The Evil that is ISIS.

The so-called Islamic State, also known as ISIL and the Islamic State of Iraq and Syria (ISIS), has created havoc in Syria and Iraq in the last few years.  In 2012, they kidnapped 33 journalists in Syria.  This week they released a gruesome video of an ISIS fighter beheading freelance journalist James Wright Foley.  A few weeks ago, Al Jazeera released photos of Christian men beheaded by ISIS.  News outlets around the world almost obsessively reported on the plight of a large number of Yadzis, a small Muslim sect, as they faced potential extinction by ISIS forces.  Over six million Syrians and Iraqis have been displaced.  Many of these refugees fled for their lives, for fear of being persecuted or killed by vicious ISIS fanatics.  Whole communities of Christians in Iraq and Syria, some of which have lived continuously in the region since the beginnings of Christianity in the first century, have been persecuted, killed and/or displaced.  Christian children have been sawed in half. Other Christians have been crucified and their corpses used to line the streets to intimidate others.  It is time for the world to confront this evil.  This is not merely a political movement.  It is an outright evil that must be stopped.  These are not merely Sunni militants, as described by the New York Times and other news outlets.  This is an evil not seen in our world since the Nazis of the 20th century.  The war crimes of Bosnia-Herzegovina/Serbia, the genocidal horrors of Rawanda, the Killing fields of Cambodia... None of these, as terrible as they were, rise to the level of evil that ISIS has become.  No person or group who advocates, sympathizes or perpetrates this kind of religiously motivated evil should be tolerated.  I believe in freedom, but that freedom ends when such freedom is used to deprive others of their freedom, liberties and rights.  This is evil, pure and simple. It is time America act, not to contain these monsters, but to destroy them.  This is not a petty civil war; this is not a conflict like the historically difficult Israeli-Palestinian struggle.  This is an evil that the world must face now.  ISIS must be confronted now.

How Obamacare is Affecting Our Family

Millions of Americans have lost their health insurance as a result of the Affordable Care Act (ACA), also known as Obamacare.  Since October 1, 2013, over four (4) million have lost coverage.  This does not include employers that are part of the large group insurance pools or self-insured employers.  Most of these have yet to decide how they will handle the ACA’s ever-widening stranglehold on the insurance industry.

 

Like many Americans, our family is insured through an employer, particularly my wife Lisa’s company.  This week, we received a letter (email) from Lisa’s corporate headquarters informing us that they will continue to provide insurance to employees through the year 2014.  They explicitly state that they have made no decision regarding future employee health insurance coverage beyond the next year or two. 

 

In fact, Lisa’s employer clearly states:  “[I]t is your obligation to purchase health insurance. . . .  Contrary to popular belief, employers are not required to provide healthcare insurance. . . .  Further, no employer is required to provide insurance to spouses or pay for coverage for dependents.”  The letter goes on to explain that Americans have three paths to obtaining health insurance:  Employer-Sponsored plans, Healthcare Insurance Market Exchanges (ACA controlled), and Government-Sponsored plans like Medicare or Medicaid.  In this discussion, the email further emphasizes that “employers may offer new ways to enroll in healthcare coverage, for example, through the private Healthcare Insurance Marketplace Exchange.  Also, more and more employers are holding employees more accountable for their lifestyle choices.” 

 

The not-so-subtle threats do not stop there.  “Although the Company has made a concerted effort to control our medical benefits costs, we continue to face rising costs and need to address them.”  They note that changes in the healthcare market, costs have risen significantly in 2013 alone.  The company’s projected estimates for 2013 healthcare expenses fell short by $8 million, a 13% shortfall.  In addition, 2014 healthcare costs will add another $8 million to the costs.  This means that for Lisa’s company alone, healthcare costs will have increased over $20 million since the beginning of 2012.  That’s a 36%+ increase in just two years.  From what I can gather, employers across the country are facing the same problem.

 

But how does the ACA affect my family directly?  The letter from Lisa’s company gives us some clues.  First, our insurance premiums are going up nearly $400.  The only reason it is not going up further is because Lisa’s company has chosen to help offset some of the increased premium costs by covering a portion of the increase.  Part of the $400 is the $63 “re-insurance fee” imposed on all insurers by Obamacare.  The rest is due to the effect the ACA is having upon the insurance market. 

