People love the story of a hero fighting against a big enemy, sticking it to the man. People are also familiar with the inverse story: a Bond movie villain, who eventually gets what he deserves. Both of these templates seem are being applied to Wikileaks’ main man: Julian Assange. He’s either hailed as a hero or as a terrorist. It’s either “shoot the guy” or “he’s a persecuted hero”, optionally followed by conspiracy theories.

The reactions are understandable. In the past, the US government certainly has been involved in shady secretive things, and most recently, in 2003, the previous administration lied about its reasons for going to war with Iraq. So it is easy to fall in to the trap of explaining actions by the US government as negative, while praising someone who seems to stand up to them.

There is also an element of gossip journalism to it. Reading the leaked cables is like reading a tabloid, but with the celebrities being world leaders. People enjoy that. Furthermore, I’ve seen journalists seemingly take Assange’s side, since possible legal action against him might overlap with something that they are (and everybody should be) concerned about: freedom of the press.

What has Wikileaks done lately to cause such a stir? It has published 1000s of confidential documents, first military, and later diplomatic, to its website. There does not seem to have been much filtering before publishing. Therefore I think it is wrong to call Wikileaks a whistleblower website. Whistleblowing usually means having knowledge of specific wrongdoings inside an organization, and then making information proving this public. But this is not what Wikileaks has done. It also isn’t Assange’s philosophy. He wants to publish large amounts of confidential data, which he thinks will weaken secretive governments, eventually leading to a more open society.

I won’t go in to his philosophy, but will point out a problem with his approach. By indiscriminately making confidential information public, you will cause damage, something that he admits himself (he has acually called it “collateral damage”). So far, this has come in the form of such things as names of Afghan informers to US forces, who are now a prime target for the Taliban (reportedly a few might have been killed already). Or in the form of lots of other information that does not contain any scandal, but is damaging to diplomatic relations (what X said about Y behind his/her back, a diplomat’s opinion about a regime, etc).

The damage caused by this can be indirect: even if the information itself does not directly cause problems, it can make people lose trust in the how their confidential information is being treated. Say you are someone with the opposition in Iran, and want to pass on information to a US contact(indirect or direct). In that position, I’d be pretty nervous. I would not want my name to appear on the Wikileaks website. Human rights groups have expressed concern over exactly this issue.

So there is a lot of information in there that does not contain any evidence of wrongdoing, But it is damaging. And that’s the problem with what Wikileaks is doing.

If there is evidence of wrongdoing in confidential documents, then bringing that wrongdoing to light can outweigh possibly breaking the rules by publishing them. If this publishing is done responsibly, the issue is exposed, and no innocent people are hurt. But this is not what has happened here. A large number of documents was dumped. The vast majority did not contain any evidence of wrongdoing by the US government. Only a small number may or may not have something, and could warrant further investigation.

Ironically, you could argue that the lack of evidence of wrongdoing by the US government actually shows that it is doing what it says, and not doing saying one thing publicly, and doing another privately, as the Wikileaks website claims.

The dumping approach also causes so much information to be published that you can’t see the forest through the trees in the media report. A targeted publication of the few items that do seem suspect would have had a much bigger impact, since those items would have been in the headlines more.

In the end, things should be judged by whether the balance of what they achieved is positive or negative. I strongly doubt that these document dumps will make Assange’s vision of an open society come true. But I do know that no serious new wrongdoing has been uncovered, while damage has been done. So the balance is negative. Which is a shame, because the idea of exposing government wrongdoing through targeted leaking is a good one. But that is not what Wikileaks seems to be about.

[update]
I’ve read reports that Wikileaks claims it is not just dumping the diplomatic cables, but that they are actually going through them and selecting them (they say 960 out of 250,000 so far). So the leaks of the diplomatic cables are not “indiscriminate”. That doesn’t change what I think much, though. In fact, it makes me think more negatively of them. If you’re selecting things to leak, why include all the gossip cables and such, that don’t contain any wrongdoings, but are damaging to diplomatic relations? The problem remains the same: Wikileaks is not out to expose specific wrongdoings, they are out to attack secrecy itself, which trumps the consequences for them. The balance remains negative.

