Overdoses threaten limited resources
For three and one-half minutes in late June, the epicenter of the nation’s opiate scourge might well have been central Ohio, as National Public Radio’s “All Things Considered” aired a segment to decry the proposal of Middletown City Councilman Dan Picard to deny emergency services to individuals experiencing a third drug overdose.
According to the segment, Middletown, Ohio, is on pace to spend 50 percent more than the entire budget for ambulance medications, if the current pace of opiate overdoses continues. The councilman’s suggestion is provocative and demands public debate, but first we as a society must decide what the context of the policy debate will be. Addressing this issue represents an opportunity for Ohio to lead the nation.
The NPR segment disapproves of the councilman’s proposal, which was introduced as “startling.” “Startling” could simply imply provocative, but at the very end of the segment, the bias was revealed when a grieving father who lost two adult children to opiate overdoses was granted the closing words of the segment. His words were powerful as he declared that only God, not a city councilman, can decide who dies.
Unfortunately, three and one-half minutes is not enough time to fully examine this issue. As all politicians know, money is fungible, so the resources to address opiate overdoses will come from the proverbial somewhere. Unfortunately, no one knows what communities across the nation will forgo to treat the dramatic increase in opiate overdoses, so the costbenefit analysis that citizens expect from policymakers is impossible, and the problem is ultimately framed as certain death versus potential for more life.
Unlike the federal government, localities and states cannot borrow in perpetuity, so when money is taken from Mary to pay Paul, Mary is harmed or even wronged. Herein lies the rub: Society is forced to choose whom to harm because state and local resources are indeed limited, oftentimes by statute.
While a compelling argument can be made that society must commit to saving every life even when the harm is self-inflicted and repeated, the public-policy debate ought to consider the limited-resources argument. More than 40 years ago, ecologist Garret Hardin published a challenging argument against helping the poor. The parallels could not be more obvious.
Hardin introduces us to the lifeboat metaphor. In each lifeboat are those destined to survive the horror of a sinking ship. Less-fortunate victims of the tragedy tread water nearby. To rescue the unlucky is to ensure death for all as the small craft is overrun and capsizes. Hardin challenges those in the lifeboat demanding a rescue effort to forfeit their seat to make room on the vulnerable boat.
His lifeboat ethic is not the only alternative perspective to consider, but it does offer a counterpoint to the bias of the “All Things Considered” segment. Local and state policymakers might choose to consider it when ultimately addressing this disturbing societal trend.
David McClough Associate professor of economics James F. Dicke College of Business Administration Ohio Northern University Ada Columbus