principal source of fuel for the alliance’s needs in Afghanistan.”

So the general has to admit that this alleged Russian “destabilising activity” is a new thing: “This activity really picked up in the last 18 to 24 months… When you look at the timing it roughly correlates to when things started to heat up in Syria. So it’s interesting to note the timing of the whole thing.”

Yes, it is.

The economic war against Russian is being waged through a series of sanctions that seem impossible to reverse, because their expressed goal is to extract confession, repentance, and restitution for crimes ascribed to Russia that Russia has not committed, or has not been proven to have committed, or are entirely fictional and have not been committed by anyone at all. We will only stop taking your bank accounts and consulates and let you play games with us if you confess and repent every crime we accuse you of. No questions permitted.

...

The enemy of my enemy is me.

The United States is only succeeding in turning itself into an enemy for Russians. Americans would do well to understand how thoroughly their hypocritical and contemptuous stance has alienated the Russian people and strengthened Vladimir Putin’s leadership—as many of Putin’s critics warnedthem it would. The fantasy of stoking a “liberal” movement in Russia that will install some nouveau-Yeltsin-ish figure is dissipated in the cold light of a 77% election day. Putin is widely and firmly supported in Russia because he represents the resistance to any such scheme.

...

Even the Pentagon recognizes that the American Empire is in a “post-primacy” phase—certainly “fraying,” and maybe even “collapsing.” The world has seen America’s social and economic strength dissipate, and its pretense of legitimacy disappear entirely. The world has seen American military overreach everywhere while winning nothing of stable value anywhere. Sixteen years, and the mighty U.S. Army cannot defeat the Taliban. Now, that’s Russia’s fault!

Meanwhile, a number of countries in key areas have gained the military confidence and political will to refuse the presumptions of American arrogance—China in the Pacific, Iran in the Middle East, and Russia in Europe and, surprisingly, the Middle East as well. In a familiar pattern, America’s resultant anxiety about waning power increasesits compensatory aggression. And, as mentioned, since it was Russia that most effectively demonstrated that new military confidence, it’s Russia that has to be dealt with first.

...

Americans are supremely insouciant about war: They threaten countries with it incessantly, the government routinely sells it with lies, and the political parties promote it opportunistically to defeat their opponents—and nobody cares. For Americans, war is part of a game. They do not fear it. They do not respect it.

The Russians are ready for war. The Nazi onslaught was defeated—in Soviet Russia, by Soviet Citizens and the Red Army—because the mass of people stood and fought together for a victory they understood was important. They could not have withstood horrific sieges and defeated the Nazis any other way. Russians understand, in other words, that war is a crisis of death and destruction visited on the whole of society, which can only be won by a massive and difficult effort grounded in social solidarity. If the Russians feel they have to fight, if they feel besieged, they know they will have to stand together, take the hits that come, and fight to the finish. They will not again permit war to be brought to their cities while their attacker stays snug. There will be a world of hurt. They will develop and use any weapon they can. And their toughest weapon is not a hypersonic missile; it’s that solidarity, implied by that 77%. (Did you read that Simonyan statement?) They may not be seeking it, but, insofar as anybody can be, they are ready to fight.

...

Americans who want to continue playing with this fire would do well to pay some respectful attention to the target whose face they want to smack. Russia did not boast or brag or threaten or Hoo-Hahabout sending military forces to Syria. When it was deemed necessary—when the United States declared its intention to attack the Syrian Army—it just did it. And American10-dimensional-chess players have been squirming around trying to deal with the implications of that ever since. They’re working hard on finding the right mix of threats, bluffs, sanctions, expulsions, “Shut up and go away!” insults, military forces on the border, and “bloody nose” attacks to force a capitulation. They should be listening to their target, who has not tired of asking for a “partnership,” who has clearly stated what his country would do in reaction to previous moves (e.g., the abrogation of the ABM Treaty and stationing of ABM bases in Eastern Europe), whose country and family have suffered from wartime devastation Americans cannot imagine, who therefore respects, fears, and is ready for war in ways Americans are not, and who is not playing their game:

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Jim Kavanagh edits The Polemicist.

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How the US Helped
Create Al Qaeda and ISIS

by GARIKAI CHENGU

Much like Al Qaeda, the Islamic State (ISIS) is made-in-the-USA, an instrument of terror designed to divide and conquer the oil-rich Middle East and to counter Iran’s growing influence in the region.

The fact that the United States has a long and torrid history of backing terrorist groups will surprise only those who watch the news and ignore history.

The CIA first aligned itself with extremist Islam during the Cold War era. Back then, America saw the world in rather simple terms: on one side, the Soviet Union and Third World nationalism, which America regarded as a Soviet tool; on the other side, Western nations and militant political Islam, which America considered an ally in the struggle against the Soviet Union.

The director of the National Security Agency under Ronald Reagan, General William Odom recently remarked, “by any measure the U.S. has long used terrorism. In 1978-79 the Senate was trying to pass a law against international terrorism – in every version they produced, the lawyers said the U.S. would be in violation.”