Harsh comments without nuance are, of course, not new, and can be heard on both sides of the political spectrum. But not by elected representatives. Or, that’s how it used to be. Now it seems to be considered acceptable.

What changed? It probably has its roots in what happened with Pim Fortuyn. Before Foruyn changed Dutch politics, politicians and their audience seemed aware of the limits to what they could say. Maybe this even went too far. I think that criticism from the right that, for a long time, you couldn’t even talk about immigration, is partially correct. When [VVD politician] Bolkesteijn brought it up in the 90s, he was vigorously attacked, but what he said then has been adopted by most parties now.

This all changed with Fortuyn. He had no problems with channeling the unfiltered negative feelings that some people had about immigration and Islam. When he was attacked for this, this was, especially after he was killed, often called “demonizing”.

This did not just have the effect that immigration became a subject that was firmly on the table. It went further than that. Determined to not be accused of demonizing someone anymore (and, in the case of politicians, to get Fortuyn voters back), people often hesitated to call someone out who used harsh language to talk about immigration or Islam. The phrases “that goes too far” or “you shouldn’t say that” were barely heard anymore. A kind of reverse political correctness: being nuanced was out. Yelling is now not just allowed, it’s almost mandatory. Because you can say something, apparently you should. This fit perfectly with the internet culture as displayed on some websites like GeenStijl, who proudly spread their bile.

It provided a good environment for Geert Wilders. He was able to let loose his hatred of Muslims. De media liked it, and certainly did not consider it to be their duty to be too critical of him. Before you’re know it, you’re demonizing someone. Can’t have that.

Now things have come to a head. Wilders made major gains in the elections (although not quite as big as the polls showed a year ago). How are other parties reacting to this? Do they are make a principled choice? Because that’s what it is. In magazine de Groene Amsterdammer Mathijs Bouman explains why [Dutch]. Yes, all those things are in Wilders’ program. But during the campaign, the [conservative] VVD did their best to ignore all that. By doing that, they crossed a line. If you try to downplay the extreme parts of the Wilders program, and only mention differences in the economic program, then you are clearly saying that Wilders’ hatred of Muslims is acceptable.

In the formation of a new government, the ball is now in the court of the Christian Democrats (CDA). During the campaign, they did make principled statements against Wilders. Will they stand by them, or will they also cross the line? Don’t they think that this is going too far?

The part where things go wrong is that they appear in big media outlets to give their opinions, and often get paid for it. Again, they have every right to their opinion. But what makes their opinion more important than others? Usually, they aren’t even experts on what they are talking about. Wouldn’t it be better to have an actual expert on the subject at hand explain things? Apparently not. Or, I should say: of course not. Because the media is about entertainment, not information.

Pundits seem to be especially popular in the US. To be sure, they exist in other countries. But they are especially numerous here. Perhaps that has something to do with the existence of 24-hours news channels. You have to do something to fill up that time, so you have panels and roundtables where pundits give their opinions, often not in the least bothered by a lack of knowledge, enthusiastically unleashing their stream of talking points on us.

When blogs became popular, they were, amongst other things, hailed as the democratization of information. A revolution in media. A big change from the old media. That seems overly optimistic. Some blogs provide good analysis and do their own research, but a lot of bloggers are pundit-wannabees. The lines between blogs and the traditional media are blurring. The Huffington Post is looking more and more like a tabloid. Bloggers are appearing on TV as pundits, and seem happy to be assimilated.

So, even more than before, we will be bombarded with opinions. But it seems doubtful that we’re being presented with more useful information. Providing information, after all, takes work. Talking about shiny objects such as celebrities, or having pundits fight a battle of the talking points, is much easier. And, apparently, gets better ratings.

