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In a new WSJ/NBC New poll, conducted July 24-27, 2009, 42% called the Obama health plan a bad idea, and 36% called it a good idea. In mid June the poll showed Americans evenly divided on this question. It reflects rising anxiety over the costs of the health plan and what it will do to the deficit, and also shows public anxiety about the ways in which Obama and Congress are reaching compromises to pay for it and to control costs. Added to this are the anxieties raised about government involvement in healthcare and medical decisions about care. Noteworthy are two differing pieces of evidence. In the WSJ/NBC News poll, only two in ten people thought the quality of their own care would improve, only 15% of those with private insurance thought that it would improve the quality of their care. And 4 in ten people thought quality of care would get worse, and 45% of those with private insurance thought quality of care would get worse. By focussing on the cost of health care, the administration seems to have ignored or missed the concerns of people about the quality of care if government focussed on cutting costs. These concerns are real as a vast majority of the public, or about 85% of the people, as Martin Feldstein points out in a recent Washington Post column, are insured. The question is what cost would they be willing to pay for the admittedly worthy cause of insuring the uninsured? And even with the unisured, it seems likely with the current Obama reform plan that immigrants and other people may still remain uninsured, at least for some time. Would a huge burden of $1 trillion make this worthwhile, and is there some better way to do this without the prospect of higher taxes further down the road to pay for this. These are points Feldstein makes. The other piece of evidence is that at the same time that there are reservations about what is coming out of Congress today, there is general support for making constructive changes to healthcare. The WSJ poll showed 56% of respondents favoring the basic ideas in the reforms being considered in Congress, with 38% opposing it....

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The Economist points out that the last thing President Obama needs - when he has serious domestic and foreign policy goals- is another Vietnam. Just as Bush's presidency was seriously affected by Iraq, Obama's presidency it says would be seriously affected by Afghanistan. And the Economist emphasizes as General Chrystal's chief conclusion: "an insurgency cannot be defeated by aforeign army alone." It points to General Chrystal's view that success means winning the support of the people, and the loss of faith in the government of Karzai. Obama and Biden will have noted this as they have growing doubts of their own about the widespread fraud seen in the Afghan election. Ground reports from Afghanistan support this assessment about acomplete loss of support for the Karzai government. See Intelilinks.

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One US military official says that there is very little respect and regard for each other between General McChrystal and Vice President Biden, going so far as to say that both men hate each other's guts. Personal strains, and the difficulties in Afghanistan compound the differences.

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Problems that may be unfixable for the Afghan national army, and for which no increase in foreign trainers could make a difference. About 3% of the army recruits are from the Pushtun south, the main part of the country, where the Taliban are strongest. Officers from the northern areas have to use translators in the Pushtun south, a bad sign. And there is a shortage of officer talent. Gereral Caldwell who is working on training the army, says he was appalled at the emphasis on quantity not quality- the Afghan army has reached 134,000 in numbers. The ratio of instructors to recruits ranges from 1 to 80 to 1 to 466. It will cost $11 billion to maintain compared to an estimated $1 million per American soldier each year. Even if training problems are fixed, having 3% of recruits from the major Pushtun part of the country where the fighting is being done, simply makes the overall problem unfixable. See the group - Defense Department biannual report on Afghanistan, for related insight.

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General McChrystal gets the support he is looking for against the Taliban in Afghanistan, as Gates, Obama and Clinton, make the decision to continue backing the Karzai government, even though it is very unpopular and the ground reports suggest that this would be amistake. It was NATO that announced the support because the Obama administration had deep concerns about the Karzai government. The US and the UN representative Kai Eide wanted to see arunoff for the elections but the "assumption" that he would be reelected suggests the Obama administration, the UN representative, and the UK and Canadian foreign ministers in ameeting have decided to continue the war in Afghanistan on Karzai's side.

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Richard Barrett, former head of overseas counter terrorism operations of Britain and now head of the UN AlQuaeda and Taliban monitoring group, in aspeech to the Washington Institute of Near East Policy, says Al Quaeda is a diminishing threat because a new generation of Muslims who have little recollection of the events and are less interested in religion. And CIA officials say they are having greater success penetrating Al Quaeda, because of vastly improved intelligence capabilities. In terms of intelligence and capabilities, the technical colllection, intercepts are much better, and overhead surveillance is much better. The human intelligence is much better and they have fewer competent people.

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A native of Turin, who was a debonair lawyer then retrained as a physiotherapist, is beloved as "Alberto" to the Afghan people. He runs the Red Cross Afghan Rehabilitation Center in Kabul, and is the most loved westerner in Afghanistan. Its a visible location, but in all these years of war it has never been attacked. In the tradition of the Red Cross founded in 1860 as a neutral entity, the Red Cross's orthopedic centers make no distinction by political affiliation and help combatants on all sides because only the name is asked, as well as civilians who have lost legs to landmines. About 90,000 people have received new limbs since 1988, and 70,000 revisit the centers each year for replacement or adjustment of their prostheses, which last an average of 2 to 3 years for adults and as little as 6 months for children. All the treatments, including overnight stays at the centers that can run for weeks, are free. About 10 million mines were strewn across the landscape in the Soviet invasion from 1979 to 1988. Because most of these mines have been cleared by the UN and charities like the Britain's Halo's Trust, patients now recieve help for congenital deformities, polio, tuberculosis, and accidents as well as other war injuries....