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War — and Health Care — on the Cheap

By KIM BELLARD

Like many of you, I’m watching the war in Ukraine with great interest and much support. For all the fuss about expensive weapons — like F-16 fighters, Abrams tanks, Stryker and Bradley armored fighting vehicles, Patriot missile defense systems, Javelin anti-tank missiles, Himars long range missiles, and various types of high tech drones — what I’m most fascinated with is how Ukraine is using inexpensive, practically homemade drones as a key weapon.

It’s a new way of waging war. And when I say “waging war,” I can’t help but also think “providing health care.” It’s not so much that I think drones are going to revamp health care, but if very expensive weapons may, in fact, not be the future of warfare, maybe very expensive treatments aren’t necessarily the future of healthcare either.

Just within the last two weeks, for example, The New York Times headlined Budget Drones Prove Their Value in a Billion-Dollar War, AP said Using duct tape and bombs, Ukraine’s drone pilots wage war with low-cost, improvised weapons, ABC News reports: Inside Ukraine’s efforts to bring an ‘army of drones’ to war against Russia, and Defense News describes how Cardboard drone vendor retools software based on Ukraine war hacks.

This is not the U.S. military-industrial complex’s “shock-and-awe” kind of warfare; this is the guy-in-his-garage-building-his-own-weapons kind of warfare.

Ukraine’s minister for digital transformation, Mykhailo Federov, says the government is committed to building a state-of-the-art “army of drones.” He promises: “A new stage of the war will soon begin.”

NYT detailed:

Drones made of plastic foam or plastic are harder to find on radar, reconnaissance teams said. Ukraine buys them from commercial suppliers who also sell to aerial photographers or hobbyists around the world, along with parts such as radios, cameras, antennas and motors. The drone units mix and match parts until they find combinations that can fly past sophisticated Russian air defenses.

“The doctrine of war is changing,” one Ukrainian commander said. “Drones that cost hundreds of dollars are destroying machines costing millions of dollars.” The AP discusses how an elite drone unit – “a ragtag group of engineers, corporate managers and filmmakers” — “assembled with just $700,000, has destroyed $80 million worth of enemy equipment.”

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Ukraine’s Secret Weapon – “Moral Superiority”

BY MIKE MAGEE

Two hundred and ten years ago, on September 7, 1812, a Putinesque commander, narrowly won a battle, but lost a war and entered a downward cycle that ended his reign. The battle was the Battle of Borodino, a town on the river Moskva, 70 miles west of Moscow. The commander was Napoleon.

The facts are clear-cut: Napoleon arrived with 130,000 troops, including his 20,000 Imperial Guards, and 500 guns. Opposing him were 120,000 Russians with 600 guns. The battle engaged from 6 AM to Noon. The French took 30,000 casualties, while the Russians lost 45,000 men, but survived to fight another day.

As Leo Tolstoy describes the scene of carnage on page 818 of his epic novel, War and Peace, in 1867“Several tens of thousands of men lay dead in various positions and uniforms in the fields and meadows where for hundreds of years peasants of the villages…had at the same time gathered crops and pastured cattle. At the dressing stations, the grass and soil were soaked with blood over the space of three acres. Crowds of wounded and unwounded men of various units, with frightened faces, trudged on…Over the whole field, once so gaily beautiful with its gleaming bayonets and puffs of smoke in the morning sun, there now hung the murk of dampness and smoke and the strangely acidic smell of saltpeter and blood. Small clouds gathered and began to sprinkle on the dead…”

But in the next paragraphs, it becomes clear that Tolstoy’s intent and focus is not to describe why and how Napoleon had won the Battle of Borodino, but rather how this was the beginning of the end of his army and the Napoleonic reign.