How about that Tiger Woods?

But if the power to exercise exclusive legislation in all cases what so ever over the District of Columbia; if the power to lay and collect taxes, duties, imposts, and excises, to pay the debts and provide for the common defense and general welfare of the United States; if the power to regulate commerce with foreign nations and among the several States and with the Indian tribes, to fix the standard of weights and measures, to establish post offices and post roads, to declare war, to raise and support armies, to provide and maintain a navy, to dispose of and make all needful rules and regulations respecting the territory or other property belonging to the United States, and to make all laws which shall be necessary and proper for carrying these powers into execution — if these powers and others enumerated in the Constitution may be effectually brought into action by laws promoting the improvement of agriculture, commerce, and manufactures, the cultivation and encouragement of the mechanic and of the elegant arts, the advancement of literature, and the progress of the sciences, ornamental and profound, to refrain from exercising them for the benefit of the people themselves would be to hide in the earth the talent committed to our charge — would be treachery to the most sacred of trusts.

– John Quincy Adams, State of the Union, December 6th, 1825

John Quincy Adams, the 6th president of the United States, believed in using the power of government for the good of society. Of course, he achieved little of what he wanted to do, as he was obstructed by a Congress that supported his rival, Andrew Jackson, who subsequently defeated him in a nasty, personal campaign in 1829.

I’m using this quote for a couple of reasons. First of all, it seems that, especially in the United States, good intentions with regard to the government’s role in society seem to get buried easily in nasty rhetoric. Secondly, it shows that the idea of government playing an active, positive role has been around for a long time in the United States, although some people would have you believe that it hasn’t.

In present day America, as a foreigner, you can’t help but notice that there is a large group of Americans who talk about “the government” as if it’s some nefarious entity that is out to get you. It’s not that you don’t hear people complain about the government in other countries. But in the United States, a lot of people take it a lot further: they see the government not merely as an annoyance, they actually think it’s evil. Where did this come from?

I can’t quite explain it, but I’ll try anyway (that’s what blogs are all about; never let a lack of understanding stop you from saying what you think, right?).

The United States were born out of a group of colonies, controlled from far away by a government in which they had no representation. Obviously this was a situation that couldn’t last, and the colonies broke free. It makes sense that this struggle lead to a distrust of a central controlling body, like the British Parliament was. Also, the slow communication of the time must have made this worse: as this faraway body made decisions about the colonies, the news about these decisions came in slowly, and must have been accompanied by rumors as the news slowly made its way across the ocean, and then spread throughout the colonies.

Ever since then, there has been a current of strong resistance to the government in the United States. Or, to be precise, to the federal government. Many resisted a strong federal government when the US constitution was written (anti-federalism), and in the early history of the United States, many things the federal government did would be challenged as unconstitutional. A long series of Supreme Court decisions slowly shaped the role of the federal government.

Having said all this, it is hard to see why this sentiment is still strong today. The federal government has been a large entity with a big influence for a while. You’d think that people would have accepted this by now. But, especially amongst the conservative / rightwing crowd, anti-government sentiment remains strong. Or does it?

There is a crowd of people who fairly consistently oppose the role of government, amongst which are libertarians and, more extremely, the bunker-building militia crowd. But for most Republican politicians, anti-government sentiment seems to be a political card that is played when it’s convenient. Government interference is decried as bad only when it doesn’t fit with their goals. When it comes to the military or anti-terrorism legislation, the federal government can’t be big enough for the Republicans. It’s also perfectly fine with them if the federal government interferes with personal matters such as marriage.

However, when the federal government (more specifically, a Democratic federal government) does something they don’t like, all of a sudden they conjure up the spirit of the Revolution in order to claim that something is just wrong and, well, just plain un-American.

