War and health

Also on Mark Kleiman’s blog

The Pentagon says the occupation of Iraq is going to cost about $50 billion per year, indefinitely. That’s not counting reconstruction costs. Keeping Afghanistan safe for its warlords is now costing about $10 billion per year. Can you imagine how much safer a world we’d have today if we’d been willing to spend half that much on rebuilding the fragments of the Soviet Empire in the years just after 1989? Or how much a tenth of that, well spent, could do for human and economic development in Africa? Or how big a horselaugh you would get if you proposed spending anything like those sums on an activity that didn’t also include killing people?

I made the identical point here (full text here, with some reasonably hard numbers

Consider, for example, the alternative option of allocating the money to improved health care or public safety. Under current conditions, marginal health care and public safety interventions in the United States typically cost around $5 million per life saved. Thus, if the direct war budget of $50 billion had been allocated to public health instead, the lives of around 10 000 Americans could have been saved.
…It seems certain, however, that the war will herald a sustained increase in military expenditure of at least $US100 billion per year. A more reasonable comparison, therefore, is the ambitious proposal of the Commission on Macroeconomics and Health, led by Harvard Economist Jeffrey Sachs. The Commission aimed to achieve, for all a poor countries, a two-thirds reduction of 1990 child mortality levels, a three-fourths reduction of 1990 maternal mortality ratios and an end to the rising prevalence of major diseases, especially HIV/AIDS.

As the Commission pointed out, in addition to the humanitarian benefits of saving as many as 8 million lives per year, reductions in mortality are directly correlated with a reduced frequency of military coups and state collapse. These provide the breeding ground for terrorism and dictatorship and ultimately lead, in many cases, lead to US military intervention. The estimated cost for the Commission’s seemingly-utopian program over the next decade is estimated at between $US 50 billion and $US 100 billion per year.

Of course, there’s nothing new here: the same point has been made over and over again for decades. What’s frustrating is that the advocates of war as public policy seem to have no answer to this except to dismiss it as politically unrealistic.

9 thoughts on “War and health

  1. actually if we’re talking economics, it shouldnt take the US very long to bleed iraq dry of oil. oil worth far in excess of a few hundred billion dollars (3.5 trillion dollars worth according to everyones favourite cia worldfactbook and bloomberg.com)

    incidentally, iraqs GDP was 58 billion in 2002 so apparently the US can nearly run the whole country for that money.

  2. The amounts spent on war and killing people never cease to amaze. Nor does the smallness of the GDPs of poor countries. I heard the combined GDP of sub-Saharan Africa the other day, and it sounded similar in scale to the GDP of Australia, which is similar to what the US spends on their military.

    On reading your post, John, I was reminded of Johan Galtung, a Prof of Peace Studies, who toured Australia a few months ago. He is currently the Director of Transcend: A Network for Peace and Development in Lund, Sweden. I looked some of his stuff up on the net. He tirelessly tells Bush what he should have done instead of what he did, and how problems can be turned into win-win opportunities.

    In a piece with Dietrich Fischer entitled “To end terrorism, end state terrorism” (www.transnational.org/pressinf/2002/pf158-EndStateTerrorism.html) they state that since 1945 the US has intervened 67 times in other countries, causing 12 million deaths, half of them through direct action. In addition, “100,000 people die every day in the world from hunger and preventable diseases in the midst of enormous luxury and waste.”

    Thatâs 36.5 million each year, which he attributes to the hegemonic and exploitative policies of ãthe Westä. Such policies are not the sole province of the US, but are certainly a large part of the root cause of ãblowbackä.

    Yet they suggest that the long-term goal of Islam fundamentalists is respect for religious sensitivities. This, they say, is the speech that Bush should have made after 9/11:

    “Fellow Americans; the attack yesterday on two buildings, killing thousands, was atrocious, totally unacceptable. They have to be captured and brought to justice by an appropriate international court, with a clear UN mandate.

