In the digital pages of the New York Times, Ezekiel Emanuel, Obamacare whiz kid and brother of Rahm, has a modest proposal to lower suicide rates by ending the sale of Tylenol in bottles. From now on there will be just be small packages of Tylenol blister packs as a kind of seven day waiting period for committing suicide.
Emanuel is no great humanitarian looking to save lives by making it slightly harder for Pete, who has been laid off work because his company found it easier to do business in China than spend an extra twenty million a year dealing with the regulations endorsed by people like Emanuel, to commit suicide. The truth is he doesn’t care about Pete at all. He isn’t looking to save Pete’s life. He’s looking to lower suicide rates.
The two might seem like they are one and the same. And it’s an easy mistake to make. Politicians make it all the time. If there is any single great error at the heart of Obamacare, it’s that conflation of saving individuals and tinkering with statistics.
In support of his proposal to ban Tylenol bottles, Emanuel cites a British ban in 1998 that he claims significantly lowered Tylenol overdoses. But while Pete, the British edition, may have become slightly less likely to down a bottle of Tylenol in Blighty, overall suicides remained fairly steady, and male suicides have spiked significantly with the economic downturn.
Treating Pete like a child and taking away his Tylenol didn’t stop him from committing suicide. And perhaps treating him like an overgrown infant under the care of an idiot nanny state that can figure out how to ban Tylenol from pharmacies, but not how to keep Somali drug dealers from overrunning London, made him feel more helpless and more determined to assert what control he could over his life.
Not that it would matter to Emanuel. The sorts of people who dig through medical journals to find some ingenious nanny state micro solution from the UK, Japan or South Africa that increased or decreased some petty statistic by some petty percentage don’t think in terms of people. They think in terms of statistics. They see people the way that Intel engineers see computer chips and they’re just trying to engineer them to get the best and most efficient performance out of them.
The modern nanny state is a diseased bastard child of Sociology, Marketing and the efficiency experts who used to roam the halls of GM and IBM back when companies still had company songs. It has an Asperger’s level of understanding of actual people, but is an incredible whiz with statistics.
If the original Muckrakers that started the machine of urban reform (that turned into national reform) seemed to occasionally care about actual people, their ideological descendants are leftist autistics, in love with statistics and devoid of empathy. They can’t tell you why Pete wants to kill himself, but they can tell you that taking away his Tylenol will reduce his chances of a Tylenol overdose.
The “Nudge” school of Cass Sunstein attempts to paste a human face on an inhuman system by tinkering with people at a microscopic level. Instead of passing big laws, there will be lots of small laws. The old totalitarians would have outlawed suicide. The new totalitarians outlaw Tylenol.
Nudgery has found its apotheosis in New York City’s Mayor Bloomberg, a billionaire with all the people skills of a cold fish. It’s dead certain that Bloomberg already has a copy of Emanuel’s latest piece and has forwarded it to one of the numerous overpaid experts who populate his administration and his political organizations. It’s not that Bloomberg really cares whether people kill themselves, but like the old efficiency experts, he likes those incremental improvements.
Tylenol overdoses down 13 percent looks good. It doesn’t tell us whether suicides as a whole have gone down. It doesn’t tell us what those people are doing instead of committing suicide. But those are all holistic questions. They deal with the whole human being instead of a sectioned off statistic, like one of Damien Hirst’s dead cows in a box. And the nudgers and nanny staters are incapable of that. They like the idea of micromanaging people because they can’t actually relate to people.