In five days, it will have been five years since the United States invaded Iraq with its campaign of "Shock and Awe". Eight months from now, the US will have a new president, and that person will face some shock and awe of his or her own. For the debacle that Bush the Second has foisted on his country - and the world - will be like a landmine waiting to blow off the legs of whichever human or animal unwittingly steps on it.

It's something of a habit of political leaders to employ lies when setting out to wage war. They manufacture events and circumstances or manipulate simple or innocent events to justify going to war. But the manoeuvring which Bush employed to attack Iraq was a special piece of work. When he targeted Afghanistan after the planes flew into those buildings on September 11, 2001, the world cheered him on and several countries volunteered actual military help. No doubt encouraged by this show of solidarity, he seized upon the appalling events as his point of triangulation for the campaign against Iraq. He marshalled his Cabinet cohorts to go out and preach the message that Saddam Hussein was behind the attacks, that even as they spoke, he was working to secure weapons that could spew nerve gas, anthrax or botulism, or nuclear block-buster bombs. The despicable Iraqi leader - whom he likened to a modern-day incarnation of Hitler - was also host to the terrorist scourge which was infecting the world.

Many people pointed out at the time that none of this was true. They noted that while Saddam did at one time have nuclear, chemical and biological programmes, after a decade of punitive UN sanctions and air patrols by the US and Britain, and after exhaustive inspections by UN specialists, he had abandoned those efforts. It was soon demonstrated that Saddam and Osama Bin Laden had absolutely nothing but contempt for each other, and that the terrorists who were plaguing the west came from other places. In fact, it's only since the US occupation that Iraq has turned into a nursery for terrorists. The war would be quick and cheap, he and his underlings trumpeted. Iraqis would welcome the "liberators" with flowers, and the war would cost US$50 billion. Well, as we have seen, while many Iraqis welcomed the end of Saddam's murderous regime, they have experienced nothing but abject misery, and the US goes through $50 billion in Iraq every three months.

An interim accounting presents some staggering figures. Two academics from Harvard and Columbia universities, Joseph Stiglitz and Linda Bilmes, have written a book they call The Three Trillion Dollar War, in which they examine the actual cost of the war. As the title states, it's costing the US$3 trillion dollars - that's three followed by 12 zeroes! Not only that, but it's also costing the rest of the world a further three trillion. The cost for the Iraqis is monumental. In the first 40 months of the war, between 450,000 and 600,000 Iraqis have died - around 150,000 of them violently, and the rest from disease, lack of medical treatment and malnourishment.

Usually, when a country is at war, the government demands that the population shares some sacrifices to prosecute the conflict. Not so in this case - Bush has cut taxes for the rich, racking up huge budget deficits, which are financed mostly by foreign investors. Naturally, the burden of paying it off will fall on future generations. Other costs of the war will become apparent only as time passes, including health care and disability payments for the thousands of wounded and disabled service people coming back home. The authors point out that for one-sixth of what the war costs, the US could put its social security system on a sound financial footing for half a century, without cutting benefits or raising contributions.

As the Republican and Democratic parties roll along with their campaigns, the war will play a big part, since the lies, bungling and mismanagement have made Bush extremely unpopular and many Americans wanting it over and the servicemen and women home as soon as possible.

Another issue will figure prominently in the campaign - one in which the people are way in front of the politicians. When Hillary Clinton's husband came to power, she became the point person in his attack on the country's lopsided health care system. While the United States is a leader in almost every field of research, treatment and care in the field of health, it has the worst record among the world's wealthiest countries for how that care is distributed.

As with everything else, private interests are paramount. Insurance companies cover the costs of health care for those who can afford it or whose employers offer coverage as part of the benefits package. If you are old or very poor, the government covers you through Medicare or Medicaid. When those programmes were introduced 43 years ago, they were attacked as "socialism" - a virulent virus that would destroy the free-enterprise system. But that system leaves almost 50 million people uninsured - that's considerably more than all the people who occupy the arc of islands from Cuba to Trinidad and Tobago.

Both Hillary Clinton and Barack Obama have only nibbled at the question, still supporting the private insurance system, rather than what is called the single-payer, or universal health care model such as is practised in neighbouring Canada or in Britain, where the system was introduced in 1948. Study after study has shown that a single-payer system is considerably more efficient, since most of the money pays the actual health costs instead of going for advertising, profits and high overheads. In 2006, the US health insurance industry earned $57.7 billion in profits. Along with the pharmaceutical industry, it wields enormous power in Washington, lobbying successfully to prevent or kill any legislation to introduce universal health care.

It's no surprise, though, for a country that devotes so much of its resources to capabilities for killing rather than for maintaining the well-being of all its citizens. It spends US$2 billion a day on military activities, while Medicare and Medicaid cost $625 billion a year. You do the mathematics.

So the candidates will talk about health care, but won't propose much to change it.

keeble.mack@sympatico.ca

The Audacity of Art

Marjorie Whylie to receive Stella Gregory Award

Traditional Thanksgiving offerings at EVITAS