Giberson Calls for One-year Moratorium on Hospital Admissions Pending Analysis of Risks Associated with Nosocomial Infection

Michael Giberson

I read recently that as many as 99,000 deaths per year in the United States are linked to nosocomial infection (also known as hospital-acquired infection).

I’m outraged, obviously, and relying on the precautionary principle I am calling for a minimum one-year moratorium on hospital admissions so the healthcare industry can bring an end to nosocomial-linked deaths and engage in further scientific study. Answers to the questions about the human and ecosystem health impacts involved will only come from scientific research.

The following statement is made available to news and media outlets:

“When it comes to hospital admissions,” Giberson said, “our guiding principle for public policy should be the same as the one used by physicians: ‘First, do no harm.’ There is a need for scientific and epidemiologic information on the health impacts of hospital admissions. Frankly, no one should admit even one more more patient before we have the scientific facts. There are health care needs in our communities that must be met safely. The reality is that the healthcare industry has not done nearly enough to finance the needed research effort.”

[Yes, I am mocking this announcement, see news story here. N.B., I’m not mocking their concerns for potential health issues, I’m mocking the idiotic recommendations. -MG]

12 thoughts on “Giberson Calls for One-year Moratorium on Hospital Admissions Pending Analysis of Risks Associated with Nosocomial Infection”

  1. ROTFLMAO

    We should probably halt all CO2 emissions immediately, based on that same precautionary principle.

  2. You analogy does not hold. No one is going to die if we halt hydrofacking temporarily.

    Like any issue involving risk, hydrofracking should be approached with a cost-benefit analysis approach.

    In your proposal for a moratorium on hospital admissions, the costs clearly outweigh the benefits. The costs of temporary moratorium on hydrofracking are much lower: drilling will only be delayed, and the amount of gas eventually recovered would be likely to be unchanged. We currently don’t have enough information to assess the true risks of hydrofracking, so the benefits of a moratorium are unknown.

    I’m not saying that a moratorium on hydrofracking is a good idea, but as an economist, I think you would do better to prove your point with economic analysis rather than knocking down straw men, Despite the cheers from the peanut gallery above.

  3. But Tom, you get my point. As you put it, “hydrofracking should be approached with a cost-benefit analysis approach.” Exactly. My main problem with the PSE for Healthy Energy is that they’ve noticed a handful of possible risks and then jumped to proposing a moratorium, but fail to suggest anything in the way of even acknowledging potential costs along side their hoped-for potential benefits.

    I think also the one doctor’s invocation of the principle “First, do no harm” in his ethical lecture to the oil and gas industry struck me as a bit sanctimonious and more than anything else probably accounts for the nature and tone of my response. (And accounts for the focus on nosocomial infection, which seems to be one issue where the dictum can be tossed back in the physician’s face.)

    And while I am being a bit facetious in my suggestion (okay, maybe more than a bit), I would think a physicians first response would be like yours: surely the benefits of hospital admission outweigh the costs by a wide margin, even in a world where thousands of people acquire hospital-associated infections. Once they have made that step, then we get to the “teachable moment” and ask “well what about the benefits and costs of a moratorium on hydraulic fracturing?”

    The analysis may point one way or the other, but the analysis does need to be done. Of course, as just one of a million different groups in the country that have a policy interest, they don’t have to feel the need to do the analysis themselves. But if they want to be taken seriously, they might want to at least acknowledge it should be done.

  4. You’re right… I should have read the article you were mocking more closely. While there are strong arguments for a moratorium on hydrofracking, this was not one of them.

    IMO, the strongest argument for a massive reduction in hydrofracking is that we simply don’t have resources to enforce even existing laws (which are pitifully weak.) This guarantees that there is no balancing of risk and reward, because drilling companies have little incentive to consider risk to the environment, and they do have an incentive to cut corners and costs. Note that this is not a problem with hydrofracking per se, only that it’s a new and our knowledge of the risks, the regulations to deal with them, and the resources to enforce those regulations have not caught up with the technology.

    So I apologize; there are a lot of cranks on my side of the argument, and I should not criticize you for making fun of them.

  5. Tom,

    Hydraulic fracturing of tight formations and the use of “propants” to keep the resulting fractures open to enhance the production of natural gas from those formations is hardly “new”, though the directional and horizontal drilling techniques which have allowed hydraulic fracturing to become far more effective are relatively recent developments. Hydraulic fracturing has been used by the oil and gas industries since the 1940s. That should have been plenty of time for regulations and regulatory resources to have been developed and deployed.