During the 1970’s the CIA used the Muslim Brotherhood in Egypt as a barrier, both to thwart Soviet expansion and prevent the spread of Marxist ideology among the Arab masses. The United States also openly supported Sarekat Islam against Sukarno in Indonesia, and supported the Jamaat-e-Islami terror group against Zulfiqar Ali Bhutto in Pakistan. Last but certainly not least, there is Al Qaeda.

Lest we forget, the CIA gave birth to Osama Bin Laden and breastfed his organization during the 1980’s. Former British Foreign Secretary, Robin Cook, told the House of Commons that Al Qaeda was unquestionably a product of Western intelligence agencies. Mr. Cook explained that Al Qaeda, which literally means an abbreviation of “the database” in Arabic, was originally the computer database of the thousands of Islamist extremists, who were trained by the CIA and funded by the Saudis, in order to defeat the Russians in Afghanistan.

America’s relationship with Al Qaeda has always been a love-hate affair. Depending on whether a particular Al Qaeda terrorist group in a given region furthers American interests or not, the U.S. State Department either funds or aggressively targets that terrorist group. Even as American foreign policy makers claim to oppose Muslim extremism, they knowingly foment it as a weapon of foreign policy.

The Islamic State is its latest weapon that, much like Al Qaeda, is certainly backfiring. ISIS recently rose to international prominence after its thugs began beheading American journalists. Now the terrorist group controls an area the size of the United Kingdom.

In order to understand why the Islamic State has grown and flourished so quickly, one has to take a look at the organization’s American-backed roots. The 2003 American invasion and occupation of Iraq created the pre-conditions for radical Sunni groups, like ISIS, to take root. America, rather unwisely, destroyed Saddam Hussein’s secular state machinery and replaced it with a predominantly Shiite administration. The U.S. occupation caused vast unemployment in Sunni areas, by rejecting socialism and closing down factories in the naive hope that the magical hand of the free market would create jobs. Under the new U.S.-backed Shiite regime, working class Sunni’s lost hundreds of thousands of jobs. Unlike the white Afrikaners in South Africa, who were allowed to keep their wealth after regime change, upper class Sunni’s were systematically dispossessed of their assets and lost their political influence. Rather than promoting religious integration and unity, American policy in Iraq exacerbated sectarian divisions and created a fertile breading ground for Sunni discontent, from which Al Qaeda in Iraq took root.

The Islamic State of Iraq and Syria (ISIS) used to have a different name: Al Qaeda in Iraq. After 2010 the group rebranded and refocused its efforts on Syria.

There are essentially three wars being waged in Syria: one between the government and the rebels, another between Iran and Saudi Arabia, and yet another between America and Russia. It is this third, neo-Cold War battle that made U.S. foreign policy makers decide to take the risk of arming Islamist rebels in Syria, because Syrian President, Bashar al-Assad, is a key Russian ally. Rather embarrassingly, many of these Syrian rebels have now turned out to be ISIS thugs, who are openly brandishing American-made M16 Assault rifles.

America’s Middle East policy revolves around oil and Israel. The invasion of Iraq has partially satisfied Washington’s thirst for oil, but ongoing air strikes in Syria and economic sanctions on Iran have everything to do with Israel. The goal is to deprive Israel’s neighboring enemies, Lebanon’s Hezbollah and Palestine’s Hamas, of crucial Syrian and Iranian support.

ISIS is not merely an instrument of terror used by America to topple the Syrian government; it is also used to put pressure on Iran.

The last time Iran invaded another nation was in 1738. Since independence in 1776, the U.S. has been engaged in over 53 military invasions and expeditions. Despite what the Western media’s war cries would have you believe, Iran is clearly not the threat to regional security, Washington is. An Intelligence Report published in 2012, endorsed by all sixteen U.S. intelligence agencies, confirms that Iran ended its nuclear weapons program in 2003. Truth is, any Iranian nuclear ambition, real or imagined, is as a result of American hostility towards Iran, and not the other way around.

America is using ISIS in three ways: to attack its enemies in the Middle East, to serve as a pretext for U.S. military intervention abroad, and at home to foment a manufactured domestic threat, used to justify the unprecedented expansion of invasive domestic surveillance.

By rapidly increasing both government secrecy and surveillance, Mr. Obama’s government is increasing its power to watch its citizens, while diminishing its citizens’ power to watch their government. Terrorism is an excuse to justify mass surveillance, in preparation for mass revolt.

The so-called “War on Terror” should be seen for what it really is: a pretext for maintaining a dangerously oversized U.S. military. The two most powerful groups in the U.S. foreign policy establishment are the Israel lobby, which directs U.S. Middle East policy, and the Military-Industrial-Complex, which profits from the former group’s actions. Since George W. Bush declared the “War on Terror” in October 2001, it has cost the American taxpayer approximately 6.6 trillion dollars and thousands of fallen sons and daughters; but, the wars have also raked in billions of dollars for Washington’s military elite.

Read the whole story at:
http://www.counterpunch.org/2014/09/19/how-the-us-helped-create-al-qaeda-and-isis/

Garikai Chengu is a research scholar at Harvard University. Contact him ongarikai.chengu@gmail.com