26 August 2016

Welcome to the Age of Strategic Triage

August 23, 2016

The next U.S. president will have to face the harsh reality of a war-weary public, contentious domestic politics, uneven economic growth, and a world in which America’s influence seems to be fading. Regardless of who wins this November’s election, the new administration will be forced to set priorities and concentrate national attention and scarce resources on the serious foreign-policy challenges facing this country.

Governing requires hard decisions concerning whether to maintain, expand, or shed commitments. The new administration will have to address questions pertaining to reducing operations in Afghanistan, maintaining obligations in Iraq, and expanding security commitments in the South China Sea. U.S. leaders must constantly evaluate the costs, risks, and potential benefits connected with the myriad of competing interests facing this country. Some obligations may promise too little gain to justify their expense in lives and resources. Others drag on, trying popular and elite patience. Some outlive their usefulness, siphoning resources from more pressing commitments.

Offloading burdens becomes necessary when a great power finds itself stretched too thin. For better or worse, the United States now presides over an age of strategic triage. While the word triage comes from the world of medicine, it is surprisingly useful for strategic deliberations. The Merriam-Webster Medical Dictionary definestriage as:

1: the sorting of and allocation of treatment to patients and especially battle and disaster victims according to a system of priorities designed to maximize the number of survivors.

Triaging is a commonsense method used by field hospitals in times of war or disaster to allocate scarce medical resources to save the most victims possible. Doctors recognize that some patients will recover without immediate medical attention, while others will die even with medical care. Identifying these two groups and excluding them from immediate care allows medical personnel to devote their energies to helping those whose chances of recovery improve with medical attention.

The goal is to wring the most life-saving value from the doctors’ labor. Makes sense, doesn’t it? Medical professionals apportion finite resources to save as many victims as they can.

The Logic of Strategic Triage:


Strategic triage is triage of a political nature, but like the public-health concept, it’s also about allocating finite resources where they can do the most good. But in this case the process benefits not the “victims”—allies, theaters, or operations of doubtful value—but the great power that took on these commitments. It’s a self-serving process conducted to bolster the well-being of the “physician.”

In international relations, health is measured in terms of a state’s military, economic, and diplomatic power and influence. Since all power is relative, it is incumbent on strategists to produce an accurate diagnosis of their country’s health, as well as the health of allies and adversaries. In the zero-sum game of global politics, in which one country’s gain is another’s loss, being healthy is necessary but not sufficient. This is particularly critical for superpowers like the United States, which must remain the strongest and healthiest of all because anything less simply means that the republic is losing ground to rivals.

After completing an accurate diagnosis, great-power strategists then develop a course of treatment that not only maintains but expands their nation’s unique strengths vis-à-vis its rivals. That’s essential because great powers need to effectively manage or cure short- and long-term ailments while seizing opportunities to reinvigorate their health. Only then can they tend to others.

A quick survey of U.S. interests around the globe reveals a dizzying array of competing interests, making an accurate diagnosis problematic. One way great powers have traditionally balanced competing interests is by establishing a clear hierarchy among them. Ideally, this involves a two-step process. The first step is a careful assessment of aims. The second step is to establish the type of aims that will be pursued. Both are required to formulate effective strategies with a reasonable chance of achieving the political aims.

Fortunately, the great Prussian military theorist Carl von Clausewitz has offered sound guidance on this matter. Clausewitz argues that the conduct of a state’s foreign policy must be governed by the pursuit of rational objectives. The value decision-makers assign to a political aim determines the amount of time and resources they are willing to invest to achieve the goal. That’s easier said than done, but it is still excellent guidance.

So the first step in determining national security interests is to measure the political aim’s importance and the costs associated with achieving it. This allows strategists and decision-makers to make logical decisions about the allocation of resources. The qualitative categorization of political aims and national-security interests enhances their ability to make rational choices.

