IT GETS TIRESOME.

"People die when the government messes up."  Well, yes, but the argument usually presents as emotional blackmail.  "Do Republicans Want Some of Us to Die?"  "Millions Will Die Unless US Aid Money is Replaced."  "Incompetence Is Not Virtue.  Also, People Will Die."  "Public radio, a matter of life and death."

I've called attention previously, and the cartoonists never lack for work.

But can we go beyond the edgy mockery?  "MSNBC's 'Millions Will Die' Trump Opioid Panic Is Political Theater, Not Reporting."

Maybe we could apply logic?

Some supporters of the Affordable Care Act (ACA) have taken to asserting that hundreds of thousands of “people will die” if it is repealed or significantly altered. These claims do not withstand scrutiny, and those who wish their policy arguments to be taken seriously would be well advised to avoid them.

These sensational claims rest on fallacious reasoning, which I’ll describe later in this piece. But first let’s acknowledge that neither I, you, nor anyone else has any idea how many Americans will live or die under alternative federal health care policies. It’s an inherently fruitless exercise to attempt to quantify these effects. However, if one seriously wished to attempt it, one would not do so via the methods now being employed to promulgate the “people will die” claim.

We could, I suppose, attempt to capture the effects of putting more people on Medicare and Medicaid at Medicare reimbursement rates and see what happened to mortality.  That's not what defenders of mandatory purchase were all about, and they, according to Charles Blahous, messed up.

But the biggest problem with the “people will die” claim is that it rests on a fundamental logical fallacy. It is related to the familiar “Fallacy of Composition,” which any discerning interlocutor will call you on if you commit it. An oft-cited example of the fallacy is that just because a standing spectator can see a baseball game better than the patrons seated near him, this doesn’t imply that everyone will see better if they all stand up.

The application of the fallacy to health insurance is straightforward. One cannot leap solely from the observation that “having health insurance. . . results in better health” to the conclusion that “the more we expand health insurance, the healthier we all will be.”

Health insurance reduces the out-of-pocket costs individuals face when they buy health services. Expanded insurance coverage increases health service consumption which, considered by itself, should improve health. But it also increases cost growth, an effect widely recognized in health expenditure forecasting. People with insurance feel this cost growth through rising premiums, but the cost inflation is felt especially keenly by the uninsured, who must pay more whenever they buy health services (or receive less care for what they pay).

Thus, even if health insurance did absolutely nothing to improve national health outcomes, we’d still expect the insured to be healthier than the uninsured. Thus, the observation that the insured are relatively healthier doesn’t by itself imply that expanding coverage will save lives.

That line of reasoning might not stand up: first, there is self-selection into insurance, second, people who have the means to purchase insurance (or have it bundled with their work) might be engaging in healthier behaviors.  That noted, you might want to treat "people will die" arguments as in the same class as "If you don't let me date the Leader of the Pack, I'll kill myself."  As Mr Blahous puts it, "Don’t use it if you want to convince others to adopt your health care policy views. If you do, the only thing certain to die will be your credibility."

You could, in the manner of Holman Jenkins for The Wall Street Journal, essay a Friday short take.  "‘People Will Die’ Isn’t the Policy Clincher It Seems."

Sen. Elizabeth Warren (D., Mass.) has been a fiery proponent of “people will die” opposition to spending cuts. But people will die no less from Ms. Warren’s failure to push through new programs or expand existing benefits to new classes of Americans. People will also die if enticed to rely on programs that politicians know aren’t sustainable and must be changed. Medicare and Medicaid are certain to produce long waiting lists in the future. Social Security benefits are already scheduled to be cut sharply as soon as 2033 under existing law.

“People will die” is a safe bet too if opportunity vanishes from the economy due to heavy tax hikes to sustain these programs. A one percentage point increase in the unemployment rate, according to a much-cited study, is associated with a 6% increase in mortality risk for working-age men in the following year.

It might be awkward to ask whether the link is unemployment to loss of health coverage to loss of life.  Alas, what has the potential to be a serious argument rapidly slips into the swamp.

Ressentiment can be a plausible basis for a career in the U.S. House or Senate. The federal government can push along pretty well from day to day without competent management. In New York things quickly run out of control if city government isn’t on the ball.

Yes, there well might be a great deal of ruin in a nation.  That real debt ceiling is still poised to cave in.  Perhaps laughter is the best medicine.

There are a lot more prognostications pointing to the End of Life As We Know It than there are Ends to Life As We Know It.