Michael Strain (or his editors at The Washington Post) might want to think a little harder about the titles applied to his articles, because “End Obamacare, and people could die. That’s okay” is something of a turn-off. The article’s subtitle, “We make such trade-offs all the time,” doesn’t really help.
Mr. Strain is urging Republicans to repeal and replace Obamacare, and he’s hoping the Supreme Court will force the issue in its upcoming ruling on King v. Burwell (aka “the Moops case”). It’s not that he’s heartless, he’s just looking at the bigger picture:
In a world of scarce resources, a slightly higher mortality rate is an acceptable price to pay for certain goals — including more cash for other programs, such as those that help the poor; less government coercion and more individual liberty; more health-care choice for consumers, allowing them to find plans that better fit their needs; more money for taxpayers to spend themselves; and less federal health-care spending. This opinion is not immoral. Such choices are inevitable. They are made all the time.
What examples does Mr. Strain provide? Well, there’s this:
Consider, for example, speed limits. By allowing people to drive their cars at speeds at which collisions result in death, our government has decided that the socially optimal number of traffic fatalities is not zero. Some poor souls die: There were more than 30,000 traffic fatalities on America’s roads in 2013. If we didn’t accept that risk, we’d lower the speed limit to a rate at which accidents simply don’t kill, such as 10 mph. Instead, we’ve raised it periodically over the years, and you can now go as fast as 85 mph on a few highways. It is tragic that thousands of people die each year in car crashes. At the same time, there are huge (if dispersed) benefits to a 70 mph speed limit over a 10 mph limit: a transportation sector that can deliver goods quickly across the country; increased productivity, because millions of commuters can spend more time at work than in transit; and more time at home with our children.
Likewise, thousands of people die in homicides in the United States every year. We could reduce this number substantially, but we have (at least implicitly) decided that the costs — financial and otherwise — of more intrusive monitoring, additional policing, stricter sentencing and other, harsher measures are not worth the benefit. (Though we should continue debating whether marginally higher costs are worth marginally fewer deaths.) A sentry on every street corner and a government-monitored camera in every private room and hallway in America would significantly lower the homicide rate. But I wouldn’t make that trade-off.
So, according to Michael Strain, Obamacare is the policy equivalent of either a 10 mile per hour speed limit or of a police state in which cameras are installed in “every private room and hallway in America”. Those analogies make me suspect there’s more wrong with Mr. Strain’s article than simply its title.
In a subsequent article, Mr. Strain replied to critics by assuring them that, yes, people could die but Congress would never be so cruel or so irresponsible as to allow that; if Obamacare is overturned or repealed, Congress will definitely provide some sort of transitional policy patch that will protect people’s access to healthcare. Plus, as we know, emergency rooms will continue to be open.
From now on, perhaps all proposed legislation and government regulation should come with the caveat, “People could die. But that’s okay”. Or maybe we should make that the new slogan of both the Republican Party and of the American Enterprise Institute at which Michel Strain is a “resident scholar”. Mr. Strain probably just thinks he's being tough-minded and realistic; but I nominate him (and his editors) for Worst Choice of Article Title Ever.