Tuesday, August 18, 2015

Nanny state submission

Australia's new libertarian Senator David Leyonhjelm has called for a Senate Inquiry into Australia's creeping 'nanny state' regulations of individual behaviour. The conflicted Senator, who's main claim to fame so far is to agitate for increased regulations on wind farms despite his apparent principles of freedom, is one of those characters who at least shakes up the dreary world of politics. By coincidence I do often agree with him on personal freedoms, though on economic freedoms and issues about the distribution of wealth and social support, we disagree quite starkly. The Inquiry is, however, a useful catalyst for considering the evidence of individual-level harm-minimising regulations.

My submission is reproduced below, and available in full here.

Background
This “nanny state” inquiry is a timely chance to reconsider the relationship between personal choice and legislated responsibilities, and to consider the evidence that exists of the effectiveness nanny state policies in terms of their intended social impacts.

The Terms of Reference for the Inquiry are:
  • the sale and use of tobacco, tobacco products, nicotine products, and e-cigarettes, including any impact on the health, enjoyment and finances of users and non-users; 
  • the sale and service of alcohol, including any impact on crime and the health, enjoyment and finances of drinkers and non-drinkers; 
  • the sale and use of marijuana and associated products, including any impact on the health, enjoyment and finances of users and non-users; 
  • bicycle helmet laws, including any impact on the health, enjoyment and finances of cyclists and non-cyclists; 
  • the classification of publications, films and computer games; and 
  • any other measures introduced to restrict personal choice 'for the individual‘s own good’. 
I respond to each in turn by taking a practical approach informed by research in these areas. An overarching message is this. It should not be okay to ‘do something’ about a social issue without a rigorous assessment of whether that ‘something’ will even address the issue at hand. Many nanny state regulations are a knee-jerk political response and not policy made with clear assessable objectives.

A second message is this. Healthier citizens need not lead to lower health care costs in general as any disease or injury prevention simply allows another disease to cause that person’s death, and it will also have associated health care and ‘end of life’ care costs.

The research is quite clear that this is the case, particularly for smokers. The following academic results are typical (my emphasis).
Health care costs for smokers at a given age are as much as 40 percent higher than those for nonsmokers, but in a population in which no one smoked the costs would be 7 percent higher among men and 4 percent higher among women than the costs in the current mixed population of smokers and nonsmokers. If all smokers quit, health care costs would be lower at first, but after 15 years they would become higher than at present. In the long term, complete smoking cessation would produce a net increase in health care costs, but it could still be seen as economically favorable under reasonable assumptions of discount rate and evaluation period.
And from here
Until age 56, annual health expenditure was highest for obese people. At older ages, smokers incurred higher costs. Because of differences in life expectancy, however, lifetime health expenditure was highest among healthy-living people and lowest for smokers. Obese individuals held an intermediate position.
Therefore when making policy decisions in the interests of improving individual health, an informed government should not naively justify such decisions on the grounds of reducing the resource burden of public health care, as this argument rarely holds. Decisions must be made on other grounds, of which there are many legitimate ones, such as externalities (in the case of passive smoking in some public areas), information failures, market or political power of interest groups.

Underlying this inquiry is also a question as to the current Australia legal situation in terms of duty of care. Take as an example children’s playgrounds in public parks. Surely a part of the trend towards excessive padding and safety is the result of legal pressures and past legal cases against “negligent” councils. The same happens with cracked footpaths (see this example, and there are many others), and other personal injuries that seem to overstep the bounds of a common sense duty of care even on private property (see this example). I believe a key part of the process of decreasing ineffective and costly nanny state regulation requires looking abroad, perhaps to Europe, at how the legal interpretations of duty of care are quite different and allows for governments the legal comfort to go without nanny-state regulations.

Tobacco choice
Legislation restricting tobacco sales, purchasing, and smoking location has had a large impact on smoking in the past two decades. As the below graph from the Australian Institute of Health and Welfare shows, smoking is declining in the general population in response to a combination of policy changes intended to have this effect. Now the rise of vaping as a alternative nicotine indulgence has attracted some attention as its growth in recent years is at odds with the continued long run decline in tobacco smoking in traditional forms. 

 
Questions about tobacco choice must centre on externalities of consumption, and information failures. Is smoking impinging on the freedom of others to enjoy a smoke free environment, and are smokers fully informed about the products they are consuming?

On the first question it seems clear that previously introduced limitations on smoking locations have addressed the majority of externalities associated with tobacco consumption. On the second, one could argue that the pubic awareness campaigns of the past decades have addressed this issue as well, and that plain packaging rules and other changes have little claim to be further addressing information failures, though there is a very light argument that it reduces the power of tobacco brands because of lower community awareness.

The rise of vaping must also be considered. Vaping is specifically designed to minimise externalities from consuming tobacco in public and enclosed spaces, and hence any regulation of vaping should focus on ensuring consumers are fully informed of the product being consumed and its personal health effects.

