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Notes -
Government happens on such a large scale that anything nontrivial which is less than perfect will lead to people dying. Never mind hospitals, you can calculate statistical loss of lives just based on the economic impact. And then you can follow up by calculating statistical loss of lives based on something that has only economic impact. If we don't allow for mistakes resulting in deaths, we can't have government at all.
Our personal intuitions don't scale up here. You on your own can only cause deaths by being malicious or by being so careless that you could reasonably be expected to not be so. But if something is large scale enough, even ordinary human imperfection is enough to cause deaths. A standard which says that you should never cause deaths there is unworkable; causing deaths is inevitable.
This doesn't work when the chance of the negative externality happening is small. Past a certain point, increasing the punishment won't cause any more deterrence.
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