It’s time to do some math. No, not dollars and cents or electoral polls but casualty projections.
A good way to frame the argument can be found in a post last week by longtime blogger and law professor Ann Althouse, who did an excellent takedown of the popular new meme that ObamaCare is Obama’s Katrina. (The comments are educational too.)
November 15, 2013
The NYT acknowledges Obama’s in trouble by reminding us that Bush was really, really bad. Remember?!!
At the website front page the teaser headline — which is also the headline in the paper version — is: “As Troubles Pile Up, a Crisis of Confidence for Obama.” But if you click to the article, the headline becomes “Health Law Rollout’s Stumbles Draw Parallels to Bush’s Hurricane Response.”
I can think of a whole bunch of non-parallels:
1. Bush’s political party didn’t design and enact Hurricane Katrina.
2. Bush didn’t have 5 years to craft his response to the hurricane.
3. Bush didn’t have the power to redesign the hurricane as he designed his response to it.
4. The Republican Bush believed he could not simply bully past the Democratic Mayor of New Orleans and the Democratic Governor of Louisiana and impose a federal solution, but the Democrat Obama and his party in Congress aggressively and voluntarily took over an area of policy that might have been left to the states.
5. The media were ready to slam Bush long and hard for everything — making big scandals out of things that, done by Obama, would have been forgotten a week later (what are the Valerie Plame-level screwups of Obama’s?) — but the media have bent over backwards for years to help make Obama look good and to bury or never even uncover all of his lies and misdeeds.
6. If Bush experienced a disaster like the rollout of Obamacare, the NYT wouldn’t use its front page to remind us of something Bill Clinton did that looked bad.
All of this is true, but it unfortunately also tends to orient the argument around the inside the beltway perspective that the most important thing about the ObamaCare debacle is what it threatens to do to the remainder of Obama’s presidency and second term agenda.
Even the harshest critics insist on communicating in euphemisms. People, they say, won’t get the healthcare they need because they won’t be able to enroll or afford the new policies. Worse, they won’t be able to keep their doctor or access to the better hospitals. The critics toss around millions in their discussions of cancelled policies because millions are the measure of critical mass in the electorate. Obama could, gasp, lose the senate.
Which leads to idiocies like Christie scolding Republicans for beating up too much on Obama because it will reduce his effectiveness at governance.
Well, I have a Katrina-Obamacare nonparallel that makes all such blather ridiculous. ObamaCare is a man-made disaster that is almost certain to result in at least four times more deaths in the next calendar year than Hurricane Katrina did in total.
Take a look at this article on the subject of preventable medical errors. Here’s the key graphic.
These are just the top ten causes of death per year, mind. (There are others, including 20,000+ due to murder, as in drive-by shootings of children…) The point is, what is the human life and death cost of chaos in a system as complex as the American health care industry?
What happens if you toss a powerful bomb into the intricately interrelated relationships of doctors, patients, hospitals, emergency services, pharmaceutical manufacturers, medical device manufacturers, insurance companies, and employers of every size?
What happens if doctors retire or opt out of Medicare and Medicaid, if patient deductibles and co-pays are so high they don’t seek medical treatment they need or can’t afford their prescriptions, if hospitals cut back on their technology investments, if people suddenly deprived of their insurance increase the load on emergency rooms, if the uninsured for whom ObamaCare was supposedly designed don’t have the hardware or the computer savvy to sign up in the world’s most complicated (and spectacularly ill conceived) IT interface?
How hard is it to imagine that the number of deaths in each of the top ten (excluding preventable medical error, for obvious reasons) will increase by One Percent? Subtract Accidents and Alzheimer’s if you want. The number is still huge compared to Katrina.
18,000 would die if fatal medical errors (or omissions) increase by just 1 percent in each of the remaining categories.
The highest estimate of Katrina deaths I have found is here, but note what the majority of casualties in this estimate are attributed to:
My official death toll of 1,723, representing deaths due to immediate and direct effects of the storm, has not changed since August 22, 2006. However, we now have a fascinating document that comes from testimony delivered to Congress, which has caused me to raise the total deaths from Katrina due to direct and immediate plus delayed effects to 4,081…
Of particular interest in terms of the Katrina death toll was the testimony given by a physician, Dr. Kevin Stephens, Sr., Director pf the New Orleans Health Department.
In his testimony (pdf), Stephens points out that New Orleans already had serious public health problems before the hurricane, including large numbers of poor and uninsured people. The number of doctors has been reduced by 70% and the number of hospital beds in Orleans Parish has been reduced by 75%…
Although the population of New Orleans is only 1/2 what it was prior to the storm, the obituaries covered not only New Orleans but also included many of the refugees tossed about to various parts of the country.
Based on this new information, we can add the previous toll of 1,723 to the new post-Katrina figure of 2,358 to posit a new unofficial death toll of 4,081. Possible causes of the excess deaths in 2006 include stress, suicide, pollution, contamination, impoverishment and the devastation of the health sector after Katrina. For instance, the suicide rate tripled in the first 10 months after Katrina.
In other words, institutional failures caused by blowing up a system produce deaths of their own, including deaths that are attributed — by a presumed liberal — to stress, suicide, impoverishment, and deterioration of the functionality of existing health care operations. All of which can be side effects in varying degrees to the rollout of ObamaCare.
Why I think Republicans are once again missing the point. They talk about this catastrophe in economic and quality of life terms, not in preservation of life terms. Their new strategy is, apparently, “Let it Burn.”
The pundits reporting on this don’t seem to get what it means.
This is a smart move, albeit grounded in a couple of political realities. First, Senate Democrats aren’t going to get bullied by Republicans into defunding ObamaCare, as the first shutdown proved. Second, an attempt by Capitol Hill Republicans to force that outcome initially distracted from the unfolding disaster of ObamaCare. That’s the last thing Republicans want now, with a full-blown feeding frenzy on the ACA. Why step in front of Democrats and give the media that kind of distraction?
Because people are going to die in greater numbers than in any other “man-caused disaster,” aka domestic terror attack.
What if my conservative one percent speculation turns out in reality to be more like five percent? That’s 90,000 dead American souls, a population invisible to all the know-it-alls dominating the public discourse.
Where are the mathematical probability mavens, the statisticians and actuaries? Don’t tell me no numbers more predictive than mine can be calculated and introduced into the media discussion.
God damn all the euphemisms on both sides.
At a bare minimum, all ye learned pundits and careful talk show hosts, quit distancing yourselves from Sarah Palin’s death panel locution. Why do the libs hate her SO much? Because she speaks truth in unforgettable sound bites. Which trump liberal lies every time.
P.S. There’s a further possibility. One I don’t like to think of. A recent branch of physics called Chaos Theory, which deals with the turbulence of the 98 percent of physical events whose behavior is not described by classical equations, argues that systems (and people) can handle incremental additional stress incrementally — hence my one to five percent speculation — but that there is indeed a scientific counterpart to the “straw that broke the camel’s back.” The one next item of complication too many causes turbulence, meaning utter collapse of order. Observably, there is a next grain of sand that falls and precipitates an avalanche. Think of the juggler who’s fine with five, six, seven balls. The eighth makes him drop them all. If that is the effect of the combination of the massive overrreach and incompetence of Obamacare, we could be facing a humanitarian disaster of crushing proportions.
Does anyone in politics know anything about math, physics, or systems theory?