Using this logic as a foundation, strategy must be based on the value of each political objective and judged by the resources and sacrifices required to achieve it. Clausewitz concludes, “Once the expenditure of effort exceeds the value of the political object, the object must be renounced […].” In other words, the value of any political aim is measured by its relative costs—the rate at which a combatant expends lives, treasure, and military resources of all types—and the time required to achieve the objective. Rate × time = total cost. Simple!

The Clausewitzian formula helps strategists determine when to abandon an enterprise short of attaining their aims. The cost of those aims may come to exceed the value of the political object, or the value assigned the political object may fall. In either case, the original goals no longer justify the expenditure of resources. Strategists should be prepared to revise their calculations to determine whether the enterprise is still worth its price. If not, Clausewitz warns them to shut down the endeavor—conserving what gains they can while cutting their losses.

Logic thus demands that decision-makers constantly tune the balance between a venture’s sunk and potential costs and the expected rewards of achieving the political objective. When cost/benefit logic no longer warrants political, economic, and military commitments, triaging the burden becomes the goal—even if it means altering political aims significantly, and even at the cost of reneging on pledges to allies.

Maintaining dominance in the international system over time, then, requires a great power capable of reconciling its national interests with its obligations to other states. That’s the essence of the rational calculus that is supposed to dominate the decision-making process.

Qualifying Aims:

We can break down interests into three qualifications: vital, important, and worthy but marginal aims. The more value the goal commands, the more readily leaders will devote resources to achieving or preserving it. World War II provides an excellent example: the United States placed extremely high value on defeating Imperial Japan and Nazi Germany. The nation mobilized millions of men and women and devoted much of its economy to the war effort. The value Americans assigned to their war aims, then, was commensurate with the resources they expended to win.

Important aims are those the United States deems worthy of serious attention but are not vital to the country’s survival. These include the challenges posed by global terrorist groups or civil wars in the Middle East, South Asia, and elsewhere that have upended entire regions while triggering crises within Europe.

Finally, marginal aims are attractive and worthwhile yet involve less obvious threats to national security. These include assistance in ameliorating humanitarian crises and the promotion of human rights and international law. The Obama administration’s tepid reaction to Russia’s military annexation of Crimea represents a good example of marginal American interests. Washington strongly condemned the invasion and annexation of Crimea but responded with only limited assistance to Ukraine and narrow economic sanctions against Moscow. This was classic cost/benefit analysis in action. U.S. officials voiced support for Ukraine’s sovereign rights, but their response was carefully calibrated to limit direct American involvement in the crisis.

The second step in appraising national-security interests is to determine the types of objectives to pursue. There are two types of political objectives, “positive” and “negative.” Positive objectives expand a country’s power and influence. Superpowers remain superpowers only if they remain perpetually on the lookout for opportunities to increase their power and influence relative to their adversaries.

The moment their relative power declines is the moment their hegemony begins to fade.

Perpetuating and expanding economic, military, and political dominance, then, is a positive objective that must be tended to with the utmost care and skill. American firms, often with government assistance, are always searching for new markets. On the political playing field, diplomats court new allies while developing strategies to gain advantage over rivals. More broadly, expanding open markets and spreading liberal democracy have been the positive pillars of U.S. foreign policy since the end of World War II.

Negative interests, by contrast, focus on preserving a nation’s power while preventing other nations from taking it. Conserving the United States’ hegemonic position requires Washington to fend off challengers who seek to weaken or replace its influence. Negative political objectives range from overcoming vital security threats that endanger the nation’s survival to countering efforts to wear down the nation’s dominant global influence.

Defense of the American homeland and that of key allies in Europe and Asia are two widely accepted negative objectives. Ensuring that the global commons remains open for trade and communication is another. Limiting the effects of global warming is quickly becoming another vital, negative political aim. Finally, holding China’s military rise and adventurism at bay commands greater and greater importance in American policy circles. In short, conserving a global status quo spells hard, painstaking work.

