The Big C

Climate Change. There are a great many things I could say about Climate Change, but today I want to make a pretty simple point about the likely health effects of Climate Change: They won't be good.

It's also common in discussions of Climate Change to talk about the effects on large systems, like cities or business sectors, or on large groups of people, sometimes even the entire population of entire countries. Such talk, I worry, can make your eyes glaze over, like trying to talk about whether the war cost one or three trillion dollars. Who can even know the difference? And yet, the difference most certainly matters.

So I'm not going to focus on large systems or groups. Most assuredly, they'll come up incidentally, but really I'm just going to talk about myself, what I fear will be the impact on me personally. But really you should know I'm not just talking about me, or meaning to say my situation is more important. I'm just using my situation because I know it best. There will be many like me. If you like, as you read along, substitute the name of someone near and dear to you, and substitute their situation. If you find a way to put a personal face to Climate Change, I'll have achieved my goal today.

Cancer is another aspect of it for me. I was diagnosed with thyroid cancer last year. I was fortunate to be covered by decent health care. Just lucky. There was a gap some years back where I could not afford health insurance and, had the cancer happened then, it might have ended differently. Fortunately, I was beyond that rough economic time and evaded what might have otherwise been a death sentence. Others have been less fortunate, which upsets me greatly. We should have universal health care.

I didn't write about my cancer at the time it was happening. Well, I did, but only indirectly. I wrote a post about roller coasters the night before I went into surgery as a metaphorical way of expressing how out of control I felt. Everything was on autopilot, and I was plenty scared. But at the time I didn't want to acknowledge the situation publicly. In fact, this article is my first time writing about it in a web-accessible location.

Frankly, I'd really rather have such matters remain private. It's a curious thing about politics. I've been a strong advocate of privacy rights for all of my adult life. My personal web page begins with an essay talking about the separation between my public and private persona, and how I don't like volunteering personal information to the public eye. There are too many ways to abuse it. There are a lot of things about me that are not the world's business and that ought not be fodder for people at search engines to browse or for marketeers to slice and dice for sale.

Citizen participation in a democracy sometimes requires otherwise, however. It's no one's business what my religious beliefs are, what I think of abortion or being gay, or how my family chooses to deal with end-of-life issues. Yet modern American politics is typified by invasive meddling in areas such as these, and so I find myself joining those who feel the urge to stand up and be counted on such important matters, even at the sometimes risk of having what should be our private lives out on display. I don't like it at all. But I see no way around it.

To speak of my medical position is scary because it's possible the information can be used against me. Of course, my medical situation comes as no surprise to insurance companies which can force me to disclose my medical history as a condition of coverage. At least, thanks to recent legislation, they can no longer exclude me for having a pre-existing condition. But they can still raise my rates, or those of an employer who has me in their “pool.” So an employer at some point in the future may quietly let me go or another may fail to hire me, never saying the reason. Who can know? What I do know is that insurance companies pay people to figure out clever ways to get around government restrictions and back to business as usual.

I guess that's why I read every day in the news that voters are ready to vote the Republicans back in. I guess voters think the protections we have now are too strong, and they'd rather go back to a time when the insurance companies weren't screaming in pain from the thumbscrews to which we consumers have put them.

Commerce is also a key component in my story. Adam Smith's much-touted “unseen hand” of capitalism has seen fit to decide that we should not make things locally any more, you see. We buy them from elsewhere. Who knows where? We assume the fuel will continue to flow, and flow cheaply, to get things from here to there. We assume there won't be floods intervening. We assume there won't be disease that causes us to restrict travel. We assume a great many things. And because of those assumptions, we're comfortable believing that commerce will just continue to function reliably no matter what.

And as long as it does, I'm probably fine. Or as fine as one gets having had a recent cancer. There are no guarantees. A highly competent surgeon removed my thyroid and with it the cancer. So I'm ahead of the game in that regard. I can't complain. I probably had more problems fighting the provider of my short term disability coverage than the cancer itself. At least with the cancer I had skilled professionals acting as my advocate. With the insurance company, it was the other way around. But I persevered in spite of administrative obstacles, and subsequent tests have so far shown me all clear. Odds are that I'll die of something else, not thyroid cancer. Of course, I still have to manage life without a thyroid, but that's mostly a routine matter in modern society. I just take some pills every day, which I can always get from the local pharmacy. Always. No matter what.

And that brings me back to Climate Change. It threatens us all in so many ways. The water level might rise. There might be more and stronger storms. The food supply is certainly in danger. If that falters, there could be famines, even wars. Any of those things could affect me, but I don't dwell on them a lot, at least not in the obvious way. But all of these problems have something in common, and that's where my mind often goes: Even in mild form, they can disrupt the normal flow of society.

