Has the US Defense Department killed a million Americans since 2001?

A significant portion of that defense spending actually goes to health care for serving men and women, and their families, and veterans.

A significant portion of that defense spending goes to training, testing, and safety measures that save a very large number of lives every year.

Finally a significant portion of that defense spending goes to the research and maintenance of weapons systems that, by deterring conflict, or in the event of conflict rendering more precise strikes possible and a faster end to hostilities, can actually save lives in comparison to alternatives.

And we haven’t begun to ascertain the likely effects of a hugely weaker US military on stability over the next decade.

I don’t know what the optimal level of defense spending is but strongly suspect it’s lower than what the US spends currently. Yet keep in mind that the world is indeed a dangerous place–wouldn’t Japan, for example, be going nuclear in response to rather shockingly belligerent activities by nuclear-armed powers against it if the US started large cuts in defense?
See http://ajw.asahi.com/article/behind_news/AJ2011101414492 (reporting 100’s of flights harassing Japan by China and Russia)

Definitely not worth a million lives a decade just for the Japanese example, no. But I do think what’s a bit chilling about the Japan example is that Russia and China are deliberately harassing Japan for no “good” reason (Japan pretty clearly poses no threat to Russia or China)–this does suggest to me that the US “stabilization” role shouldn’t be downplayed. So 2% might be too low for optimal stabilization. But your post is very useful indeed in showing just *how* costly the current commitments to defense spending are.

I should probably extend my post a bit – the economic/technological improvements added via defense surely have some indirect impact on extending or saving lives … only, it’s impossible to say to what extent. And the process is certainly less efficient than real aid, or even funding for, say, NIST. But it shouldn’t be ignored.

Watson Ladd@10

The life saved is not a “government life”, but the resources expended to produce and administer the regulatory regime are financed by taxes, the regulatory regime and resulting “rules of the game” for private economic activity generally being in the nature of public goods. So the costs of regulation are, indeed, costs to the government.

Presumably the official counterargument is that at least 1.5 million American lives have been saved by the Defense Department in that time. And I have to say the logic is impeccable.

Andrew F. makes the provably false claim: A significant portion of that defense spending actually goes to health care for serving men and women, and their families, and veterans.

That’s a lie and I can prove it.

American military spending runs 1.2 trillion dollars per year, when properly accounted, not 500 billion dollars per year. The 500 billion dollar per year figure is incorrect from the git-go, since Obama specifically requested more than 700 billion dollars for the military in FY 2011.

But that 707.5 billion dollars (NOT 500 billion, 707.5 billion — somehow you haven’t seen fit to include the 200 billion dollars a year getting pissed away in Afghanistan and Iraq. Presumably the U.S. soldiers in Iraq and Afghanistan are not part of the American military?) specifically excludes:

VA spending – 70 billion dollars per year

military pensions – 82 billion dollars per year

NRO (military satellites: try explaining how military satellites aren’t part of the military) – 50 billion dollars per year

CIA (which is now a de facto part of the American military, with drone squadrons equipped with missiles and assassination teams in 140 countries) – 50 billion dollars per year

NSA – 50 billion dollars per year

Department of Homeland Security – 56.3 billion dollars per year, most of it now devoted to acting as copyright police for private corporations like Disney and the Pittsburgh Steelers.

The “defense related” part of the budget of the Department of Energy – a stalking horse of military weapons development: 21.8 billion dollars per year

Pentagon “black” projects off budget and never reported: 50 billion dollars per year

Xe (formerly Blackwater) – a private army full of ex-SEALS and ex-Special Forces military, now revealed as a CIA front by Erik Prince, its CEO, along with many other no-bid military contractors: 60 billion dollars out of a whopping total of 140 billion dollars in no-bid military contracts per year in 2011.

Can we do third grade arithmetic, people?

Add up the numbers.

1197.6 billion dollars per year. That’s 1.2 trillion dollars per year.

TRILLION. One point two TRILLION dollars per year America pisses away on worthless useless military spending to fight endless unwinnable wars in third-world hellholes against barefoot fifteen-year-old kids who are armed with bolt-action rifles.

Cue various ignorami rushing in to claim my numbers are incorrect. They’re lying. Examine this breakdown of U.S. military expenditures as of FY 2011. 707.5 billion dollars represents only the tip of the iceberg, the official Pentagon military budget. All the other expenditures like annual VA funding and military retirements and Xe and DOE “defense related projects” come on top of that 707.5 billion dollars per year.

You are right and you are wrong.

1. A childcare tax credit/child support tax deduction/child benefit grant of around 25,000 dollars per first ten years and 5,000 per year subsequently would definitely result in more americans, at least in more middle class americans. So half a million dollars per life when you include cost of schooling, etc. You are right that this war is costing millions of american lives.

