Be Careful What You Wish For

It's easy to get caught up in the excitement of the wave of anti-government protests sweeping through the Arab world. As Americans, our first instinct is to view every revolution against tyranny through the lens of our own history. Reflexively, we root against the dictators, corrupt fascists who have denied freedom to their people for decades. Such an instinct is entirely appropriate: our democracy means nothing if it is used as a pillar of oppression overseas.

Unfortunately, misreading history is also an American instinct. Revolution may be common, but democracy is precious and rare. The upheaval in the Muslim world is not inspired by a philosophy of what those governments should be; they are inspired by a revulsion at what those governments have become. The common goal of the rioters in the streets is change, but once they have successfully forced the autocrats from their palaces, that goal will have been met. What will be left is a vacuum demanding to be filled. If history is a guide, it is likely to be filled by the largest, best organized, or most heavily armed aspirant to leadership.

In the Muslim Middle East, revolution has never yielded democracy. Indeed, the only Muslim democracy in that part of the globe was not the result of popular rebellion, but rather, imposed by the United States on Iraq (and, let's face it, the long-term viability of that experiment is still very much in doubt). If, as George W. Bush suggested, "liberty... is God's gift to the world", it is a gift rejected time and again, not only by Middle Eastern tyrants, but by the revolutionaries who supplant them.

The situation in Egypt is no different. Modern Egypt was born of a revolution against British rule led in part by Gamal Abdul Nasser. Assuming the premiership in 1956, Nasser, a military dictator, ruled Egypt with an iron hand, even as he maneuvered to become the leader of the Arab world. Nasser's position only deteriorated after his humiliating defeat at the hands of Israel in 1967 in a war he precipitated.

The correlation of Nasser's career with his military success—or lack thereof—against Israel is unsurprising. Egypt's leaders in the latter half of the 20th century depended on the average Egyptian's antipathy towards Israel for their popularity. One of Nasser's first acts in office was to provoke the 1956 Suez Canal crisis; the resulting failure of Israel, Britain and France to hold the Suez, and Israel's withdrawal from the Sinai, firmly established Nasser's position at the head of the Egyptian regime.

As the sun sets on Mubarak, will the peace with
Israel be plunged into darkness?

Indeed, one contributor to the current unrest—unmentioned on CNN but implied in the cheerleading coverage of al Jazeera—is dissatisfaction with Egypt's peace with Israel. Don't get me wrong: the cold peace with Israel, the status of which has remained unchanged for some time, probably didn't spark the outbreak of popular revolt. But it is and remains an irritant, a perennial entry on the list of grievances nursed by Egyptians against their leader.

So what can we expect in post-revolutionary Egypt? The main players in the revolt are the Muslim Brotherhood, an Islamist organization with ties to Middle Eastern terror groups, and Kefaya, a more secular opposition movement. Neither has asserted itself as a successor so far—it is still too early for such positioning. But perhaps we can get a clue to the outcome from the reaction of other Muslim nations.

The most important Islamic revolution in my lifetime took place in Iran in 1979. Fed up with the history of oppression under their US-backed dictator, the Iranians rose up, successfully replacing their secular autocracy with an Islamic theocracy. Most Iranians today were not yet born in 1979—the only oppression they've known has been at the hands of the Imams. Their 2009 revolt, perhaps the first such rebellion in the region with any chance of producing a native-born Islamic democracy, was ruthlessly crushed by the Ayatollah's regime.

And so, the Islamists remain in charge in Tehran. Their reaction to rioting in Egypt? They are cheering on the revolution:

[In Egypt], Muslims are more active in political agitation and, God willing, they will establish the regime that they want... Today, as a result of the gifts of the Islamic revolution in Iran, freedom-loving Islamic peoples such as the peoples of Tunisia, Egypt and nearby Arab countries are standing up to their oppressive governments.

Clearly, the Islamists are betting on the Muslim Brotherhood. American intellectuals, such as Leon Wieseltier, fear that the Iranian analysis may be on the mark:

[T]he politics of the revolt are murky. Its early stages have not been the work of the Muslim Brotherhood, but it is hard to believe that the Islamist organization will not be tempted to play the Bolshevik role in this revolution: it has the ideology and the organization with which to seize control of the situation, and it is the regime’s most formidable political adversary.

  Whatever Egypt looks like in the post-Mubarak era, we can be pretty sure of a few things:

1. The government will be hostile to Israel. While the Egypt-Israel relationship under Mubarak has hardly been a love affair, it's entirely possible that a new Egyptian regime could scuttle the peace treaty entirely. That treaty, brittle though it may be, has been the platform on which decades of relative stability between Israel and its neighbors (Lebanon being the notable exception) has rested.
2. The government will be hostile to the United States. As an incentive for its treaty with Israel, the US has gifted Egypt with about $2 billion per year of foreign aid. The average Egyptian, not without reason, has viewed this money as a means of propping up the dictator they hate and as a reward for their sworn enemy, Israel. Make no mistake: anti-US sentiment is a significant driver behind the protests in Egypt's streets.
3. Jordan will be next. If anything, Jordan's relatively enlightened monarch, King Hussein, is even more hated by his subjects than Mubarak. Perhaps as much as half of Jordan's population is of Palestinian extraction; in 1970, the PLO even tried (unsuccessfully) to overthrow the father of the current king. Needless to say, Jordan's peace with Israel and solid friendship with the United States are deeply unpopular with Jordanians.

