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

by John Quiggin on October 21, 2011

I’ve spent the day at a workshop on benefit-cost analysis where a lot of discussion is on valuing policies that reduce risks to life of various kinds.  US policy, for better or worse, is focused on  the idea of Value of a Statistical Life. Typically a policy that reduces  risks of death will be approved if the cost per life saved is below $5million, and not otherwise.  (There are similar numbers applied to publicly funded health care services, prescription  drugs and so on, usually per year of life saved).

A striking thing I found out is that anti-terrorism policies of the Department of Homeland Security are subject to  the same benefit-cost requirements as EPA  and Transport. But Homeland Security is only one way  the  US  government spends money with the aim of protecting Americans against attacks from terrorists and other enemies. Defense spending is far bigger and not subject to BCA, even though money spent on defense is money that can’t be spent on reducing terrorism risk through DHS or more reliably on reductions in environmental, health and transport risk

The numbers are quite striking. The ‘peacetime’ defense budget is around $500 billion a  year, and the  various wars of choice have cost around $250 billion a  year for  the last decade (very round  numbers here). Allocated to domestic risk reduction, that  money would save 150 000 American lives a year.

So, since 9/11, US defense spending has been chosen in preference to measures that would have saved 1.5 million American lives. That’s not a hypothetical number – it’s 1.5 million  people who are now dead but  who could have been saved. I think its fair to say that those people were killed by the Defense Department, or, more precisely, by the allocation of scarce life-saving resources to that Department.

What can be said that might suggest that the defense budget didn’t really cost all those lives.?

Some objections can be dismissed fast.

First, a lot of people are uncomfortable with notions like valuing statistical lives. But  there’s no need to believe in this notion as far as the  argument here is concerned.  What matters is that there are lots of  policy  options that would save lives at a cost  of  around $5 million each, and those  options are not being taken up.

Second, there are various  responses that amount to the claim that refusing to  do things that would reduce death  risks is, in some important moral sense, different from doing things that increase death risks. [1] Maybe that’s arguable for individuals, as shown by the endless debates over trolley problems. But I can’t see that the distinction can be made meaningful for governments. Choosing one policy rather than another will raise the risk of death for some group of people, and perhaps lower it for another. This is true whatever choices governments make.

More seriously,  it’s not really plausible to think of eliminating defense spending altogether. But if the US spent 2 per cent of GDP like other rich countries (around $250 billion a year) and didn’t engage in wars of choice, it could have saved a million US lives over the past decade.

A still more serious objection  is that  money saved on defense wouldn’t be used to save lives anyway. A couple of responses to this.

 First, even  if the money was just handed back in tax cuts, around 15  per cent would probably be allocated to health care and more to  things like education that are positively correlated with health status. Rounding to 20 per cent, that would still have saved something like 100 000 lives over a decade.

Second, saving American lives is much more expensive than saving lives in poor countries. US military interventions are usually presented as being, at least in part, a kind of foreign aid. But  civilian foreign aid can save lives at a much  lower  cost, perhaps  100 times lower. After deducting various forms of quasi military aid the  US currently spends around $10 billion a year on development aid.  Diverting 2 per cent of  regular defense spending would allow  that to be doubled, and could save something like a million lives a year.

 

fn1. As Clough put it “Thou shalt not kill, but needst not strive, officiously to keep alive”.

Update A lot of commentators have expressed doubt that there are policy options that could save 100 000 lives a year[2] at a cost close to $5 million per life. There’s a valid point here, but not nearly as strong as many seem to think. Suppose the cost per life saved rose linearly from $5 million to $10 million as the amount spent increased. The average cost would be $7.5 million, which would allow for saving more than 65000 lives a year. And, in fact, there are many options that would save lives at lower cost than this. The Obama administration has adopted or proposed a range of air quality improvement measures that are estimated to save between 20 000 and 50 000 lives a year, with a best estimate of the cost that is substantially less then the official VSL of $5-6 million. These measures could have been adopted a decade ago, and saved between 200 000 and 500 000 lives. At the same time, Obama rejected ozone rules proposed by the EPA that could have saved thousands more lives per year, at a cost above the official VSL but below $10 million per life. That’s just one policy area, and a relatively small one compared to health care.

I’ll mention one other example that came up at the workshop. About 300 people a year, mostly children under 5, die in driveway “backover” accidents. The Department of Transport looked at a requirement to fit cameras that would provide rear visibility to drivers. This proposal would normally have been rejected because the cost came in at $7.5 million, but the accidents are so horrific in their consequences for families that they found a way to bend the rules. I’m pointing to this one, not because the numbers are large, but to point up the kinds of tragedies that are the opportunity cost of all those military interventions. The money it costs to keep 30 US soldiers in Afghanistan for a year ($1 million apiece) could save the lives of four American children, or many times that number in a poor African country.

fn2. More precisely, premature deaths avoided. For various political and theoretical reasons, the US standards treat all premature deaths saved as equally good, although they sometimes bend the rules a bit to place a higher value on children – this would happen automatically if the metric were life-years saved.