2. We aren’t paying the money, we are borrowing the money, and we can’t pay it back. I wish to be clear, it is not that we can’t politically pay it back, it’s that we can’t actually pay it back. We don’t make, mine, or grow net exports. The cost of the US empire is to the sort of people who buy US tbills directly or through banks. The cost of this war is born buy rich foreigners.

WL@14: “if a regulation costs a particular company $5 million, that $5 million isn’t a cost the government incurs”

If the company was costing some unsuspecting statistical individual her life, that wasn’t a cost the company was incurring, and that was a problem, eh?

But, I didn’t think JQ was talking about regulations, or regulatory programs, per se.

Yes, please on the VSL post. Fascinating.

@Watson Ladd: Actually, yes! Government can incur costs of regulation. Current example: energy efficient lighting (CFLs, LEDs) are some to way more expensive than incandescent light bulbs, particularly now when supply/demand is low. Government research has led to legislation setting regulations and further standards (EnergyStar, a separate DOE entity called Lighting Facts); government funds have already helped defray costs of CFLs and are in the works to lower costs of LED lamps. So some of those regulatory costs are indeed being paid for by the government. Also tax rebates for solar panels and energy efficient appliances.

More direct responses to the argument:

1. The current threshold for statistical life-saving may be $5 million, but that doesn’t mean there are thousands more lives waiting to be saved at a cost of $5,000,001 each. As further lives are saved, the marginal cost of saving the next one will go up. I don’t know how much – perhaps there are figures on how many lives were saved for $4.8 million, how many for $4.9 million and we can extrapolate. But 100,000 a year is quite a lot (about 4% of all deaths in the US) and I’d expect that it would become very expensive to meaningfully save them. Especially if we exclude the cheapest (but arguably lowest-value) option, which is probably to extend the lives of 83-year-olds by one more year. I know you don’t want us to get into the actual definition of saving a life, but it’s worth noting.

2. Even though the DoD doesn’t explicitly consider the cost of saving a life in its decision making, this doesn’t mean that their actions don’t in fact save some lives, as suggested by other posters. Given that they don’t overly consider this goal, it probably works out as a quite inefficient way of achieving the outcome; but it might turn out that defence is a really efficient public good and actually saves millions of (risk-adjusted) lives every year. It’s very hard to estimate the counterfactuals, but we shouldn’t reject this out of hand.

3. A more compelling argument might be to focus on quality of life. I suspect that investments in early childhood education and other long-payoff investments would result in some substantial improvements in the recipients’ experience of life; not to mention the returns from increased income, resulting taxation and so on. In the UK we use a measure called QALY – the Quality-Adjusted Life Year – this means that we are willing to spend more to save the life of a 5-year-old than a 75-year-old; and also that we can spend money to keep that 5-year-old from being malnourished, or keep them out of a wheelchair, or give them a better education. Not that this system works perfectly, but it’s philosophically quite well-founded (assuming you’re happy with utilitarianism). On this basis, I am sure that $500 billion of defence spending would improve the quality of countless lives. But that makes a less compelling headline than killing a million Americans.

“I really just want to know where they came up with $5 million.”

No doubt JQ will give us the post that explains this better than I’m about to.

All sorts of decisions involve risk, risk of death. For example, the decision to be a deep sea fisherman or lumberjack (two of the highest risk jobs out there). So if we look at the wage premium (as compared to jobs requiring similar education, skills levels, human capital) we can see what wage premium people demand for taking that risk. This can then be translated into a statistical value of a life.

Yes, it’s messy, involves much more than just those two jobs, it’s an estimate, but that is essentially what is being done.

It’s then used to decide on both direct spending (the NHS approves treatments through NICE where the cost of QUALY (Quality Adjusted Life Year) gained through the treatment is less than £30,000….although that too is a slightly grey area, some more expensive are approved to be paid for out of NHS funds, train safety systems in the UK tend to be approved if the VSL saved is less than £2 million or so, not if above) and whether to insist on certain regulations. For example, will this regulation on benzine cost more than $5 million per life saved? Then don’t do it.

This again is breached often enough, the EPA is supposed to offer an estimate of the cost (as opposed to value) of life saved with most regulations and some of them come out in the $billions per life saved. Other actions, as JQ points out (say, vaccination programs anywhere) cost a few $ per life extended and so obviously meet the test.

It isn’t that people are willing to give up their specific lives for $5 million, rather, that by their actions that’s about the price they put on the risk of doing so. The point of using it is that resources are scarce and we really should be using them where they do the most good.

As to the specific point about DoD spending, yes, I’m sure it could be better spent. But we should also include those technological benefits that come with it: I’m sure I’ve seen people insisting that the internet, as it came from Arpanet and thus DoD spending, should be considered a success of govt spending on research and so on.

