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Thursday, October 4, 2012
The Iola Register
Opinion
A5
Warmup debate polite, bloodless Wednesday night’s debate state government is showing encouraged Republicans and not the slightest interest in cremay have disappointed Demo- ating a state-funded program crats. to reverse that trend. If Gov. Mitt Romney was the more Sam Brownback has a Massaaggressive. President Barack chusetts-style health care iniObama held back. tiative on his must-do list, he Romney’s points came in has kept it under lock and key. harping on the persistent high unemployment numbers and IT IS IRONIC, but Mr. Romhis claim that he will create 12 ney made the Republican case million new jobs in the coming when he wised off at a highfour years. dollar fundraiser in May and Obama responded with a said that about 47 percent of demand for the American specifics that people pay no will be made income tax, over and over Romney would expect feel victimized again between states to create their by the system now and Nov. and depend on own health care plans g o v e r n m e n t 6. Both men similar to what he did in handouts to handled themMassachusetts, provid- keep body and selves presisoul together. ing health care for all. dentially — He hasn’t Good luck with Kansas, denied which is to say that that neither Mr. Romney. statement and made personhas, instead, al attacks or repeated it and indulged in said the debate dramatics. should be about the role govAt this late stage of the cam- ernment should play in our paign, these assessments are society. calming. The guy and gal in Maybe the next two debates the street can feel comfort from will touch on that theme. their professional deportment: Wednesday night both the take-away from those 90 agreed a good education was minutes is that the union will critically important. But if eisurvive until 2016, regardless. ther said how they would (a) But important differences increase funding to individual were emphasized. Romney hit school districts so they could hard on the Republican themes upgrade their faculties, or (b) of lower taxes and greater re- find other ways to increase stusponsibilities for the states. dent learning, I missed it. Obama stressed the nation’s The opening debate was poresponsibility for a quality lite and bloodless. Depend on education system and the op- the next two to turn up the volportunity to bring health care ume. The undecideds make up costs down through the Na- their minds late. They will be tional Affordable Care Act the targets on Oct. 16 and Oct. (Obamacare.) 22. Romney gave Obama an At the townhall style debate opening by saying that if he Oct. 16, Romney will be forced wins, he would expect the oth- to defend his support of low er 49 states to create statewide taxes for the rich. The followhealth care plans similar to ing week, when the focus is that which he helped create in on foreign affairs, he will be Massachusetts when he was asked to contemplate the congovernor. That would be the sequences of his unqualified way, he said, to bring health support of Israel’s aggressive care costs down while provid- stance toward Iran. Is he really ing all Americans health care ready to start another Middle coverage. East war? Good luck with Kansas, Mr. October will be full of politiRomney. The number of unin- cal fun. sured Kansans is rising. The — Emerson Lynn, jr.
How to maximize kidney transplants Every year, too many kidneys recovered from deceased donors don’t end up in transplant patients. They end up in medical waste incinerators. Last year, 4,720 people died while waiting for kidney transplants. Meanwhile, 2,644 kidneys were discarded. Some of these kidneys had problems that rendered them unfit for transplant. But many could not be transplanted because the system for allocating them is inefficient and outdated. Right now the waiting list for a kidney transplant stands at 93,702 people. The system isn’t saving — or improving — as many lives as it could. A committee that oversees kidney transplants in the United States recently proposed a series of smart changes to better parcel out 14,700 kidneys recovered from deceased donors. Under this plan, the top 20 percent of kidneys — the kidneys expected to last longest — would be directed to those candidates expected to live the longest after a transplant. That typically means younger patients. That proposal is a significant departure from the current system, which generally can be summed up as: Get in line and wait your turn. Depending on what part of the country you live
Right now the waiting list for a kidney transplant stands at 93,702 people. The system isn’t saving — or improving — as many lives as it could. in and other variables, you could wait two years or 10. The committee’s chairman, Dr. John Friedewald, a transplant nephrologist at Northwestern University’s Feinberg School of Medicine, tells us the new plan — called “longevity matching” — will help doctors “get more out of what we have.” The proposed changes would yield an estimated 8,380 more years of life from one year of transplants. Think about that: 8,380 years. This new proposal is similar to but not as aggressive as a 2007 plan that would have doled out kidneys more often to those who could live longest after transplant. But that proposal ran afoul of the federal government, which warned last year that it would violate age discrimination laws. Yes, this plan still tips the scale in favor of some younger patients. But it will still be possible for some in their 40s and 50s to make the cut and get the best organs, Friedewald says. Even those who don’t
make that cut will still be eligible for a transplant. Bottom line: The system won’t drive as many older organs to younger recipients, who may outlive them and wind up on the list again. A similar concept is already part of the system to determine who receives a transplanted lung, heart or liver. We understand why some people are nervous about these changes. In a fairer world, there would be enough kidneys to go around. But there aren’t. This is about maximizing the years that a kidney will work inside someone’s body, not rendering a judgment about how any recipient uses that time. Officials have spent the last nine years seeking to make the system more efficient. Let’s not wait another nine. The board that oversees transplants in the U.S. can — and should — make these changes next summer. Thousands of people are on kidney transplant waiting lists. Every day, every week, that officials delay, people die waiting.
