Serious health care reform is needed in the US. Despite spending more than any other OECD nation on health care expenditures, we are also the only democracy with any sort of substantial uninsured population–over 40 million in 2002. While we pride ourselves in intellectual capacity, we’re the last of the industrialized nations to realize that voluntary pooling of risk in a competitive, capitalistic market is absolutely unsustainable. Insurers will skip high risk “uninsurables” in order to avoid large expenditures–leaving the uninsured to find their care at emergency rooms and the government footing the bill with the highest risk populations.

It’s time to move up with the rest of the world. Health care reform is necessary.

[Image from artbymags via Flickr.]

Wait… what?

That’s right. In his published article, he brings up the point that drug harm is often less than harm in everyday life. Now, at this point, I’d like to state that I have never done a drug. I realize how much writing this post makes me look like a pothead or e-tard. I can promise I’ve never done either and while I know plenty of people who have or do, I have no immediate plans to do any drugs either. However, he brings up an interesting question. Why do we tolerate risky behavior in other domains but once it comes to drugs (or sex, for that matter), suddenly minor risks are unacceptable? His answer–politics. And he is probably right–as my pothead friends like to say, you never hear of people dying from marijuana, but you can read about a DUI-related death every Saturday morning.

Either way, it’ll be interesting to see where how this plays out over the next few years.

[Image from mslivenletlive via flickr. Also, that's Excedrin. Not ecstacy.]

It doesn’t take a lot of money or science to figure this out. All you have to do is try to buy a drink at a hip Manhattan bar during graduate school and you will quickly realize you’re going to have to split that drink with your friends in order to pay for it. The same could be said of almost anything–cigarettes, drugs (illicit and presciprition), candy, food, water, toys, haircuts, etc will all be used less and less frequently as they cost more and more. (And it could be argued the invese is equally true to a point.)

However, the public health implications are dramatically different. High cigarette taxes will hurt poor people much more than rich people. Is the public health payoff worth it in that case? When people are poor, stressed, and driven to smoking as a coping mechanism, will raising prices make them quit or just cut another meal out of their day?

History, of course, has lessons for us. When you make something inaccessible, the black market and illegal mechanisms will always step in to fill that void. The prohibition lead to massive bootlegging. Higher taxes on cigarettes has led to an intricate black market underground or the purchase of cigarettes through other tax-free outlets (Native American reservations, for example). The “war on drugs” has become anything but with increasing public support for legalized and controlled sale of marijuana.

Will increasing the taxes on alcoholic beverages decrease consumption? Probably for social drinkers such as myself. There’s a definite inverse relationship between how much I will drink and how much I can afford. Will increasing taxes help the majority of high-risk populations? Probably not. Addicts will find other (illegal) avenues to support their alcohol consumption or they will find other substances. Increasing taxes will have minimal effect on the bigger picture.

[Photo via hadesigns on flickr.]