 

In order to keep our monthly insurance premiums from going up too drastically, Lisa’s employer has elected to increase our “Out of Pocket” (OP) maximum by $3,000.  Because of Lisa’s cancer, we reach our Out of Pocket maximum every year. Even with the increased OP maximum, next year we will meet the new OP maximum as well.  That means, for us, our healthcare costs will increase next year by nearly $4,000. 

 

These figures do not include the myriad of new taxes that we will pay next year due to the Affordable Care Act.  Fortunately, we do not plan to sell our home in 2014.  That would increase our taxes by over $15,000.  So, think about it.  We are just one family.  Obamacare will cost us thousands of dollars next year alone.  There are millions of Americans who, like us, will be paying thousands more next year because of the ACA.  Millions are losing their healthcare coverage already, forcing many of them into more expensive, government controlled plans.  I expect that millions more in the next few years will also be dumped by their employers and private insurers.  And as a result, they will likewise be forced into insurance plans controlled by the federal government.  If we had to move today from Lisa’s company sponsored plan into a comparable insurance policy through the federal government’s ACA-controlled “Healthcare Insurance Market Exchange,” our premiums would increase 400%.   The ACA may help many poor, uninsured and underinsured Americans, but it is also financially crippling many other Americans.  Is it right to harm millions of Americans, even if it means other Americans benefit?  We could have accomplished the same goal without this devastating, poorly conceived law.  It certainly isn’t fair to us.            

 

Affordable Care Act: Compliance Standards

The Affordable Care Act of 2010 (ACA), also known as Obamacare, created a new oversight structure to allegedly manage the “quality and efficiency” of healthcare delivery in the United States.  Prior to this time, federal oversight of healthcare quality was primarily limited to the regulations related to Medicare and Medicaid laws.  Most governance with regard to healthcare quality was done by each individual state.  Under Obamacare, federal oversight has been expanded to cover all healthcare, whether the provider is a doctor, a hospital, a nursing home, etc.  Add to this, previously only quality of healthcare was monitored; now quality and efficiency will not only be monitored but federally regulated for all healthcare delivery as well.

 

Under the authority provided by the ACA, new compliance rules have been established by the Department of Health and Human Services (HHS) in Washington, D.C.  These rules are technically voluntary, but no healthcare provider may receive any federal funds if they do not comply.  Therefore, effectively, this forces virtually all healthcare providers to comply with the new rules and regulations authorized by the Affordable Care Act. 

 

So, hospitals and doctors across the nation are now diverting millions of dollars in resources to comply with the new rules and regulations set down by the HHS.  In College Station, Texas this means that hospitals in our area have had to hire new staff simply to meet these new ACA compliance standards, or shift these responsibilities to already overworked hospital staff.  Compliance officers now keep up with these voluminous and highly complex regulations, as well as oversee the implementation of these compliance rules throughout their hospital departments.

 

As a result, nurses and/or other specified staff are required to call every patient after they leave the local hospital and ask a specific set of questions, many of which do not apply to a particular patient’s situation.  The hospital is measured against an ideal goal established by the HHS in Washington.  Even though a question may not apply to a particular person’s situation, the hospital is negatively affected by an answer HHS deems unsatisfactory. 

 

For instance, one question local hospitals are required to ask each patient is “Have you been contacted by Home Health regarding your follow-up care?”  Most patients do not require follow-up care, much less Home Health care.  As a result, if hospital representatives are not savvy enough to recognize this, they will ask the question without any adjustment, and thus produce results that will hurt the hospital’s compliance rating.  This in turn will affect hospital reimbursement in the future, for the ACA provides HHS the authority to penalize hospitals that fail to meet “quality and efficiency” standards.

 

Over time, hospitals in our area will find ways to address the problem, either by training their staff responsible for follow-up calls differently, or they will secure home health follow-up for every patient, thereby increasing the overall cost of healthcare delivery.   In any case, the “one size fits all” approach from Washington, D.C. seems absurd to locals who deliver healthcare services every day. 

 

In addition to a limited number of questions asked by a hospital representative in a follow-up phone call, there are other surveys that are performed by an outside HHS approved agency overseeing a hospital’s compliance.  A series of detailed questions are asked and the hospital’s “quality and efficiency” is measured by the results of these questions.  One of the measures is whether or not the hospital’s compliance representatives reach at least 60% of the patients in follow-up phone calls.  That means if a hospital does not contact at least 60% of all discharged patients every month -- and keep in mind that this contact is valid only if the patient answers all questions of the survey required by HHS -- then the hospital is penalized for not providing quality care.

