Posted on March 26th, 2010 by D. Aristophanes
Megan McArdle has been in a mathematical uproar since HCR passed, honking on about how she’s 95 percent certain that three-fourths of half of a third of Ezra Klein’s predictions about a baker’s dozen of 17-sixteenths of the cosine of future mortality rates are eleventy percent likely to be a sham. We can’t quibble, but then this:
But the biggest problem is how much we’d then be spending per year to get this added benefit. I think it’s entirely plausible that we’ll be saving 3,000 people a year. But 3,000 people a year, at a cost of $200 billion, is almost $70 million per life saved.
Well, $200 billion is indeed a big number in simoleons, material even, but we feel obliged to point out that McMegan is freaked out about a per capita yearly expenditure of $666 on the part of the American personage to achieve this, which … well, you have to wonder if she jiggered the numbers a bit to get so Satan-y with it.
At any rate, the cost and/or savings that we’ll eventually associate with health care reform is important stuff. We passed this bill (and continue to hope for much more by way of HCR) because we think it’ll lead to better overall health outcomes for the country’s citizenry.
But that’s not all that this is about. It’s also about a much-needed bit of equity in an increasingly stratified society, where wealth disparity has been accelerating like a runaway freight train in recent decades.
In short, the belief that we’re offered a fair shake despite the accidents of our assorted births is not something that anybody’s figured out a way to put a price tag on. But we do know that America has had a pretty good run of it in the past 100 to 200 years, and a big factor in that streak has been an idea amongst the people that — contra other, shittier places — any one of us can hit it big via grit and keeping our nose clean and a bit of hard work. And that even if hitting it big didn’t happen, we’d still have a solid, middle-class peg upon which to hang our hat.
It’s not clear if that communal faith in America’s willingness to give everybody a fair shake was the biggest factor in our success as a nation, or if it was trumped in its beneficence by various historical accidents — geography, resources, the convenient self-destruction of Europe just as industrialization and its fruits were on the cusp of peaking in the 20th century — but most of us Americans agree that at the very least, it’s made us who we are, that it is the very stuff of our national mythology. And we continued to believe in that story for a long, long time.
But then something happened to crush that healthy attitude — or rather, fermented over time until one day we woke up and realized that everything had gone to shit. More and more of us were fucked in a merciless system that shat buckets on you if you slipped up just a couple times, or were born with a hole in your heart or with asthma or as a woman with working ovaries and a natural desire to fuck, or otherwise didn’t hit that increasingly improbable succession of lucky streaks at the crap table of life that gave a vanishing few the run of the place. Our great middle class kept getting smaller, until it wasn’t as much of a bulwark against the general hopelessness and cynicism that’s always knocking at the door, even in the best of times.
But, as any study of probability would predict, a few people continued to hit the lucky streaks against all odds, collected those overflowing buckets of extra chits that signaled they were winners and that the rest of us chumps milling about and coughing into our sleeves were losers, and this kept getting worse and more pronounced until this great and mythological haven of opportunity, America, was in fact home to a greater gulf between the very richest and the working poor than even the most outrageous and cruel satrapies existing in exotic tales could ever purport to match.
And yet the McMegans of the world, not quite big winners in the new arrangement but rather apologists for them, still insist — perhaps out of stubbornness or pique — that the old social glue that held us together still ought to do, despite it having long been eroded. That ethics long since abandoned by those who hold all the cards should be upheld by those who are being demonstrably gamed in every possible way. That what we need isn’t a radical reappraisal of our ancient national mythology befitting our new, cruel circumstances, but a reaffirmation of its most base and exploitable tenets.
It’s true — we can’t know for sure if the health care bill just passed will eventually yield the returns its advocates hope for, in the strictest statistical measures. Probably not. It wasn’t even our first or second choice for dealing with the problem. But one thing it is, at long last, is a visible rebellion against the cruel jungle law of three-plus decades that relentlessly sought greater spoils for the few at the expense of the many.
You can’t put a price on a return to sanity. You can’t assign an exact dollar figure to a strong and encouraged middle class. You can’t measure the economic value of a citizenry’s restored faith in a livable baseline for their prosperity when emerging from an era where no floor for that basic security seemed to exist at all.
Megan can’t see that, but it’s hardly surprising. She’s fucking thick.