US AND THE WORLD

Why Trump’s ‘America First’ stance is detrimental to the foreign policy of the US

Empathy, and not more munitions, may be key to establishing peace and ameliorating global suffering from terrorism and war.

Donald Trump’s foreign policy is bereft of any overarching debate over the urgent threats confronting the United States and the entire global system. The most serious threats, easily identifiable, include war, terrorism and genocide. To counter such complex threats, whether as Americans or “world citizens,” it’s vital to bear in mind that these two identifications overlap and are mutually reinforcing.

Taking a narrow “America First” stance on terrorism ignores the intersecting nature of major terrorist groups and organisations, quickly leading to unstable situations. For example, Trump’s needlessly announced preference for certain Sunni dictatorships over Shiite dictatorships, or for selected Sunni dictatorships like Saudi Arabia over other Sunnis like Qatar, introduces more instability in West Asia. If US foreign policy were conceptualised, originally, from a broadly system-wide perspective rather than from a self-defeating stance of “America First,” Washington could establish a single plausible criterion of support and intervention. Such an unwavering standard would benefit the US and its allies, while simultaneously countering the core strategic interests of relevant adversaries.

The Trump administration recently signed a southern Syria ceasefire agreement with Russia, underscoring a particularly visceral America First strategy for dealing with Damascus. Among other liabilities, this agreement perpetuates Iran’s unhelpful presence in Syria. Taken together with Trump’s soon-to-be expected endorsement of the Allen Plan for Palestinian statehood – a plan, that would inter alia, replace Israeli troops in the Jordan Valley with UN forces – the new ceasefire calls upon Moscow to secure Israel’s border with Syria, undermining regional order in general and Israel in particular.

Global oneness

The president and his counselors must cope with such intersecting perils that require far more than “common sense.” Many might ask: what would a suitably more thoughtful American foreign policy actually look like? Answers depend on a myriad of individual human needs and expectations. Demonstrably global elucidation, either intellectually or “operationally,” is not easy.

Determinative factors include “aloneness,” not fully belonging to a specific tribe, nation or faith, and the primal human fear of simply “not being.” Individual fear of death can contribute to collective violence, yet the insight also reveals an overlooked opportunity for widening human empathy.

Only a serious attempt to understand an imperative global oneness can save the United States from irremediable hazards. Significantly, Trump’s America First orientation represents the opposite of this sorely needed global effort and could undermine any remaining chances for meaningful safety. As for the planet’s physical environment, Trump is indifferent to climate change studies and the global ecology. US withdrawal from the Paris accord on climate change is a retrograde abrogation that undermines US and global interests while placing billions of people on an unalterable trajectory of human declension.

Instead, national security is about collective human growth and species survival. In global politics, true remediation requires sincere depth of analytic thought and a fully imaginative and broadly global set of policy understandings. Power over death is the most eagerly sought-after form of power in world politics. Perhaps this is why science and technology notwithstanding, cruelty still reigns throughout the world – unreformed, undimmed and proudly undiminished. Historically, a juxtaposition of healing and murder is not without precedent. In Syria, dictator Bashar al-Assad is a trained ophthalmologist. During the Holocaust, death camp gassings were identified as a “medical matter,” supervised by physicians.

More than many might care to admit, education and enlightenment have had precious little tangible bearing on the “human condition.” Prima facie, too, steadily expanding technologies of mega-destruction have done little to transform people into more responsible stewards of this endangered planet. Instead, with unhindered arrogance, whole nations continue to revel in virtually every conceivable form of mass neglect and violence. Most of the time, this ominously primal immersion is advanced as some sort of immutably zero-sum or us-versus-them struggle for domination.

Far too many often take delight in observing the sufferings of others. The specific German term for experiencing such twisted pleasure is schadenfreude. To what extent, if any, is this markedly venal quality related to our steadily-diminishing prospects for building modern global civilisations upon aptly resurrected premises of human oneness? To what extent, if any, does this corrosive trait derive from human death fear? This is a crucial question for rational formulation of American foreign policy and for certain corollary obligations of global consciousness.

Sigmund Freud argued that the human unconscious behaves as if it were immortal. Still, however widely disregarded, an expanded acceptance of personal mortality may represent the last best chance for the United States to endure as an enviable nation. This represents the very opposite of America First and the ongoing association of immortality with inflicting grave harms upon others.

