Franz Josef Jung, Defense Minister of Germany at the time of the Kunduz airstrikes gone bad, got demoted to the Labor Ministry in the post-election cabinet reshuffle and will now be resigning from the cabinet altogether. General Wolfgang Schneiderhan and State Secretary Peter Wichert have already resigned over this matter.

In light of the fact that all this is happening in part because of an increased American emphasis on the need to reduce civilian casualties, it does strike me as worth wondering whether you can imagine anything comparable happening in the United States? In any bureaucratic organization, it’s one think to adopt rules or policies saying that such-and-such is a priority. It’s another thing entirely to demonstrate that doing such-and-such is, in fact, crucial to one’s career.

One issue that probably hasn’t gotten the attention it deserves is the growing evidence that the watered-down (i.e., “level-playing field”) version of the public option currently under consideration is so watered-down that it doesn’t really accomplish anything. A new report from the Urban Institute appears to make precisely that argument. As Igor Volsky explains:

The report says that the Senate and House’s public option provisions (which require the public plan to independently negotiate rates with providers) would have little hope of lowering costs in areas of the country with high provider concentration. In areas where hospitals have “too strong a market presence to be excluded from insurer networks,” hospitals could dictate prices, stripping the public plan of its ability to negotiate cheaper rates, the report warns. According to a 2006 study, 86% “of large metropolitan areas were considered to have highly concentrated hospital markets.”

The report’s authors suggest that a better compromise would be a trigger mechanism, in which the trigger, if pulled, unleashes a strong public option:

In the absence of enough political support to pass a strong public option at this time, a “trigger” for a strong public option should be considered for inclusion in health reform legislation whether or not a weak public option is included as a political compromise. Even the threat of such a plan being triggered offers the potential to affect market dynamics between insurers and providers.

I think this suggestion is probably correct, but also a bit politically naive. The concern about a trigger has always been that if the proponents of a public option don’t have the political clout to get one created in the 111th Congress, they’re definitely not going to have the clout necessary to get a trigger pulled by the 114th or 115th Congress. The stronger you make the hypothetical public option, the less likely it seems that the trigger will ever be pulled. The genius of a public option that actually exists, no matter how watered-down or opted-out or whatever, is that it actually exists and whatever good it can do it can actually do. And note Peter Harbage and Karen Davenport’s argument that a level playing field public option could do a great deal of good even without exercising the kind of market power that Urban is confirming the level playing field public option won’t have.

But this should remind us that the majority of funds that employers and people pay in insurance company premiums ends up in the pockets of doctors, hospitals, and other purveyors of medical services. Compared to other countries, Americans pay for more services and we pay more for them. The evidence that all this extra money is getting us extra value is hard to come by. But note that even mild suggestions for mild shifts in direction away from the status quo—such as the recently floated idea that women aged 40-50 with no identifiable risk factors for breast cancer should be spared the expense and inconvenience of mammograms that lead primarily to false positives and painful, unnecessary treatment—tend to be greeted with hostile reaction from the public.

Dubai World, which is a state-owned company out of (you guessed it) Dubai, has announced the need to restructure its debt payments creating a lot of uncertainty in markets as to whether this amounts to a sovereign default that should lead people to panic. Willem Buiter says there’s no need to freak out, that this is basically just a real estate company having problems, and Paul Krugman observes that “US bond prices are up right now, suggesting that the Dubai thing hasn’t raised expectations of default.”

It’s worth thinking about this, however, in the context of suggestions from the SIGTARP and others that Timothy Geithner should have driven a harder bargain with AIG’s counterparties rather than paying out the full value of AIG’s debts on credit default swaps. The only way to achieve this would have been for the US government to credibly threaten to default on the debts of a US state-owned company. It looks like the world financial system probably can process the default of a Dubai-owned company without that unduly impairing the ability of major sovereigns to borrow. But still people are clearly at least somewhat nervous. An American default scenario would have posed much bigger risks and would have done so at a period when the whole world looked more vulnerable to shocks.

For what it’s worth, though, Felix Salmon seems to agree with me about the relevant linkages but reaches the opposite conclusion and thinks sovereigns should let state-owned enterprises default on their debts all the time.