Guest Musing: What Price Snowmageddon?

February 12th, 2015 Posted by Susan's Musings 11 comments

A decades old stereotype exists of Jewish mothers wanting their sons to be doctors. That was never my dream. I wanted my son to stay true to his faith, finding fulfilling work with which he would contribute to the world. Ari majored in physics in college intending to enter the business world. After a few years of working in business as he was about to start an MBA he called us to ask what we thought of his going to medical school. He realized that he was most fulfilled in his volunteer activities, all of which centered around medicine.

After a grueling two year program that caught him up on all the pre-med science courses he hadn’t taken, he entered medical school, graduating last May. He is now an emergency room resident in NYC, where he sees first-hand both the successes and failures of our medical system. He is fulfilling my dream and, incidentally, I do get to say, “My son, the doctor.” 

 This winter he and many of his fellow doctors, along with nurses and other staff, slept overnight at the hospital in anticipation of the blizzard that wasn’t. Here are some of his thoughts.   

 

New York’s recent non-blizzard and the pre-emptive safety measures taken by Mayor de Blasio have been subjects of much conversation lately. Even before we were aware of just how lackluster a blizzard it would prove to be, his panicky press conferences and predictions of doom and gloom suggested that perhaps the mayor would do well to listen to “Let It Go,” from Disney’s “Frozen,” a time or two and adopt a small part of the fortitude demonstrated by teenage Elsa’s attitude toward snow and storms. 

There is no doubt de Blasio’s precautions took government nannying to unprecedented levels. Streets were closed to non-emergency vehicles, pedestrians were discouraged from walking outside, and for the first time in the 110 years of its existence, the NYC subway system was shut down for a snowstorm. Following the anti-climactic snowfall, I noticed a widespread and disturbing viewpoint that needs addressing. In conversations among friends, interviews in the media and no small number of social media postings, I have seen and heard comments such as these:

Better safe than sorry!

Would you have rather seen people dying if the blizzard had been as devastating as predicted?

Or in the words of Mayor de Blasio himself, “Would you rather be safe or unsafe?”

I have no doubt that the motivations of these speakers were entirely pure, but statements such as these reveal a fundamental problem that lies at the root of many of the poor policies consistently implemented by legislators at both the local and federal level. You may have heard a similar idea expressed with regard to other policies. For example, “Even if the number of deaths caused by drunk drivers decreases to one person per year, that would still be one person too many.” Or, “Of course we should install nets on the sides of the Golden Gate Bridge! If they stop just one person from committing suicide, then they will have been worth it.”

Of course, the flaw in these arguments is that they take into account only the benefits of these actions and disregard, or worse, don’t even consider, the costs. If one death from drunk driving were really one too many, there exists a very simple plan to guarantee an end to all motor vehicle related collisions: Ban motor vehicles. Or, if you’d prefer, install speed governors on all motor vehicles in the United States limiting their speeds to 5 mph. Contemplate the benefits! No deaths from motor vehicle collisions (the leading cause of death in the U.S. for people 5-34)! Reduced carbon dioxide production! Restored polar ice caps and a burgeoning polar bear population! However, no one in their right mind would implement this, because … wait for it … the cost is too high.

All suicides must be prevented? How much are you willing to contribute from your paycheck to erect nets at all sites frequented by suicidal jumpers? Ten dollars? One hundred dollars? One thousand dollars? The figure may be different for each of us, but there is no question that at a certain amount it is no longer worth the cost to you. To view this as a choice between saving lives or saving dollars is a fatal mistake. In the real world, money translates into lives. The money used to install nets might have been spent on other, more effective suicide prevention programs. Or it might have been earmarked for medical research, foreign aid, disaster relief programs, donations to charity, or any other number of life-saving possibilities.

When seat belts and airbags were made standard equipment, required by federal law, in all cars in the United States, the legislators had the best of intentions. After all, could anyone possibly be against saving lives? But did anyone consider the resulting price increase of those cars? Did anyone consider the newly arrived, poor immigrant or the young single mother who would be more than happy to drive a car without airbags that he or she could afford? What about the tax increase necessary to pay for the bureaucracy to enforce the new policy, which subsequently left less money in citizens’ pockets with which to hire employees? Nothing comes free; there is always a cost.