{ 95 comments }

1

Andrew F. 10.21.11 at 1:23 am

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.

2

Bruce Wilder 10.21.11 at 1:29 am

Is a “life” saved a full life — like 70 years worth?

3

John Quiggin 10.21.11 at 1:38 am

@Bruce: This was a topic of (for academics) heated discussion. Official US policy is that a life saved is a life saved, whether at age 100 or age 1.

But I really don’t want to divert the thread onto discussion of the minutiae of VSL. If people are interested, I’ll write a new post on this topic.

4

Sandwichman 10.21.11 at 1:40 am

“What can be said that might suggest that the defense budget didn’t really cost all those lives?”

Presumably the answer would be that the cost in lives was worthwhile because without it, the U.S. would have been overrun by terrorists and enemy nations killing 20 or 50 times as many Americans.

5

Jawbone 10.21.11 at 1:58 am

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)

6

spyder 10.21.11 at 2:04 am

Just a small quibble to bring up before more of the discussion proceeds. There is no such thing as life saving. There are only a series of acts that prolong one life over an other. We all die, we all are going to die, we all will sooner later be dead.

Thus, substituting “prolong” for “save” in John’s post, we find this statement becoming: “Diverting 2 per cent of regular defense spending would allow that to be doubled, and could prolong something like a million lives a year.” This seems somehow less meaningful but more realistic.

7

John Quiggin 10.21.11 at 2:05 am

@Jawbone (and, assuming no irony alerts, Sandwichman) Even at the massively lower level I propose, the US would be outspending China and Russia combined (and Japan already outspends either). Do you think the marginal change in the balance is worth a million US lives a decade?

8

Khan 10.21.11 at 2:13 am

To add to 1, and in the spirit of playing devil’s advocate: can’t a large portion of the defense budget be thought of as a massive (albeit indirect and horribly inefficient) R&D program? Also, a kind of massive subsidy for a variety of high technology sectors — not to mention a way to partially pay for the education of students in those fields. For that matter, one could argue about the existence of a kind of technological (not to mention economic) multiplier effect.

9

Jawbone 10.21.11 at 2:13 am

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.

10

Watson Ladd 10.21.11 at 2:24 am

One quibble: Costs from regulation aren’t costs to the government. Other then that, good post.

11

Khan 10.21.11 at 2:25 am

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.

12

LFC 10.21.11 at 2:36 am

Jawbone @5
reporting 100’s of flights harassing Japan by China and Russia

shockingly belligerent activities

I could be wrong, but a glance at the linked article suggests these were closer to routine intelligence gathering flights than anything “shockingly belligerent”.

(Btw there is an article by Jacques Hymans in the current issue of Int’l Security on “domestic barriers” to Japan going nuclear; I haven’t read it but the link is here.)

Anyway the relevant point is that “the world is a dangerous place” is not a good argument for not cutting the US defense budget. The problem is that the Pentagon is the world’s largest office building with a huge bureaucracy each of whose segments is, not surprisingly, devoted to protecting its funding. Already Panetta is on Capitol Hill somberly warning about the “dangers” of too deep cuts.

13

Bruce Wilder 10.21.11 at 2:43 am

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.

14

Watson Ladd 10.21.11 at 3:06 am

Bruce, if a regulation costs a particular company $5 million, that $5 million isn’t a cost the government incurs. It’s not going to result in $5 million of borrowing or taxing by the government. That’s the sense in which I’m critiquing John: the money saved by the defense department cannot go to offsetting the costs from regulations.

15

David Moles 10.21.11 at 3:10 am

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.

16

Manoel Galdino 10.21.11 at 3:49 am

1. In general I’m in favor of CBA, but if pushed too far you may end making silly statements, like economists who claim that most (if not all) deaths are suicides (see Gelman’s blog for an entry on this topic).

2. In general, these CBA are based on partial equilibrium analysis an the value is estimated on margin. You can’t really assume that the clause “ceteris paribus” will hold with such a large amount of money.

3. The world is complex and there are a lot of feedbacks and multiple equilibria that may arise of a large change in policy. In this sense, it’s quite tricky to believe in such numbers.

4. Another silliness of these kind of reasonings is related with economic discussions of ennvioronment, in which they discuss about te proper discount rate to value future life… (see Stern report and Varian criticism…).

5. Finally, despeite all that, assuming you’re right, why not extend this reasoning to protection of animals, financing of arts, museums etc. that are luxury goods?

ps.: I’m a Brazilian and I’m in favor of all countries (inclunding US) to reduce they defense spending… But it’s not related to CBA…
3.

17

mclaren 10.21.11 at 4:10 am

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.

18

js. 10.21.11 at 5:30 am

Typically a policy that reduces risks of death will be approved if the cost per life saved is below $5million, and not otherwise.

I really just want to know where they came up with $5 million. Also, is this figure indexed to inflation?

19

wkwillis 10.21.11 at 5:34 am

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.

