12/07/2014 05:21 pm ET Updated Feb 06, 2015

An Election's Consequences: People Will Die

Elections, victors are prone to crow, have consequences. Today that gibe carries a tragic truth. One consequence of our recent elections will be deaths -- many deaths. A few thousands or tens of thousands, if we are lucky, millions if we are not. Let us specify some of the ways.

Twenty-three states have refused to expand Medicaid coverage to a combined total of about 4 million citizens, even though they are enabled to do so at minimal expense by the Affordable Care Act. They will be encouraged by the election to keep refusing, although we do not know how many will succumb to fiscal sanity and at least a minimal level of concern for the welfare of their citizens to finally expand their coverage later. Some portion of those 4 million citizens could die due to inadequate health care, although it is, of course, impossible to estimate just how many until some time has passed and we have more data on those who have been covered and those who have not been covered and who has survived or succumbed to their states' indifference. Secondary effects -- resulting from such things as thrusting people into irredeemable debt or bankruptcy, leaving children homeless or parentless, and driving parents or other caregivers to drugs or alcohol, will assuredly be present and will bring their own share of deaths, but the deaths will be even harder to predict before they happen or to count afterward. Those whose policies caused the deaths will therefore, as usual, be able to escape accountability and prattle self-righteously about abstract principles that serve only to disguise their savagery.

Many infrastructure projects that otherwise would have been done, will be delayed or never started, although we'll never know how many. The bridges that fail, the water mains that break, the electrical grid that remains in a state of primitive dysfunction unable to serve our increasing need, the inadequately maintained roads and highways that result will all make their own contributions to deaths, but often indirectly, so we'll never be able to assign most of those deaths to the people and policies that led to them.

Research of many kinds, at least those kinds that do not deal with war, will receive less funding than it otherwise would have. Most of the lost opportunities, the delays in our understanding of the world, its people, and its inter-dependencies, will remain untraceable. In some of the cases more directly affecting disease and public health, as when we fail to curb an epidemic we could otherwise have stopped, we may come to regret our short-sightedness as deaths mount and threaten even the prosperous, but the chances are the authors of the deadly policies will escape accountability, and we will blame our problems on those on the front lines of disaster, the lower their status the better.

We will follow absurd economic policies, at least from the standpoint of the welfare of those not at the very highest tip of the economic pyramid, ignoring everything that macro-economics teaches and embracing the kitchen-table economics that are so full of the myths politicians favor to hide their ignorance or deceive their constituents. Corporate dominance of policy will be even more complete than it would have been under the bank-subservient Democrats. Austerity (for the middle class and poor) will wreak even more havoc than it already has, and mortality rates will be driven higher than they otherwise would be, though the authors of those rates will stir myth and hysteria to hide their responsibility.

All of the above, though, is penny-ante stuff. The really huge catastrophes will come from human-driven climate disruption. Republicans may not be able to completely disable the EPA or reverse measures already taken, such as mileage standards for new cars, but they can block new initiatives, just as we forge deeper into the period when policy momentum must build. We know that a great deal of damage is inevitable, given the heat that already suffuses the air, land, and seas, and the greenhouse gasses already in the atmosphere. We do not know, however, what critical tipping points we are on the verge of -- whether or when there will be a massive release of methane from the tundra, the outgassing of clathrates, the loss of biological supports critical to human survival due to the extinction of some organism we don't yet even know is essential to entire ecosystems, or calamities of which we have not yet even conceived. This is where the luck comes in. We may be so incredibly lucky that none of the amplifying feedbacks that ominously loom will be able to run away with the climate because of the political obstruction the next two years will bring. The extent of the unknown dangers is, of course, unknown, but we already know we will encounter rising seas, temperature extremes, drought, floods, and storms that will cause billions (and probably trillions) of dollars of damage and cost many lives worldwide, first, but not exclusively or forever, among the world's poor, who have the least ability to protect themselves. Yet as Bangladesh inexorably turns into a salt-water marsh and millions of its people -- those who survive long enough -- become refugees seeking survival on an Indian sub-continent likely welcoming them with epidemics, conflict and starvation, the U.S. Senator who absurdly claimed global warming was a massive hoax will never be held accountable, nor will the constituents who kept re-electing him.

Many deaths will be quiet and not photogenic, the immediate or delayed consequences of strokes or heart attacks resulting from untreated or under-medicated hypertension or high cholesterol, cancers our inadequate research has not soon enough taught us how to treat or cure, nerve and brain diseases we could have learned more about sooner, illnesses to which poor children are more likely to succumb due to malnutrition whose incidence is increased due to high food prices traceable to droughts, fire, flood, and changing ecology. Yet we must consider them as well as the leaking pipelines, exploding tank trucks, collapsing bridges, floods, storms, and starving children, mostly abroad (we crassly trust), with their vacant eyes, distended bellies, and flies buzzing about.

We must consider all of these things. We must picture them. We must summon our attention and our empathy for them, however distant they may seem in time or space, however soothing it may be to exclude them from our consciousness. It is only by doing so that we will marshal the emotion, the energy, the passion, the determination to fight the people, attitudes, institutions and forces that contribute so much to producing them.

But here we encounter a paradox. We know that arguing with too much anger, or on grounds that threaten the identity and affinity group loyalties of those to whom we direct our arguments will only drive them into ever more determined defense of their existing positions and an inability to even perceive evidence that would undermine those positions. But we should also understand that showing no passion will only convince people that we are not serious or, at best, can safely be ignored.

To be effective in today's society, we must tamp down, cloak, compartmentalize, and then effectively direct our sorrow, our rage, and our outrage. It is not just that, on an individual scale, if the roil of emotions was too great we would be paralyzed and incapable of prioritizing our causes and choosing our actions, nor that we would be unable to walk the streets or share holiday dinners with reactionary Uncle Henry without erupting in rage. It is that, on a larger scale, unleashing the full storm of the passions provoked by the vicious or blind and unwitting injustices of today and the catastrophes soon to be unleashed upon the world would make civil society impossible, discredit us, and doom our causes within society as we know it. We must, in the appropriate circumstances, rage, argue, protest, and work to overthrow what would destroy us, but we will have to employ all the intelligence we can muster to find the strategies and tactics that will be most effective in every venue and bind our passions to them.

Already, some people question whether society as we know it is worth preserving if it cannot be induced to curb the devastation it is on course to cause. If the world suffers the higher levels of estimated global warming possibilities, the survival of humanity itself is in question and civilization is unlikely to survive anyway. We cannot allow that possibility, however likely it may seem, to lead us to the passivity of despair. We can and will affect the future, but we cannot predict it, however bleak it now seems, and our understanding of our inability to see beyond the looming event horizon must give us the hope and the strength to fight on.

We who understand the overwhelming evil and devastating consequences of denying or ignoring the evidence with which the world presents us must collectively school ourselves in human nature and how best to bring our fellow humans to acknowledge and confront dangers for which evolution has ill prepared us. If we understand how poorly equipped human beings are to deal individually with the world or even the institutions we ourselves create, we must become most skilled in collective action and even in eliciting collaboration from those regressive recalcitrants upon whose cooperation our collective welfare depends. The challenge is great, and the risks are high. Winning elections is only one aspect of the work before us, but it is an aspect upon which not just dignity, affirmation of our values, or some airy notion of the greater good depends. Survival itself is at stake for too much of our human family.