In the early 1990s, the New York State Department of Health instituted a cardiac surgery reporting system that identifies surgeons who have had poor surgical outcomes (e.g. patient deaths). Once again, in theory a terrific way to hold practitioners accountable and enable patients to make educated decisions about where to seek treatment. However, as an emergency room physician, I see the cost of this exacted on the very patients it was intended to help. Interventional cardiologists frequently refuse to operate on those patients who are the sickest and most in need of intervention because the likelihood is that the patient won’t survive and that death will then go on their record. Studies have demonstrated that 83 percent of interventional cardiologists in New York agree that the publishing of these statistics has led to patients in need of these procedures being less likely to receive them.

Time magazine estimated the cost of Mr. de Blasio’s recent blizzard shut-down to be $500 million to $1 billion, while a Moody’s Analytics preliminary report came in at a conservative $200 million. These financial costs do not even begin to encompass the myriad other losses caused by the travel bans. Struggling business owners, hourly employees working to make ends meet, tourists who had saved and scrimped to afford a New York City vacation, brides and grooms whose weddings had to be canceled last minute – all suffered real losses as a result of this policy.

At the Manhattan hospital where I work, ambulances, instead of standing ready to respond to civilian emergency calls, were diverted to transport me and my colleagues to work. To my knowledge this change did not result in any direct loss of life, but did it result in longer wait times for ambulances? Could it conceivably have resulted in loss of life or in a decline in the quality of medical care? Add to this the number of medical staff who were stuck attempting sleep on cots in the hospital hallways to ensure that they’d make their morning shifts, whose competence and proficiency inevitably suffered.

These accountings need to be factored against the possible lives saved before one can argue that the pre-emptive shut-down was warranted. And let’s not forget that we’re talking about New Yorkers, some of the toughest and most self-reliant citizens in this great country. A city that has braved and survived terrorism, hurricanes and Big Gulp sodas. As Elsa would say, “Let us go, Mayor. The cold never bothered us anyway.”

When all the factors are taken into account (financial costs, quality of life costs, health and well-being costs), I do not know whether the travel bans were justified by their potential benefits. For the purposes of this argument, the answer is largely irrelevant. What is important is that we understand that every decision has a cost, and that unless that cost is weighed against potential benefits, it is impossible to arrive at a wise decision. To think otherwise is foolhardy, disastrous and short-sighted. None of this should come as a surprise. These are calculations that all of us make all of the time in our professional and personal lives, weighing risk and reward, cost and benefit. It is only in government, where Mayor de Blasio and politicians of his ilk are playing with our pocketbooks, that they are able to proudly proclaim policies without regard to costs. The rest of us, the ones who actually pay for their misguided policies, can’t afford that luxury.

Ari Lapin is an emergency medicine physician and entrepreneur living in Manhattan who writes on politics and culture. This piece appeared on World Net Daily.

If you are snowed in, use your reading time wisely.
Two great books at one low price 

Business book set

 

11 comments

Correction: Ari’s ‘catch up’ program to fill in all the pre-med science was a one year accelerated program, not two years as I miswrote.

James says:

Ari’s post boils down to one question: how risk-averse must we become? De Blasio’s Nanny State would deliver us from all risk: of life, of death, of injury, of failure. And thus sheltered from all the insecurity and pain of life and living, how meaningless our life then becomes! And who bears the astronomical cost of all the preparation for Chicken Little what-if’s and doomsday scenarios, if the sky never actually falls? Most of the awful things we fear never even happen.
As for the success of your son above and beyond your aspirations for him, Ms. Susan, I am reminded of Christian author C.S. Lewis, who told us that if you aim for heaven, you get heaven and the earth thrown into the bargain. If you aim for the earth, conversely, you get nothing. Your son aimed for heaven!
Congratulations and mazel tov, Dr. Lapin!