20

dangermouse 10.21.11 at 6:23 am

can’t a large portion of the defense budget be thought of as a massive (albeit indirect and horribly inefficient) R&D program?

Not sure how this isn’t an argument for taking that money and putting it into a direct, not horribly inefficient R&D program.

21

Bruce Wilder 10.21.11 at 7:10 am

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.

22

Henri Vieuxtemps 10.21.11 at 7:14 am

Why do you all call it ‘defense’? Has it not been renamed to Ministry of Peace yet? That would make everything much more clear.

As the Soviets used to joke about their government’s ‘struggle for peace': there will be no war, but there will be such a struggle for peace that everything will be razed to the ground.

23

duck-billed placelot 10.21.11 at 7:33 am

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.

24

Pete 10.21.11 at 8:17 am

I’m of the opinion that reducing the US defence budget would increase global stability. Especially defunding the CIA’s destabilisation budget would help.

25

Leigh Caldwell 10.21.11 at 8:24 am

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.

26

Chris Bertram 10.21.11 at 8:31 am

John denies that

_Avoiding the statistical aspect, not saving people when you could do so is morally different from killing them._

But contra John that does often seem right, as a whole host of examples would bring out.

Suppose I can rescue one and only one of Abel, Belinda and Caroline who have all fallen into the sea and are drowning. If I rescue Abel, have I killed Belinda and Caroline?

This example matters because when I allocate, say, my health expenditures one way rather than another, there are some who otherwise would have died whom I save, and vice versa. But it doesn’t make a lot of sense (imho) to talk about me killing the people whom I would have saved in the alternative scenario where they lived (espcially if my choice is reasonable).

And reasonable choices might not be the ones that maximize the numbers of living. Perhaps I use my budget to enhance the life quality of younger people using money saved not trying to extend the lives of very old people. Am I doing something that is not “morally different” from killing those old people. I don’t think so.

27

Tim Worstall 10.21.11 at 8:39 am

“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.

28

Chris Bertram 10.21.11 at 9:01 am

Generalizing from my last example:

bq. The government deliberately killing people

is very different, morally speaking, from

bq. The government allocating its budget in ways that give to weight to values other than death avoidance.

Note, John, that you are (as I’m sure you realise) committed to giving weight to such other values simply in virtue of the fact that in making calculations about, say, road safety measures, you allocate a notional value to each life saved as part of your CBA.

29

ajay 10.21.11 at 9:58 am

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.

30

John Quiggin 10.21.11 at 10:29 am

Responding to Leigh (and others who have raised those points)

(a) Undoubtedly you would move some way up the curve, but the total amount spent on health care is well over 10 per cent of national income, and the opportunity cost of other life-saving measures is also very large. So, shifting 4 or 5 per cent of income to these activities would almost certainly not exhaust the opportunities to save lives at reasonable cost. Say that the marginal cost of the last life saved rose (linearly) to $10 million. That would still leave you with 75 per cent of the original estimate.

A notable point in this respect is that the US does badly, relative to other developed countries, as regards life expectancy (that is, mortality). So, there must be a lot of opportunities out there simply by doing things that other countries are already doing.

(b) Certainly, I think quality-adjustment matters – I’ve done a bunch of work on the pros and cons of Quality-Adjusted Life Years as a basis for health spending. This was debated a lot at the meeting.

(c) The point of the post was to force people to pose your Question 2 in as sharp a way as possible. Do you think the US, by spending so much more than others in its regular defense budget is saving 100 000 lives a year? Do you think the wars in Iraq and Afghanistan have saved 50 000 lives a year? Before allocating money for another weapons system or overseas deployment, shouldn’t we be thinking about such things?

31

Andrew F. 10.21.11 at 11:02 am

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.

32

soru 10.21.11 at 11:05 am

I think this style of argument does actually serves to demonstrates where the level of US military spending comes from.

US casualties in WWII were approximately half a million. Baseline assumption of planners, calibrated from the first half of the 20C, is that there is 40% chance of a conflict on that scale in any given decade.

So reducing that to a negligible chance saves ~200,000 US lives per decade, which is in the right order of magnitude. So by the time you account for the possibility of a worse (or just less successful) conflict, and the points mentioned above about the incidental benefits of defence spending, increasing marginal costs of other measures and so on, it starts to make sense on its own terms.

Run the same numbers for other democracies, and you would get much smaller budgets, as observed.

To argue against it, I’d concentrate on ways of achieving the same net result (near zero chance of major conflict) with lower spending, saving resources for other issues. The fact that corporations have been successful in extracting the full worth, or more, of the avoidance of major war as revenue is a strong clue that the same goal could be achieved at radically lower cost by a non revenue-seeking organisation.

33

Barry 10.21.11 at 11:29 am

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

34

John Quiggin 10.21.11 at 11:29 am

@Chris: I’ll agree with you as regards individual moral responsibility (and will edit the post when I get a bit of time). Without rerunning debates over trolley problems and so on, I agree that it’s unhelpful to talk of killing B and C when you save A, or in all sorts of actions of this kind. It’s impossibly morally demanding to require individuals to think in this way all the time about the potential lives they could save by acting differently.

