Health Care vs Terrorism

Spencer Ackerman brings an interesting anecdote:

At a counterinsurgency conference sponsored by Marine Corps University recently, the author and Marine Vietnam veteran Bing West unfavorably compared Obama’s focus on health-care reform with his focus on Afghanistan. West might not have meant it this way, but 47 million Americans and approximately 30 million American citizens without health insurance is not something to diminish, whatever the requirements of a war. Indeed, it’s ultimately counterproductive for elements of the military community to ask for a commitment to Afghanistan that’s just plainly unsustainable, politically. And this seems to be something the defense community needs to grapple with further.

And, you know, lack of access to health care leads people to die:

A study published online today estimates nearly 45,000 annual deaths are associated with lack of health insurance. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.

The new study, “Health Insurance and Mortality in U.S. Adults,” appears in today’s online edition of the American Journal of Public Health.

The Harvard-based researchers found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.

Even if we want to go with the Institute of Medicine’s lower number, that’s still around 18,000 excess deaths per year. That’s three 9/11s. If we had a terrorism-related death rate anywhere even vaguely in that neighborhood, people would be freaking out. Indeed, if military casualties were happening in that neighborhood people would be freaking out. I don’t think we should necessarily see ourselves in a zero-sum choice between terrorism and other public health issues, but there are real tradeoffs and it’s not even remotely clear to me that prioritizing hard security makes sense. Both better provision of social servcies and more rapid overall economic growth seem to me to have more to do with the welfare of the vast majority of Americans.