Dr. Edgar Suter's letter
regarding Coben & Steiner's "Hospitalization for firearm-related
injuries"
31 January 2003 Letters
to the Editor Re:
Coben JH, Steiner CA. Hospitalization for firearm-related
injuries in the United States, 1997. Am J Prev Med (2003 Jan) 24(1):1-8 Dear
Editor: We
wryly recall the late Sen. Edward Everett Dirksen's "pretty soon we'd be
talking about big money" quip as we note that the much-vaunted $802
million estimate of 1997's gun injury medical costs represents 0.064% of
America's $1.25 trillion in annual total medical costs. Apparently, neither the
authors nor the peer reviewers noticed that this already minuscule fraction
represents a 60% decrease from the last published estimate of gun injury
medical costs. [1] That
minuscule percentage highlights another conceptual flaw in Coben's methodology.
Where in medicine would we settle for a risk-without-benefit analysis? Doctors
have themselves estimated that we kill 180,000 people each year (five times
annual gun deaths, the equivalent of three jumbo-jet crashes every two days).[2]
Would we leave the analysis of American physicians at that sensational factoid
without considering the benefits physicians provide? We think not. When we last
visited this issue,[3] we noted, with detail and citation, that every
one of the relevant 15 studies found that annually 400,000 to 4 million
Americans use guns to defend themselves. Using the methodology of gun ban
advocates Max[1] and Nieto,[4] we calculated that the economic
benefits of defensive gun usage was potentially $4.5 billion annually. Lives
saved, injuries prevented, property protected, and medical costs averted are
the benefits from guns far outweighing the purported detriment. Another
factor is invariably overlooked in tallying the benefits of gun ownership. As
many as one-third of a billion people died at the hands of government in the
twentieth century,[5] dwarfing all tallies of private crime. We doubt
that anyone can convincingly refute that America's high rate of individual gun
ownership has played a fundamental role in protecting Americans from deadly
genocidal tyranny and planned wartime invasions. What is that worth in lives
and money? Finally,
for the last 10 years as the proportion of the crime-prone 15-25 age cohort has
fallen in the US population, so too has violent crime fallen (yet gun sales
have skyrocketed). Medicine's gun ban polemicists have been silent about this
news, but we expect that when violent crime parallels the anticipated increase
in the crime-prone age cohort, we will once again hear Chicken Little in white
coat and stethoscope shriek that "the sky is falling"; and, of
course, that will certainly be "due to guns." Yours,
[1]
Max W and Rice DP. Shooting in the dark: estimating the cost
of firearm injuries. Health Affairs. 1993; 12(4): 171-85. Posted by Edgar A. Suter MD |