 

Another such question is: “During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?”  The HHS compliance requirement for local hospitals is an average positive response of at least 72.5%.  That means nearly three-fourths of all respondents must answer that they received satisfactory responses most of the time in order for the hospital to receive a satisfactory compliance grade by HHS.  This might seem like a reasonable guideline for measuring how a hospital or hospital service is doing relative to patient expectations, but this particular measurement becomes part of the “quality and efficiency” markers for a hospital’s overall rating and reimbursement rate by the federal government.  This rating even affects reimbursement from insurance companies in the federal health insurance exchanges. 

 

Does this subjective assessment actually determine whether or not quality healthcare was delivered?  No.  Certainly, it is a useful indicator to the hospital.  But should it be a determining factor in how much money a hospital receives in reimbursement?  Obviously, the HHS thinks it should.

 

Below are a series of questions from the compliance surveys which measure local hospitals’ quality and efficiency compliance.  The percentage listed next to the question is the minimal HHS standard to receive a “green” (satisfactory) quality and efficiency score. 

 

1.      During this hospital stay, how often did nurses treat you with courtesy and respect? (91.0%+)

2.      During this hospital stay, how often did nurses listen carefully to you? (87.6%+)

3.      During this hospital stay, how often did nurses explain things in a way you could understand? (85.5%+)

4.      During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it? (72.5%+)

5.      How often did you get help in getting to the bathroom or in using a bedpan as soon as you wanted? (74.5%+)

6.      During this hospital stay, how often was the area around your room quiet at night? (76.2%+)

7.      During this hospital stay, how often did the hospital staff do everything they could to help you with your pain? (89.1%+)

8.      During this hospital stay, did doctors, nurses, or other hospital staff talk with you about whether you would have the help you needed when you left the hospital? (86.9%+)

9.      Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? (83.7%+)

10.  During this hospital stay, how often did doctors treat you with courtesy and respect? (96.5%+)

 

These are representative questions from the HHS-directed “compliance protocol” for local hospitals in our area.  In addition to the specific questions, patients were asked to provide overall ratings of the hospital, as well as their willingness to recommend the hospital to others.  These and the results of several other similar questions are then tabulated and an overall rating score for the hospital is derived.  This score is compared to a previously established quality and efficiency compliance standard by HHS. 

 

Do these questions actually tell anyone about the quality or efficiency of the healthcare provided by a local hospital?  It certainly measures a certain sense of patient satisfaction. And this information could be useful to a hospital.  But does it really tell us anything about the medical care provided by the hospital or other healthcare provider?  Does this not merely create an illusion of healthcare quality?  Because won’t hospitals begin to adjust their practices to produce the kinds of results the HHS is trying to elicit?  So, on paper patients will appear satisfied with the kinds of things HHS deems important, but does this really qualify as “quality and efficiency compliance”? 

 

Clearly, HHS uses other standards to measure quality and efficiency.  Hospital readmission rates are reported, as well other information, but the mere reporting of these statistics should be deemed compliance.  However, under the ACA, if results do not match the HHS-established “compliance standards,” hospitals are no longer deemed in compliance with quality and efficiency standards.  As such, in the case of the information provided above, compliance includes the percentage of patients contacted after a hospital stay, and the number of surveys completed by patients, as well as satisfactory results of these surveys.  A hospital is not in compliance if they do not produce satisfactory survey results.  This seems insane.

 

Moreover, each department within a hospital is similarly measured.  A “compliance percentage” for each service is produced by the questions asked.  The score is based on the subjective answers provided by the patients, not by the actual actions of the hospital service in question.  For instance, if a patient answered “yes” to the question, “Do you have any discharge questions,” that is viewed as a negative mark toward the overall compliance score.  Or if a patient answered “no” to the question, “have you set up your follow-up appointment with your physician,” then the compliance score for that department is affected.  This is true even if the department has no responsibility for the patient’s follow-up appointment with their doctor.  Nonetheless, each department is given a compliance score and they are graded by the HHS on whether or not they produce satisfactory compliance scores. 

 

It seems to me that this method for evaluating healthcare delivery is not only inefficient, it ultimately does not measure quality of care, nor does it truly measure efficiency.  It seems to be a bureaucratic political tool to reinforce the illusion that the ACA will improve healthcare in the U.S.  Imagine that hospitals and other healthcare providers begin adjusting their practices to produce high scores according to HHS expectation.  The HHS can then report that the quality and efficiency of healthcare in the U.S. has dramatically improved under the ACA.  However, these statistics actually only demonstrate that healthcare providers have managed to manipulate their practices to produce the image of improvement. 