Three Examples of When and When Not to Triage:

Three examples illustrate the utility of employing this two-step evaluation of national security interests—ranking goals by importance, and by whether they are positive or negative—as a guide for assessing U.S. commitments. The first assesses how U.S. strategy towards China combines pressing political value with converging negative and positive aims. The second entails the negative aim of supporting Iraq in its battle against ISIS. This aim is of moderate political value and cost. And finally, there is the more problematic case of Afghanistan. The value of maintaining the status quo in Afghanistan may no longer merit an indefinite outlay of American resources.

U.S. strategy vis-à-vis China shows how negative aims can converge with positive political interests in Asia. Over the past two decades, China has become the only viable near-peer competitor boasting the potential to threaten U.S. regional hegemony. In response, Washington is pursuing a negative aim to limit China’s influence in East Asia. It has done so by increasing the U.S. Navy’s presence in the area, refurbishing relations with current and former allies, and reaching out to erstwhile foes like Vietnam.

Deployments of military hardware also signal U.S. resolve to allies and partners. For example, the deployment of the advanced antimissile system known as the Terminal High-Altitude Area Defense system (or THAAD) in South Korea reaffirms America’s security commitment to a valuable ally in Asia. THAAD ostensibly went to the peninsula to protect the South from North Korea’s burgeoning arsenal of missiles. Yet the antimissile emplacements also quietly put Beijing on notice that the allies can counteract China’s ballistic-missile inventory.

The United States, moreover, has long pursued positive economic interests in Asia, a region to which 28 percent of U.S. goods and 27 percent of service exports flow annually. Those percentages exceed the shares going to the European Union and to the United States’ NAFTA partners, Mexico and Canada. The Obama administration, furthermore, is pushing a Trans-Pacific Partnership trade agreement that would join the United States with 11 other countries along the Pacific Rim. Through the TPP and other economic outreach, the administration is pursuing positive interests that conform to historic U.S. policy aims—namely opening markets while reducing barriers to American goods and capital.

The U.S. “pivot” to Asia, then, is founded on solid, rational strategic calculations. But the strategy also comes with significant caveats and dangers. For example, reallocating ships, aircraft, and munitions to the Asia-Pacific region weakens the U.S. Navy’s capacity to project power in the Mediterranean, the Persian Gulf, and other important theaters.

There could also be unintended consequences to pivoting to the Far East. Rebalancing the U.S. Navy, for instance, could unwittingly signal irresolution to rivals like Russia and Iran. President Vladimir Putin could interpret the pivot as a license to launch new adventures in Ukraine and the waters around Europe. The refugee crisis in the Mediterranean, where hundreds of thousands are fleeing Syria, Iraq, and other war-torn countries, provides a daily reminder of the instability emanating from the Middle East and South Asia.

Clausewitzian calculations, then, warrant an effort of intense magnitude and open-ended duration in the Asia-Pacific. But there are opportunity costs to the pivot. Taken to its extreme, the rebalance might impel Washington to triage other regions.

U.S. strategy in Iraq, on the other hand, provides an example of a strategy seeking equilibrium between an important but not vital political aim coupled with limited efforts to achieve the goal of defeating the Islamic State. One can argue that the precipitous withdrawal of American forces in 2011 created the conditions for ISIS to flourish. However, U.S. strategy is now carefully calibrated to uphold a balance between the costs and benefits of American support of the Iraqi government’s efforts to defeat the terrorist group.

The absence of domestic political support for another major U.S. troop commitment to Iraq compelled the Obama administration to devise a moderate and patient course of action promising a reasonable chance of success. The cornerstone of U.S. military strategy is an air campaign designed to assist allied forces on the ground while degrading and destroying the military and economic capacity of the Islamic State to hold territory.