Alcohol choice
There is no doubt Australia, like many countries, has high levels of alcohol related violence and a binge drinking culture. Australia has some shocking ‘alcohol related violence’ statistics
  • 1 in 4 Australians were a victim of alcohol-related verbal abuse 
  • 13 percent were made to feel fearful by someone under the influence of alcohol 
  • 4.5 percent of Australians aged 14 years or older had been physically abused by someone under the influence of alcohol 
But all the scientific research says that alcohol has absolutely no effect on aggression, and in fact impairs coordination.

One must be clear about what social problem taxes on alcohol and other regulations limiting sale are targeting; the binge drinking that arguable creates externalities on others, or drinking alcohol in general? Clearly it is the rowdy culture and late night violence in cities and suburbs that is a problem.

Yet it is not clear that “sin taxes” on alcohol are an effective way to change the binge drinking culture, and in fact might have the opposite effect. Those who choose to drink alcohol may change their patterns of consumption to only drink to get drunk. Why pay so much for alcohol unless you are going to get drunk?

Anecdotal evidence across countries suggest that countries with binge drinking cultures also have the more expensive alcohol, such as the Scandinavians and the UK. While in Mediterranean countries where wine is part of the dining culture, cheap enough to consume with most meals, the binge drinking culture is less prevalent. In fact the weight of evidence now points to regular small quantities of alcohol being beneficial to lifetime health.

So what sort of policies would reduce our violent binge drinking culture? I have a radical proposal.
  • Remove taxes on alcohol (revenues can be made up with land taxes) 
  • Reframe the public alcohol messages. 
  • Reduce the drinking age to 16 
  • Allow alcohol to be sold in supermarkets in States where it is not 
  • Remove liquor licensing rules and simply retain responsible serving of alcohol requirements. 
Essentially such changes would make alcohol boring and integrate it into everyday life.

Public health messages might have a grandma drinking Bundy Rum diluted with cold water after dinner, who then falls asleep on the couch. Or we could do a complete reversal and really drill home the point that rowdy drunks are puppets of their social environment and that they can’t blame alcohol. If you are a tool when you are drunk, you are a tool. Embarrass them into less binge drinking.

As anthropologist Kate Fox explains
I would like to see a complete change of focus, with all alcohol-education and awareness campaigns designed specifically to challenge these beliefs – to get across the message that a) alcohol does not cause disinhibition (aggressive, sexual or otherwise) and that b) even when you are drunk, you are in control of and have total responsibility for your actions and behaviour.
Yet at the moment we have alcohol messages that seem to reinforce the message that alcohol is an excuse for disruptive behaviour, with phrases such as “alcohol is responsible for..”. Actually, no. Would you seriously say ‘tea is responsible for…”.

As I have discussed before, culture is often a good explanation of social and economic phenomena. The more we understand culture, and get over our simplistic ‘Pigouvian taxes can fix everything’ mentality, the more we can strategically intervene in highly effective ways to change behaviours that are having negative effects on others.

Marijuana choice
The same arguments discussed above in relation to tobacco smoking and alcohol apply to marijuana. It is mostly through historical happenstance that marijuana consumption is fully prohibited while tobacco and alcohol is not, and certainly prohibition of various types of drugs have a complex social history.

The main comment is that modern experiments with legalisation of marijuana have showed that there is little social disruption to such changes, and that legal and police resource devoted to the current illicit marijuana industry can be much better employed elsewhere.

Bicycle helmet choice
Australia is globally unique in our laws about compulsory bicycle helmet for all riders. As discussed in the background section of this submission, the argument that injured cyclists will be cared for in public hospitals, and as such create externalities on other through the costs of public health care, is rubbish.

Moreover, even if one believed this argument it would also justify helmet wearing for drivers and pedestrians, who on average account for the overwhelming majority of head injury hospitalisations.

As a general observation the helmet laws has been a knee jerk policy without a clear assessable objective, and has for nearly 30 years been an excuse to ignore investing in urban cycling infrastructure because ‘something’ has already been done for cyclists to keep them safe.

Again, the overwhelming research findings are that helmet laws reduce cycling, make cycling less safe for this who do, and decreasing health of those who opt out of cycling. Being a world outlier in this area should be enough of a signal that this law is not achieving any particular goal of reducing externalities or improving information failures for cyclists, and if anything does the opposite by making cycling appear more dangerous that what the statistic show.

Media classifications
Unlike most of the items int he ToR, media classification do serve to address an information failure, in media and games, where viewers are unable to judge the content until after they have experienced it. The simplest way to view media classification is as a type of labelling, similar to that in the food and groceries, which allows customers to easily access additional information about the product.

In an ideal world media classifications would be simple and their design would imply self-evident feature of the media content in terms of violence, sexual content, language and themes. The main use of these classification is for parents of children who are taking responsibility for their child’s exposure to particular types of media, and hence for these parents some form of classification tools appears to address a possible information failure.

No comments:

Post a Comment