All this assumes that defense and health care should be treated equally in the national budget. We would argue that they should not be . . . Universal health care, however desirable, is not “fundamental to the defense of our people.” Nor is it a “necessity” that it be adopted this year: Mr. Obama chose to propose a massive new entitlement at a time of historic budget deficits. In contrast, Gen. McChrystal believes that if reinforcements are not sent to Afghanistan in the next year, the war may be lost, with catastrophic consequences for U.S. interests in South Asia. U.S. soldiers would continue to die, without the prospect of defeating the Taliban. And, as Mr. Obama put it, “if left unchecked, the Taliban insurgency will mean an even larger safe haven from which al-Qaeda would plot to kill more Americans.”

Actually, a recent study from the Harvard Medical School and Cambridge Health Alliance documented that “nearly 45,000 annual deaths are associated with lack of health insurance” in America.  Whatever the exact number, nobody doubts that lack of health insurance causes thousands of Americans to die every year.  If you’re Fred Hiatt and you already have health insurance, it’s easy to dismiss those deaths as unimportant, “not fundamental,” not a “necessity” to tend to any time soon.  No matter your views on Obama’s health care reform plan, does it really take any effort to see how warped that dismissive mentality is?

But it becomes so much worse when one considers what we’re ostensibly going to do in Afghanistan as part of our venerated “counter-insurgency” mission.  In an amazingly enlightening interview with Frontline, military expert Andrew Bacevich explains what that supposedly entails:

I think the best way to understand the term “counterinsurgency” is to understand what the U.S. Army and the Marine Corps today mean by that term. What they mean is an approach to warfare in which success is to be gained not by destroying the enemy but by securing the population.

The term “securing” here means not simply keeping the people safe, but providing for the people a series of services — effective governance, economic development, education, the elimination of corruption, the protection of women’s rights. That translates into an enormously ambitious project of nation building. . . .

John Nagl says that in effect we are engaged in a global counterinsurgency campaign. That’s his description of the long war.

Now, think about it.  If counterinsurgency, according to current doctrine, is all about securing the population, if securing the population implies not simply keeping them safe but providing people with good governance and economic development and education and so on, what then is the requirement of a global counterinsurgency campaign?

Are we called upon to keep ourselves safe?  To prevent another 9/11? Are we called upon to secure the population of the entire globe? Given the success we’ve had thus far in securing the population in Iraq and in Afghanistan, does this idea make any sense whatsoever?

Can anybody possibly believe that the United States of America, … facing a federal budget deficit of $1.8 trillion … has the resources necessary to conduct a global counterinsurgency campaign?  Over what? The next 20, 50, 80 years? I think [there] is something so preposterous about such proposals. I just find it baffling that they are treated with seriousness by supposedly serious people.

So according to The Washington Post, dropping bombs on, controlling and occupying Afghanistan — all while simultaneously ensuring “effective governance, economic development, education, the elimination of corruption, the protection of women’s rights” to Afghan citizens in Afghanistan — is an absolutely vital necessity that must be done no matter the cost.  But providing basic services (such as health care) to American citizens, in the U.S., is a secondary priority at best, something totally unnecessary that should wait for a few years or a couple decades until we can afford it and until our various wars are finished, if that ever happens.  “U.S. interests in South Asia” are paramount; U.S. interests in the welfare of those in American cities, suburbs and rural areas are an afterthought.

As demented as that sounds, isn’t that exactly the priority scheme we’ve adopted as a country?  We’re a nation that couldn’t even manage to get clean drinking water to our own citizens who were dying in the middle of New Orleans.  We have tens of thousands of people dying every year because they lack basic health care coverage.  The rich-poor gap continues to expand to third-world levels.  And The Post claims that war and “nation-building” in Afghanistan are crucial while health care for Americans is not because “wars, unlike entitlement programs, eventually come to an end.”  Except, as Bacevich points out, that’s false:

Post-Vietnam, the officer corps was committed to the proposition that wars should be infrequent, that they should be fought only for the most vital interests, and that they should be fought in a way that would produce a quick and decisive outcome.

What we have today in my judgment is just the inverse of that. War has become a permanent condition.

Beltway elites have health insurance and thus the costs and suffering for those who don’t are abstract, distant and irrelevant.  Identically, with very rare exception, they and their families don’t fight the wars they cheer on — and don’t even pay for them — and thus get to enjoy all the pulsating benefits without any costs whatsoever.  Adam Smith, all the way back in 1776, in An Inquiry into the Nature And Causes of the Wealth of Nations, described this Beltway attitude exactly:

In great empires the people who live in the capital, and in the provinces remote from the scene of action, feel, many of them, scarce any inconveniency from the war; but enjoy, at their ease, the amusement of reading in the newspapers the exploits of their own fleets and armies . . .

Lounging around in the editorial offices in the capital of a rapidly decaying empire, urging that more Americans be sent into endless war paid for with endless debt, while yawning and lazily waving away with boredom the hordes outside dying for lack of health care coverage, is one of the most repugnant images one can imagine.  It’s exactly what Adam Smith denounced.  And it’s exactly what our political and media elite are.