If you’re confused about our current squabble over the debt limit, you have my sympathy.
I won’t even try to explain how that peculiar ceiling works. Or why congressional Republicans have balked at raising it. Or why, if a deal isn’t reached soon, the U.S. economy might collapse.
I’m confused, too. That’s probably because when I first encountered the term “debt limit” on some scary newscast, I thought I heard “death limit.”
Seemed plausible enough. If the economy collapsed, a lot of people would lose their money, jobs, health coverage, sanity and, probably, a few years off their lives.
Hmmm ... What if America actually did impose a death limit, an annual ceiling on the number of fatalities the nation can tolerate?
After all, we have so much mortality to work with. About 700,000 people die every year from heart disease, our leading killer. Another 600,000 perish from cancer, plus nearly 300,000 from accidents or other violence. And those are just the big ones.
Interestingly, all those numbers are influenced by government action, or deliberate lack thereof.
Take health care. Expand access to it, and deaths from all sorts of causes tend to decline. Restrict access, as some debt hawks have proposed, and the opposite happens.
Same with workplace, auto and product safety. The more protections we write into law, the fewer people die. And vice versa.
Of course, saving even a single life can be expensive. Federal agencies over the years have put that cost — shouldered by both public and private sectors and, ultimately, us — at anywhere from $100,000 (making cigarette lighters safer) to several million bucks (tightening a few restrictions on air pollution).
A 2005 proposal that would double the roof strength of new cars was rejected by the George W. Bush administration because the 135 lives potentially saved were judged insufficient for the $800 million cost, which worked out to $5.9 million each.
Economists, actuaries and moral philosophers have produced a Mount Greylock of treatises on how to value human existence. For many of us, though, the debate is irrelevant — especially if the life in question is our own.
We are never going to eliminate mortality, though we can keep it at bay through medical breakthroughs, public health improvements and, let’s not forget, basic arithmetic.
We can calculate, for instance, that seatbelt laws save an estimated 15,000 lives a year, motorcycle-helmet mandates another 2,000 and child-proof caps on pill bottles a few dozen, plus thousands of costly trips to the emergency room.
We also know what COVID vaccines cost the federal government at the height of the pandemic ($21 a dose), how many Americans got inoculated (160 million) and how many lives were saved (nearly 300,000).
The expansion of Medicaid under the Affordable Care Act cost the federal government about $70 billion in 2019 and resulted in 19,000 fewer deaths. From that, we could no doubt plot the additional savings in revenue (and cost in lives) for various proposals — floated during the recent debt-limit talks — to curb Medicaid access. Of course, we’d also have to factor in lost wages and tax payments.
So, if we want to keep that lid on the national debt, perhaps we should impose one on death as well. If the latter limit gets close to being breached, our servants in Congress and the White House would be required to do what’s needed to restore compliance. Fail to act, and they’d lose their subsidized health care.
Don’t laugh. The U.S. is the only developed country that has chosen not to have universal coverage — a distinction that has left us with sub-par outcomes in several medical categories, most notoriously infant mortality. We have also opted to endure the world’s highest medical costs.
Meanwhile, we avoid adopting some rather simple legislative and regulatory fixes that could lower not just health care prices, but also our above-average casualties from car accidents and gunshots. Indeed, we’re the only major country that tolerates billion-dollar lobbying efforts to block such measures.
It’s silly to squabble over an arbitrary ceiling on debt the U.S. incurred years ago. Especially when we have it in our power to reduce the number of taxpayers who will die this year.
So, let’s take advantage of the current kerfuffle to set a new kind of limit, one that could save a few lives. It’s the fiscally responsible thing to do.