When all is said and done, we can shed few tears for a dictator who is at long last deposed by those he has oppressed. At the same time, however, it's imperative to take a clear-eyed view of developments in the Islamic world, armed with a thorough understanding of the threats and opportunities presented by these events.

Unbalanced Gunman, Unbalanced Policy

Yesterday, a seriously disturbed young man shot twenty innocent people, killing a nine-year old girl, a federal judge, a 30-year old political staffer, an elderly gentleman trying to protect his wife, and two others, and wounding the rest, including Jewish Congresswoman Gabby Giffords. His precise motives remain unknown, although he clearly held some extreme political views, and there is some evidence that anti-Semitism may have played a role as well.

Many, including me, have pointed a finger at the irresponsible and violent rhetoric that has overtaken politics since the Obama election. It is so self-evident that the hateful, often racist, occasionally treasonous rhetoric coming from the Tea Party and other extremists contributed to this incident, it's hardly worth exploring here. In any event, that discussion will dominate the national debate for a while, just as it did in Israel following the 1995 assassination of Prime Minister Yitzchak Rabin.

I began to wonder, though, about the shooter. By all early accounts, he suffers from a degenerative, paranoid, and violent mental illness. While we cannot know at this point what diagnosis, if any, might be appropriate for him, it does appear that he began displaying abnormal behavior in his teens—typical of schizophrenia.

The shooter had attended Pima County Community College, where his increasingly erratic behavior did not go unnoticed. As a student in one of his classes observed, "He disrupted class frequently with nonsensical outbursts." He'd had brushes with the law as well. All in all, there were many people—his classmates, the school administration, and law enforcement—in a position to recognize the urgent need for some kind of intervention.

Unfortunately, the options for such intervention have narrowed considerably in the past decades. And so, like hundreds of thousands of others, the killer will spend his life in jail after committing a heinous, violent act, rather than spending time in a therapeutic setting that might have prevented such behavior in the first place. According to Pima County Sheriff Clarence Dupnik:

Back in 1960, when I was a young cop on the beat, we put mentally ill people who were threats into a system that incarcerated them. Today they're out on the street and we're paying a price for it.

The history is fairly well known. Ronald Reagan dismantled the federal system of mental health care. While state mental institutions deserved, by and large, to be shuttered, the Regan administration offered no safety net for the mentally ill who suddenly found themselves thrust back into society.  According to one paper on the subject:

[T]he number of beds available to the mentally ill in public and private hospitals dropped over forty percent between 1970 and 1984. Most of this decline was due to cuts in public hospitals. During the 1980s, the number of beds provided by general hospitals in psychiatric wards and in private hospitals for the mentally ill increased. In 1970, there were 150 private psychiatric centers... by 1988, there were 450 in the United States. General hospitals offering psychiatric services increased from 1,259 in 1984 to over two thousand in 1988. With such growth in the private sector, there were substantial profits to be made in mental illness, assuming that the patient had adequate health insurance. Those without medical insurance frequently did not receive adequate care.

(Emphasis added.) Mental illness isn't going away any time soon. In addition to the normal statistical occurrence of mental illness within a population of our size, we are adding thousands of post-traumatic stress disorder (PTSD) victims, veterans of the wars in Iraq and Afghanistan. Tragically, the Reagan administration's abandonment of mental health care has left many in the mentally ill population with only two places to go: the streets or the prison system.

What does all this have to do with Tea Party and Republican policy? The Tea Party was founded on the wrong, but at least defensible, principle that federal bailouts had grown out of control. Since then, however, the platform has grown to encompass opposition to all things Obama. By last year, the Tea Party had targeted (quite literally) Gabby Giffords, not for her position on government bailouts, but rather, for her support of health care reform.

Indeed, the Republican majority in the 112th Congress, assiduously ignoring all manner of pressing issues on which they might realistically have some impact, have decided that their first order of business will be purely symbolic: the repeal of health care reform. I say "purely symbolic" because, of course, such legislation will never make it to the floor of the Senate, and even if it were to pass the Senate, it would promptly be vetoed by the president. Thus, the Republicans are simply spinning their wheels on America's dime to score political points with the minority in this country who believe that health care reform was "too liberal".

Health care reform: hope for the mentally ill

One of the innovations of the health care reform legislation was to force insurance companies to cover mental health care to the same extent they cover traditional health care. This policy, known as "parity", has been the law since 2008, but only for group policies for employers with 50 or more covered employees. This loophole not only leaves out the 49 million previously uninsured, who of course also lack mental health coverage; it also excludes the over 30 million people who work for small businesses in America.

Permit me to suggest that leaving nearly 80 million Americans—call it one in four of us—without recourse to adequate mental health care hardly qualifies as "equity". Apparently the 111th Congress agreed, including parity in the health care reform legislation that became law last year. By guaranteeing adequate mental health care for nearly all Americans, health care reform assists the mentally ill to get off the streets and stay out of the prisons. Such a policy benefits not only the mentally ill, but all of society.

This, then, is the progressive reform that Tea Partiers and Republicans consider "socialist", evil, or simply unconstitutional. In the coming days and weeks you will hear right wing apologists defensively argue that the Giffords shooting was the work of an "unbalanced" individual, and not in any way the fault of their incendiary demagoguery. Perhaps. And yet, the policies that the Republicans put into effect in the Reagan era, and which they hope to continue through the repeal of health care reform, will ensure an uninterrupted supply of such individuals—untreated, uncared for, and unnoticed, until the next preventable atrocity splatters across our TV screens.