In Which I Agree With Senator Inhofe

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.
A few of the thousands of owner-flown small aircraft that gather each summer for the Oshkosh AirVenture convention (Experimental Aircraft Association)

I have not always been in perfect alignment with the policy views of Sen. James Inhofe (R-Snowball). But here is a case in which he is right and a NYT columnist with whom I often agree is just flat wrong.

Yesterday Gail Collins began a column with this misleading claim. I’ll explain why it’s misleading in a minute:

In honor of the coming vacation travel season, the Senate is working on a bill that would loosen the requirement that pilots take medical examinations.

Since 99% of the reading public associates the word “pilots” with “the people sitting up in the cockpit on a commercial flight,” most readers would naturally think the story is about weaker safety or medical standards for the people we rely on at United or Delta. This might lead them to think about the Germanwings crash into a mountainside six months ago, when a depressed airline pilot decided to kill himself and take the helpless passengers along with him. And now someone’s talking about relaxing medical tests? What a terrible idea!

Five paragraphs down, Collins reveals that the bill she’s talking about, championed by Sen. Inhofe, would in fact have zero effect on any person who takes a commercial flight.  Why can I put it in those absolute terms? Because the proposal is for changes in medical standards that explicitly do not apply to pilots who fly for hire under any circumstances — for an airline, as a charter pilot, on a commercial jet, you name it. Is the mis-impression that sets up the column intentional? I can’t be sure, but imagine the difference in tone if it had begun, “loosen the requirement that private pilots take medical examinations before they fly their own small airplanes.”

What the Senate is considering is a change in “third-class medical certificates,” the kind you must have if, like me, you fly only yourself or your family or even friends, but not for pay. It’s roughly like needing a medical examination to drive your own car.  Under current rules, private pilots (who are forbidden to fly for hire) need to pass a third-class exam once every five years, or every two years after age 40. People who fly for pay must pass much tougher, more thorough, and more frequent exams. Airline pilots must get a first-class medical certificate every six months (or every 12 months, for pilots under 40). Charter, air freight, and other commercial pilots need to get a second-class medical certificate once a year.


Obviously small private aircraft are much more perilous for their operators than cars are. (As for danger to other people — pedestrians, other drivers, victims when someone drives his own car while drunk — cars are obviously in the lead.) So making sure that people are in good health before going aloft would seem to make good safety sense.

Unless you have seen how the system works. Then you think of it as the health-security version of security theater. The list of forbidden medical conditions is complex and detailed, and at best imperfectly related to risks that might make someone crash. Anyone in the flying world can tell you about the Bob Hoover case: even while performing uniquely precise and demanding aerial feats at air shows, Hoover was in a fight with the FAA about whether he was medically “fit” to fly. Some pilots worry about a prescription or diagnosis that will cross some FAA line and ground them for the months or years it takes to process an appeal. People in overall good health, which fortunately has been my case, view the every-two-years session as a nice chat with an FAA-designated doctor for which you pay $250.

Is there some giant risk of private pilots (the only group we’re talking about) keeling over at the controls? The most authoritative study of non-airline accidents, the 24th annual Nall Report, found that a total of 11 people had died in “pilot incapacitation” episodes in the latest year for which studies have been completed (2012).  These were ten pilots who died themselves, plus a total of one passenger. The report said:

PHYSICAL INCAPACITATION Ten pilots, all in airplanes, died after becoming incapacitated during flight. One passenger was also killed. Three cases were definitively attributed to cardiac disease, and unmistakable signs of underlying heart disease were present in three others. One pilot fell asleep 17 miles from the end of a nearly 2,000-nautical-mile ferry flight. There was one confirmed case of hypoxia; the circumstances of a second accident were also consistent with hypoxia, but its role could not be confirmed because neither the aircraft nor the pilot’s body was recovered from the Gulf of Mexico. The cause of one apparent loss of consciousness in flight was not determined.

Eleven deaths is eleven too many. But as a benchmark: 11 people die roughly every two hours in car crashes in the United States, and a similar number from gunshots. And the 10 incapacitated pilots are of course people whose disorders the current medical screening system did not pick up.

Does that mean the system should be toughened? Here’s the best evidence for the opposite case. Right now all you need is a valid driver’s license to fly a category of small planes called “light sport aircraft.” That is, apart from the regular DMV vision and “are you still alive?” tests, light-sport pilots went through no special medical screening.  And according to the latest Nall report, in an entire year there were a total of three known episodes of pilot incapacitation among such pilots. That’s worse than zero, but it’s not very many, and it’s not obvious that medical-certification would have prevented any of them.

Is this a major policy issue? Well, for me and the couple-hundred-thousand other people with third-class medical certificates, it would be easier if the Inhofe rule change goes through. But I wouldn’t have bothered to mention it if the NYT hadn’t used its op-ed megaphone on this issue in what I consider a clearly misleading way. Plus, this gives me a chance to agree with Sen. Inhofe! I do hope his bill passes.


There is one other misleading touch in the column. Gail Collins says that this rule change would humor the moneyed class. New airplanes of any kind are expensive, and some private pilots are rich. But the really rich people in the skies are the ones with corporate jets or time-share privileges — that is, people who are having someone else fly for them. By definition, that someone else will have a “commercial” or “air transport pilot” certificate, will have passed tougher medical standards, and won’t be affected by Inhofe’s bill.

If you take one trip to a nearby small airport, you will see that most owner-flown planes are not new, are not fancy, and are not playthings of the elite in the way you would imagine. Go to the annual Oshkosh AirVenture some time, the largest gathering of aircraft in one place each year, and you’ll see what I mean, or take a look at the photo at the beginning of the post or the one below.

At a small airport in the Midwest, on one of our recent trips. This is the less glamorous world of owner-flown aircraft that Sen. Inhofe’s bill is aimed at. (James Fallows)