A childcare tax credit/child support tax deduction/child benefit grant of around 25,000 dollars per first ten years and 5,000 per year subsequently would definitely result in more americans, at least in more middle class americans. So half a million dollars per life when you include cost of schooling, etc.

Somehow it doesn’t seem quite right to balance out “Americans killed as a result of our policies” against”new Americans born as a result of our policies”.

We aren’t paying the money, we are borrowing the money, and we can’t pay it back. I wish to be clear, it is not that we can’t politically pay it back, it’s that we can’t actually pay it back. We don’t make, mine, or grow net exports.

The US doesn’t have any mines or factories. Riiiiight.

LFC @12: I’m not sure about “routine” intelligence flights, but certainly numerous cases of intimidation by various parts of PRC’s naval forces with respect to contested territories in the South China Sea are cause for concern, as is the level of nationalist rhetoric emanating from the PLA. East Asia is going to require much more attention as time progresses.

Aside from the fact that huge portions of US military spending actually do save lives, which renders the entire analysis flawed, the level of military spending in the rest of the world does not occur in a vacuum. What the US spends, and how the US deploys, affects that spending.

The PRC is spending around 200 billion per year, and is projected to continue increasing that spending by 10% per year or more. They are becoming increasingly aggressive with respect to contested territories, for various reasons. Reducing US military capability would have the immediate effect of causing Japan and South Korea, among others, to ratchet up defense spending sharply.

It would also raise the probability of a conflict centering around Taiwan, as a shockingly weaker US military would make it more difficult to assess what actual US policy is. When you raise the probability of a misperception on these matters, you raise the probability of war. Robert Jervis’s Perception and Misperception in Int’l Politics is a great place to start on this.

Finally, the loss of the US as a nation able to project force globally, and in a manner sufficient to dominate conventional military conflict anywhere in the world, adds uncertainty everywhere. It increases incentive for nations to build their own military capabilities, as the US capability to intervene declines.

The result is a much more dangerous world, where the possibility of large-scale inter-state wars will have been dramatically increased.

Andrew F, ‘significant’ doesn’t mean what you think it means. But thanks for the continuing evidence of your honesty and math skills.

Andrew F: “Aside from the fact that huge portions of US military spending actually do save lives,…”

Again, perhaps ‘huge’ doesn’t mean what you are asserting it means.

But to check the numbers, do you really think that if US defense spending were reduced by 50 per cent, there would be a 40 per cent chance of a WWII style conflict per decade?

Assuming a straight 50% cut while keeping everything else the same, and next decade rather than this (to give the cuts time to take effect)? It’s not clear that isn’t about right.

It would only take a 10% chance of a bad decision by any one of China, Russia, Saudia Arabia or Israel for them to start a major war on the assumption they could win it. And there’s also the possibility of a downright stupid choice by smaller actors like North Korea, Iran or Pakistan. Any such war could easily have the destructive potential of WWII.

It’s just like the US health system. Corporate revenue-seeking driving deliberate inefficiency means spending vastly more for a worse outcome than possible under a less bad system. But the cost is constrained to only increase up to the point where overall benefits secured are still worth it. No more, and also no less.

So halving the input to the same system would be disastrous.

Instead, focus on ways to get the same, or better, outcome with less expenditure. Collective security is the obvious one, but also nationalising the defence corporations, bring weapon system development in-house, hiring fewer mercenaries, and so on.

Of course it occurs to me, when talking about the US and mortality we should whisper something about guns (widespread possession and use thereof).

Last 5 paras before final one belonged inside blockquote.

Anyway, for anyone wanting a brief summary of Andrew F’s position, he feels the USA must start an arms race in order to prevent an arms race from starting.

(frikkin’ frackin’ comment forms………..)

P.s. What’s the size of the Saudi navy?

wkwillis@19 writes: “2. We aren’t paying the money, we are borrowing the money, and we can’t pay it back. I wish to be clear, it is not that we can’t politically pay it back, it’s that we can’t actually pay it back. We don’t make, mine, or grow net exports. ”

This can’t be correct. We borrow in our own currency. That currency can be devalued by central bank actions to the point of creating a trade surplus without increasing our debt load.

Also debt can be paid off by the federal reserve simply buying back the bonds with new money and shredding them. This may cause one-time inflation, but it will not cause an inability to pay back the debt.

If the US has a problem paying its current debts, it will be a political problem, not a lack of resources relative to commitments.

This will remain the case until the day that creditors refuse to buy US debts denominated in US dollars at reasonable interest rates, *and* we continue to amass more debt beyond that point.

Michael@49, this is the sign of a true believer- your arguments are not likely to be persuasive. The fact of the matter is that significant US resources are directed towards military purposes. If those resources were directed towards domestic purposes there would be a significant boost to other sectors of the economy. This is the analysis which matters regardless of how the funding is supplied. For many people they get caught up in the book keeping which is the essence of the monetary system and also systematically believe in lump-of-labor type fallacies. Macroeconomics is confusing, so I am actually pretty understanding, but it is a case of missing the forest for the trees.