Carrying capacity of the planet figures in here, too. It's defined by Wikipedia as “the population size of the species that the environment can sustain indefinitely, given the food, habitat, water and other necessities available in the environment.” I've had many debates with people about what that number is. I agree with those who think we're already there. I've heard others suggest that carrying capacity is not a number but a function of technology—that as technology improves, so will carrying capacity. I don't agree. Hanging our hopes on technology is dangerous because if technology ever fails us, we will suddenly and “unexpectedly” find ourselves with far less ability to sustain ourselves than we thought we had. It's not written in stone that technology will get ever better and more accessible.

Ask someone who's been through a hurricane or a flood and has had to back up and start over. The march of increasing technology is more variable than we sometimes allow for. The temptation may be to dismiss such things as “local effects,” but there can be global disruptions. Peak oil and the looming shortage of rare earth elements will have profound effects on the sustainability of present technology. And Climate Change is affecting food supplies in the ocean and even on land, as Russian droughts have caused a global wheat shortage. We've also built a society that relies on global assembly of goods; things are not made in one place any more. If transportation becomes suddenly expensive or inaccessible, that's a problem that can be highly disruptive.

When the stock market crashed, we found suddenly that we had been overleveraged. People who thought they were making enough money or spending it in the right places came to realize that they had based these thoughts on assumptions that the world would always be precisely as it was, only always better. Suddenly they realized how fragile this assumption was and how little prepared they were for deviation. Climate Change is going to be a rude awakening that we have spent our technology enabling spectacles rather than increasing basic robustness. I think we'll find that this is what carrying capacity is really about—not how are we living in normal times, but how capable are we of surviving exceptional times, of dodging the global extinction events that have taken down the dominant species of past eras. Do we have good plans for emergencies? I look at events like the Katrina hurricane and shudder.

Calamity, you see, has this very personal aspect in my mind. If the complex engine of our society's continues on track, if commerce continues without interruption, I'll probably continue to have access to the pills that compensate for my missing thyroid. My most personal fear isn't all those big things—the sea level rise, the storms, the fires, the pests, the diseases, the famines, the wars. If those problems happen, we all have to fight them. I won't be alone.

It may seem silly, but I just worry the drug companies won't make my pills any more. Or they'll make them, but the free market won't find enough value in getting them to my town, especially in an emergency. I'm dependent on what feels like a Rube Goldberg mechanism to get them from wherever they come from into my hands. If that breaks down—if the stores close, or can't get stock—I worry no one will notice. It's such a small thing that I fear it will be overlooked. I'd love to stock an emergency supply, but my doctor has to prescribe only what I need, and the insurance companies work to prevent my buying pills ahead of when I need them. Talk about death panels. They try to placate me by noting the pills don't have a long shelf life. Or they mention I can buy a 90-day supply instead of a 30-day supply. But, 30-day or 90-day, they still make me burn that supply down to almost zero before I can get more.

So I obsess about what may seem to others as a comparatively mild risk of Climate Change—about the mere interruption of business as usual. It's not the biggest effect one could imagine. But it's how I personalize it. Your circumstances being different, you'll probably personalize it differently. That's okay. Just please do try, once in a while, to think of Climate Change not just as a global phenomenon, but as something more local, tangible, and personal. After all, Climate Change won't just affect the future of our species and perhaps of all life on Earth, but it will also, as part of that, affect you and me personally.

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Originally published September 14, 2010 at Open Salon, where I wrote under my own name, Kent Pitman. I have reproduced the article here, but to read the original discussion, you'll need to click through to the snapshot created by the Wayback Machine.

Tags (from Open Salon): politics, climate change, cancer, citizen participation, convergence, carrying capacity, calamity, catastrophe, personal, personalize, supply chain, leverage, over-leveraged, stock market, crash, medication, drugs, supplies, hurricane, drought, war, disruption, society, capitalism, planning, population, overpopulation, zpg, health insurance, health care, health, bad for your health

The Cost

For those of you just waking up from a coma or returning from a sensory deprivation chamber, the last “US combat brigade” officially left Iraq last week. It seemed an appropriate time for a pause to reflect on the cost we've incurred.

I heard someone remark on TV the other day about over four thousand lives lost and a trillion dollars spent. The four thousand people I understand. It's a lot of people, but I can conceive of it. Forty rows of a hundred people each. Or perhaps eight or ten large passenger jets full of people. That's a lot. Each was a person, with a life, probably a family, all affected.

But I don't think that's the full count of lives lost. I hope to convince you it's a terribly low number. I think the number of casualties of this war was much, much larger. And I didn't mean the injured or those with psychological damage, such as PTSD. Those are also costs, and I don't mean to discount them. But those are not the ones I mean. I'm actually meaning to count deaths. And yes, there are Iraqis dead. They're often not counted. That's sad as well. But I mean the count of American deaths is low, at least as I tally it.

But first, let's return to the trillion dollars. That's an incomprehensibly large amount of money. A million dollars is hard for many to comprehend. A trillion is a million million. It makes it seem almost quaint to think back on the late Senator Everett Dirksen's familiar quote, “A few billion here, a few billion there and before you know it, you're talking real money...” A trillion is a thousand billion. That's a lot. It's more than seventeen times the wealth of Bill Gates.

