Kenosha News

Steve Herzfeld managed an admirably inventive end-run around high healthcare costs for his Parkinson's- and Alzheimer's-afflicted parents. After in-home care was no longer possible, he priced American nursing homes, but found that the cheapest acceptable option was still $6,000. So he sent them to India. Quality elderly care in Puducherry cost less than his father's fixed income. According to the Guardian:

[In India, Herzfeld] could give his parents a much higher standard of care than would have been possible in the US for his father's income of $2,000 (£1,200) a month. In India that paid for their rent, a team of carers—a cook, a valet for his father, nurses to be with his mother 12 hours a day, six days a week, a physiotherapist and a masseuse—and drugs (costing a fifth of US prices), and also allowed them to put some money away...."In India, they really like older people," says Herzfeld, describing how the staff seemed to regard his parents as their own family.

Of course, the care was inexpensive because a couple thousand bucks goes further in Puducherry than it might in, say, Fort Lauderdale. Herzfeld, though, apparently believes that it was cheap because elderly care in America is greedily overpriced by providers. He vents about about healthcare and the profit motive: 

[Herzfeld] believes that India could teach the US and UK a lot about care of the elderly. "In America, healthcare is done for profit, so that skews the whole thing and makes it very inhuman in its values," he says.

I try not to begrudge a man his fantasies, but the idea that the nurses, valets, and masseuses of Puducherry were doing it all out of the goodness of their hearts—rather than the goodness of their paychecks—is condescending. It was simple outsourcing, not subcontinental altruism, that saved Steve Herzfeld so much money.

In Reason's May 2009 print edition, Ronald Bailey wrote about the outsourcing of hip replacement.

About the Author: P.J. Crowley serves as Assistant Secretary of State for Public Affairs.

Last week, I began my tenure as the Assistant Secretary of State for Public Affairs.  I am humbled and exhilarated by the task before me and am grateful for the trust and confidence President Obama and Secretary Clinton have placed in me.

Almost 20 years ago, I was assigned to Germany, one of the highlights of my 26 years serving with the U.S. Air Force.  I have been contemplating those days as I prepared for this assignment.  During my time in Germany, the Berlin Wall ceased to divide East from West.  The people of East and West Germany literally pushed until the wall was breached and ultimately removed.

In the aftermath, when given a choice, the people of Eastern Europe rejected Communism and moved swiftly to associate themselves with the rule of law, market economies and responsible and accountable governments.  This success was due in no small measure to institutions like the United States Information Agency, Voice of America and Radio Free Europe, which helped foreign publics understand that they could have the rights and opportunities of free people.  This was public diplomacy at its best, and proved to be a cornerstone of our policy of containment.  Now, Secretary Clinton’s focus on using smart power – the full compliment of diplomatic, economic, military, political, legal, and cultural tools is leading us back to a balanced approach to foreign policy that served us well throughout our history.

As we know, global challenges hardly disappeared with the end of the Cold War.  Today, we continue to combat extreme ideologies in an expanding conflict in Afghanistan while dealing with festering violence in Iraq.  Success in this current struggle will require the same kind of patience, determination and skill that we demonstrated during the Cold War – identifying a clear, peaceful and modern alternative to the people of the world, reinforcing our strategic narrative while diminishing that of extremist insurgents.  As Secretary Clinton stated in her recent testimony before the Senate Foreign Relations Committee, the State Department is seeking the resources to deploy a new strategic communication strategy to buttress our foreign policy.  Ultimately, we cannot succeed unless we build and sustain public support at home and around the world.

Today’s global communications environment is dramatically different than it was even a few years ago.  A digital image can be transmitted from anywhere in the world at an instant, as we saw with the cell phone image of the execution of Saddam Hussein and its impact.

One of my goals is to have the State Department communicate its message more strategically.  In order to do this, we must be dynamic and use all available means both old and new media - traditional methods such as the Daily Press Briefings as well as experimenting with new media, such as Facebook, Twitter, and video through the Internet.  The culmination of this effort will be a virtual presence that is engaged in a global dialogue, 24 hours a day, seven days a week, in all corners of the world.

Given the expanded nature of the communications environment, Secretary Clinton decided to restructure the Bureau of Public Affairs.  I will serve as the Assistant Secretary, but not as the every day spokesman for the department.  One of my foremost responsibilities will be to ensure that public affairs informs public policy.  This is why you’ll hear me repeatedly coming back to the idea of a strategic communications plan.  My task, working with Under Secretary of State for Public Diplomacy and Public Affairs Judith McHale and the newly designated spokesman, Ian Kelly, will be to serve as the senior advisor to the Secretary, contribute to the administration’s interagency strategic planning and lead the Bureau of Public Affairs and the dedicated public affairs professionals at the State Department and around the world.  I am an avid Red Sox fan.  Judith is a Yankees fan and Ian, a Cubs fan, but we are united by a higher calling and significant challenges.

Tackling these global challenges – extremism, nonproliferation, climate change, global health and food security just to name a few – will require, as Secretary Clinton has said repeatedly, coordinated, international partnerships at the government-to-government and people-to-people levels and all variations in between.  In order to build and sustain such partnerships, we must communicate effectively.  Effective communication is a two-way street, so as much as I look forward to keeping you informed on new initiatives, I’m even more eager to hear your ideas.