I’m pretty much in agreement with LFC. A US which spent 50% of the current amount on defense would still be a very credible deterrent. The point of defense buildup is to make it expensive and risky enough to pursue war that only an insane leader would try.

Our ability/willingness to project ourselves into areas where we have little or no legitimate national interest has been demonstrated by the last decade to be somewhat limited. But even at that, it is not as though the people we fought won anything.

And we’ve demonstrated little or nothing about our willingness to protect ourselves or our major allies and trading partners, which I am going to bet will be *considerably* greater. If somebody launched a serious attack on Canada, Mexico or any major european country, you can bet we would not limit ourselves to deficit spending. Also, significantly, defense is much less expensive than occupations.

When we went into Iraq and Afghanistan, we were able to demolish the organized forces very quickly. If we were repelling an invasion of an existing, non-failed friendly state, that would have been the end of it. a few weeks or months of war, then at most 6-12 months of transition back to the successful state we knew before the invasion. The handoff of power would be easy, because we would *trust* the potential leaders.

The reason we are spending so much money in Afghanistan and Iraq for so long is that there was no one we trusted who could credibly take the reins of power and rule the country in our absence. While if somebody was invading, say, Canada, or Poland, or Japan, that would not be the case. One the invasion was repelled, our military job would be mostly done.

We are currently paying not really enough to have a full-on empire. What we would need merely to be a credible defense force for ourselves and our allies all around the world is much, much less than we are currently spending.

Advisor: You do realize this war could kill tens of thousands of our people?

King: So what?

Not clear which history books would you have to read to give the impression that that conversation is a wild implausibility.

Doesn’t need to be probable: take a whole bunch of scenarios that are each individually 95% likely not to happen, and you end up with a sizeable risk.

‘If we started this war, we would lose’, coming from a military professional, is a pretty strong argument. And anyone who could start and win a war is going to have such military professionals.

It’s likely true that in the modern world, winning a war isn’t going to be particularly profitable or worthwhile by any sensible standards. But there has been 50 years where, outside central Asia, the US determines who would win a war, and so what kinds of war can be won.

That represents a lot of pent up demand for bad decisions.

I have a plan: why not convince Hu Jintao to maintain perpetual peace and freedom of navigation (he sounds like a reasonable guy), and spend that extra trillion/year on something useful?

Well.

This is certainly clever. But there is more than one way to reconcile the facts that (1) the US government claims to undertake mortality-reducing policies whenever the cost per life saved is under $5 million and (2) military spending is around $750 billion per year. One way is John Q.’s, that the opportunity cost of military spending is 150,000 deaths per year. Another is the Sandwichman’s — that somehow or other the military must have saved a million Americans since 2001. But the simplest is that the VLS rule is not consistently applied. (It does seem rather odd to assume that the VLS rule does not apply to military spending, but that it would apply to the alternative use of the marginal military dollar.) While this exercise is fine as a counterfactual — “what if the USG really applied the rational standard it claims to?” — I’m not sure why we should believe there’s any kind of consistent standard in the real world.

Only about 2.5 million Americans die each year, total. So the same logic that says the US military has killed 1 million Americans in the past decade says that we could eliminate death entirely for $12.5 trillion. I’m not convinced immortality is so easily within reach.

As economists, I suppose we should say that the fact (if it is a fact) that the marginal benefit of saving a life is $5 million does not necessarily mean that that’s the marginal cost — how do we know that the market for mortality-reducing policy interventions clears? And more importantly, while we don’t know the slope of the mortality-reduction supply curve, it is certainly rising, not flat.

Of course, if this post is, as I suspect, just a dramatic way of making the point that military adventures have opportunity costs, and that “but how can we stand by when people are dying?” is not a moral trump card, then I agree entirely.

There’s a lot questionable here.

1. It presumes there are in fact 150,000 ‘savable’ lives a year via transport, health, and environmental policy. Against a background of ~35,00o *total* traffic fatalities in the US in 2009, one might wonder if this presumption holds. Professor Quiggin seems very confident that there are lots of good policies that would save lives at $5M a pop. But 150,000 people a year is a big number, on the same magnitude as accidental deaths from all causes. (http://www-fars.nhtsa.dot.gov/Main/index.aspx)

2. Many elements of US government expenditure are not allocated on the basis of lives saved. Spending in the department of education, agriculture, are not, to my knowledge, allocated in this fashion. Nor are social security or Medicare/Medicaid expenditures. So by failing to means-test social security we are also, per the post’s logic, killing Americans.