 

Let me provide a comparison.  In the past, when I took my automobile into my car dealer’s service department for maintenance, I might or might not receive a satisfaction survey.  In the last few years, as I’m leaving the dealer, my service representative now reminds me not only that I will soon be receiving the survey and would I please complete the survey, but that if they do not receive an excellent rating on every question, their commission will be affected.  In fact, they might not even receive a commission if I am not completely satisfied in every single detail of my experience.  As a result, I now answer my surveys as “completely satisfied” on every question.  Why?  Because my service representative is outstanding, and even though other aspects of my experience might be mediocre, I won’t risk him being affected by my answers.  So, the tactic used by the service representatives – i.e. to inform me how the system actually works – affects my responses.  And thus the system only produces the illusion of customer satisfaction.  This is likely to happen with regard to healthcare quality and efficiency compliance as well.

 

If this is the case, then why do it?  Because the people who implement these techniques are not interested in the truth about the issue; they are only interested in the political effect the illusion produces!  Don’t be duped by the way the HHS is utilizing their authority under the ACA.  The mission is political; it is not even remotely connected to improving healthcare delivery.  

 

Egypt's Turmoil 2013: What Happened to Hope?

Not long ago, optimism and hope reigned among many around the globe. An "Arab Spring" seemed to be emerging, with tyrants and dictators overthrown along with their repressive regimes. Back then, one of IDEO's contributors shared a sense of optimism with regard to Egypt's revolution and the toppling of the Mubarak regime. At the same time, they cautioned that Egypt's aspirations for democracy would not be so easily achieved. Their caution was prophetic, for Egypt is once again in turmoil. For the elections in the wake of Mubarak's fall, produced an overwhelming victory for members of the Muslim Brotherhood, an organization not known for its democratic ideals. In Egypt's "first" revolution, muslims, Christians and secularists, liberal leftists and wary conservatives, all stood side by side as they called for Mubarak's ouster and for a new and free democratic Egypt. When their protests grew large enough to topple the Mubarak regime, it seemed Egypt had an opportunity to establish a new and free democratic society. Even when members of the Muslim Brotherhood won the presidency and the majority of seats in the new Egyptian parliament, people still held out hope for democracy. But President Morsi and his parliament chose to impose their own religious, political and economic ideology upon the Egyptian people. They produced a new constitution that failed to protect the liberties and rights of the Egyptian people, especially the religious minorities and secularists in the country. They moved the nation toward an islamist state, dividing the nation even more than it had been. [By islamist, I mean the belief that islam should be the basis for law and society, thereby ignoring -- even repressing -- the rights of those who do not agree with the tenets and beliefs of Islam, and in some cases preventing non-muslims from having any significant role in governing or making of laws.] While Morsi's dream for Egypt did not seem as extreme as the mullah controlled regime of a nation like Iran, it, nonetheless, oppressed and repressed the sizable minorities in the country who wanted their own rights and freedoms to be protected, not dictated, by the government. Of course, there were economic realities that contributed to the current "second" revolution, but these seem to be secondary. One need only look at the rhetoric espoused by Morsi supporters and critics alike. Morsi supporters claim that the revolution is anti-Islam and that protestors are upset that Morsi and the Egyptian parliament passed a constitution along with several laws that would bring Egypt in line with islamic law or principles. Anti-Morsi protestors cry out for freedom and complain that Morsi and his supporters were trying to make Egypt more islamist and less democratic. Both sides seemed to be in agreement; however, one views Morsi's political moves as good and morally right, while the other considers these moves anti-democratic and morally unjust. As our earlier IDEO contributor suggested, without political inclusion of minorities in the crafting of Egypt's new laws and constitution, the result would be a failure to achieve democracy. As A. Hussein suggested, democracy is difficult to achieve. But one thing is certain: whenever any group, religious or otherwise, imposes its view of "the good" upon others in a society, democracy is not present. And in the case of "democratic" political structures where majorities control via the electoral process, this is all the more evident. In 1780 John Adams put it this way: even when majorities when elections, a "tyranny of the majority" is still possible. We have seen this in America on many occasions, and we are now witnessing the consequences of this in Egypt. A. Hussein's and John Adams' caution is still relevant: majority rule is not equivalent to democracy or its relative, the republican/representative form of governance. Let us not give up on true democracy, for at its root, its goal is the freedom to govern ourselves and chart our own destiny as free individuals.