The best example of something done by the government that triggers much gnashing of the teeth are taxes. Now, nobody likes taxes. In countries all over the world, you will hear people grumbling about them. But, in the US, to a lot of people, taxes are the work of the devil himself. For a politician to raise taxes (even if it’s just on the rich, and not by very much) is a very risky move. The word ‘tax’ is almost a curse word. This situation is exploited by Republican politicians. If they don’t like a bill, they will almost invariably claim it will raise taxes (like, for example, the cap and trade bill currently being discussed).

All in all, any discussion in the US about the federal government using its power for the good of society tends to be polarized by dogmatic attacks. That’s unfortunate, and it makes it harder to discuss the actual merits and drawbacks of the plans at hand. As John Quincy Adams might have said: “tell me about it”.

First of all, you need to say that you speak “the language of the people”. Nobody knows exactly what that is. That doesn’t matter. You know what the man in the street thinks. You know what TheAmericanPeople(tm) want. What do you mean you can’t define what the language of the people is? That’s obviously because you don’t speak it! You’re out of touch!

Of course, you don’t just speak the language of the people. You also excel in plain speaking. All difficult problems have an easy solution. Even better, there are no hard problems. “They” just don’t understand, or are afraid to. You’ve got the solutions. The details don’t matter. Details are for those who can’t speak plainly.

Speaking of “them”, it is of course important that you create an us versus them situation. You can do that in several ways, but usually it’s easiest if you say that it’s all the fault of the “elite”. Elite is another one of those words that doesn’t mean a whole lot in practice. When are you part of the elite? If you have a degree? If you live in a certain neighborhood? And are you automatically wrong if you are part of the elite, whatever that is? That doesn’t matter. The elite is everyone who disagrees with you.

Of course, it is useful to have a set of different “they”s that you can use. The elite is always a good one, but, you can also use more easily identified groups of people. Racial, religious and geographic differences help.

Lastly, it has to be obvious that you are the underdog. The others are out to oppress you. The media is in cahoots with the others. You speak plainly, so you can call the others names. But if they are critical about you, that is obviously part of the conspiracy to keep you down.

In the next part of this course: “I can protect you from ‘them’”.

One difference that is impossible to overlook is healthcare. Some differences are small. For example, in the Netherlands it is common to greet people when you come in to a family practice waiting room, but here that doesn’t happen (which is strange in a way, as Americans are more chatty in other ways). In the United States it is normal to get a call reminding you of your appointment, which is a service that I like.

I also noticed that it took a while to find a primary care doctor who was taking on new patients, and who had appointments available soon (and, new patients have lower priority). I’ve heard a few stories of people who had problems finding a new primary care doctor in the Netherlands, but it seems a little easier, and the waiting times for an appointment are shorter.

The same goes for specialists. Waiting times for specialists are certainly a known problem in the Dutch system, but they seem to bit longer on average here.

Another difference is overall attitude. The system in the US seems to have evolved to the point where patients are considered to be consumers, consumers who want satisfaction. Patients are expected to be more assertive. They are egged on by ads by pharmaceutical companies who urge people to “ask your doctor about X”. Ads by those companies are certainly not unheard of in the Netherlands, but they are much more common here. People also seem to go see a doctor a bit sooner in the US than in the Netherlands.

Of course, the main difference is health insurance. Currently, some 16% of Americans (about 47 million people) are uninsured, and this number goes up every year. They often aren’t insured because they simply can’t afford it. This is a tragedy; in a rich Western country like the US, millions of people run the risk of having very high medical bills if something goes wrong, and then won’t be able to pay for them. It is not uncommon for people to have to declare bankruptcy because of medical bills. What also happens is that people postpone going to the doctor as long as possible, because they know they can’t afford it, causing whatever they have to become a very serious problem.