    “But my address tonight goes beyond this. There are serious flaws in our foreign policy, however well intended. We create enemies through our insensitivity to the basic needs of the peoples around the world, including their religious sensitivities. I am therefore taking these steps: – withdraw our military bases from Saudi Arabia, – recognize Palestine as a state, details can follow later, – enter into dialogue with Iraq to identify solvable conflicts, – accept President Khatami’s invitation for the same with Iran, – pull out militarily and economically from Afghanistan, – stop our military interventions and reconcile with the victims.”

    The result, they suggest, would have been:

    “That evening, 1.3 billion Muslims would have embraced America; and the few terrorists left would have no water in which to swim. It would have taken a speech-writer half an hour, and ten minutes to deliver it; as opposed to, say $60 billion for the Afghanistan operation. Psychologically, this is not easy, but the benefits are immeasurable.”

    The critical phrase here is that terrorists would ãhave no water in which to swimä. Surely this is what Blair had in mind when he made a fine speech about draining the swamps of terrorism and then went off and started killing people.

    We do need a change of attitude on the part of the US leadership. Then dollars to prevent diseases like TB, which I understand kills 5,000 every day, would easily be found.

    Fat chance, I know, but change needs to be imagined first of all.

    Galtung, the eternal optimist and conciliator, has expanded in some detail the approach the US should have taken in “September 11 2001: Diagnosis, Prognosis, Therapy”. It’s longish at 8,700 words or so, but I found it interesting. It’s in a few places on the net, including http://www.peace.ca/September11byjohangaltung.htm

    btw on ABC radio he said that he can always dine out on the fact that he predicted the demise of the Russian empire 10 years before it happened. With even greater certainty, he says, the US empire will fail through its manifest internal contradictions. I really went looking at his stuff to see whether I could find an expanded version of what he meant. I found zilch, but much of interest once you get your head into the Îpeace discourseâ. Sad that it seems strange!

    Sorry to be so long-winded and take up so much space, John, but itâs the quiet part of the week.

  3. PS. It’s important to note that the quotes from Galtung precede the whole Iraq thing. He regards the Afghanistan venture as a failure. You can imagine what he thinks of Iraq!

  4. Excuse my absence I have been on military service.
    once more unto the breech…

    Numberless times have I made the point that the cost of military actions and installations must not be compared with the value of worthy social alternatives, such as health education etc
    It must be measured against the cost of military inaction against state and non-state threats.
    The 20th C and 911 prove that the cost of not meeting & neutralising these threats is much higher than poorer community services for some in the short term.
    THus the cost of another 911 would be $1 trilion losses (market capitalisation & physical infrastructure) to the US & RoW and would entali the nuclear anihilation of several Middle Eastern countries.
    To prevent this bad out come, short term largish up front costs of military ventures in Southern Asia are indeed cost-effective.
    Unless the democratic Left take security (border & military) serioulsly the, democratic electorate will not take the Left seriously.

  5. PS I agree with Pr Q’s remark that a moderate Marshall Plan for post-one party states in transition, such as Iraq and the CIS, would be far more cost-effective security measure than extra expenditure on military expeditions or military gadgets.

    But, as in WWII, preventative welfare could be a complement, not substiture, to preventative warfare. Both Patton and Marshall were necessary to beat the threat of fascism in Europe.
    But the Left don’t seem that upset about Arab fascism, when it is opposed by the US.

    In the case of the stratgic problems and economic costs of GW II, I apportion considerable blame to the Cultural Left, and their myopic Economic Leftist fellow travellers, for not coming aboard a military operation that would have both strategic, moral and economic benefits.
    With multilatral UN support Operation Iraqi Freedom would have a much better chance of succeeding. Military-enabled civic reform of fascist and fundamentalist states remains the best hope of all peoples within the region.

    It is dispiriting that no one on the Left has bothered to engage the strength of the argument for GW II in terms of:
    containing Saudi state’s chronic fundametalist terrorism
    reforming Iraqi states dynastic fascist despotism

    As far as the Left is concerned leaving half the supply of cheap crude oil in the hands of a megalomaniacal democidal fascist dictator is ok.
    And leaving safe havens for fundamentalist tarrorists is evidently preferable to warlordism, which truth be told, has been the condition of Afghanistan since time immemorial.

