Michael Gerson on budget cuts, malaria, and being pro-life

Conservatives get regular pokes around these parts, but there are some columnists I enjoy reading very much, like Michael Gerson.

He has a very nice column in the Washington Post this week about the real-world effects of budget cuts.

I take a bit an extended quote:

But last week, a neon line was drawn by an unlikely administration official. Rajiv Shah, the administrator of the U.S. Agency for International Development, possesses the mildest of manners. Testifying before the House state and foreign operations subcommittee, however, Shah had this to say:

“We estimate, and I believe these are very conservative estimates, that H.R. 1 would lead to 70,000 kids dying. Of that 70,000, 30,000 would come from malaria control programs that would have to be scaled back, specifically. The other 40,000 is broken out as 24,000 who would die because of a lack of support for immunizations and other investments, and 16,000 would be because of the lack of skilled attendants at birth.”

This is the hardest of hardball politics — accusing budget cutters of unwitting complicity in the deaths of children. House GOP lawmakers responded angrily. “Nearly every administration witness appearing before the Appropriations Committee,” said Rep. Jerry Lewis (R-Calif.), “has put forward nightmare scenarios and dire numbers to argue why we should not be reducing spending in any program. Republicans won’t be drawn into a debate over what might happen based on speculations and hype.”

But it is not realistic to take credit for cuts while forbidding a discussion of their consequences. Republicans were drawn into this debate when they proposed major reductions in foreign assistance, believing this category of spending to be an easy political target. Instead, they have stumbled into what one poet called “a problem on the borderline of ethics and accounting.”

Brilliantly noted: you don’t get just turn a blind eye to what the programs are for in your desire to claim that all spending is ineffective and social-welfare-lowering. You have to look at the actual evidence. That’s your job as a legislator (not, actually, to throw a big bootyhoo fit that somebody has confronted you with forecasts you don’t like much.) And the evidence on malaria programs is painfully clear: malaria is cheap and easy to prevent, and we really can, in fact, afford to eradicate it. As Gerson notes, maternal and child heath, and malaria prevention, are two places where there is an established relationship between social benefit and dollars spent–unlike lots of other things we routinely pursue (as in, I’m sorry to say, public transit, where proving the benefits has been analytically much, much more difficult).

Economists are taught to think in margins. Yesterday at lunch, I proposed that our goal should be zero highway deaths and acccidents–we won’t get there, but that’s what we should be thinking. My lunch partner somewhat balked. He, like me, has been raised on the idea that you abate to where the marginal cost=equals the marginal benefit. This is so ingrained in our thinking that it seldom occurs to us that of course the optimality condition still allows for–at least in theory–the corner solution at 0, or perfection. There’s actually pretty good evidence that malaria, given how much benefit comes from a dollar spent, is an arena where we could pursue perfection and not much notice the costs.

Unless you think you have a easy budgetary target on your hands, and your constituents could care less.

Gerson ends with a moral note:

Cuts for global health programs should be of special concern to those of us who consider ourselves pro-life. No pro-life member of Congress could support welfare savings by paying for abortions. No pro-life member of Congress could support Medicare savings by cutting off life support for the sick. And it should give any pro-life member pause to support minuscule budget savings that risk the death of children from malaria.

You mean you actually are supposed to care about a kid’s fate once they are in the world, too, and not just in the baby factory? I’m not sure I can handle this much ideological consistency all at once.