But I think the converse applies to governments. Governments necessarily take lots of actions that lead fairly directly to some people living and others dying, as well as to some living better and others living worse.

I agree that we are willing for governments to make trade-offs, ideally similar to those we would make ourselves, between saving/extending lives and making the quality of life better. That’s the whole point of the VSL analysis, for all its flaws.

But precisely for that reason, when governments spend money in ways that purport to make us safer, but forgo better ways of spending the same money, they should be held to account for the lives that are lost as a result.

35

Barry 10.21.11 at 11:30 am

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.

36

Anderson 10.21.11 at 11:32 am

So how many people have been killed by Social Security or the interest on the national debt? (Sure, with SS you have to offset some lives presumably saved by the program.)

It’s a provocative rhetorical device, I suppose, but at bottom this is just guns-or-butter.

37

John Quiggin 10.21.11 at 11:39 am

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’d suggest that, even on the most extreme negative views of China and Russia (some seen in this thread), the likelihood of either launching a large-scale conventional war any time soon is minimal, and there is no-one else large enough to even think about war with the US or Europe. There’s still the chance of a nuclear war, but “defense” doesn’t defend against that.

As we noted in the previous thread, interstate wars have become very rare in recent decades, and not because the US military routinely rushes to stop them.India and Pakistan might still go to war, but it’s not obvious that US policy has done much to reduce this risk.

38

Matt McIrvin 10.21.11 at 11:44 am

By this reasoning, the tax cuts are in the same league.

Actually, I’m a little nervous about this line of argument, because it could easily turn into one of those weird utilitarian calculations that turn almost every human activity into homicide. I suppose applying it to the DoD is more legitimate than most applications since defense money is specifically supposed to be money spent on protecting people; the question is whether we’re getting value for money.

39

soru 10.21.11 at 12:39 pm

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.

40

reason 10.21.11 at 1:30 pm

Leigh Caldwell

“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. “

Why do you think the cheapest option is to extend the lives of the old. My guess is the cheaper options are actually at the other end of life – especially in the US (with its extraordinary infant mortality figures for a western nation). Not to mention the possibilities inherent in road transport.

41

reason 10.21.11 at 1:32 pm

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

42

Adrian Kelleher 10.21.11 at 2:12 pm

@Andrew F

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. The US is even very reluctant to sell arms to Taiwan (as is everybody else), which would like to import and could afford much more than the US is willing to provide. Taiwan’s defense expenditure is barely half of that in the USA as a percentage of GDP, as is that of South Korea, even though each has genuine security concerns. You speak of threats to Japan but Japanese defense expenditure is also a tiny fraction of the USA’s even if the large chunk it hands over immediately to the USA is taken into account.

The rest of your post reminds me of Mussolini’s remark that von Ribbentrop was “one of those Germans who is the ruin of his country, always speaking of war here and war there without once naming an enemy or stating an objective” [from memory but close to verbatim]. If US strategy in the 21st century is to maintain military dominance over all comers based on 3% of the world’s population then it really is doomed. I’m going to quote a post I made elsewhere:

It would not be difficult for an Irish person to think that US hegemony is the greatest thing ever. The US may become involved in often bizarre entanglements in the middle east or where ever but it never hurts our interests. Not only that, it guarantees freedom of navigation and tacitly underwrites western investments in unstable regions.

The manner in which US conservatives move from this sensible point to endorsing all US actions abroad is strange, however, and bears little resemblance to the traditional definition of the word conservative. Little heed is given to whether the involvements advance the national interest or not. On more than a few occasions US political leaders have lied with great verve and persistence to maintain the domestic popularity of a foreign engagement. Iraq and Vietnam are the most obvious and well documented examples but there are many more.

Conservatives’ loyalty to their leaders takes on a bizarre quality when it seems to sanction party interest over national interest and to digest these lies without upset. The interests their leaders have sought to advance were often sectional and divisive domestically and cannot be compared with the national interest.

[...]

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. Also, US leaders have found it convenient to exploit their central position in the Western system of alliances. Only the USA is involved in the Pacific as well as the Atlantic sphere. This has enabled it to advance its leaders political aims more successfully than if its allies were all part of a single alliance but arguably at the expense of a broader national interest in a stable international order based on shared values of democracy, open government, free trade and market economics.

Having self-consciously marginalised its allies, the USA can hardly complain that its allies are not doing their part. Why would they when they have no influence? And how can US conservatives justify to themselves denying them influence to advance party interest ahead of the national interest? The process has now become so involved that second- and third-order effects have come into play. Specifically, what were once incidental or momentary differences with allies have solidified into matters of dogma. Much US political ideology is now a simple reaction against European political trends.