This strategy has the added benefit of limiting the scale of U.S. commitments. Washington currently restricts the number of American ground forces to fewer than 5,000, most confined to logistical support and a stringent train-and-assist mission. This reduces the risk to American forces while strengthening Iraqi security forces. Meanwhile, a relatively small contingent of U.S. Special Forces has undertaken reconnaissance and narrowly targeted search-and-destroy missions. Collectively, these three operational strategies furnish crucial assistance to Iraq’s war against the Islamic State while limiting costs to the United States in blood and treasure.

Yet this moderate course of action also comes with risks. Critics argue that the administration’s approach is too risk-averse. They contend that this strategy allows ISIS to retain control of significant swaths of territory in both Iraq and Syria for some time, even as the terrorist group expands to other areas in the Middle East, Africa and South Asia.

While this critique merits serious consideration, the current strategy has much to commend it. By imposing restrictions on the size and scope of U.S. military actions in Iraq, the administration has compelled local and regional forces to bear the brunt of the fighting. This allows the United States to proffer a helping hand and demonstrate commitment to its ally while greatly reducing American liability.

Washington’s strategy toward ISIS may prolong the conflict and allow other, less savory actors like Iran to claim credit for military gains. But that seems like a reasonable tradeoff in a region that has cost Americans so dearly for so little tangible gain. Strategic triage, then, is not final. So long as a patient like Iraq survives being triaged—even in an enfeebled state—the physician can renew care in some form and degree.

The continuing American presence in Afghanistan provides the most troublesome example of how difficult it is to balance the costs and benefits of the status quo. President Obama recently announced that the U.S. military will keep 8,400 troops in Afghanistan until the end of his term. The president also authorized U.S. forces to expand their engagement and granted them greater flexibility to pursue enemy forces.

Taken together, these measures signal the prolonging of the fifteen-year American commitment to Afghanistan. The costs of the endeavor should give decision-makers pause. Some 2,365 U.S. servicemen and -women have perished in the conflict, while the estimated outlays far exceed $1 trillion. At the very least, the Obama administration should reevaluate whether the costs have exceeded the potential returns from a major commitment to a war that is seemingly unending.

Here a strategist might ask whether the cognitive bias of “sunk costs” has warped U.S. calculations. Economists warn against making decisions about future investments based on what has already been invested. Transposed to the strategic sphere, decision-makers must not invest more lives, treasure, and military hardware simply because they’ve already sunk so many lives, treasure, and hardware into an enterprise. Clinging to past investments flouts rationality.

Those gripped by the sunk-cost fallacy insist the Afghan war must continue in order to justify the sacrifices already made. The rise of the Islamic State in the aftermath of the U.S. withdrawal from Iraq, as well as the domestic political fallout, may be distorting the administration’s assessment of the value of the U.S. commitment to Afghanistan.

Lyndon Johnson famously disregarded the imbalance between the value of victory in Vietnam and the cost of attaining it. Johnson proclaimed, “I am not going to be the first American president to lose a war.” One wonders whether President Obama will utter some similar statement to explain his decision to remain tethered to Afghanistan. It is easy to add up costs, risks, and benefits, and conclude it is time to execute a strategic triage. But it is politically difficult, for a variety of reasons, to actually cut off support. This is true even when the costs have far outrun the potential benefits of remaining in Afghanistan.

Avoid Strategic Triage at Your Peril:

These three examples underscore the utility of strategic triage. Wise conduct of foreign policy requires constant reassessment on the part of all states—especially great powers such as the United States that must juggle a multitude of interests and commitments. The history of great powers is rife with examples of states that tried to do it all, everywhere, and frittered away their dominance by failing to retain a balance between resources and obligations.

Knowing how to reassess, reevaluate, and redefine aims is a difficult task involving unpalatable tradeoffs. In the end, however, strategic triage allows the United States to use its power more wisely. This hardnosed approach helps U.S. leaders husband resources to protect vital national security interests and exploit new opportunities.

Marc Genest and James Holmes are professors of strategy at the U.S. Naval War College. Genest was the founding director of the College’s Center for Irregular Warfare and Armed Groups. The views voiced here are theirs alone.

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