To understand this number better, I'd like to speak for a moment about something called opportunity cost. Opportunity cost is not the direct cost we pay out, but is a measure of what we lose by not doing something else. One can't do everything in life. Usually making a choice to do one thing locks out the opportunity to do other things. So sometimes you can't just look at what you got by taking a certain choice, but you also have to look at what you lost.

For example, there are 310 million people in the US. Instead of going to war with Iraq, we could have borrowed a trillion dollars and just given $3226 to each person (man, woman, or child). We'd still owe the trillion dollars, just like we do now, but everyone in the US would be that much richer. We didn't choose to do that. But one way to conceive the cost of the war is to say we denied ourselves that money.

It's unlikely we'd have ever had such a handout, at least not like that. But here's another thought: Lots of people get sick and don't have health care. Sometimes they get sick because they don't have health care—maybe they weren't getting screenings for things they should have. So the cost of saving them might be trivial. Perhaps a few hundred dollars. Or maybe it would be a simple procedure or some medication. Perhaps a few thousand dollars. Maybe it would require serious surgery. Let's be very, very conservative and guess that it takes $100,000 to save a life. It will make my point and then we can come back and look at the other possibilities.

Instead of paying a trillion dollars on a war, if it cost $100,000 to save a life, there are ten million $100,000's in a trillion dollars. That means we lost the chance to save ten million lives. Let me say that another way: Ten million people died who didn't have to. Or maybe more, if you think my $100,000 number is high. If you could find a way to save a life for $10,000, there are one hundred million such bundles available in a trillion dollars. But let's be conservative in our back-of-the-envelope calculations here and say just ten million. It makes the point well enough. Either way, we didn't spend our money that way. We made our choices, and those who could have been saved were not. We spent the money on the war instead of on them.

So going back to where I began and trying to fathom the depth of meaning in “a trillion dollars and over four thousand lives,” one way to conceive the phrase is to say “ten million civilians dead and four thousand military dead.” And, in a sad irony, if the money had been spent on those ten million, the four thousand military would probably still be around, too.

Ten million people. That's six times the population of Manhattan.

Let's not forget the chilling imagery created by Condoleezza Rice when she said, “The problem here is that there will always be some uncertainty about how quickly he can acquire nuclear weapons. But we don't want the smoking gun to be a mushroom cloud.” We didn't want even the chance of losing one actual city to terrorism, yet in order to avoid it, we spent enough that we could have probably saved that many people six times over. That was a lot to spend, both in dollars and in lives.

And if you don't like me making up numbers about how much it costs to save a life, another way to sum up the human cost is by looking at the cost of universal health care. It's estimated to cost somewhere around $70 billion (annually). So we could have paid for universal health care for 14 years with that same trillion dollars we borrowed to help out Iraq. That would, again, be a lot of healthy people. At no more cost than we're paying today.

Oh, right. I'm being unfair. We supposedly gained something from the war. We didn't fight it for no reason. We were told we were fighting the war in Iraq so we wouldn't have to fight the terrorists here. Is it likely that we're safe now? After all that expense, did we achieve that goal? Bush said “mission accomplished.” (I've noticed that Obama has avoided that phrase, even as he pulls so-called “combat troops” out of Iraq.)

Are we safe now? Do we have no more risk of terrorism here now that we fought that war? I don't know about you, but I think not. It's not the soldiers' fault, of course, but we didn't accomplish our mission, not that one. That mission was not possible to accomplish. We couldn't rid ourselves of terrorism by fighting with people in Iraq. And we won't be free of terrorism if we keep on in Afghanistan. We'll just be poorer, and that makes us less safe.

The big risk to our national security is wasting our wealth. We neglected the lesson of the Cold War, that one can lose a war by simply overspending. We've squandered our dollars and, I claim, in ways that we'll never bother to tally, we've squandered lives.

Yes, a lot of our military died. We should mourn them. But there are hidden casualties—really a lot of them. We should mourn them, too. Many Americans died here at home but won't be counted as war dead, even though if we hadn't fought this war, they did not have to die. We could have been wealthy enough to afford to spend that money on life.† But we gave up that opportunity. That is the true cost of the war.

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Originally published August 26, 2010 at Open Salon, where I wrote under my own name, Kent Pitman.

Tags (from Open Salon): saving lives, opportunity, pro-life, choice, mushroom cloud, body count, death count, casualties, casualty count, opportunity cost, million dollars, billion dollars, trillion dollars, health care, life, death, cost, civilian, military, war, politics

Click here to see the cost of the ongoing wars.

Click here to see the Iraq War casualty count.

†Yes, you're right that the Republicans would have opposed spending the money on such saving of lives. They're not that kind of “pro-life.” But letting such people have a say in our government is still a political choice we make. Electing them at all may indeed imply that such opportunities are lost from the outset, but I still feel obliged to point out that the opportunities are there to decide these things every time we go to the ballot box. We're just locking in that cost earlier by letting them be involved.