REFLECTIONS ON THE U.S. LABOR MARKET

Recent debates regarding the health of the U.S. economy have included questions about how the U.S. unemployment rate is calculated.  For instance, the U.S. Bureau of Labor Statistics (BLS) calculates a monthly unemployment rate in the U.S. by dividing the number of unemployed adults (age 16 to 65) who are still looking for work by the sum of both the total number of employed persons and this number of unemployed adults who are still looking for work.  Some adults are not in the unemployment rate, including people are not able to work, such as disabled persons.  Most important, however, is the fact that the unemployment rate does not include adults who have stopped looking for work.  How do we know what the real unemployment rate is?  How many adults who are able to work are both unemployed and not included in the unemployment rate?  At the very least, this problem makes the unemployment rate potentially insufficient for gaining an accurate measure of the health of the U.S. labor market.  So, in our current economic climate is the unemployment rate a good barometer of the health of the U.S. labor market?

Many economists argue that a better barometer of the health of the U.S. labor market is the labor participation rate.  The labor participation rate is essentially the percentage of the total number of adults who can work who are actually employed.  Another term for this number might be the U.S. employment rate.  It is the percentage of all adults age 16 and older who are actually employed.  Let’s consider for a moment the history of the U.S. labor participation rate, and ask whether or not the U.S. labor market is showing signs of genuine recovery since the crash of 2008.

After the end of World War II, from 1945 to 1963, the U. S. labor force generally held at a steady labor participation rate or employment rate of around 59%.  After 1963, however, a steady rise in the employment rate of the U.S. labor force began an unprecedented forty-five year growth in the size and active participation of American labor in the overall U.S. economy. 

                From 1963 to 1990, the average employment rate grew from 58.7% in 1963 to a high of 66.5% in 1990, despite several recessions during these years.  The U.S. recession of the early 1990s resulted in a slight retreat from this trend, but by the end of 1994, a return to this trend became clearly evident.  By 1996, this long trend in U.S. labor growth peaked at a labor participation rate of 67.1%, followed by a flat plateau of 67.1% for four full years, despite the economic growth at the time.

                After September 11, 2001, however, the U.S. employment rate began a gradual, albeit minor decline for nearly a decade, sliding from a rate of 66.8% in 2001 to 66.0% in 2008.  Given the collapse of the tech market after 2000, the tragic events of 9/11 in 2001, the Enron and MCI/ WorldCom collapses of 2003, and the financial burdens of two expensive Middle East wars, this slow decline in the U.S. employment rate might be seen more as a signal of a slight to moderate weakening of the U.S. economy than a necessary long term trend regarding the future of the U.S. labor market.  Indeed, without the economic collapse of 2008, this 0.8% gradual decline over eight years might have been seen merely as a plateau in the labor market due to critical economic stressors during the period. 

                Unfortunately, more serious economic issues emerged in late 2007 and 2008, resulting in a major crash of the U.S. stock market in late 2008.  The crash, which followed a serious weakening of the U.S. housing market, was sparked by the collapse of several major financial companies, most importantly American Insurance Group (AIG), as well the powerful investment firms of Bear Stearns and Lehman Brothers.  What followed was a panic in the global market, leading to further erosion of titan companies like auto giant General Motors. 

To slow the downward spiral of world markets and the U.S. economy, U.S. President George W. Bush initiated a near-trillion dollar rescue package known as TARP (Troubled Asset Relief Program).  Despite this effort, it took President Barak Obama's administration and the Federal Reserve Bank nearly another trillion dollars in 'stimulus' as well as two 'quantitative easing' efforts to stop the bleeding and stabilize the U.S. economic situation. 

                This attempt at remedying the woes of the U.S. economic system, however, did little to stop a precipitous drop in the U.S. employment rate.  The U.S. economy shed jobs after the crash of 2008 at a rate unseen since the late 1920s and early 1930s.  And despite all protestations to the contrary, the shedding of jobs in the U.S. economy steadily declined from early 2009 until January 2012, which U.S. Bureau of Labor Statistics’ labor participation rates clearly reveal (http://data.bls.gov/pdq/SurveyOutputServlet).  The U.S. labor participation rate dropped from 65.7% in January of 2009 to 63.7% in January of 2012, two full percentage points.  The last time the U.S. saw a consistent labor participation rate this low was 1979 to early 1981.  In fact, it took a full decade of vigorous economic expansion during the 1990s to increase the U.S. labor participation one percentage point.  It could well take unprecedented economic growth beyond anything we've ever seen to recover these losses even in two decades.  This is something to ponder.

