Tuesday, 1 December 2009

Leeches


Via the Tobacco Harm Reduction blog, Smokles, I find an article of glorious common sense written by the editor of the irreplaceable STATS.org, Trevor Butterworth.

For two millennia, leeches were used to balance the humors--or to drain the patient of "excess" blood and other substances thought to be the cause of most of humanity's physical and mental ailments. 

In a similar vein, some doctors and public health advocates are turning to a modern equivalent of the leech--taxes--in order to draw "excess" money from going to "unhealthy" activities, thereby reducing disease and balancing health care spending.

Regular readers will greet the latest public health ruse with a familiar sigh:

Now the latest advice for "leeching" America comes from Dr. Lloyd I. Sederer, medical director for the New York State Office of Mental Health, and Dr. Eric Goplerud, director of the Center for Integrated Behavioral Health Policy at George Washington University. 

Writing in the Washington Post, they argue that imposing heavy taxes on alcohol would both reduce the harmful effects of heavy drinking and help pay for health reform. The logic is that if teens drink less, they'll have less unprotected sex, reducing their exposure to sexually transmitted diseases.

These people are deadly serious and - behold! - they come clutching research and a spurious statistic:

They claim that a tax increase of "3 cents per beer would cut youth gonorrhea by 9%"

So why not raise tax by 33 cents and reduce gonorrhea by 99%? Hell, why not go the extra cent and eradicate it entirely? Because, as Butterworth shows in delicious detail, this statistic is completely bogus. It comes from a 2000 paper published in the Journal of Law and Economics which noted that cases of gonorrhea fell between 1981 and 1991, at a time when beer tax had doubled.

What more evidence could anyone ask for?! Why, it's almost as compelling as the well known association between rock music and oil production:




Using the classic junk science tactic of cherry-picking, and making the classic mistake of confusing correlation with causation, the authors stated that this association is "consistent with the assertion that alcohol tax increases can reduce STD rates". 

Consistent, perhaps, but utterly wrong. Rates of STDs had been falling before the tax rise and they continued to fall afterwards. Between 1992 and 1996 - with no rise in beer tax - there was a decline in rates of STDs that was almost as sharp as that seen in the previous years.

So what really happened? A far more convincing reason for the fall in STD rates during the late 1980s and early 1990s is AIDS awareness and the corresponding upsurge in condom use. 

It is far from unreasonable to conclude that the steepest decline in gonorrhea rates between 1991 and 1993 had more to do with increased awareness of the dangers of unprotected sex than the sobering effects of an extra 2.7 cents on 12 ounces of beer.

This, surely, is the real reason. But this logical explanation offers no excuse for the forces of public health to tax, tax and tax. Consequently, it is ignored and replaced with junk science. The only wonder is that it has taken them nearly ten years to catch on to the potential for extortion that lay dormant in the 2000 study.

Will it ever end? And as Smokles says, wouldn't it be simpler if we just gave the state all our disposable income and let the politicians and health groups decide what it gets spent on? 


*Thanks to Dick Puddlecote for the graph.



2 comments:

Ann W said...

This one is priceless Chris. Thanks

Dick Puddlecote said...

You used it very smartly, I have to say. :-)