    The Left, including Pr Q, fall back on the line that it is “politically unrealistic” to attempt to use military means to aggressively reform the ME.
    And the Left say that a “relaxed & comfortable” policy is sufficient to deal with the security problems thrown up by terrorists and tyrants in the age of WMD proliferation.

    As always the sterotypical ideologies present a perverse mirror images of each others deformations:
    the Economic Right is blase about the problems of capitalist prospertity
    the Culturalist Left is blase about the problems of statist security

    Both are wrong.

  6. Jack, I assume you’re not asserting that the cost of 9/11 was $1 trillion or anything close to it – a reasonable estimate might be $50 billion-$100 billion, taking account of property damage, economic shocks and lives lost (compared to opportunity cost of saving a similar number through health care).

    Your argument seems to be that since the US would be driven to irrational military revenge, the costs of a second attack would be greater. Hence, large-scale US military expenditure now is justified if it could reduce the probability of such an attack, even marginally. But we can shorten this by saying that the US needed revenge for the first attack, that Afghanistan didn’t satisfy this need, and that Saddam Hussein was next in line.

    To summarise, your position is the one I alluded to, that the use of war as a policy instrument is irrational, but that it is politically impossible to do anything about it.

  7. Jack, I have previously responded to the arguments about oil, which simply don’t stack up. Oil is not economically important enough to make them work.

    The Afghanistan war was justified (morally and in cost-benefit terms) as self-defence, though the benefits are largely being dissipated, because reversion to warlordism creates the preconditions for a renewed threat in the near future.

  8. Pr Q’s response to my comments are wrong-headed, mis-read and beside the point – which is a considerable improvement on the typical quality of most Leftist analysis of this issue.

    TO deal with the economic points first:

    I have never argued that economic prosperity issues have driven US policy in the Gulf. It is fundamentally driven by political security issues.

    The cause of GW II has it’s roots in the drive of the US ruling class to preserve the Saudi alliance, which gave immense profits to the US military-industrial-financial complex:
    – arms sales (advanced fighters)
    – oil revenues (west texan arabs)
    – financial investments (recycled petrodollars)
    This class, typified by the Carlyle group, wilfully avoided the costs of the saudi alliance.
    The Wolfowitz-articulated faction in the US ruling class (Cheyney Rumsfeld) seeks to disengage from the Saudis and reform the Iraqis.
    They are to be applauded.
    Instead the Left bags them and praises the corrupt old stle conservatives (BushI, Scowcroft)
    The Left fails to appreciate the problem and then attempts to thwart the solution.

    The US solution to the Saudi problem is driven not by greed but by fear of Iran II (X 10) given the fanatacism of the Wahhabis and the scale of the Saudi oil industruy.

    The desire of the US for Iraqi oil was not a causal factor in initiating GW II, although it’s subsequent control of the oil asset is consequential to success in GW II.

    The main flaw in the Left’s analyis of GW II is to look at the US’s behaviour in terms of the quest to acquire positive benefits (oil or territory). These benefits are trivial in relation to the cost of GW II.

    Thus the fiscal costs of the US for GW II exceed the financial benefits interms of oil prices and profits. But reduced oil prices and increased oil profits will amortise the cost of GW II.

    The real issue for US security managers is the aversion of costs of non-intervention (hostile control of oil revenues and hostile arms complexes and militias) rather than the attraction to benefits of intervention.

    Pr Q is looking at the benefits of alternative non-military investments. His arguments are true as far as they go, but they don’t get up to the starting line as he neglects the cost of non-investments in the military. These are:
    – massive attacks by fundamentalists/fascists against Western urban centres
    – takeovers of Muslim societies by fundamentalists
    – massive retaliation of Western states against Islamic fundamentalist states

    Each and any one of these events would have costs well in excess of $1 trillion
    – Econoimic infrastructure damage costs run into hundreds of billions
    – Financial disorganisation costs run into trillions as they would impute a slow down in world growth

    Each and any one of these scenarios is possible, and in my opinion, plausible. Moreover, passive reactive “relaxed policies” have been tried and have failed during the appeasing/containing nineties. Active-aggressive policies are now indicated in the noughties.