Tolstoy writes: “For the French, with the memory of the previous fifteen years of victories, with their confidence in Napoleon’s invincibility, with the awareness that they had taken part of the battlefield, that they had lost only a quarter of their men, and that they still had the intact twenty-thousand-man guard, it would have been easy to make the effort (to advance and annihilate the Russians)….But the French did not make that effort….It is not that Napoleon did not send in his guard because he did not want to, but that it could not be done. All the generals, officers, and soldiers of the French army knew that it could not be done, because the army’s fallen spirits did not allow it….(They were) experiencing the same feeling of terror before an enemy, which, having lost half his army, stood as formidably at the end as at the beginning of the battle. The moral strength of the attacking French was exhausted…(For the Russians, it was) a moral victory, the sort that convinces the adversary of the moral superiority of his enemy and of his own impotence, that was gained by the Russians at Borodino.”

The Russians not only retreated, but did not stop in Moscow, continuing another 80 miles beyond their beloved city. But as Tolstoy describes, “In the Russian army, as it retreats, the spirit of hostility towards the enemy flares up more and more; as it falls back, it concentrates and increases.” 

As for the French, they take Moscow but stop there. Again from Tolstoy, “During the five weeks after that, there is not a single battle. The French do not move. Like a mortally wounded beast, which, losing blood, licks its wounds, they remain in Moscow for five weeks without undertaking anything, and suddenly, with no cause, flee back…without entering a single serious battle…”

Putin’s aging dreams of conquest likely are Napoleonic in scale. But as his hesitant forces observe the Borodino-like human carnage that they have unleashed on Mariupol, at the estuary of the Kalmius and Kalchik rivers, and prepare to enter Kyiv, the first eastern Slavic state which, a Millennium ago, acquired the title “Mother of Rus Cities”, their vulnerability and lack of “moral strength” is already apparent. Lacking a rational stated goal other than dominance, the young Russian conscripted soldiers and their commanders must certainly grow more concerned day by day.  They too have become entrapped, and are “experiencing the same feeling of terror before an enemy, which, having lost half his army, stood as formidably at the end as at the beginning of the battle.” 

As for Putin, like Napoleon, he may feel the winds of fate blowing heavily on his shoulders even now. Napoleon did make it back to Paris. But three years after the Battle of Borodino and the 5-week occupation of Moscow, he met his Waterloo on June 16, 1815, at the hands of the Duke of Wellington.  He died in exile on the island of Helena on May 5, 1821. In his last will, he wrote, “I wish my ashes to rest on the banks of the Seine, in the midst of that French people which I have loved so much.”

Putin likely feels a similar love for Mother Russia, but ultimately the Russian people may choose not to return the affection.

Mike Magee, MD is a Medical Historian and Health Economist, and author of  “CodeBlue: Inside the Medical Industrial Complex.“

When Crypto Comes to Health Care

By KIM BELLARD

The conflict between Ukraine and Russia has been called many things.  To most of the world, of course, it’s considered an invasion, a war between the two countries.  To Russia, it’s a “peacekeeping” mission.  The description that I can’t get out of my head, though, is one that I believe The Washington Post first used:  it’s the world’s first crypto war.  

“There is something about the war in Ukraine that feels different,” a former U.S. intelligence official told Nick Bilton. “We’ve seen wars documented on Twitter and images shared on the internet before, but this time it isn’t just bombs and bullets; this war is digital from the top to the bottom.” And, Mr. Bilton says: “At the center are cryptocurrencies.”  

If crypto has come to war, can healthcare be far behind?

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Reflections From the Ukraine

By MIKE MAGEE

The English translator of Tolstoy’s epic Russian novel, “War and Peace”, Richard Pevear, writes in his introduction, “The book is set in the period of the Napoleonic wars (1805-1812) and tells the interweaving historical events of two very different families of the Russian nobility – the severe Bolonskys and the easygoing Rostovs – and of a singular man reminiscent of the author himself – Count Pierre Bezukhov. It embodies the national myth of ‘Russia’s glorious period’ as Tolstoy himself called it…”

On page 348, in a moment of intense introspection, the very same Pierre broodingly reflects, “What is bad? What is good? What should one love, what hate? Why live, and what am I? What is life and what is death? What power rules over everything?”

Pierre’s mind provides this very dark response, “You will die – and everything will end. You will die and learn everything – or stop asking.”

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