By Kevin D. Williamson
Wednesday, June 29, 2016
In 2014, Islamic terrorists had a banner year, nearly
doubling their annual body count to 32,658, according to the Institute for
Economics and Peace. Last year probably wasn’t any less bloody, and this year
probably will be just as bad.
But, as always, it is important to keep such numbers in
perspective. That horrifying Islamist death toll is about 1/227 the combined global
kill count of respiratory cancer, HIV, diarrhea, diabetes, and road injuries,
which each account for about 1.5 million deaths a year. We should not downplay
the horrors of Islamist terrorism or fail to take measures against it, no more
than it would be wise to go swimming where you know there to be sharks, even
though you are, statistically speaking, about 300,000 times more likely to die
of a mosquito bite. The current hysteria surrounding the Zika virus may be
excessive, but the attention paid to mosquito-borne diseases is entirely
appropriate.
Not all dangers are equally responsive to public policy
and public action, and the line between political acts and public results isn’t
always straight or clear. For instance, our states derive tremendous revenues
from the sale of tobacco products, and only a tiny share of that (less than 3
percent) is used for purposes such as educating people about the dangers of
smoking. But it does seem that the past 40-plus years of anti-smoking
propaganda has had some effect: New cases of lung and bronchial cancers have
declined steadily for decades. And that is an excellent thing, inasmuch as
respiratory cancers are a particularly nasty sort: Almost the same number of
Americans are diagnosed with lung and bronchus cancers every year as breast
cancer (225,000 vs. 247,000), but while lung cancer lags a little bit in
incidence, it far exceeds breast cancer in deaths, 158,000 to 40,000. Fewer
than one in five lung-cancer patients will survive for five years or more.
Is there any obvious public-policy takeaway from that?
Some people will look at those figures and say: We should do even more to
discourage people from smoking. It seems obvious, but it isn’t. Most people who
smoke never get lung cancer. Men die of lung cancer more often than women, and
blacks more often than whites, with black men having a dramatically higher
death rate than white men.
Men in Kentucky get lung cancer at five times the rate of
men in Utah. Those numbers parallel the prevalence of smoking. Perhaps the U.S.
Department of Health and Human Services should be consulting the Church of
Jesus Christ of Latter-day Saints on the question of tobacco use and its
prevention.
Smoking prevention gets a lot more attention than does
lung-cancer treatment, for a couple of reasons. One is that people get
moralistic about lung cancer: It’s one of those diseases, like HIV, that bring
a special joy to a certain kind of person, a very common type, who likes to
say: “You brought that on yourself.” These are the sort of people who tell
people suffering from depression that they should just think of how much worse
off the poor kids in China are. There isn’t really very much to say about these
people. But on the question of smoking, their puritanism is amplified by the
fact that the people who create public policy are in the main people who
disapprove of smoking, which they see as a vice characteristic of dirty people
without liberal-arts degrees.
And that produces some strange consequences. The American
Heart Association has compiled a fair amount of research suggesting that vaping
— the inhalation of nicotine vapor produced by an electronic device, which
looks a lot like smoking but isn’t — is in fact less destructive to one’s
health than is smoking cigarettes, and that it might be a useful tool in
smoking cessation. The American Heart Association is practically alone in
taking a sober, evidence-driven approach to the question. For the rest of the world,
vaping means nicotine (which isn’t the thing in tobacco that kills you) and
looks like smoking — it feels like
smoking, culturally — and, therefore, it is treated like smoking. The city
fathers of New York banned vaping in public spaces simply because it too
closely resembles smoking, an act that has produced inevitable litigation. The
FDA just issued 499 pages of vaping regulation, which will impose ruinous costs
on many vaping-oriented businesses, which does not displease the tobacco barons
with whom they compete.
That is something to keep in mind the next time you hear
from the so-called party of science, when their favorite “experts” produce
policy prescriptions that are only loosely coordinated, if that, with any
meaningful evidence.
Politicians tend to pay the most attention to issues that
command public fascination. And the public’s attention is most easily commanded
when the public is given someone to hate: Try explaining the integration of
global supply chains to your average American college student and he will be
beyond even Adderall’s reach, but talk about “inequality” — which is to say,
give him a rich-guy villain to hate — and he’s rapt. People who make lots of
money in finance or as entrepreneurs are “those people.” Smokers and vapers are,
for members of the policy-making class, “those people,” the same way that
people with HIV or heroin addictions are “those people” for others. The NRA is
“those people” for the gun-control gang, even though the people who do most of
the shootings in these United States are not very much like the people who
belong to the NRA.
It is easy to substitute an enemies list for careful
thinking.
One of the most interesting projects of recent years is
the Copenhagen Consensus, the Bjørn Lomborg–led project to apply welfare
economics to deep-seated global problems, inviting economists and issue
scholars to do some rigorous number-crunching and come up with some projects to
maximize the bang/buck ratio. The recommendations have been surprisingly
unsexy: micronutrient-supplement programs, bigger and better-structured
subsidies for malaria prevention (those damned mosquitos, again), immunization,
the spread of better agricultural practices, water projects.
Straight-up policy questions, notably barriers to trade,
also are on the radar. While foreign aid accounts for only a tiny share of U.S.
government spending, in absolute dollars the sums are considerable. It is spent
better than you might expect: Thanks in no small part to President George W.
Bush, the United States has made large investments in HIV prevention,
especially in Africa, which actually seems to do some good. A great deal of
money is spent on infrastructure projects and capacity-building for foreign
states such as Afghanistan, which, even with the inevitable graft and waste, is
probably the right approach.
What’s needed is a similar approach to domestic
questions, and to a few foreign-relations questions closer to home. It’s a hard
sell when a non-trivial share of the population has adopted “Eek! A Mexican!”
as the main principle governing relations with our southern neighbor, but it is
inarguable that the United States would be much, much better off if Mexico were
a lot more like Canada and a lot less like Venezuela (Mexico is only two steps
ahead of the late Boss Hugo’s socialist heap on the GDP/capita rankings) and if
it had stronger institutions that were more capable of dealing with things like
drug cartels and internal economic refugees. But who is going to help Mexico
build that capacity? Guatemala?
In a sane world, U.S. political debate would be less
about how rich men live in Greenwich and San Mateo Park and more about how the
schools are run in Cleveland and Philadelphia, and we’d acknowledge that
Mohammed al-Kaboom isn’t going to kill nearly as many Americans this year — or
any year — as diabetes and prescription-drug addiction. We’d acknowledge that
what is hurting the U.S. economy is mainly decisions made in Washington (and,
Albany, Sacramento, Columbus, Lansing . . . ) and not schemes hatched in
Beijing or Mexico City. The headlines would be about mosquitos, not about
sharks. This isn’t a call for post-ideological “pragmatism,” which is almost
always just 20th-century progressivism dressed up with a few dodgy charts, but
rather for a genuine effort at discerning what actually can be done, at what
cost, and establishing priorities among those things.
But that would require some hard work, maturity,
literacy, tolerance, forbearance, and delayed gratification — and nobody ever
made a career in Washington selling that basket of goods.
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