When the US was securely in the saddle, the strategy adopted gave its leaders freedom of action: it could simply override its allies where it chose. I would be interested to hear anybody’s list of examples where this advanced US interests in any way, however. It’s allies have grown delinquent and taken to self-indulgent moralising precisely because this is the best option remaining to them. They may as well preach love and peace because they have no other remaining function. It is US policies that have done most to bring this about, however.

[...]

Fondness for my own voice isn’t my only motivation here… The key point is the distinction between national and party interest. The USA has grown increasingly reluctant to share decision making with allies simply because that would be complicated and complicated policy doesn’t sell well. The result: Americans worry about threats to Japan and Korea and spend more per capita to avoid them than they do themselves.

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Adrian Kelleher 10.21.11 at 2:14 pm

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.

44

Barry 10.21.11 at 3:07 pm

mclaren @ 17 – thanks for the smackdowndangermouse 10.21.11 at 6:23 am

45

Barry 10.21.11 at 3:09 pm

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

46

LFC 10.21.11 at 3:25 pm

soru 39:
It would only take a 10% chance of a bad decision by any one of China, Russia, Saudi Arabia or Israel for them to start a major war on the assumption they could win it.

scenario:
King Abdullah (or King X, sitting in Jiddah): The US naval presence in the Indian Ocean has been substantially reduced! Now we can launch the wars we have always wanted to launch against Israel and Iran! Which shall we invade first?

Advisor to the king: Well, to invade Israel we’d have to cross either Jordanian or Egyptian territory, which they might not let us do. More importantly, the Israelis have nuclear weapons. You can never be 100 percent sure they won’t use them, esp. if their backs are to the wall.

King: OK, then let’s invade Iran. Launch a naval flotilla across the Persian Gulf immediately. We’ll strike the Iranians’ soft underbelly. I am a strategic genius! (aside to servant): More tea, you fool.

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

King: So what? The US naval presence is down. That’s all that matters. Launch the flotilla immediately!

Advisor: Yes, your highness.

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LFC 10.21.11 at 3:26 pm

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

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LFC 10.21.11 at 3:41 pm

Andrew F @31:
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.

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michael e sullivan 10.21.11 at 3:51 pm

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.

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mpowell 10.21.11 at 3:53 pm

I think Soru makes a few good points (though his hypothetical is pretty terrible – if rulers are going to be that crazy irrational it’s not like a US military presence is a guaranteed fix), but I would like to add a few comments. First, even if we grant that it is difficult to maintain a strong military deterrence while dramatically reducing spending (because the process is inefficient and can only be marginally reformed) that certainly doesn’t mean we have to launch wars of choice. That is a decent percentage of spending in the last decade and doesn’t do any good. Secondly, I think it would be possible to squeeze down spending over time. Part of the real problem here is that I don’t think the US actually has much projection capabilities in Asia anyways. If North Korea invades South Korea, millions of people are going to die and there is nothing we can do to prevent that. If China is willing to start a shooting war over Taiwan, either we don’t commit our naval resources and therefore immediately surrender air superiority or our carrier task force groups last days against their land based missile attacks (defensive measures that currently exist are basically a huge boondoggle). The downside for China is economic not in the field of battle. Saudia Arabia is a different story with a much different level of capability, of course. But our projection ability against our most determined adversaries is basically a mirage. Maybe that actually has a lot of value, but it’s not as clear cut as at first glance.

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mpowell 10.21.11 at 3:57 pm

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.

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Watson Ladd 10.21.11 at 4:03 pm

@LFC: Israel will use nuclear weapons under 4 conditions: 1) Post 1947 border violation, 2) Air superiority being lost, 3) Mass bombardment of population centers, 4) Retaliatory strike for nuclear weapon attacks. This is from the wiki, so it might not be the real posture, but I’m sure the Saudi king would be thinking “they will use them rather then endure a defeat that results in depopulation”.

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michael e sullivan 10.21.11 at 4:12 pm

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.

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Uncle Kvetch 10.21.11 at 4:49 pm

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.

Next thing you know you’ll have countries invading each other on the basis of transparently fabricated pretexts about imminent threats and mushroom clouds and weapons of mass destruction. That sure would suck.

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soru 10.21.11 at 4:55 pm


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.

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Kenny Easwaran 10.21.11 at 4:57 pm

I’m surprised to hear that Homeland Security is subject to this same cost/benefit analysis. I would be very surprised to learn that there is evidence for any lives saved from the policy of removing shoes or disposing of liquids at airport security, and yet surely those two policies have cost travelers many millions of dollars in destroyed goods and hours spent waiting in line, not to mention all the economic damage from reduced air travel. (On the plus side, I suppose you could count all the lives saved from decreased CO2 emissions from those forgone airplane trips. But you should also count all the lives lost due to substituted automobile travel.)

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Henri Vieuxtemps 10.21.11 at 5:04 pm

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?

