Nicholas Kristoff, Obamacare, and the Broken Window Fallacy
Nicholas Kristoff offers up an individualized argument for Obamacare:
>>> John is a sawmill worker from Yamhill County, Ore., where I grew up. He was a foreman at a mill, he felt strong and healthy, and he had very basic insurance coverage through his job. On April 18, he was married, at age 23, and life was looking up.
Ten days after the wedding, he was walking in his backyard carrying a neighbor's dog — and he suddenly blacked out. That led, after rounds of CAT scans, M.R.I.'s and other tests, to the discovery that the left parietal lobe of his brain has a cavernous hemangioma. That's an abnormal growth of blood vessels, and in John's case it is chronically leaking blood into his brain. ...
Perhaps the worst is the pain — blinding, incapacitating headaches that have left him able to sleep only in short intervals. He vomits daily when the pain surges. "The pain is constant," John said. "It's a 7 or 8 on a scale of 10, and then it hits the high peaks and makes me vomit."
With John unable to work, he lost his job — and his insurance coverage. Esther had insurance for herself and for her two children (from a previous marriage) through her job building manufactured homes. But she couldn't add John to her plan because of his pre-existing condition.
Without insurance, John has been unable to get surgery or even help managing the pain. When he collapses or suffers particularly excruciating headaches, Esther rushes him to the emergency room of one hospital or another, but an E.R. can't do much for him. One hospital has told them not to come back unless he gets insurance, they say. ...
If a senator strolled indifferently by as John retched in pain, we would think that person pitiless. But isn't it just as monstrous for politicians to avert their eyes, make excuses and deny coverage to innumerable Americans just like John? <<<
As far as individual morality is concerned, the Parable of the Good Samaritan seems wholly apt here. We have an obligation to those we encounter in life who need our help.
As an argument in favor of a specific social policy--namely, Obamacare--Kristoff's column is riddled with fallacies.
1. Appeal to pity: Substituting a story designed to elicit pity for evidence
2. Misleading vividness: Using a vivid example to imply that it is likely to occur
3. Spotlight: Creating the impression that those who receive the most media attention actually represent the groups they belong to.
4. Cherry picking: Finding cases that support your argument while ignoring those that don't
Probably the most egregious problem in Kristoff's argument, however, is his invocation of the broken window fallacy. Frederic Bastiat explained that we all too often focus on consequences that are easy to see, while ignoring those that are hard to see:
In the department of economy, an act, a habit, an institution, a law, gives birth not only to an effect, but to a series of effects. Of these effects, the first only is immediate; it manifests itself simultaneously with its cause - it is seen. The others unfold in succession - they are not seen: it is well for us, if they are foreseen. Between a good and a bad economist this constitutes the whole difference - the one takes account of the visible effect; the other takes account both of the effects which are seen, and also of those which it is necessary to foresee. Now this difference is enormous, for it almost always happens that when the immediate consequence is favourable, the ultimate consequences are fatal, and the converse. Hence it follows that the bad economist pursues a small present good, which will be followed by a great evil to come, while the true economist pursues a great good to come, - at the risk of a small present evil.
In fact, it is the same in the science of health, arts, and in that of morals. It often happens, that the sweeter the first fruit of a habit is, the more bitter are the consequences. Take, for example, debauchery, idleness, prodigality. When, therefore, a man absorbed in the effect which is seen has not yet learned to discern those which are not seen, he gives way to fatal habits, not only by inclination, but by calculation.
Kristoff here invokes a single but attractive and sympathetic example as an argument for a major shift in national policy. Presidents do this when they invite a symbolic figure to sit next to the first lady at the State of the Union address. Congressmen do this when they decide who to invite to legislative hearings. Trial lawyers do it when they select the most piteous victim to be the named plaintiff in mass tort class action.
It's effective because who amongst wants to seem like the priests in the Parable of the Good Samaritan. It's analytically flawed, however, because it fails to take into account the interests of the mass of other individuals who may be adversely affected by the change of policy in question.
Sure, it would be great if John had health care insurance. But at what cost to everybody else? Should women under 50 be denied mammograms so as to hold down health costs so that John can have government-subsidized insurance? How about men over 70 with slow acting prostate cancer? Should we deny them treatment on the assumption that something else will kill them first, so that the government can afford to insure John?
The point is that Kristoff and his ilk are basically running a con. They want you to focus on the most sympathetic cases, while ignoring the large and amorphous mass of individuals who will be adversely affected.
Resources are scarce. There ain't no such thing as a free lunch. Hard decisions have to be made.
Let's at least make sure that, as Bastiat urged, both the effects that are seen and those that are unseen.
Nicholas Kristoff, Obamacare, and the Broken Window Fallacy - ProfessorBainbridge.com (30 November 2009)
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