No Easy Victories

Abstract

A couple of years ago, when I was about ten years younger, Fred Mosteller asked me to give this speech. I said yes partly because I've known and admired Fred for many years, partly because I once taught statistics and have many friends in this Association, but mostly because I was flattered that someone thought I would last long enough to keep the engagement. My days and my energies are niow totally absorbed ill hlandling some of President Johnson's major domestic programs, anid I want to talk about some of the problems in our domestic effort, problems in the governinig of this free society in other words, problems facing the I cannot speak with assurance, only with concerni. I constantly marvel at the number of people outside the arenia of action who know precisely how to solve our problems, and the number of people in the heat of action who lack that superhuman clarity. I've often wondered why this is so. I want to talk about resources, expectatioiis, planniing, the public mood, institutional change and civil disorder. We have seen in the years since 1961 a growth of domestic social programs unrivalled in our history except for the period 1933-37. not speaking solely of government programs-I'm speaking of activities in and out of government, in every corner of this land. It has been an extraordinary outburst of social conscience, marked first and foremost by a heightened awareness of social problems. There is no precedent for the scope of goals envisioned by the people in and out of government wlho concern tlhemselves with the social fields today. We lhave declared war on ignorance, disease, poverty, discrimination, mental or physical incapacity-in fact, on every condition that stunts human growth or diminishes human dignity. I am deeply committed to that effort and heartened by the progress we have made. But it is a struggle all the way, and there are grave problems ahead. Consider, for example, the coming crunch between expectations and resources. The expectations of the American people for social benefits are virtually limitless. In the past six years we have opened up innumerable areas of constructive governmental activity-in early childhood educationi, work with handicapped children, special education for the disadvantaged, health research, work oni artificial organs, programs for the aged. rural development efforts, conservatioin aind beautification activities, manpower training and so on. We have begun most of these programs oni a modest scale. The proponents of every social institution or group aided by these prograins believe passionately that support to their field Imiust be vastly enlarged in the near future. The colleges and uniiversities have ideas for future Federal support that would run to billions per year. And they ask little compared to the advocates of aid to elementary and secondary education. The aninual cost of a guaranteed incoimle would run -to scores of billions. Estimnates of the cost of adequate air and water pollutioni control and solid waste disposal run even higher. Es-timiiates of the cost of renovating our1 cities run to hundreds of billions. Today we attribute budget constraints to the Viet Nam war, but if the war ended tomorrow, in 12 monithls we'd again be bumpingt against the ceiliing of resource constraints. How do you make rational choices between goals when resources are limited and will always be limited relative to expectations? To those of you familiar with program budgeting, the question translates itself into several others: How cani we gather the data, accomplish the evaluation, anid do the planning that will make rational choices possible? Forced choices are of course nlot the only conisequence of a limit oIn resources. We can have our cake and eat at least some of it if we can get a higher yield from the dollars, talent and inistitutional strength available to us. But that raises questions of good management and unit cost that are painful to most people active in the social fields. Once in talking witlh a physician who was ministering to poor people I asked about unit costs of his government-supported clinic, and he said I'm not an efficiency expert, I just want to heal sick people. What he was refusinig to face is that somewhere up the line hard decisions will necessarily be made, and a limit placed on resources available for delivery of health care. So if he is in fact functioning with high unit costs, the number of sick people hie can treat will be correspondingly few. Without knowing it he has made a decision oln resource allocation. Now let me mention onie more kind of probleiii that arises when demand is great and resources are limited. Any effort to plan amid rationalize the allocation of resources tenids to reduce pluralism, and to introduce new kinds of institutional controls. If we have less tliami enough to spend in constructing hospitals, then we must be sure that those constructed are properly located and * As delivered at a meeting of the American Statistical Association, Washington, D. C., Wednesday, December 27, 1967.

Cite this work

No public copy is stored for this record, so only the metadata is cited.

Stored only when both papers are in the corpus — 29 citations exist upstream.