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Omega Centauri 10.21.11 at 5:10 pm

I think there is a question of what level of (USA) defense spending actually minimizes probabilistic US military loses from security threats. It is taken as given in most domestic circles, that more is always better. [I think this comes because we think of ourselves as the good-guys]. But, when you look at things like our recent Iraqi adventure, would that have been more or less likely if we had spent less on defense in the years prior to the decision to invade? We have a very expensive hammer, and will thus seek out nails to pound with it. We are probably well above the point in the curve where further expenditure increases probable losses because it allows us to be cockier in our decision making.

59

Lemuel Pitkin 10.21.11 at 5:12 pm

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.

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soru 10.21.11 at 5:25 pm

I’m surprised to hear that Homeland Security is subject to this same cost/benefit analysis.

It makes sense, or at least is internally consistent. 1% chance per decade of a nuke on a major city, at $5 million per casualty, translates to a pretty immense budget. The fact that there are relatively few things to spend that budget on sensibly is unusually evident.

But revenue is revenue; it makes no more sense to expect corporations to leave the money on the table than for Apple to announce ‘hey, I think people have enough gadgets now; we are not going to make any new ones’.

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Ben A/baa 10.21.11 at 5:32 pm

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.

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Barry 10.21.11 at 6:29 pm

(something I missed earlier) Andrew F:

“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.

BWAHAHAHAHAHAHAHAHAHAH!!!!!!!!!!!!!!!!!!!!!!!!!!

I have a challenge for CT-ers – find an example of Andrew F being right.

63

James 10.21.11 at 6:29 pm

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

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Barry 10.21.11 at 6:31 pm

soru (re: the cost of Homeland Security):

” It makes sense, or at least is internally consistent. 1% chance per decade of a nuke on a major city, at $5 million per casualty, translates to a pretty immense budget. The fact that there are relatively few things to spend that budget on sensibly is unusually evident.”

You forgot to link to any reason to assume that anything Homeland Security does makes us safer.

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John Quiggin 10.21.11 at 7:10 pm

“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 was noted above (in criticism of my estimate), there’s a cost curve, which means the approximation is only valid for “small” changes”. I’d say a 4-6 per cent reduction in mortality is small enough to make the approximation OK, but that’s a judgement call. 100 per cent, clearly, is not.

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someguy 10.21.11 at 7:14 pm

What Leigh Caldwell said times 10. Also what Ben A/baa said.

There just aren’t anywhere near that many opportunities to save lives at 5 million.

They just don’t exist. [Or at least we don't know about them.]

The annual US death rate is 2.5 million.

At 250 billion and 150K saved I get 1.67 million per life saved.

TAt 1.67 million per would mean that Sweden’s spending levels we would save 1.5 million lives per year. At which point we should just go ahead up the spending a little more and eliminate death. I wish! Really!

Even at 5 million I get over 500K less deaths a year a 20% improvement. At 10 million we still get a 10% reduction in total death rate.

And I also totally agree it would be great if at very least defense spending dropped from 750 billion to 500 billion. But great != 500K less deaths per year in the US.

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someguy 10.21.11 at 7:29 pm

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.

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kosimba 10.21.11 at 7:48 pm

Not really on the subject but I cannot let pass the assertion by many contributors that US military spending is a force for stability in the world – do you have eyes and ears? Look at the destabilising effect of unmanned drones in Pakistan, even forgetting the decades helpful US foreign and military policy in the region, promoting and arming dictators and fundamentalists.
The last two wars – Afgan and Iraq – especially make this clear. Even leaving aside the people killed by the war + mere anarchy unleashed – have clearly made the world massively less safe, more unstable, etc. Ditto the massive US defence subsity + access to US military technology granted to Israel. Outside of the US media hall of mirrors all reasonable people accept that Israel is one of the major causes of instability in the middle east. Substantially lower military expenditures by the US would result in a substantially safer world, especially as this would force the US to accept that multilateral and legal restraints and foreign policy dictated by wisdom and a real conception of their national interest rather than the oil lobby.

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Sandwichman 10.21.11 at 8:20 pm

“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.]

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Soru 10.21.11 at 8:30 pm

Using your eyes and ears only gets you access to the world in which US defence spending is what it is.

A world with a 50% cut, and no other changes, would be a sufficiently different place that current real world information would be actively misleading. The impractical would become merely unlikely, the strange normal, the possible near-inevitable.

In contrast, change the world to the kind of place that doesn’t assume US hegemony and there would be no particular need to stop at 50%, or 95%.

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Glen Tomkins 10.21.11 at 9:45 pm

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.

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Omega Centauri 10.21.11 at 10:38 pm

kosimba: Far beyond the damage done to parts of the world that the US has already done, largely because it possesses such a strong military, I worry about the potential for massive future damage. Given the political currents afoot within the country, it is not beyond the pale to imagine the US becoming a rogue superpower, pursuing some delusional goal (such as Christianizing the muslims via a new crusade, or whatever).