    I would argue that the current concerns regarding hydraulic fracturing are more the result of concerns about the implications of the availability of large quantities of inexpensive natural gas for the future or renewable energy penetration in the US market than the result of the concerns currently being vocalized. (I freely acknowledge that this is a cynical position.)

  6. On the question of “newness” and regulatory needs:

    Like Ed remarks (and we’ve posted here about before) the basic technologies have been around for a long time. Over the last decade or so it has been discovered how to combine them effectively so as to efficiently produce shale gas and tight oil.

    The thing is, the ability to efficiently produce shale gas and tight oil opens up several regions for the application of these technologies. Because many of the relevant regulatory issues are handled at the state level, there is some “newness” to deal with.

  7. Ed,
    That *should have been* sufficient time to get the regulations in place, but it wasn’t. An exemption from the clean water act is a great case in point.

    I really don’t have a problem with hydraulic fracking, except that we’re seeing a lot more drilling (and hence more risk of contamination) to get at the same amount of gas. With more risk for less gain, we need to make sure the incentives are right.

    As for your cynical comment, I will personally agree that I want higher natural gas prices. I believe than there are many externalities which are not priced into the cost of gas, and I think they should be. The risk of environmental contamination from drilling is just one of them.

    Another is that natural gas is a finite resource, so even if you believe we have a 200 year supply, we want it to be priced high enough so that we make the most efficient use of this limited resource.

    It’s not so much that I want more renewable energy. What I want is less under-priced fossil energy, and the best way for that to happen is to price fossil energy properly. If that lead only to much higher energy productivity in our economy and no new renewable energy, that would be fine, too.

    Low energy prices encourage energy waste, and a wasteful economy is an economy that’s much more vulnerable to spikes in energy costs. The real advantage to renewable energy is that it has fewer externalities than fossil energy, so its true cost is much closer to its price.

    But we should use renewable energy as efficiently as possible, too.

  8. Tom,

    One more shot from the “peanut gallery”.

    I am surprised that you, as an economist, appear to be advocating rationing by price.

    Monetizing environmental externalities has a long, though not stellar, history. Typically, the attempts have been based on the “damage cost estimate” method, rather than the “control cost” method, even though the details of damage estimates tend to be very “squishy”.

    In the current situation, however, it might be more direct to set the externalities cost at the level necessary to make renewable energy competitive with fossil energy. However, you would still have to decide whether the externalities penalty should be set to make intermittent renewables price competitive with reliable fossil generation, or to make reliable renewables (firmed renewables) competitive with reliable fossil generation.

  9. Ed,
    I did not intend to advocate rationing by price, and certainly not solely by price. The price mechanism does not work well in energy markets, since they are not very efficient. I do think raising prices would help, but not as much as steps to make the energy market more efficient.

    Rather than monetizing externalities, we should work to reduce externalities where possible, as in the case of environmental contamination from natural gas drilling. This will have as a side effect raising the price of energy.

    I agree that the damage cost estimates are squishy, but setting them at $0 may be precise, but it’s precisely wrong (to misquote Warren Buffett.) Which means we should try to set a cost, even if it’s hard. The goal would not be to make renewables cost effective compared to fossil energy, but simply to make fossil energy pay its full costs.

    You’re also missing my point about energy efficiency, which is more cost effective than fossil fuels. Here we need measures (such as better information) to break down non-market barriers and make the market more efficient.

  10. Tom,

    I spent a career conceiving, designing, building, testing and attempting to develop markets for more efficient natural gas technologies for use in the residential, commercial and industrial markets, including natural gas vehicles and power generation. I have no doubts about the value and importance of energy efficiency. I have watched US DOE work to force market acceptance of these more efficient technologies by progressively removing less efficient technologies from the market, thus reducing consumer choice. I have seen and experienced the effects of government legislation and regulation on the industry. In many cases, the results have not been pretty.The ugliest results were spawned by wellhead price controls.

    I wish you luck with reasonably monetizing the environmental externalities resulting from the use of fossil fuels. I would encourage you to remember that not all of the environmental externalities resulting from the use of fossil fuels are negative externalities. Very few, these days, pay any attention to how much richer our lives have become as the result of the uses of fossil fuels. It would be nice if we could eventually move beyond fossil fuels without giving up those positive externalities.

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