An American-Iranian Health Care Proposal

We have all learned, over the past month, how the fate of a great nation can turn on the roll-out of a website. And we will learn, over the next month or so, whether the future of the Middle East will also turn on that same website. President Obama has been weakened, how much so it remains to be seen, by the botch-up over the ACA website.

This is not a time for Obama to be picking unnecessary fights; his track record of standing up to Bibi’s importuning is mixed at best. The government of Israel and its American allies, notably AIPAC, is now engaged in a full court press in Congress to tighten sanctions against Iran just when they are likely to do the most harm–-to stall or kill the tentative feelers of moderation the Rouhani government has extended. Either the US will respond in kind, or the Iranian thaw will, hell-like, freeze over.

Nuclear proliferation is a very complicated subject. This is not the place to go into all of its complexities, many of which I don’t understand. Like most people, I would prefer not to see Iran develop a nuclear capacity, or develop a heavy water facility in Arak. But if one thing is clear to me, observing our almost seventy years of living with nuclear weapons, is that they convey little or no strategic advantage to their possessors, from the US in Korea to Vietnam to Iraq to Afghanistan, to several wars between India and Pakistan, to Israel in 1973, 1982, and 2006. (Their deductible, as they say in the insurance biz, is way too high.)

The biggest problem with an Iranian bomb, for most observers, is not what Iran will do with it, but that it will prompt several US quasi-allies, notably Saudi Arabia and Egypt to acquire nuclear weapons of their own, presumably from another US quasi-ally, Pakistan. This would be a very regrettable development, but it doesn’t seem worth going to war with Iran about.

A word many of us have learned in connection to the ACA website fiasco, is kludge, pronounced, I am told “kloodge” (hey geeks, why not spell it that way?), meaning an inelegant, temporary software fix, rather than something that has a Euclidean or Eulerian elegance. The ACA, observers have noted, is a kludge, a more or less successful effort to get all the parties (insurance companies, consumer groups that hate insurance companies, hospitals, medical professionals, the underinsured, the overinsured, sixty senators and a pre-Boehner house) all more or less on the same page.)

I think my favorite political saying of all time is Lyndon Johnson’s remark of a political adversary that he wanted him inside the tent pissing out than outside the tent pissing in, and this is the Big Tent we have erected for health care. And any agreement on Iran is likely to be a similar kludge, and a similar Big Tent, and likely to be as appealing, if I may continue the presidential urination metaphors, as a pitcher of warm piss, in the immortal words of FDR’s vive-president, John Nance Garner.

Where does this leave us? John Kerry has been going around saying, loudly and persistently, that no deal is better than a bad deal. Well, there are bad deals and worse deals, but I more or less think that is wrong. Because “no deal” means: 1) a likely attack on Iran by either Israel, the US or both, 2) Iran, after licking its wounds, will definitely develop nuclear weapons, to be followed by 3) the Saudis and the Egyptians doing the same. And from there, who knows?

It’s hard to see precisely what Israel wants from Iran, other than continuing the status quo indefinitely, which it thinks is favorable. When things seem to be going well, most people feel the same way. It’s the sort of attitude that led Obama to utter his now infamous pledge that “if people like their health insurance they can keep it.” But the Middle East is changing; the US is weaker, and its debility is liking to continue and worsen; the Arab Spring has bloomed and decayed; and in Syria, Egypt, Libya, and other places, there is more political instability than there has been in a generation. The Sunni-Shi’ite split, which the US invasion of Iraq did more to exacerbate than any event since the assassination of Muhammad’s son-in-law, continues to draw grim dividends. No nation will be able to keep its health insurance; every country, including Israel will need a new policy.

The status quo in the Middle East is falling apart; a US rapprochement with Iran might be one positive way of dealing with a changed situation. For Israel, both in terms of its broader role in the Middle East and in terms of the Israel-Palestinian conflict, the belief that the current situation can more or less continue indefinitely has become the greatest enemy of thinking creatively and hopefully about a better future. The US can’t allow Israel and its congressional allies to derail talks about the P5+1 powers and Iran. Let us carefully examine what, if anything, the powers agree to. The devil, they say, is in the details. But the devil is also in the broad strokes of a settlement and in an agreement that is desperately needed. Unless there is an agreement between the western powers and Iran, war and nuclear proliferation is the almost certain outcome. And Israel will be the worse for it.