I’m no toxicologist, and I didn’t vote for him, but George W. Bush is getting a bum rap on his administration’s decision to put the kibosh on the new the10 parts-per-billion (ppb) limit on arsenic in drinking water. Take the following comment by New York Times columnist Maureen Dowd: “W. wants to keep the poison in—to help the enviro-villains who contributed to his campaign.”
That is off the wall. Everyone may not agree with the decision, but it is not an unreasonable one. More importantly, the whole brouhaha illustrates our society’s systemic inability to define priorities in improving public health or the environment.
Let’s start with arsenic in drinking water. Everyone knows that arsenic is poisonous; it has figured in murder stories for centuries. But unlike modern pesticides, such as organo-phosphates, arsenic is an element, like fluoride, that often is present naturally in groundwater in trace amounts.
News reports indicate that some 50 systems serving 135,000 people in Minnesota fall into this group. The frequency tends to grow as one moves west across the Dakotas. People in these towns have been drinking arsenic-tainted water for decades.
Has such naturally occurring arsenic caused illness or death? It is probable. Would these communities be better off if they had water with lower levels of arsenic? This is undoubtedly true.
But look at the question another way. The estimated costs per inhabitant of reducing arsenic levels in small community water systems often runs from a few thousand to tens of thousands of dollars. If one would go to such a community of 1,000 people and ask the residents how they could best improve their community’s public health with $10 million or $20 million, few would identify removing arsenic from the water as the best use of such funds.
Nor would our nation’s best health experts necessarily come to a different conclusion. Most communities have a variety of unmet health needs, and many alternative public health expenditures might have a much higher payoff per dollar spent that lowering arsenic levels to 10 ppb.
The old standard of 50 ppb was set in the 1940s. Based on accumulating research, scientists have called for a lower standard. The Clinton administration decided on 10 ppb. Many communities, largely in states that are rock-solid Republican, protested that this was too stringent and would be inordinately expensive, especially for very small systems.
The Bush administration, listening to such communities, not to “enviro-villains,” halted the new standards and promised a review balancing the health benefits of tighter standards with the real-world resource constraints that communities face. New standards will eventually be issued, but perhaps with a level higher than 10 ppb. If the administration follows through on this promise, I think it unfair to use this action to paint it as anti-environment or anti-public health.
That brings us to the broader point. We lack a good system of weighing the costs of environmental or health measures against the benefits. As specific problems are identified, they are considered on an ad hoc basis. Depending on the problem, varying mixtures of scientific, medical, economic and political considerations lead to some decision.
But no one is charged to look at all the health or environmental problems of our nation and identify or rank the measures that would yield the greatest improvement in well-being, relative to resources expended.
Critics may respond that we should deal with all health problems as they arise and not try some grandiose effort to rank which ones have greater or lesser payoffs. Cost-benefit calculations should not apply to health or the environment.
That ignores the fact that resources are limited. If a small community has to raise taxes to abate arsenic in its water system, that may mean less money available for schools or a new ambulance or repairs to rusting water mains. And for the nation as a whole, the more we spend on measures that are useful, but have a low payoff, the less we have available to spend on higher-return programs.
Even though we spend a higher proportion of GDP on health care than any other nations, it is clear that we under fund many public health programs. Childhood vaccination levels are low for a wealthy country and falling. Infant mortality rates in inner cities are at Third World levels. We would save many more lives by devoting resources to these two problems than we will by getting all public water supplies down to 10 ppb.
© 2001 Edward Lotterman
Chanarambie Consulting, Inc.