                Finally, the serious weakening of the U.S. labor market over the last four years notwithstanding, some pundits today, desperate for good news on the economy, believe the slide may be coming to an end.  The first quarter of 2012, they argue, seems to indicate a small but positive change in the U.S. economy, given that the labor participation rate grew from 63.7% in January to 63.8% in March 2012.  Unfortunately for the optimists, the most recent labor report (April 2012) revealed a labor participation rate of 63.6%, which marks a continuation of the steady decline in the U.S. employment rate since early 2009.  Clearly, whatever other economic indicators may reveal, the U.S. labor participation rate is showing no signs of improving, which, pardon the pun, is definitely a troubling sign.  In fact, for all the talk of an improving economy by the Obama administration, this one indicator at least is shouting that something is rotten in Denmark… um … in the American economy.  Hang on to something, folks.  The rough ride doesn’t seem to be going away any time soon.  And if the European economic crisis doesn’t stabilize soon, things may get even rougher over here.  

 

---- David Adcock, Managing Editor

 

Pursuit of Democracy for Egyptians

I witnessed history unfold in front of my eyes. I impatiently switched channels between Al-Jazeera the Arab channel and CNN; I watched President Mubarak's representative bravely announce Mubarak's resignation. I couldn't believe it; it felt surreal that I had the opportunity to witness people standing up for their rights, revolting against an old regime and demanding justice, in my lifetime.  We always studied about the past and other rights movements especially the civil rights movement, rights people fought and died for, but I never thought I would get the opportunity to witness that taking place. I was overcome with joy and hope for the Egyptian people. They persevered and had tenacity and even went beyond the naysayers. I was proud, today I felt like an Egyptian.  However, as much as I tried to stay in the moment, and enjoy history unfolding in front of me, I recognized the hard work ahead for Egyptians and all nations surrounding Egypt. The Egyptians demanded and fought for freedom and democracy. I believe God is giving them an opportunity to put those theories in to practice. Aristotle states the hardest form of government to run is a democracy. It is hard because people with different point of views have a say in how the government is run.  Egyptians must define their idea of a democracy, what form of democracy they want for their country, and how they will avoid returning to the old regime they ousted. As a philosophy graduate, I had the opportunity to study different views and the outcomes of those views. I will explain the causes of a revolution in an oligarchy, and factors to consider in the process of beginning a democratic state. I hope I can offer meaningful advice to my Egyptian brothers and sisters and all nations surrounding Egypt.   What stirred these revolutions in the Middle East? Not many people pondered this question, but I think it is poignant to ask and study these causes. The uniqueness of human nature means we have a history to which we may refer and which may apply to our current situation. Aristotle raised these questions in the Politics; I think it is worth studying his perspectives on revolutions. Aristotle notes revolutions arise from inequalities, numerical or proportional; i.e., from a numerical mass claiming equality denied them, or from a minority claiming superiority denied them. Aristotle informs us that a revolution may result in a complete change of government or a modification of the existing one. Egypt had an oligarchy government, so I will discuss Aristotle's definition of an oligarchy and the causes of a revolution in an oligarchy. According to Aristotle, an oligarchy government has in view the interest of the wealthy. An oligarchy is when men of property have the government in their hands. The leader looks out for the interest of the elite group; it is the government of the few and the wealthy. In an oligarchy the majority of the citizens have some property, but not very much; it allows any citizen who obtains the required amount of property in sharing in the government. The elite groups make the law represent their wishes. This form of oligarchy leads the ruler to amend the law so that the son shall succeed the father. So what causes a revolution in an oligarchy system according to Aristotle? In an oligarchy, revolution arises from the oppressive conduct of an oligarchy leader. In Egypt, Mubarak began as a moderate leader; he improved the conditions of Egypt. However, power and wealth led him to be dissonant from the wishes and desires of the people. He created an elite group and kept much of the wealth of the nation within his inner group. After recognizing Mubarak intends his son to take his place; Egyptians could no longer take the oppression of Mubarak. The Egyptian people felt deceived by Mubarak, they saw his corrupt ways and violence his army committed against the people. Egyptians erupted and there was no way stopping them, until granted their wishes. John Donne in Meditations XVII quotes "No man is an island, entire of itself; everyman is a piece of the continent, a part of the main"; this quote should guide the Egyptians. To become a democratic state, the people must be in it together. One group that defies the concept of democracy potentially destroys the evolving nature of democracy. People view America as a democracy, but even America has a long way to reach democracy. Democracy is the hardest government to run. People die and kill each other to reach democracy. I hope Egyptians do not reach to that level. To avoid dire circumstances, Egyptians must first define their idea of democracy with inclusion of other religions in the country. They must decide what form of democracy they want for their people. Remember, democracy doesn't equate to majority rules. All people must be represented in the system.  Aristotle, James Madison, Tocqueville, and John Stuart Mill expressed their fear of the tyranny of the majority. Who will protect the minority if the majority forces its beliefs on the minority? The only solution, I believe, is a 'checks and balance' system in the election process, to make sure the law protects the minority. Aristotle warns of this in The Politics and considers it a potential cause of a revolution in a democracy. We must not resort to oppression and unfair treatment of minorities. I know many consider religion to be ideal with government; however, we must understand religion is a personal choice and should come from an intuitive choice, not enforced externally. Islam requires Muslims to teach others about Islam, but also to allow them to practice their own faith.  Egyptians must understand that just because a majority wins, this doesn't necessarily equate to fair representation of the people. Secondly, Egyptians must focus on creating a constitution and improving the conditions in Egypt, before worrying about international interest. Only, when a nation is settled and developed does it worry about allies and others. Egyptians must first create a democratic, strong Egypt before dealing with other nations. Remember, a nation's word matters in the international arena, when the nation has a strong cooperative nation. I would like to warn the future Egyptian leader to be wary of the capital interests of the super power nations. What I mean by this is, the super nations like the US, Europe, and other countries offer large sums of money to ask a nation to support them in a cause. I believe this is wrong and unethical; whenever money is involved in a peace treaty, I think it deteriorates the notion of peace. Money does not bring peace; it creates resentment, which leads to anger and a revolution. I believe this is what led Mubarak to his downfall; he did not listen to the concerns of his people. Egyptians must be very careful in their strategies for creating a better government for themselves. Once Egyptians concretely figure out their concept of democracy and freedom, Egyptians will be ready to choose their leader. When electing their leader and creating their constitution, I would urge the people of Egypt to please consider the following: 1.  Egyptians must understand that secularism doesn't mean democracy; it is a particular attitude that may be held within a democracy, but it can be held in other forms of government as well.  And it should be noted that secularism may lead to worse conditions.  So, Egyptians should focus on democracy, not necessarily on secular notions of governing.  2. Egyptians must not rely on the government for funding or providing economic security in the form of welfare; they must focus on creating a prosperous Egypt that leads to economic independence. Nonetheless, Egyptian leaders and the people must find a way to protect the poor. Egypt has a strong history, and this movement is part of that history. 3.  Create a strong government system that creates a balance and check system between the different branches.  Don't give too much power to the executive leader, whether that person is called president, prime minister or whatever.  If Egyptians do this, this could lead to another tyrant leader.  So, Egyptians should be very cautious in this transition period. Some groups who are not interested in genuine democracy will attempt to take advantage of the chaos of this time of transtion. Egyptians must not allow these groups to derail Egypt's new opportunity for democracy. -- A. Hussein, IDEO contributor