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stostosto 10.22.11 at 12:10 am

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

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

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sg 10.22.11 at 3:35 am

a few people have complained that the US couldn’t save 100,000 lives a year at 5 million each, but I really think that’s too pessimistic. There are a multitude of ways that this could happen in the US that aren’t even particularly costly: improved immunization coverage; improved HIV/AIDS intervention; gun buy-back schemes (which have been shown to reduce suicide rates significantly in Australia); investment in roads and road safety; implementation of a coherent nationwide harm reduction and methadone maintenance treatment program; investment in high quality mental health services; or, most obviously, introducing a single-payer health insurance system that guarantees coverage.

Also, about the issue of saving A killing B or C, I think that’s only valid for this issue in the context of deciding to redirect existing money (from e.g. a $4 mill per life program to a $3 mill per life program). What we’re actually talking about here is decisions on spending new money (that is, money that is either additional to previous revenues or, per JQ, was being used in programs assumed not to save lives at all). In this case, A B and C were all going to die anyway, so we can legitimately argue that we have not killed B or C by saving A. I think this issue draws a false moral equivalence between an individual good samaritan and a government program. When you improve vacccination coverage, for example, from 70 to 80 %, you aren’t actually saving any individual in the extra 10%, you’re just increasing vaccination coverage. But less people will die as a result. It’s a false moral equivalence to compare govt spending programs with good samaritan acts.

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Paul C 10.22.11 at 6:29 am

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.

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sg 10.22.11 at 8:23 am

A funny thing about this thread – if you try to argue in defense of e.g. AGW mitigation efforts using the precautionary principle with a hard-headed realist, they’ll sneer and tell you the precautionary principle is no basis for good policy – they’ll then move on to hard-nosed economic discussion of cost-benefits and discount rates and oh don’t you think that money would be better spent alleviating infant mortality in the third world?

Prof. Q does exactly the same thing with defense spending and what do we see? A bunch of people rushing to apply the precautionary principle and looking very askance on his economics.

Cute!

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John Quiggin 10.22.11 at 10:01 am

The final question of the conference concerned what the questioner called the “religion issue”: is it cost-benefit analysis or benefit-cost analysis? The keynote speaker’s answer, in full “It’s benefit-cost analysis”.

So there you have it.

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anon 10.22.11 at 9:35 pm

Gosh, as an American Tax Payer I always thought it was the US Congress than made the budget for the Defense Department. I can only thank all your foreigners for letting me know that it is the Defense Department that tells Congress what to give it while the President only provides a rubber stamp.

You should all win Nobel Prizes for Brilliance in thought!

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Adam Acosta 10.22.11 at 11:56 pm

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.

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Jack Strocchi 10.23.11 at 1:40 am

You do realise don’t you, Pr Q, that the two US politicians who have had credible Presidential aspirations with whom you have most in common with on national security issues are Ron Paul and Pat Buchanan.

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Jack Strocchi 10.23.11 at 10:57 am

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.

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sg 10.23.11 at 11:47 am

Adam Acosta, I think your whole paragraph starting with “Cancer survival is mostly a matter of early detection and avoidance of carcinogens, which are individual efforts. ” is full of misconceptions about public health. Just in that first sentence there are three major errors: whether or not cancer survival is affected at all by early detection depends on the cancer and available treatments; whether survival has much to do with avoidance of carcinogens depends on the cancer, the availability of treatments and the effectiveness of early intervention; and none of these things have much at all to do with individual efforts (screening and carcinogen avoidance are not individual activities). The rest of your paragraph follows this kind of nonsense. There are many things that the US could do – from funding access to healthcare to improved seatbelt laws – that could reduce mortality through spending.

Jack S, your ideas are interesting but I don’t think benefit cost analysis is very well accepted when it has to posit counter-factuals involving freak events. And once again, your suggestion for counter-factuals begs the question: why do people on the right refuse to tolerate this kind of speculative thinking in assessing the economic case for AGW mitigation?

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Andrew F. 10.23.11 at 7:02 pm

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.

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jack lecou 10.23.11 at 9:04 pm

Combining smoking with chronic liver disease, mostly caused by drinking, with suicide, and you have people killing themselves.

Just to amplify what sg said, this sentence above seems especially phenomenally wrong headed.

I marvel at the twists in logic it must take to ignore or erase decades of relatively successful public health interventions and corresponding reductions in the prevalence and lethality of smoking, drinking and depression and to simply shift these (more or less wholly preventable) causes of death wholesale over into a shiny, hopeless new category of “people killing themselves”.

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Chrisb 10.23.11 at 10:36 pm

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.

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soru 10.24.11 at 1:09 am

if you try to argue in defense of e.g. AGW mitigation efforts using the precautionary principle with a hard-headed realist, they’ll sneer and tell you the precautionary principle is no basis for good policy

It’s easy to work out why: global warming is highly(~75%) likely to lead to the deaths of 10 million Americans a decade. At $5 million a head, that’s a not a percentage of GDP, but a multiple of it.

Now, you could reform the system such that the required measures ended up being priced at whatever they actually cost. Which might be high, but would almost certainly be drastically less then if they were priced like defence, health care or a ransom; keep bumping up the total until we find out what they _won’t_ pay.

