Within the United States alone, there’s a long list of comparisons that could be made. Here’s one: Roughly 14 percent of Americans do not have health insurance. That’s 41 million people. Nine percent of American kids—6.5 million—have no insurance. In 2004, the Institute of Medicine— one of the National Academies of Science—issued a report that found the lack of health insurance “causes 18,000 unnecessary deaths every year in the United States.” That’s six 9/11s. As for the monetary costs, a committee of the Institute of Medicine concluded that the lack of health insurance costs the United States between $60 billion and $130 billion annually.
Here’s another comparison: According to the Centers for Disease Control and Prevention, “hundreds of thousands” of deaths happen in the United States each year because “fewer than half of all Americans receive some of the most valuable preventive health services available.”
The costs of extending health insurance to all Americans, and expanding access to prevention services, vary widely depending on the complex details involved. It would certainly be very expensive—a cost measured in the tens of billions of dollars annually. But given the number of lives that could be saved and the economic costs that could be recouped, it’s probably safe to assume that either of these policies would do much better in a cost-benefit analysis than counterterrorism. And yet neither Republicans nor Democrats have dared to compare the value of expanded health insurance or more prevention services with that of counterterrorism spending, and they keep losing out. In the administration’s 2008 budget, which again boosted counterterrorism spending, the budget of the CDC was cut—forcing the agency to scrap a $100 million preventive health program.
Globally, there’s an even longer list of comparisons that cast doubt on the wisdom of current counterterrorism spending. Measles kills almost 300,000 children a year, even though the measles vaccine costs 16 cents a dose. More than 1.6 million children are killed by easily treatable and preventable diarrhea. In 1988, polio was paralyzing 1,000 children a day, but a $3 billion campaign pushed the virus to the brink of extinction by 2003— when the money ran out and polio surged back to life in twenty-seven countries.
In 2004, Danish political scientist Bjorn Lomborg brought together an array of experts from all over the world to discuss which of the world’s many woes could be tackled most cost-effectively. Terrorism wasn’t examined, unfortunately, but many other major issues were and a ranked list of priorities was produced. At the top came controlling HIV/AIDS. “At a cost of $27 billion, around 28 million cases of the illness could be prevented by 2010,” Lomborg wrote in How to Spend $50 Billion to Make the World a Better Place. “The benefit-cost figure is predicted to be 40 times that figure.”
Malaria also ranked highly in the Copenhagen Consensus. The disease kills roughly one million people a year, most of them African children, and drains $12 billion a year from African economies. Jeffrey Sachs, a renowned economist and development guru, estimates malaria could be controlled at a cost of between $2 billion and $3 billion a year, so here is a case where millions of lives could be saved and billions of dollars saved for an annual cost equivalent to about 5 percent of the money the United States budgeted for counterterrorism in 2007. But the money’s not there. The UN spent just $220 million for malaria in Africa in 2007, while the World Bank has promised between $500 million and $1 billion over five years. In 2005, President Bush was applauded for creating the “President’s Malaria Initiative,” but it provides only $240 million a year for five years. And so malaria will likely continue to kill sixty-seven times more people each year than the almost 15,000 killed by international terrorism over the last four decades.
None of this makes sense. It is all the product of the “unreasoning fear” that Franklin Roosevelt warned against in 1933, at a time when the economic order was collapsing, and the political order looked set to go along with it. Fascism and communism were ascendant and the shadow of war grew. It was a time so much bleaker than our own, and yet Roosevelt was calm. “This great Nation will endure as it has endured, will revive and will prosper,” he said in his inaugural address—if we do not allow our thoughts and actions to be guided by “nameless, unreasoning, unjustified fear.”
By word and deed, Roosevelt, the thirty-second president, steadied the United States and led it away from destructive fear. He left the country stronger and more confident. By word and deed, the forty-third president did the opposite, leaving the nation weakened and afraid.
12
There’s Never Been a Better Time to Be Alive
In central Ontario, near where my parents live, there is a tiny cemetery filled with rusted ironwork and headstones heaved to odd angles by decades of winter frost and spring thaws. This was farm country once. Pioneers arrived at the end of the nineteenth century, cut the trees, pulled up the stumps, and discovered, after so much crushing labor, that their new fields amounted to little more than a thin layer of soil stretched across the bare granite of the Canadian Shield. Most farms lasted a generation or two before the fields were surrendered to the forests. Today, only the cemeteries remain.
The pioneers were not wealthy people, but they always bought the biggest headstones they could afford. They wanted something that declared who they were, something that would last. They knew how easily their own existence could end. Headstones had to endure. “Children of James and Janey Morden,” announces one obelisk in the cemetery. It’s almost six feet tall. The stone says the first to die was Charles W. Morden. He was four years and nine months old.
It was the winter of 1902. The little boy would have complained that he had a sore throat. He was tired and his forehead felt a little warm to his mother’s hand. A day or two passed and as Charles lay in bed he grew pale. His heart raced. His skin burned and he started to vomit. His throat swelled so that each breath was a struggle and his head was immobilized on the sweat-soaked pillow. His mother, Janey, would have known what was torturing her little boy, but with no treatment she likely wouldn’t have dared speak its name.
Then Charles’s little brother, Earl, started to cry. His throat was sore, he moaned. And he was so hot. Albert, the oldest of the boys, said he, too, was tired. And yes, his throat hurt.
Charles W. Morden died on Tuesday, January 14, 1902. His father would have had to wrap the little boy’s body in a blanket and carry him out through the deepening snow to the barn. The cold would seep into the corpse and freeze it solid until spring, when rising temperatures would thaw the ground and the father could dig his son’s grave.
The next day, both Earl and Albert died. Earl was two years and ten months old. Albert was six years and four months. Their father would have gotten out two more blankets, wrapped his sons, and taken them out to the barn to freeze.