Tyler Cowen has a post on how much we should worry about pandemics. In it, he writes:
I say think probabilistically, a concept not prominent in his piece. A one percent chance of one hundred million deaths is, in expected value terms, one million deaths and that is a big deal. Probably the United States is less vulnerable than it was in 1918, but how many people would die in China, India and many other locales? How much disruption to trade, travel, and the world economy would take place? Even in the United States, our public health systems would break down quickly and render many modern medical advances useless (e.g., when would the Tamiflu run out?). Having lots of living space is wonderful, but it pays off only if people stay home from work and that means dealing with massive absenteeism. Not pretty. Better safe than sorry.I agree with this. Despite the fact that globalization has improved the flow of new medicines between countries and that medical technology is much more sophisticated (especially in wealthy countries) than it has been in decades (this, by the way, accounts for the majority of increases in annual health care expenditures), I do happen to think that investment in public health is a consistently important endeavor and, as Cowen writes, it is better to be safe than sorry.
However, then Tyler uses this point as a jumping off point for attacking universal health care:
The main thing we should do -- invest in public health infrastructure -- is in any case a good idea with many possible payoffs, whether a pandemic comes or not. It is a better investment of money than pursuing the ideal of universal health insurance coverage. I might add that one of the better arguments for universal coverage is simply that it could lead to better monitoring of some public health issues.And there's where I disagree. As I said, public health is always a good investment. One of the most important investments for sure. Yet, we are not going to prevent the outbreak of new pandemics. Diseases mutate. There's a new strain of the flu every year. Having efficient awareness and technology to combat these manifestations is a big help, but so is having insurance to actually obtain treatment. Is it any surprise that there is a strong correlation between the sick and the uninsured? This is where universal coverage comes in and this is one of its better arguments -- not just to improve public health.