Let’s compare insurance costs for a minute. In the Netherlands, a basic health insurance package for one person costs of about 90 euro (125 dollars) per month. The items in this package are determined by the government, but you get it from private health insurance companies. Most items in the package are covered 100%, and they include primary care, specialists and hospital visits. Children under 18 ride along on their parents’ insurance, at no extra cost. Health insurance companies are required by law provide this basic insurance for any patient. Age or pre-existing conditions don’t matter. The government provides a pool of money that is used to cover some excess costs for health insurance companies (chronically ill, and the free healthcare for children). This pool is paid out of money that is paid by employers, per employee. Employers pay 6.5% of an employee’s gross income, with a maximum of some 2000 euro per year. If you’re self-employed, it’s 4.5%, with a maxium of 1400 euro per year. The Wikipedia entry on Dutch Healthcare gives a pretty decent overview of the system.

In the United States, the best position to be in is to work at a larger company. Most of these will provide health insurance to their employees. Not all, and noto all employees; about 60% of working people are insured this way. Companies that provide insurance have a contract with a health insurance company. The cost per employee was on average about $4700 for a single employee, and $13,000 to cover the family of an employee. The employee him/herself pays about $65 average per month, and some $275 to cover their family. For a good set of data on employer-provided healthcare, see this 2008 study by the Kaiser Family Foundation (PDF)

For people who have to pay for health insurance all by themselves, the costs varies. It depends on where you live, your age, and your medical history. If you’re young and healthy, and live in, say, North Dakota, you can get an individual plan for $70. If you’re older, have had some serious health problems, and live in New York state, you can easily pay $600 per month. For a family you start at about $275 per month in the cheapest state (and no prior conditions, etc). But on average, is much more, and can easily get up to $1200 per month in a state with a higher cost of living (a cost of living that is more comparable to the Netherlands).

The employer-provided coverage may seem better in the US at first, since it’s a little cheaper for the employee on average. But, it is important to keep several things in mind when making comparisons like this. Only 60% of working people have this insurance; getting health insurance for yourself is much more expensive. Employers have a much higher cost than in the Netherlands. Coverage is much better for the standard Dutch plan. The standard deductible for Dutch health insurance is 155 euro ($225), for US plans it’s much more (up to $2000 for an individual plan, and bringing this number down gets you an even higher premium, obviously). The basic package in the Netherlands will cover most things 100%, insurance in the US will cover basic things 80-90%. So you’ll end up paying a lot more, even if your premium isn’t that high.

There are more differences. Like I mentioned earlier, your medical history is not considered in the Netherlands. In the United States, it will lead to much higher premiums for individual plans, or being refused insurance altogether. I have also heard several stories about people actually being dropped by their insurance. There is no co-pay for most items in the Dutch plans, there usually is in the US, even for something simple like a visit to your primary care doctor. If you lose your job in the US, you will also lose your health insurance. This can lead to very bad situations, e.g. you can’t get to work in a new job because you’re ill, but you can’t get insurance, or can’t afford it, because you don’t have a job. A recent study showed that a lot of people are unwilling to change jobs or start up their own business because they know they’ll lose their health insurance.

In other words, the Dutch system wins out easily. I am not saying that the Dutch system is perfect. It has its flaws, and I am worried about the increasing influence of health insurance companies. But the differences are striking.

Back to my own experiences. I’ve had a hard time getting used to having to get out my wallet when arriving at our family care practice, at the pharmacy, or at the hospital. “People pay for basic medical things here?” I’m also not used to having to worry about whether a doctor will accept your health insurance. Lastly, I was somewhat surprised when they had to get pre-approval from the health insurance company for something as simple (and in my case very necessary) as a colonoscopy. It seems that the health insurance companies have a large role in running the show. That’s strange. If you’re a licensed doctor, you can be expected to know what to do to treat a patient, right? Apparently not according to US health insurance companies. Lastly, when you see the bills, you wonder where all the money goes. The medical staff doesn’t seem to be getting the money.

There is much more to be said about this issue. Currently, the Obama administration and the Democrats are trying to pass a healthcare reform bill. I am pessimistic about the possibility of meaningful reform. It would be sad if it didn’t happen. The health insurance situation in the United States is unworthy of a modern Western state.