In my latest reading of M. Stanton Evans’ Clear and Present Dangers: A Conservative View of America’s Government (copyright 1975), I finished the chapter on health care, read the chapter on “The Population Scare”, and started the chapter on the environment. Here are three items:
1. On page 211, Evans quotes economist Herbert Klarman, who said that Medicare and Medicaid’s reimbursement of hospitals was based in part on the hospital’s cost of operation, and that discouraged hospitals from keeping down costs because having a higher cost of operation could get them more money from the government. Klarman states: “The hospital administrator can no longer deny requests for higher wages or more supplies on the ground that money is lacking; to get money, he need only spend more.” According to Evans, government intervention has increased the cost of health care. Evans is critical, however, of government attempts to solve this problem, since it entails government bureaucrats snooping through medical records to see that doctors are behaving themselves and imposes high fines if the government concludes that they are not.
Evans may have a point that government intervention has increased the cost of health care. At the same time, I doubt that health care prices were especially low before the government stepped in, which was why the government stepped in in the first place: the poor were having problems paying for health care, and many private health insurance companies were reluctant to cover the elderly because there was more illness among that particular population. Consequently, I don’t favor getting the government out of health care, for I believe that this would leave many people vulnerable. But I do support reforms. If Obamacare, for example, is living up to its claim to control costs, then I support it.
Evans also critiques federal drug regulations. I don’t know if he’s for eliminating them, but he does believe that the rigor with which the government practices such regulation hinders the supply of potentially life-saving medication. Evans is often a critic of the European health care systems, but he notes that a number of new drugs are appearing in Europe, but few have made it to the U.S. Evans doubts that even penicillin would have passed the FDA’s “‘safe and effective’ meter'”, for it has caused “unfavorable reactions in some people [and] is less effective in certain cases than in others”, even though it has saved many people’s lives (Evans’ words on page 215).
I do know people in the health food industry who had to put up with the FDA and its rules regarding vitamins and supplements, but, when it comes to pharmaceuticals, the complaint among many today is that the pharmaceutical industry has too much power. It’s interesting that Evans notes that new drugs were appearing in Europe, which many conservatives regard as socialistic in its health care policies, for conservatives often have argued that the U.S. system’s stress on the profit-motive provides incentives for the development of new drugs in the U.S. Since Evans in the 1970’s appeared to lament that new medications were not sufficiently making their way into the U.S., I wonder if Evans would support the importation of cheap prescription drugs, something that a number of Republicans have opposed.
2. Evans does not buy into the population scare, the notion that the number of people is rapidly increasing even as space and resources are limited. For one, Evans notes that the birth rate is decreasing in the U.S., even as there is a lot of space in the country. While Evans is not into scare tactics regarding population, he does appear to be concerned about the decline of the birth rate, for that would result in a smaller workforce, which would not be able to adequately sustain the Social Security system. Second, even in the Third World, Evans argues, people having children may be helpful because it could result in more human-power and thus increased productivity. For Evans, productivity is important because that entails that there is more food to go around. Evans notes on page 220 that Malthus wrote “before the full effects of industrialization became apparent”, and that “it is precisely this neglected factor that makes all the difference.”
I first heard about the population crisis when I was in seventh-grade social studies, which was in 1989-1990. And, in the 1970’s, there was a lot of concern about over-population, as was evident in such movies as Soylent Green (which is made of people!). I don’t hear much about the population crisis nowadays, though I do think that there is a belief that overpopulation is a problem in the Third World, and thus we should encourage contraception there. And yet, it seems to me that contemporary discussions about contraception revolve more around women’s rights than over-population.
3. I started the chapter on the environment. I’ve encountered some of Evans’ arguments in other conservative and libertarian writings that I have read: that businesses pollute public lands that nobody owns, and thus privatization of parks and beaches can reduce pollution; that DDT is not a danger to humans, for too much of it was pumped into animals when it was tested on them and it had ill-effects; that nature causes more pollution than human beings do (and Evans documented this claim better than Ronald Reagan did when Reagan claimed that Mount St. Helens caused more pollution than cars, or that trees cause pollution, for Evans refers to a team of Harvard researchers), etc. Evans also made arguments that I had not read as much before: that human-caused pollution was decreasing prior to the onset of federal anti-pollution legislation, that there is no evidence that leaded gasoline harms human beings (Evans quotes Dr. Robert Kehoe of the University of Cincinnati College of Medicine and a 1972 National Academy of Sciences Report), and that there is a potential danger that oil refineries could substitute something more hazardous than lead (Evans quotes E.P.A. Administrator William Ruckelshaus).
Evans may make some good points, here. But there’s probably more to the story than what he presents. While Evans may be correct that pollution declined prior to the onset of federal anti-pollution legislation, and this was probably due to improved technology, I’ve still heard stories about how smog was at one time a problem in major cities. Moreover, if businesses would do a good job by themselves in keeping the air clean, why would they have a problem with federal mandates for air quality? Granted, they may feel that there are better ways to keep the air clean than what the government is prescribing, but I wouldn’t be surprised if, on some level, companies think that pollution is an unavoidable side-effect of the services that they provide. On DDT, I’m somewhat skeptical that scientists wouldn’t have recognized that there is a difference between animal and human ability to absorb DDT and that the quantity of DDT injected into the animals is important, and that the scientists didn’t take that into consideration in their studies. On privatization, I wonder if that would hinder businesses, since businesses would be restricted in terms of where they could log or drill or dump their waste. Wouldn’t that lead to higher costs for consumers?
Personally, though, I’m a person who hopes that we can have our cake and eat it, too: that there are ways that we can have cleaner air and cleaner water, without harming the economy. I hope that technology, both existent and developing, can make this possible, and there are many who argue that it indeed can.