3. There’s some (intentional) political naivete here. I certainly wish that ‘peace dividends’ got spent on life-saving regulatory interventions. I don’t think we have much evidence that this is what we can expect, nor what has happened in the past. If the US shutters some wasteful program or raises revenue from a new tax, the ‘proceeds’ go back into the same political process that provided our current spending allocation. So when a political actor advocates for $10M more spending on program Y, it’s unfair to say “so you want to kill two Americans, then?” Because any political actor knows that’s not the actual choice being faced.

4. None of this means that the US should not be spending less on defense, of course.

Adrian Kelleher @42: The US provides its (um…) peace services for free simply because as the cold war wore on it became less and less willing to share decision making with its NATO and other allies. Again, this was in the service of party interest rather than the national interest. Its allies’ positions were more agreeable to Democrats than Republicans.

The US is less willing to share decision making with NATO and other allies because the decisions made by allies (namely France). France & NATO, France & Vietnam War.

Like the Council, from time to time the Military Committee also meets at a higher level, namely at the level of Chiefs of Defence, the most senior military officer in each nation’s armed forces. Until 2008 the Military Committee excluded France, due to that country’s 1966 decision to remove itself from NATO’s integrated military structure, which it rejoined in 1995. Until France rejoined NATO, it was not represented on the Defence Planning Committee, and this led to conflicts between it and NATO members.

http://en.wikipedia.org/wiki/NATO

But 150K is 6% at 1.67 million per life? At an average of 5 million we would still get a 20% reduction at Sweden’s level of spending? [2.8 trillion 20% more of GDP] What does the slope look like? I would think from 1.67 to 5 million on average we would get more than 20% savings in annual mortality if at 250 billion we save 6%.

It doesn’t look like it adds up.

“assuming no irony alerts, Sandwichman”

Always a risky assumption but more so in present circumstance where Sandwichman is studying the triumphal procession of marginalist analysis in the succession of A.C. Pigou to Alfred Marshall’s chair at Cambridge. What is said is one thing. What is meant or what is thought but withheld is something quite different and the clue, I am discovering, is “reticence.”

My apologies for being so cryptic. But CBA is applied welfare economics and welfare economics is constituted by Pigou’s Economics of Welfare, Pareto optimality, Kaldor-Hicks compensation and the Coase Theorem. And its all bunk.

Alfred Marshall repudiated Pigou. Well, not really, but if you read between the lines and don’t assume any reticence alerts, Marshall blew Pigou’s analysis off and with good reason.* Pigou led the way to a mechanical analysis that Marshall explicitly rejected. Subsequent critiques of Pigou and “new” welfare economics discard whatever slender thread of the living from Pigou and preserved what was dead.

CBA is nonsense on stilts. And even those stilts are on stilts! As for the trillions of dollars pissed away into a shallow latrine called “the defense budget,” how do we know those dollars would even exist if it wasn’t for the opportunity to piss them away? Smedley Butler told us that war is a racket. And that’s just the romantic version.

In the cynical version, war is an accounting shell that facilitates an even larger racket taking place behind the lines, so to speak. For all we know that bigger racket may be five times as big. But if the racket includes cost-benefit analysis how the heck are we going to use cba to calculate the cost in lives?

*[Here’s what I mean by Marshall’s reticence: in Industry and Trade he wrote, “The brilliant work of Edgeworth and Pigou has special claims on English readers. But their route is not followed here: for mathematical analysis cannot easily be applied to conditional monopoly: it is almost constrained to start with the hypothesis of pure monopoly, and gradually to introduce successive limitations, corresponding to the various limitations and restrictions…” Translation? In his marginal notes to his copy of Pigou’s Wealth and Welfare, Marshall wrote, “I incline to think that the marginal supply curve Part II Ch. VIII has no reality; I think he overrates the possibilities of the statical method, and so far I agree with Hobson’s criticism of marginalism… In this I may be wrong. For I can’t follow all that A. C. P[igou] says: and it is possible that he has some recondite meaning. Anyhow I incline not to controvert him, even under 4 eyes, for the present. When he translates his W[ealth] & W[elfare] into realism, then I may perhaps raise a question, if I still cannot follow him.” Shorter translation: Pigou’s work is brilliantly useless and unrealistic.]

Leave the US military the same size, but withdraw all of our troops from foreign conflicts and start a War on Cigarrettes. Unlike the War on Terror, the War on Drugs, and whatever wars we imagine we’re preventing by having bases all over the world, we could actually win a war on cigarrettes pretty handily. That’s 440,000 lives saved every year. You could save those lives for a lot cheaper than $5,000,000 per.

Of course this is a case of Pogo’s, “We have met the enemy, and he is us.” Can’t have the US Army shooting job creators. If only al Qaeda would go public, start a PAC and hire Americans, they could get the same inviolable status as the tobacco companies.