  9. I sometimes feel that I am talking to myself, despite the fact that my recirded predictive record on this issue is better than anyone else.

    My main political fear is the effect on Moderate Muslims who are the subjects who are really at risk from:
    – domestic fundamentalist takeovers
    – foreign fundamentalist attacks
    – Western massive nuclear retaliation
    US led reform of Muslim societies and containment of fundamentalist terrorists is their best hope of survival.

    I did not say that the US’s political motive for GW II was “revenge”, nor that it’s economic motive was oil. These factors are consequential not causal to GW II.

    The cause of GW II, as is now recognised, was the desire for the US to ditch Saudi/hitch Iraqi:
    – recoil from a former ally (saudi) now adversary
    – reform a former adversary (iraqi) now ally
    This may or may not work, but political race revenge or economic oil greed has nothing to do with the strategic value added.

    On the issue of the supposed irrationality of a massive US retaliation to another 911 scale attack, Pr Q accuses me of falling back on the old saw of dismissing alternatives to military force as “politically unrealistic”. I make no apologies for this charge.

    Realism is correct whether it is political or economic. The world is as it is, what ever Pr Q’s realistic proposals and idealistic fantasies are.

    It is not as if non-military means have not been tried in the attempt to manage the mess of Gulf politics.

    Alternatives to military force have been tried and have failed in connection to Saudi terrorism over the past decade. The Left simply does not register this threat – it is “unserious” on this issue.

    Alternatives to military force have failed to enable regime change in IRaq. A US Military force was the only way to get rid of a democidal fascist dictator, unless Leftists are happy to let SH and his dynasty to control half the worlds supply of cheap crude for the next two generations.

    It is true that the US admin has passively exploited racist and sectarian hostility to Islamic Arabs as a political reward for the risk of GW II. To that extent, the populist desire for revenge is an attendant factor in the elitist planning of GW II.
    But it was not causal. And as Pr Q has rightly noted, Bush has so far not played the xenophobe card. The US Right has not yet been let off the leash to fan the flames of a civilisational conflict.

    But it is a factor to be considered, and it is not political cynicism to acknowledge this.
    But it is politically naive to imagine that UN style “foreign policy as social work” and mulitalateral appeasement, although necessary, will be sufficient to deal with the toxic political forces that have been roiling in the Gulf ever since the UK withdrew from East of Suez.

    I have not said that the US’s use of massive force in relation to another 911 would be irrational. That is Pr Q’s value judgement, and in my opinion it is not justifiable.
    Massive nuclear attacks are emminently rational: economicly cheap and technicly effective.
    They would appear to be immoral, but History generally records that Might is Right. To be sure another Carthage would be iniquitous, but most people have forgiven the Romans.

    It is the case that the US actively planned the nuclear anihilation of four major states, the Nazis, Nippons, Soviets and Chi-Coms.
    Each of these states were industrial giants whose destruction would have harmed the US economicly.
    None of these states dared to stage a 911 scale attack on the US homeland.

    Why would a US/CIS Cathaginian solution to the Islamacist problem be irrational?
    A nuclear anihilation of Southern Asia looks to be win-win.
    The ME does not produce any serious service exports besides suicide bombers.
    What would the US/CIS have to lose?
    – Remove the costly political agents.
    – Acquire the beneficial economic assets.
    – Avoid messy and bloody impossible regime change, nation building democracy promotion etc

    My greatest fear is that US and CIS security managers will cold-bloodedly make these rational calculations and wipe out large numbers of trouble spots in Southern Asia.
    The Islamicist Arabs do not seem to appreciate the danger they are in, or perhaps being suicidal, they do not care.
    They can be excused for their ignorance, irrationality if not their immorality.

    What is inecusable is the Left’s persistent aversion to a serious analysis of security issues.
    It explains why Leftists are losing national elections all accross the OECD.

    This fact that stems from the political fallout from the Vietnam war, and which will only disappear with the retirement of the baby boomer cohort involved in that conflict.

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