Alternatively, you could just go into denial about that particular risk, with a fallback position of ‘well, if we can’t afford to keep them alive, then what can we do?’.

No prizes for guessing which is the most common choice.

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kosimba 10.24.11 at 3:03 pm

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.

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kosimba 10.24.11 at 3:10 pm

And my aquaintance with people in the ‘health promotion community’ is that they are very into all sorts of micro interventions – there is for example a big push to introduce and harmonise taxes on cigarettes in various parts of the developing world, not to mention Meviedev’s recent attempts to re-introduce minimum prices on vodka in the wake of the lancet study. Such interventions are in no way opposed to doing wider socio-economic stuff.

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John Quiggin 10.24.11 at 3:16 pm

I thought I had posted in response to Adam Acosta along the same lines as sg, but it must have got lost

I’ll just mention that the OP (as revised) includes references to environmental measures that would prevent thousands of premature deaths from respiratory disease and cancer. Statins have greatly reduced heart disease deaths – improvements at the margin could save many more lives, but presumably would be costly. And so on.

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Hidari 10.24.11 at 3:30 pm

‘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.’

Yeah like what about the ‘targeted assassination’ of Patrice Lumumba? That certainly didn’t lead to any long term problems, which is why the DRC is now the earthly paradise it is.

Or what about the assassination of Archduke Ferdinand? His death certainly brought peace to Europe for a few decades.

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LFC 10.24.11 at 4:41 pm

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.

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Adam Acosta 10.25.11 at 2:00 am

Maybe my first post here was misstated, but more to the point, given that we spend far more per capita on healthcare to achieve worse outcomes than most of the developed world, and most premature American deaths still result from poor health, I don’t think that shifting defense spending to spend even more on healthcare is the answer.

The African-American rate of low birthweight is what? Double the rest of the population? What is really the answer there? Universal coverage is a step in the right direction. Decriminalizing drug crimes so that more black families have fathers is probably an even bigger step in the right direction and it’s free.

The greatest rising problem in American public health is what? I’m guessing obesity, which has ballooned even as our spending on healthcare has skyrocketed. The problem there is clearly not an issue of spending. It’s an issue of deteriorating diet and exercise and at the state level, that’s an issue of poor food policies such as subsidizing corn (we could improve health by spending less public money in this case) and all but eliminating PE programs in primary schools. It’s also an issue of deliberate urban and regional planning decisions, in which we’ve decided to be a nation of widely dispersed communities in which we shop, work, and live in three separate places, all of which we drive to, in addition to the long hours Americans work. More hours working plus more hours driving equals less hours exercising.

Additionally, all that driving equals more air pollution, which equals more asthma, COPD, and pneumonia, and more anthropogenic global warming. We can tax carbon and use the proceeds to buy inhalers for all American children, or we can encourage mixed-use development and the buying of locally-grown food from all that new arable land that is no longer being leveled to build McMansions at the outskirts of our cities. Heck, we’d even eliminate some fire deaths by doing that since we’d no longer be building into the chaparral.

There are different ways to address these issues. The typical American answer is to throw money at the problem after it has become a problem and spend billions a year on dialysis for people who would never have had the problem in the first place if they’d simply walked more and eaten less fructose as children.

I’m not discounting the power of spending money on public health to lengthen the life of someone with metabolic or heart disease by a year or two. What I’m saying is we can all but eliminate these diseases, which are diseases of affluence we’re not absolutely doomed to suffer and must do nothing but treat after the fact at all costs, with far less costly policy decisions. Relative resource allocation by sector is not the reason we have poor healthcare outcomes and die sooner than we should.

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sg 10.25.11 at 3:14 am

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.

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Andrew F. 10.25.11 at 10:33 am

LFC, I agree with much of what you write. But I think I’m less sanguine about the stability of peace between nations. In particular I’m suspicious of the notion that we’ve entered a time when the inter-state wars that have been with us as long as states have are now a thing of the past. My worry is that we will begin drawing down the military advantage which has enabled much of the world to live in relative stability and security.

The International Security article you cite, in some ways, illustrates how weakness, in conjunction with a perceived threat, can cause instability. Suppose that the article is correct that Iran – at present – lacks the capability to disable Saudi Arabia’s oil industry with a missile strike. If so, this increases the chances that Saudi Arabia would countenance a strike on Iran in an attempt to retard Iran’s nuclear program. Were the US not to be a guarantor in that region of a certain amount of order – and it will become vastly more important if/when Iran obtains nuclear weapons – Saudi Arabia’s incentive to countenance a strike now on Iran would be even greater.

While democratic peace theory offers some hope for the future, imho we’re slowly transitioning to a more dangerous, and unstable, world than we’ve experienced in some time. And so while I respect the spirit of arguments that we should cut defense spending and use those dollars for other endeavors, I also think those arguments fail to take the uncertainty of history, and the ubiquity of war in human history, seriously.

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mossy 10.27.11 at 9:27 am

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.

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