Whatever figures they use for accounting purposes in generating rationales for the existence of this or that program within DoD, it is all just rationale. DoD has long since stopped relying on any actual even potential use to justify its existence. We support it at such great expense not because it serve a purpose, but simply because it exists, and is so massive that it’s too big for us to even start to think about consigning it to the oblivion it deserves.

In all their ideological overreach in imagining that the US Constitution provides for some sort of “power of the purse” whereby all US obligations should be sunsetted, should require each new Congress to find again every year the majorities needed to pass a new law reauthorizing each program, the Right, of course, ignores the one provision in the Constitution that actually does sunset one sort of spending. The US is not supposed to have land forces approved for longer than two years. For the first thirty years, that was taken to mean that every two years every Army unit had to be disbanded, and only then whatever new units authorized by new law would be formed.

The Founders understood that military force uniquely tends to become an end in itself, and so needed to be the one sort of institution that the new US could never let acquire a permanent existence. Military forces seem to confer power, and power never seems anything but desirable. It always seems that it can be controlled and used only for good ends. But the Founders had been the victims of His Majesty’s Government’s infatuation with military force during perhaps the Empire’s most unchallenged position as the strongest power of the day. They saw that government make the gross and obvious mistake of relying on force to deal with its American problem, just to avoid upsetting some trivial and temporary uspet in the balance of the parties in Parliament. Too much trouble, too much riks of loss of face and a few seats in Parliament involved in talking, let’s just send in the Royal Army and the Royal Navy.

Of course, the US has taken over Great Britain’s former franchise as the New Carthage, the imperial power grown so great that it cannot imagine that the power promised by military force is mostly illusory. The vast expense of this vast military establishment is merely a symptom of the loss of rational oversight. That establishment should be disbanded even if it cost less than first class postage. It’s an inherent danger and force for evil even aside from the good things we forego in order to support its existence.

“I’ve spent the day at a workshop on benefit-cost analysis”

It used to be called cost-benefit analysis, didn’t it?

It used to be called cost-benefit analysis, didn’t it?

Until cost-benefit analysis showed that calling it benefit-cost analysis was more efficient.

I’d question whether we can actually extend that many lives simply by shifting government spending from defense to something else. The top 15 killers of Americans are as follows, in order:

1) Heart disease
2) Cancer
3) Stroke
4) Chronic respiratory disease
5) Accidents
6) Alzheimer’s disease
7) Diabetes
8) Flu and pneumonia
9) Kidney disease
10) Septicemia
11) Suicide
12) Chronic liver disease
13) Hypertension
14) Parkinson’s
15) Homicide

Cancer survival is mostly a matter of early detection and avoidance of carcinogens, which are individual efforts. Avoiding heart disease is almost entirely a matter of diet when it isn’t a matter of genetic luck. Stroke is not avoidable. Chronic respiratory disease, when preventable, is caused by atmospheric pollution or smoking. Combining smoking with chronic liver disease, mostly caused by drinking, with suicide, and you have people killing themselves. Diabetes is mostly a matter of diet. Flu and pneomonia only kills the very young and very old and we do about as much as we can reasonably be expected to do on a governmental level providing free vaccinations to anyone who is in any serious risk category. Hypertension is mostly a matter of diet and individual stress. Parkinson’s is not preventable. I think there is a lot the government can do to prevent homicide, such as allowing abortion, decriminalizing non-violent crime so the prisons can be filled with murderers, and especially decriminalizing the production of currently illegal drugs. Those are not, however, spending measures. The only spending measure is increasing police hours.

We’re left with what? Accidents? I’m going to guess that those are mostly vehicle accidents, and the measures our governments have taken to lower these are things like having speed limits, lowering the legal BAC, and requiring seat belts. Those are regulations, not spending measures. So what further spending measures could be instituted? Increasing highway patrol hours and widening highways? That might work, but we’re talking about a category of death that kills 100,000 people a year. You could eliminate every single one of those and not hit 1.5 million in a decade.

Look at every other category of death and consider how the people who die from those causes might have their lives extended for any meaningful period of time and I’m left over and over again concluding that our best bet is to smoke less, wear more sunscreen, and eat better and less good, measures that don’t require the government to spend a dime. As it stands, we already spend more on healthcare than any other nation to achieve worse outcomes, which also makes me question whether it’s not wiser to question the allocation of dollars within the healthcare sector, not between that sector and defense. How many dollars each year are spent on end-of-life care for people with a few days left or on chemo for people with terminal cancer to keep them alive a few more weeks. How much of that could be spent on better prenatal care for black women?

For that matter, how improved could our public health outcomes be simply by changing zoning laws to encourage mixed-use development so more people spent two hours a day walking and fewer spent two hours a day driving? We’d have less pollution, fewer accidents, fewer back problems,and less obesity, all by changing regulations without spending a dime.