Viable forms of wider cooperation represent the only credible path toward moving beyond schadenfreude. Such core orientations are not mutually exclusive, but rather mutually reinforcing. Death “happens” to us all, but acceptance is more than most humans can bear. At times, it is almost as if dying had somehow been reserved exclusively for “others.”

Most of us do not choose when we should die. Still, we can choose to recognise our common fate, and thereby our unbreakable interdependence. This powerful intellectual recognition could carry with it an equally significant global promise.

Ironically, regardless of divergent views on what actually happens after personal death, the basic mortality shared by all could represent a chance for global coexistence. This requires the difficult leap from acknowledging a shared common fate to actually “operationalising” more generalised feelings of needed empathy and caring.

Across an entire planet, we can care for one another as humans, but only after accepting that the indisputable judgment of a resolutely common fate will not be waived by palpable harms deliberately inflicted upon “others” through war, terror and genocide. Always, our just wars, counterterrorism conflicts and anti-genocide programs must be fought as intricate contests of mind over mind and not just narrowly tactical struggles of mind over matter.

Ultimately, only a dual awareness of death as our common human destination and the associated futility of sacrificial violence can offer an accessible defense against the Islamic State, North Korea, Russia, Iran and other adversaries in the global “state of nature.” This “natural” or structural condition of anarchy was well known to the founding fathers of the United States, and only this difficult awareness can relieve an otherwise incessant Hobbesian war of “all against all.”

Significantly, US advisers HR McMaster and Gary D Cohn articulated a “Trump Doctrine” premised on fully Hobbesian perspectives: “President Trump has a clear-eyed outlook that the world is not a ‘global community,’ but an arena where nations, nongovernmental actors and businesses engage and compete for advantage.” They then added as a concessionary coda: “Rather than deny this elemental nature of international affairs, we embrace it.”

American democracy was founded upon authentic learning and not flippantly corrosive clichés or abundantly empty witticisms. Human death fear has much to do with a better understanding of enemies. Reciprocally, only a people who can feel deeply within itself the unalterable fate and suffering of a broader global population can embrace genuine compassion and thereby reject collective violence.

America can never be truly “first” as long as its president insists upon achieving such misconceived status at the unavoidable expense of others. Inevitably, the Trump administration must recognise that American and global survival remain not only bewilderingly complicated, but also mutually interdependent and inextricably intertwined.

Global politics are never a “zero-sum” game or a furiously merciless contest wherein one country’s expected gain requires another’s loss. Apropos of French philosopher Pierre Teilhard de Chardin’s relevant wisdom, no single player in this grievously complex global system can expect to survive and prosper except “with and by all the others with itself.” For President Donald Trump, there is still time for lucidity, but not a great deal of time.

Louis René Beres, Emeritus professor of international law at Purdue, was educated at Princeton (PhD, 1971). He is currently examining certain previously unexplored connections between human death fears and world politics. Beres is the author of many books and articles on international relations and international law. A previous contributor to YaleGlobal Online, his latest writings have appeared in the Harvard National Security Journal; Jurist; The Bulletin of the Atomic Scientists; International Journal of Intelligence and Counterintelligence; The Atlantic; Israel Defense; The Jerusalem Post; The Hill; US News & World Report; Parameters: Journal of the US Army War College; and Oxford University Press. His 12th book is Surviving Amid Chaos: Israel’s Nuclear Strategy (Rowman & Littlefield, 2016).

This article first appeared on YaleGlobal Online.

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What hospitals can do to drive entrepreneurship and enhance patient experience

Hospitals can perform better by partnering with entrepreneurs and encouraging a culture of intrapreneurship focused on customer centricity.

At the Emory University Hospital in Atlanta, visitors don’t have to worry about navigating their way across the complex hospital premises. All they need to do is download wayfinding tools from the installed digital signage onto their smartphone and get step by step directions. Other hospitals have digital signage in surgical waiting rooms that share surgery updates with the anxious families waiting outside, or offer general information to visitors in waiting rooms. Many others use digital registration tools to reduce check-in time or have Smart TVs in patient rooms that serve educational and anxiety alleviating content.

Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.