Jim says:

I agree with Dr. Ari’s commentary completely. He exposed the arrogance of one person believing they are smarter than the rest of the world and we should leave all the thinking to them. This thinking has always rubbed me painfully and may be the main reason I support conservatives. Worse, my guess is that the Mayor and his staff did not begin to take in many of the economic aspects your son laid out so well.
On the flip side, had the Mayor not done anything, and the weather forecast had been accurate, many would have condemned him for their problems. Come on folks, aren’t you adult enough to make your own decisions as to what you will do to protect your own selves? A free man can make his own decisions and accept the consequences of them. Any desiring less, has the make-up of a fine slave. This is America! I prefer to take responsibility for my self and accept the consequences or rewards of my choice. Please keep in mind while I do that, I also have the opportunity to reach out and help another, or even be helped myself. That is just the way God intended us to live. It kind of brings us together, doesn’t it?
Congratulations to Dr. Ari! You will do well and honor your good parents with your accomplishments!

JIm, You are absolutely correct that had things not shut down and had people gotten stuck on the highways and trains, as happened last year, people are furious. The whole idea of making your own decisions, accepting responsibility and knowing that there actually are ‘acts of God’ is disappearing. And there will be lawyers available to make sure you can blame someone. We are turning into a lose/lose society.

Jean says:

The crux of this issue is that in order to save us from ourselves, we have to give up the freedom of choice completely and place our faith in government or some other external entity that we’ve deemed smarter than we are. I’m sure that if suicide nets were installed on every bridge in every state, there would still be suicides – by drug overdoses, self-created auto accidents (e.g. driving the wrong way on the interstate), suicide by cop, etc. Last winter, the midwest had what Boston is getting in terms of snow. Those of us who drove to work daily chose to run a few hours late, giving road crews the chance to clear & salt roads. Some people with the technology chose to work remotely. And during one major blizzard, our employer chose to tell everyone not to bother coming in. We calculated the risks vs. the rewards of going out on hazardous roads, the potential costs of getting stuck (when the counties declare a snow hazard and you still go out, you are fined up to $500 if you slide off or are in an accident), and the cost of taking a day off, and made decisions based on those calculations. I guess Mayor DiBlasio has less faith in his constituent base than we have in ourselves.

Jean, We are being trained to be docile and to learn that we cannot make decisions for ourselves. I don’t think this is unrelated to the statistics showing that younger people are less entrepreneurial than they used to be. Not taking risks is taking root.

peter says:

I thinks Ari makes some interesting points about Cost Benefit analysis, however, I don’t know if I would completely agree with the statement “they are able to proudly proclaim policies without regard to costs”. The problem is not that certain individuals don’t take into account costs, rather these individual might weigh those costs and benefits differently form you and I. For example, lets just say that tomorrow a report comes out saying there is excellent scientific evidence that proves male circumcision leads to a 75% increase risk for cancer. Now if you were not a member of the Jewish or Muslim community, you probably wouldn’t have a problem if the government suddenly deemed to ban all circumcisions. However, I assume as a member of the Jewish community you on the other hand would weigh the cost of disobeying God’s law far higher then the cost of getting cancer. By the way I apologize if that was a poor example, but I hope you were able to understand the gist of the argument.
Now specifically talking about the New York situation, most of the reports/models I heard coming from meteorologists was that the blizzard was supposed to hit New York and that it in fact was supposed to shatter records. The only issue was that instead of hitting New York like the models predicted, the blizzard hit Boston. I think its safe to assume that the Mayor’s office did not just simply disregard the 250 million dollar price tag, rather they decided that the cost associated with loss of life, and maybe even loss of political capital if indeed the storm hit would be far greater.

Al Hoffman says:

Look Before You Leap
Knee jerk do what you’re told is not good use of our democratic volition. Vox of the citizen with proper planning is best, and conscience intact.

Peter, I do wonder if gov’t workers and municipal union employees had pay deducted for that day (just as storeowners and private businesses lost money) whether the calculation would be different. I may be wrong, but my guess is that gov’t employees will not take home less this month because of the closure.
You are right that when a storm hits and there are casualties and chaos, gov’t gets attacked. Though often, it is the clean-up rather than the initial impact during the storm that is targeted. We as citizens do need to distinguish between poor government which deserves criticism and the reality that gov’t cannot and should not protect us 100% of the time from 100% of danger.

I need to go look up the word ‘vox’.

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