Pr Q @ #37 said:

Soru, that’s the right approach in principle. But to check the numbers, do you really think that if US defense spending were reduced by 50 per cent, there would be a 40 per cent chance of a WWII style conflict per decade? Or that the Iraq and Afghan wars have produced a similar reduction in risk?

I strongly endorse the opportunity cost approach to defence spending, indeed to all spending. But opportunity cost cuts both ways. There are costs to excessive pacifism and appeasement (between the wars I am looking at you!)

The flaw in the DoD (M-I complex) mass mortality theory is that it ignores humanitarian benefits of Pax Americana, both for the US and the RoW. Arguably a counter-factual multi-polar world would spend more money on arms and, for obvious reasons, get more involved in regional, and even global conflicts. Maybe India and China and Russia would not get up to mischief if the US were not dominant. But maybe they would. The example of multi-polarity between the wars and during the Cold War is not encouraging.

The evidence of US uni-polarity during the latter half of the eighties and the nineties shows that a benevolent hegemon, prudently led (Reagan, Bush, Clinton) can run the world peaceably and relatively cheaply. This graph shows US per capita defence spending is now running at 40% above its post-Cold War lows, bottoming out at $2500 pa in 2000 and peaking at 4000 pa in 2010.

I haven’t looked at US mortality figures for this period but on Pr Q’s theory they should have declined substantially from their present rates. My impression is that the “peace dividend” did not get spent on cool new ways to save lives.

The implication is that the US, with a sensible foreign policy and disengagement from foreign wars of choice, could run a hegemonic military at around 4% of GDP. So to the extent that a big, but not extravagant, DoD budget reinforces US uni-polarity it may save lives.

Of course, this good performance over the nineties has to be measured against the factual evidence of a unipolar world over the naughties, with the US’s gigantic own goal in Iraq. But one can put the mistakes of the noughties down to freak events (Gore’s loss of 2000 election, the neo-cons take-over of the DoD whilst the REP’s adult supervisors (Baker et al) were otherwise engaged in Florida, Bush’s fatal oversights in border protection in 2001, Atta’s beginners luck, Cheney’s “mushy head” syndrome.)

FWIW, I would welcome the US moving from a warfare to a welfare state, in fact I predicted that Obama would do this in his second term. This prediction has not yet gone through the formality of actually occurring.

Specifically, my observation is that warfare is now more targetted and stealthy – stealth bombers and smart bombs, spooks and drones – which tend to be cost effective. So maybe as a start the Left should push towards a military that specialises in assassination of individuals rather than the destruction of states. In fact they already have with the DEMs promoting regime change by aerial assassination.

LFC @48: I disagree with almost everything you say. For one thing, you are assuming that there is a clear, direct connection between countries’ mil. spending and likelihood of war. But there isn’t. India, for ex., is planning to spend $100 billion on weapons over the next decade, largely to show that it’s a great power. After India has finished throwing away that $100 billion on fancy jets and whatnot, the chance (imo) of an Indian-Pakistan war will be exactly the same as it was before the $100 billion was spent.

We may not be as far apart as you think. I don’t think that there is a simple and direct connection between increased military spending and a reduced likelihood of war. There are other factors at work.

However, the commitment of an overwhelming military advantage to given principles X, Y, Z, etc. is a strong deterrent to any other nation crossing principles X, Y, Z, etc. When the military advantage is less clear, and commitment to given principles less clear, then you have an increased likelihood of conflict.

In an earlier comment you gave a fictionalized dialogue between a Saudi king and an adviser to illustrate the absurdity of diminished US military power in the ME increasing the probability of war between Saudi Arabia and Iran.

But lacking in that dialogue is an appreciation of the uncertainty with which Iran and Saudi Arabia evaluate the intentions of the other. No government, and particularly no government in the ME, has the luxury of an easy certainty in its own security. The existence of a 900 pound gorilla in the room, in the form of the United States, mitigates the impact of that uncertainty.

Shrink US military spending by 50%, add a crisis that requires commitment of US military resources elsewhere, and the presence of that gorilla becomes much less certain. Indeed, by undermining US capability to act as that 900 pound gorilla in more than one region during simultaneous crises, you’ll enhance the extent to which a crisis in one region can affect stability in another. That makes for a much less stable world.

Adrian Kelleher @42: You speak of clarity with regard to US policy on Taiwan, but clarity is precisely what the US seeks to avoid in this issue. The USA recognises Taiwan as a part of China, and cannot therefore legally fight in its defense.

Well, the US to some extent is deliberately ambiguous in order to discourage a declaration of independence, but the US has also acted quite clearly to dissuade the PRC from launching an attack, e.g. by deploying carrier groups to the Taiwan Straits, and by selling Taiwan sophisticated weapons per the Taiwan Relations Act.

