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On Death and Dying: Economic Perspectives for a Bleak Winter Day

Last August, Hurricane Irene wreaked havoc along the East Coast from North Carolina to Vermont. However, setting aside the destruction and inconvenience, it may well be that Irene actually saved lives. How? News reports attributed 37 deaths across nine states to this major storm.  But in the absence of Irene—that is, a normal summer weekend without a calamity—how many deaths would have occurred in these same areas “naturally”? Irene kept crowds away from Atlantic Ocean beaches and automobiles off the roads as everyone hunkered down. As a result, there simply had to have been fewer traffic fatalities and drowning over that stretch.
To get a true picture, one would want to tally the expected number of lives lost vs. the 37 caused by Irene (then to that figure we would also want to factor in any additional deaths of construction workers who were employed to repair bridges and roads damaged by that hurricane).
In 1991, when the United States invaded Kuwait to fend off advances from Saddam Hussein in Operation Desert Storm, we lost a small number of lives in that military campaign. But a back-of-the-envelope calculation done shortly afterwards suggested that had we not moved troops and equipment to the Arabian peninsula, more lives would have been lost if these soldiers had continued to be stationed “stateside,” due to traffic deaths, other accidents and domestic violence. Being stuck in the middle of a desert for a month, instead of in South Carolina or California, had its advantages.
Ten years ago, as a result of the 9/11 attacks, for understandable reasons fewer people flew on commercial airlines, and some folks simply did not travel. But others chose alternative means. However measured, automobiles, trains and buses all have higher death rates than flying. An estimated 351 more people were killed in transportation related accidents from October through December 2001 than we would have expected. (Why do we always wish friends a safe flight?  Their bigger risk is the drive to the airport!)
In the years just ahead, as automakers scramble to comply with new federally-mandated minimum mileage—CAFE (Corporate Average Fuel Economy)—standards for automobiles and light trucks, we will save energy and perhaps reduce our dependence on foreign oil. However, the chief way we will achieve those standards is by making vehicles lighter, which makes them less safe for their occupants. Estimates are that this energy savings will come at the cost of perhaps 2,000 or more lives annually. There is an inescapable tradeoff: energy saved but lives lost. The counter argument—if all cars were lighter this wouldn’t be the case—is largely irrelevant because most automobile deaths involve one car hitting a stationary object or rolling over, not a Hummer crushing a Civic.
Smoking is the leading cause of preventable death in the United States, allegedly killing more than 400,000 Americans annually. But these “lives saved” or “deaths prevented” are in reality just “deaths postponed.” Or, as the SNL Gilda Radner character Roseanne Roseannadanna used to say, “If it’s not one thing, it’s another.” These 400,000 folks would have eventually died from something, and that something could be more expensive, another form of cancer, a stroke, or dementia in a rest home. Should we quit smoking and search for cures for cancer? Of course. But we must also realize that the cost of extending life is not costless.
Obesity is the other contemporary preventable cause of death in this country. Here again the same questions and metrics apply: Yes, it contributes to short-run health concerns and costs, such as diabetes (though having to buy XXL clothing and missing work more frequently are costs borne by the heavyset themselves, not society), but the jury may be out on the longer-term “bottom line”: Do the morbidly obese die earlier, and thus save society more costly treatments later?
In addition, smokers pay into Social Security and Medicare over their lifetimes but actually draw little in the way of the benefits because of premature deaths. Ghoulish as it may seem, smokers are actually a net benefit to society, and so may be the obese. Ending all of this on a somewhat more upbeat note and something to relax with while waiting for the snow to melt and our tax refund checks to arrive: Christopher Buckley’s deliciously wicked and hilarious novel, Boomsday, offers Baby Boomers and the elderly a proposal—society will care for your every need as long as you agree to kill yourself at age 75.

Published: February 12, 2012
Issue: February 2012 Issue