US should tread lightly, but skeptically, on Iran By ROGER Z. GEORGE Los Angeles Times
As the U.S. contemplates whether to attack Iran’s nuclear facilities, intelligence community leaders should be asking themselves a question: What if we’re wrong? That question wasn’t asked — or at least wasn’t answered — in the run-up to the 2003 Iraq war, with devastating consequences. Before giving up on containment or deterrence polices and undertaking a “preventive war” against a nation that has not attacked the United States, we should be as certain as possible of the evidence. Iran today presents an even murkier intelligence picture than Iraq did in 2003. We have not had a diplomatic presence there since 1979 and have had to rely on intelligence collected through technology, international inspectors and foreign intelligence relationships. In the absence of solid intelligence, the intelligence community has had to fall back on its own assumptions or mind-sets regarding Iran’s nuclear program and make educated guesses about how its government would probably operate its programs. Our assessments of Iran’s military capabilities have had to rely in part on our understanding of how American weapon developers conduct tests and develop weapons. Such analytic assumptions have and can again lead to incorrect conclusions.
... (T)he intelligence community should never be called on to make the case for intervention, as was the situation in 2003, when so-called white papers on Iraq’s WMD program were fashioned by the intelligence community to support Bush administration policies. So what can be done to avert another military strike based on devastatingly wrong intelligence estimates? How can we avoid terrible mistakes, followed by commission investigations and finger-pointing? First, we must set extremely high standards for evidence. Intelligence professionals must challenge themselves to look at their forecasts skeptically, asking whether underlying assumptions about Iranian behavior and technical talent are well founded. Policymakers should encourage this kind of critical thinking and be attentive to signs of faulty logic or flawed intelligence. Second, the U.S. must not overrely on information gathered and supplied by foreign governments. Such intelligence can be useful, but it is often provided as much to influence action by American policymakers as to provide unbiased and accurate information. Much of the foreign intelligence used to analyze Iraq’s supposed development of weapons of mass
destruction, for example, was self-serving, biased or flat-out fabricated. The U.S. is almost certainly the target for influence operations designed to shape American perceptions of the Iranian nuclear program. We should be especially wary of reporting that fits what we are expecting to see and challenge that reporting vigorously. Third, U.S. intelligence personnel should be kept at arm’s length from policy discussions, particularly those involving military options. Being too close to the decisions made by the Bush administration more than likely contributed to then-CIA Director George Tenet’s assertion that the U.S. had “slam-dunk” evidence that Saddam Hussein was actively developing weapons of mass destruction. Senior intelligence officials are not immune from wanting to be team players, and if a policy team is looking for information to support a desired action, this can skew an intelligence agency’s views
on the information it has gathered. James R. Clapper, the U.S. director of national intelligence, would be well advised to run all intelligence about Iran’s nuclear weapons program through a rigorous “red-teaming” exercise, involving outside experts who have no ax to grind or connections to the current administration or its policies. Fourth, the intelligence community should never be called on to make the case for intervention, as was the situation in 2003, when so-called white papers on Iraq’s WMD program were fashioned by the intelligence community to support Bush administration policies. Such reports are not rigorous intelligence assessments but rather advocacy pieces devoid of the important qualifiers that coordinated intelligence reports should carry. Finally, the intelligence community should immediately, if it has not already done so, prepare candid assessments of the effect military strikes against Iran’s nuclear facilities could have on both Iranian politics and regional stability. In 2003, such assessments proved to be prescient, but they were completed only after the decision had been made to invade Iraq. Consequently, they had virtually no impact on decisionmakers, who had convinced themselves that Iraqis would greet us as liberators and quickly restore
... (T)he decision to attack another Islamic state would carry consequences far beyond reducing Iran’s military potential .... the functioning of their society and economy. Needless to say, the decision to attack another Islamic state would carry consequences far beyond reducing Iran’s military potential, and the intelligence community needs to analyze those consequences concurrently with its analysis of intelligence regarding Iran’s nuclear intentions. These steps will not guarantee that intelligence used to reach the important decisions regarding Iran will be perfect. Clearly, it will not be. However, the intelligence community should not repeat mistakes it made in 2002 and 2003, nor allow itself to become the scapegoat for decisions that properly reside with the nation’s political and military leadership. ——— About the writer Roger Z. George, a former national intelligence officer, teaches at the National War College in Washington. He wrote this for the Los Angeles Times.