Dollars per life and the TSA

I've written previously about how much money we spent in Iraq, and what other things we could have done with that sum of money. I've also suggested that taxes should be seen as transactional; are you getting what you pay for? I'd like to focus that discussion. Let's look at causes of death in the United States, and what we spend preventing them. In particular, let's look at terrorism, and the TSA.

TSA was created in response to 9/11, to prevent other similar attacks. Since then, TSA has been budgeted something like $7 billion per year. Assume they've prevented one 9/11 per year, which is terribly unlikely. So that's a little over $2 million per life saved, as an extreme low-end estimate. It's probably more like $200 million per life saved.

Now, how does that compare to other means of saving lives? Are we getting a good deal?

First, the number of lives involved. Less than five thousand Americans have been killed by terrorists in the last thirty years. Compare that to annual death rates of tobacco use, which is something like 400,000. Or 43,000 for traffic collisions. 85,000 for alcohol. 17,000 for drug abuse. Or 41,000 suicides. Looking at the leading causes of death in the United States, it's clear that terrorism shouldn't even enter your mind as possibly leading to your death.

So we have our numbers of deaths. Let's start with those who die of alcohol and drug abuse. Presumably at least some of those lives would be saved if the drug abusers got into rehab. So say we're extremely generous, and pay for six months of rehab for every drug and alcohol abuser. How much would that cost? Roughly $28,000 per month gives us $168,000 per life saved. Even supposing only a tenth of those given treatment actually come out the other side more likely to survive, that's still $1.7 million per life saved. Better deal than the TSA. Suicides could probably benefit from similar treatments being available.

Or how about motor vehicle accidents? Something like 16,000 people die each year from drunk driving alone. I could come up with all sorts of complex solutions, but suppose we just gave out free taxi rides to drunk people? That's about as dumb and expensive as it gets, right? Say it's $100 a ride, a million rides a week, so five billion dollars a year. Even if we only prevent 20% of drunk driving deaths, that's $1.6 million per life saved. Still a better deal than the TSA on it's best imaginable day.

And how about tobacco-related deaths? Let's again throw money at the problem: free vape for everyone! According to one very biased source, a vaper might spend $600/year. Say it's $1,000. Suppose everyone who smokes took advantage of that, and that we actually created even more users since it's now free. Call it $70 billion a year. And suppose we prevent just 10% of smoking deaths in a year, or 40,000. The inefficient, expensive, barely effective plan I've just described is still more cost-effective at saving lives than the TSA!

Let's have some fun and look at colorectal cancer! 41,000 lives a year could be saved by appropriate screening. Like everything in the American medical system, pricing is completely opaque. Uninsured cash price for a colonoscopy is, at the high end, $5,400. It'll probably be less. Suppose we pay out $6,500 per procedure, and let the patient keep the difference as a cash incentive. Say that everyone over the age of 50 has a colonoscopy every five years, twice as often as recommended. So that's twelve million colonoscopies a year. We spend $78 billion dollars a year to save 41,000 lives. That's still cheaper than the TSA!

On a dollars-per-life basis, we could do much more good with the TSA's budget, even with incredibly stupid ideas like these.