Innaharda, ehna kullina Misryeen… Today, we are all Egyptians

For nearly three weeks now, the streets of Cairo, Egypt have been flooded with thousands of protesters calling for Egyptian President Hosni Mubarak to step down after thirty years of oppressive rule.  Complicating matters for the U.S., Mubarak has been a loyal friend of the U.S. and a stabilizing force in the region against radical Islamist extremism.  Moreover, there are some indications that Islamist groups like the Muslim Brotherhood are taking advantage of this opportunity to press their own agenda, causing some in the west to fear a repeat of the Iranian revolution of 1979.   Caught in the middle are the vast majority of Egyptian nationals who simply want a better life with more freedoms, especially freedom from the oppressive tyranny they have been enduring for the last thirty years.  Yet, for the second time in two weeks, today Mubarak has declared he will not step down until September.

As Americans, it is right for us to sympathize with the Egyptian people.  One of my former students' recent Facebook posts reflects the right attitude:  "Innaharda, ehna kullina Misryeen.  Today, we are all Egyptians!"  But which Egyptians?  This is our real dilemma as Americans.  Certainly, many of us would welcome a secular democracy in Egypt, where individuals are free to pursue their own  dreams, while respecting the rights of other Egyptians to do the same.  This is perhaps our main objection to groups like the Muslim Brotherhood.  Any group which imposes its own ideology on its fellow citizens is not only morally repugnant, it is antithetical to genuine democracy.  This is true whether the group is religiously motivated or politically motivated by left or right wing ideologies. 

