The government does a Cost Benefit Analysis (CBA) of most big proposed regulations, to see if they're worth it...if the benefits are greater than the costs. They compare the dollar cost of the regulation against the benefits, measured by the number of lives the regulation is expected to save. To make it an apples-to-apples comparison, economic techniques convert those saved lives into dollars, creating something called the Value of a Statistical Life - VSL. Understandably, many people find VSL - lives converted into money - repugnant. They say that such cold economics fail to take into account the nature of the risk...how scary it is, how worried about it we are and, therefore, how much we want to be protected from it. Dying of cancer, for example, is worse in many people's minds than dying most other ways. Shouldn't a life spared from cancer count for more when VSL is calculated?
It's a stickier question that it seems, and it highlights a huge problem with risk perception; sometimes, no matter how right our feelings about a risk might feel, we're wrong, in the sense that our fears don't match the scientific facts. And sometimes when we're too afraid of smaller dangers, and not afraid enough of bigger ones, it creates a Perception Gap, as I call it in "How Risky Is It, Really? Why Our Fears Don't Always Match the Facts" , which can be a danger all by itself. There's a great example being considered right now by the EPA. If you breath in the United States, read on. Your safety hangs in the balance.
The agency is considering a Cancer Premium when it calculates VSL. Lives spared from cancer would count for 50% more than lives spared from any other causes of death. Essentially our fear of cancer would be monetized, and reflected in the Cost Benefit Analysis of whether a regulation is worth it. That seems fair, doesn't it? I mean, cancer is scarier than other ways of dying, even other more likely ways of dying (e.g. heart disease, accidents - the leading cause of death for those under 39). There are well established psychological reasons why a statistically less likely risk scares us more.
• Cancer is associated with more pain and suffering. The greater the suffering the greater the fear.
• Cancer feels more like a risk that's imposed on us, caused by forces beyond our control. Risks we don't choose to take frighten us more than risks we take voluntarily.
• Ever since Rachel Carson's Silent Spring, cancer has been stigmatized, the psychological effect of which is that the very mention of the word is more fear-provoking than many other threats.
Those are powerful arguments for a Cancer Premium. After all, shouldn't government protect us most, from what we are most afraid of? Isn't that democratic? Well, yes. Only it's dangerous. Here's why.
Environmental sources like hazardous waste and toxic chemicals and pesticides cause thousands of cancer deaths per year. Nobody is sure how many. But cancer isn't the biggest environmental killed. That dubious distinction goes to particulate pollution from burning coal and oil and gasoline in our factories and power plants and vehicles. Tiny particles from the incomplete combustion of fossil fuel get deep into our lungs and cause tens of thousands of deaths per year from cardiovascular problems. Most environmental public health experts believe that particle pollution causes far more cardiovascular deaths than the annual death toll from environmental carcinogens. So if you want regulations to protect you from what's most likely to kill you, control of particulate pollution would probably be the best investment in public health.
But a Cancer Premium would give a 50% bonus to the benefits side of the economic evaluation of regulations to control carcinogens. So those regulations would be more likely to come out looking favorable in a Cost Benefit Analysis than regulations to control non-carcinogenic threats. Using the supposedly rational (emotion-free) economics of CBA, we'd be more likely to approve environmental regulations to control cancer than particles. We could end up with more control of the scarier risk, and less control of the less scary risk that's more likely to kill you! As unpleasant as it may seem to argue against the Cancer Premium, it could actually increase the overall environmental death toll in America.
The issue boils down to this; how, in a democracy, is government supposed to deal with the risk of risk perception? Yes, a government of, by, and for the people should reflect the public's values, and fears, in its rules and regulations. But shouldn't "for the people" also mean a government that wisely applies resources in ways that will do the most people the most good, even if that means doing something based more on reason and factual evidence than on how we feel? Our values and feelings should of course be part of any debate about how to regulate public and environmental safety. But inserting our emotions into the supposedly emotionally-neutral/purely rational process of Cost Benefit Analysis may not be the wisest way to actually keep the most people healthy, and alive.
