{"id":3573,"date":"2009-12-30T16:13:22","date_gmt":"2009-12-31T00:13:22","guid":{"rendered":"http:\/\/secularright.org\/wordpress\/?p=3573"},"modified":"2009-12-30T16:13:22","modified_gmt":"2009-12-31T00:13:22","slug":"terrorism-and-health-care-reform","status":"publish","type":"post","link":"https:\/\/secularright.org\/SR\/wordpress\/terrorism-and-health-care-reform\/","title":{"rendered":"Terrorism and health care reform"},"content":{"rendered":"<p>In 2000, commercial jets carried 1.09 billion people on 18 million flights, according to a no-longer-linkable Boeing document.\u00a0\u00a0 Assuming that the number of flyers has not increased since then, that makes for one would-be underwear bomber out of about 10 billion travelers over the last decade.\u00a0 Does that record represent success or failure?\u00a0 Are we jacking up physical security measures on planes and in airports because we think that the risk of another underwear bomber has risen since Dec. 25, or because we think that our record of prevention over the last decade was inadequate?\u00a0\u00a0 The notion that we should be able to protect against every terrorist incident is understandable, and announcing that we are not going to try to stop every such incident is unthinkable, though former DHS Secretary Chertoff did make tentative noises in that direction regarding cargo screening.\u00a0 But it\u2019s still intriguing to me why dying in a terrorist-induced airplane crash has a greater hold on the public imagination than driving on the highway, where there are about 40,000 fatalities in the U.S. a year, much higher on a per-mile basis than the number of deaths from non-terror-induced airline crashes, of which there are many more than terror incidents.\u00a0 We do not have a federal agency checking everyone who gets on a highway for driving safety.\u00a0 Terror attacks are intentional, not accidental, so the public policy imperative of sending a tough-on-terror message is arguably far greater than for highway crashes.\u00a0 But that fact doesn\u2019t affect the individual perception of risk, which seems to be influenced by issues of agency, control, possibly even altitude.\u00a0<\/p>\n<p>Maybe the proper denominator in assessing risk is rather the number of would-be underwear bombers.\u00a0 If the number of would-be underwear bombers is small&#8211;let\u2019s say, one&#8211;then our security system deserves a huge black eye, but our perception of a huge phalanx of ready recruits would need readjusting.\u00a0 Admittedly, the size of the recruit pool is probably affected by the perception of our security system, so security overkill may be responsible in part for its own disproportionality.\u00a0<\/p>\n<p>(Contra my impatience with what appears to me to be security excess at airports, one could argue that we approach all activities with similar levels of risk intolerance.\u00a0 The difference is that security measures designed to eliminate even very small risks are constantly being engineered into the design of products&#8211;such as cars and planes&#8211;making them invisible.\u00a0 That may be.\u00a0 But then people drive while texting and talking on the cell phone [see below], introducing massively higher levels of risk into their own and others\u2019 lives.)<!--more--><\/p>\n<p>Perhaps Abdulmutallab\u2019s intentions really should have been as obvious before as after the fact, resulting in the revocation of his visa and his placement on the no-fly list.\u00a0 But hindsight wisdom can make the chaos of intelligence signals look clearer in retrospect than they are in real-time.\u00a0 There may be many other people with comparable levels of security suspiciousness who never end up becoming suicide bombers.\u00a0 It has not been officially decided yet whether Abdulmutallab slipped through the cracks because the threshold for categorizing an imminent terror risk was too high or because officials failed to implement the standards that already exist.\u00a0 The former problem is easier to fix than the latter, and the dichotomy is overly simplistic in any case, since it is impossible to create a bright-line set of rules for such judgments that eliminates discretion.\u00a0 But if we want to put a lower threshold on terrorist categorization, thereby increasing the size of the no-fly list and the heavy surveillance of suspects, we\u2019re going to have to do a better job of standing up to the ACLU and the privacy advocates, who complain vociferously at physical screening measures, and at the gathering of intelligence, which ideally renders physical screening less imperative.\u00a0 It is amusing to see the ACLU\u2019s Jay Stanley <a href=\"http:\/\/www.nytimes.com\/2009\/12\/29\/us\/29screening.html?scp=1&amp;sq=jay%20stanley%20safety%20gaps&amp;st=cse\">argue<\/a> that whole-body scanners should be used only on people who are subject to extra scrutiny, since it\u2019s not clear that the ACLU has ever seen a security list that it finds acceptable and it certainly would fight any expansion of that list.\u00a0 I couldn\u2019t give a damn about being X-rayed at an airport, but you\u2019d get a heck of a lot more safety bang for the buck by ending all non-emergency use of cell phones and text-messaging while driving than by adding billions more collective hours spent in airport security lines.\u00a0<\/p>\n<p>Holman Jenkins rightly <a href=\"http:\/\/online.wsj.com\/article\/SB10001424052748703510304574626301516709852.html\">points out <\/a>that the real story should be how few terrorist attempts there have been in this country.\u00a0 If Obama were really the force for change and new thinking that he purported to be, he would undertake a study of whether the terrorist threat is such as to justify the massive bureaucracy of DHS.\u00a0 Of course, there is no chance that DHS will ever be dismantled in any case, it will merely evolve new functions.\u00a0<\/p>\n<p>(I have also not seen a full-throated assertion that the Nigerian\u2019s planned bomb could have brought down the plane.\u00a0 Perhaps that is so obvious that it doesn\u2019t need stating, but I would like to see it stated.)<\/p>\n<p>If the increase in post-12\/25 security measures roughly reflects the popular will, and is not simply a bureaucratic reflex unmoored to popular sentiment, the chance of driving down health care spending through more rational use of precautionary testing becomes more unrealistic, it seems to me.\u00a0 Perhaps it\u2019s not just a ravenous tort bar or doctors\u2019 pecuniary self-interest that drives the aggressive ordering of medical tests, as we have been led to believe, but patient attitudes towards risk.\u00a0 The revised mammogram guidelines debacle would suggest that to be the case.\u00a0 Making patients pay for every diagnostic test may increase their tolerance of risk, but such a cost arrangement is never going to happen.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In 2000, commercial jets carried 1.09 billion people on 18 million flights, according to a no-longer-linkable Boeing document.\u00a0\u00a0 Assuming that the number of flyers has not increased since then, that makes for one would-be underwear bomber out of about 10 &hellip; <a href=\"https:\/\/secularright.org\/SR\/wordpress\/terrorism-and-health-care-reform\/\">Continue reading <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":50,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mi_skip_tracking":false},"categories":[15],"tags":[346,353],"_links":{"self":[{"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/posts\/3573"}],"collection":[{"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/users\/50"}],"replies":[{"embeddable":true,"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/comments?post=3573"}],"version-history":[{"count":2,"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/posts\/3573\/revisions"}],"predecessor-version":[{"id":3575,"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/posts\/3573\/revisions\/3575"}],"wp:attachment":[{"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/media?parent=3573"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/categories?post=3573"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/secularright.org\/SR\/wordpress\/wp-json\/wp\/v2\/tags?post=3573"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}