How do Egyptians find a path to genuine democracy when organized protest is the means by which they hope to achieve political victory?  While many of the protesters are crying freedom as the basis for their political action, what do these activists mean by 'freedom'?  The English language site for the Muslim Brotherhood, for instance, implies that its real agenda is freedom.  However, a careful analysis of both their English and Arabic websites indicates an Islamist agenda, where Islam and Sharia are imposed upon society.  This is because to many Islamists, true freedom and peace come only from total submission to Allah (Islam) and Allah's Law (Sharia).  So, for these believers, freedom can be imposed from the outside simply by establishing a theocracy in accordance with the Qur'an and Hadith, at least a particular reading of these. 

In contrast, American Christians, particularly Protestants, have a unique perspective on the American notion of democracy.  The European religious struggles in the 16^th and 17^th centuries led to intense persecutions and wholesale disenfranchisement for those who did not belong to the dominant religious group of a region or country.  My own family heritage involved persecution and death at the hands of French Catholics, since my ancestors were French Huguenots.  Having fled to Nova Scotia to avoid persecution, arrest and death, my forebears eventually migrated to an isolated rural part of French speaking Louisiana, in what is sometimes referred to as Cajun country today.  These family members resisted the systematic pressures of Catholic practice, even marrying relatives in order to avoid becoming Catholic.  Even when Louisiana became part of the United States, it took nearly a century and a half for Protestants in the region to feel genuine freedom from religious oppression and pressure. 

As a Baptist, I also have a keen awareness of the religious persecution and struggle involved in the formation of the United States in the late 18^th century.  Baptists were influential in getting the freedom of religion clause included in the U.S. Constitution's Bill of Rights.  Baptists were a religious minority in both New England and Virginia, and knew first hand the political difficulties faced by minorities in any system of government.  They wanted to make sure their religious liberties were protected; however, they also knew that in order to secure their own liberty, they must protect the liberties of those with whom they disagree.  This is a fundamental aspect of American democracy, and all notions of democracy must include this basic principle in order to qualify as a genuine form of democracy.  This alone accounts for why Americans could not accept an Islamist involvement in a democratic Egyptian government.

    I could include American and European Jews, or other minority religious groups living in America in my discussion of the problem of achieving genuine democracy.  African-Americans, Native Americans, immigrants from Mexico and elsewhere, all face similar difficulties of disenfranchisement, and sometimes persecution and outright hostility.  We are all well aware of the horrors and evil of racial slavery, and how an entire population was systematically exploited, abused and oppressed solely based on the color of one's skin.  And this evil was not remedied simply by the removal of slavery as a sanctioned social institution.  Even today, democracy is difficult in our country.  Some feel that the political and legal mechanisms and institutions in place today still have not granted true equality for many in our country.  Economic, political and social injustices still persist, in spite of our dreams of a truly democratic America. 

As you might be able to tell at this point, I do not see "majority rule" or "one person one vote" as the basis for democracy.  My notion necessarily includes both individual liberty and self-determination (self-governance) AND minority protections.  When any group, even a majority, can impose its will upon another, democracy is not present.  This is one of the main reasons the founders of American democracy tried to constitutionally limit the power of the federal government.  When a small group of people – a centralized government – can dictate its will, overriding the will of the local community or state, democracy is lost.  It is no different than the Muslim Brotherhood or other Islamist group dictating its religious ideology as sovereign law.  American democracy, in order to remain genuinely democratic, must remain predominantly decentralized, with a cooperative 'republic' forming the basis of national action.  This is the fundamental basis of American democracy.

If Egypt is to transition toward a genuine democracy, the people must have constitutional and political protections against the rise of Islamist rule, or even against a tyranny of the majority.  Minority rights and liberties must be protected and guaranteed.  The right of dissent is not an absolute right, meaning dissent cannot be used as a club to impose the will of the minority upon the majority.  However, without the right to dissent, democracy is equally impossible.  Egypt must find a way to navigate the treacherous waters of disagreement democratically if it is to eventually achieve some semblance of genuine democracy.  It has taken America over two hundred years and we are still struggling toward this ideal.  Certainly, it will take time in Egypt as well.  But if democracy in this sense is the goal of the Egyptian people, then truly today we are all Egyptians!

               -- David Adcock, managing editor