I don’t know, doesn’t anybody from the health promotion community read CT? The entire discussion seems to be using the health promotion axioms from twenty years ago. At a population level, we’ve moved on, and now we look at major shifts or differences in death rates as being accounted for not by micro factors such as cameras in the arse end of station wagons but by macro factors such as national income inequality or lack of a sense of meaning. Russia’s death rates didn’t go up by 10% in the decade after the fall of the Soviet Union because people stopped jogging.
Read your Marmot, folks.

Another spectacularly off subject contribution – Chris B, not really my area of expertise so feel free to do kung fu reply, but… as I understand it the lancet paper which did the serious work on the rise in death rates in Russia was done by a team lead by Richard Peto, an epidemiologist who is I think quite skeptical of Marmot’s approach, and they tended to indicate that the spurt in deaths after the fall of communism was linked very strongly in all sorts of ways to the abolition of minimum prices for Vodka which Gorbachov introduced and were removed by Yeltsin. Now that is not to say that loss of meaning etc did not play a role in Russians deciding to drink themselves to death, and indeed in the laisser faire (laissez-mourir?) attitude of the government as they fell of there perches but there does seem to have been a quite specific cause for a lot of the deaths – alchohol – not some more amorphous ‘status syndrome’, which attacks the immune system in some unknown way.

re Andrew F. @83

A few things:
(1) I’m not advocating a specific percentage reduction in the US defense budget (15%, 20%, 30%, 50% or whatever) b/c I lack the expertise to do that. (Not that anyone in authority would care if I were advocating a specific percentage reduction.)

(2) The relation between increased mil. spending and likelihood (increased or decreased) of war is more complicated than I suggested at 48. A lot depends, I think, on the particular context.

(3) The issue of uncertainty about others’ intentions, which you raise, is also context-dependent. I disagree with Mearsheimer when he writes (The Tragedy of Great Power Politics, p.31) that “states can never be certain about other states’ intentions…. no state can be sure that another state will not use its offensive military capability to attack the first state.” In fact, for example, Canada can be sure that the U.S. will not attack it. Britain can be sure that France will not attack it. Examples could be multiplied. Now, admittedly, Saudi Arabia and Iran are uncertain to some extent about each others’ intentions. The questions are “to what extent?” and more to the point “how would a reduction in US military presence/capability in the region affect their calculations?” I don’t know the answers to those questions. However it may be relevant to note an article in the Summer 2011 issue of International Security: “A Crude Threat: The Limits of an Iranian Missile Campaign Against Saudi Arabian Oil,” by two doctoral students at MIT. The abstract reads, in part:

The United States and its Persian Gulf allies have been increasingly concerned with the growing size and complexity of Iran’s ballistic missile programs. At a time when the United States and its allies remain locked in a standoff with Iran over the latter’s nuclear program, states around the Persian Gulf fear that Iran would retaliate for an attack on its nuclear program by launching missiles at regional oil installations and other strategic targets. An examination of the threat posed by Iran’s missiles to Saudi Arabian oil installations, based on an assessment of Iran’s missile capabilities, a detailed analysis of Saudi Arabian oil infrastructure, and a simulated missile campaign against the network using known Iranian weapons, finds no evidence of a significant Iranian missile threat to Saudi infrastructure.

Adam, you’ve easily identified areas where structural changes brought about by spending increases (or reprioritization) will make huge inroads into health: universal coverage (there’s a reason this is the WHO’s new priority!); urban planning; changes in law enforcement policy.

What you miss is this: The “typical american response” is not to “throw money at the problem” (as you say) but to look for individual responsibility for health problems that are caused or prevented at a structural level. Avoiding carcinogens is not possible at an individual level; neither is preventing your very young child from getting measles, or ensuring that your childbirth goes smoothly and safely. These are structural phenomena, and the shift to privatization of these problems in the USA is precisely why American healthcare is so inefficient.

I’ve been in the health promotion/prevention biz for over 15 years, largely in the more or less developing world (Eastern Europe and former USSR), and the mantra is pretty much: governments do not create health, families and individuals do. Now it’s more complicated than that, of course. The government (mostly) has to make services available and accessible, and it must (for good health outcomes) make people aware (of the services, of health risks, of symptoms, of healthy behaviors), but it’s the individuals who have to make use of them.

It’s not just legislation. It’s public service campaigns (long term and massively expensive), gyms and such, exercise programs, HIV and TB drugs (insert long list of expensive drugs existing or that need to be developed, equipment, treatments, etc.), prenatal and perinatal care, healthy school lunches, accessible clinics, etc. etc. etc. So on the one hand, there’s plenty to use our taxpayer dollars on to improve health, but on the other hand, in the end a lot depends on the individual.