Yesterday the Department of Justice filed suit against the giant retailer Walmart, accusing it of fueling the opioid crisis by encouraging its pharmacists to fill prescriptions–legally written by health care practitioners licensed by the Drug Enforcement Administration–they should have suspected of being inappropriately prescribed.
The Justice Department seems uninterested in the fact that there is no correlation between the number of opioid prescriptions and the non‐medical use of prescription pain reliever or the development of opioid use disorder. And while the number of opioid prescriptions has dropped 57.5 percent since 2010, the overdose rate has continued to climb, soaring to record high levels in the latest report from the Centers for Disease Control and Prevention.
In its complaint, the Justice Department continues to conflate “physical dependency” and “addiction,” seemingly ignorant of the difference between the two. It also apparently ignores the words of Drs. Nora Volkow and Thomas McLellan of the National Institute on Drug Abuse who stated in a 2016 article in the New England Journal of Medicine:
Unlike tolerance and physical dependence, addiction is not a predictable result of opioid prescribing. Addiction occurs in only a small percentage of persons who are exposed to opioids — even among those with preexisting vulnerabilities. Older medical texts and several versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) either overemphasized the role of tolerance and physical dependence in the definition of addiction or equated these processes (DSM-III and DSM-IV).
Research shows the overdose rate has been climbing exponentially since at least the late 1970s, long before the creation of the potent prescription opioid OxyContin in 1996, and continues to climb. The only thing that has changed over the years has been the type of drug that has predominated among the overdose deaths. As Josh Bloom, the director of chemical and pharmaceutical science at the American Council on Science and Health, and I recently pointed out, the top killers are now fentanyl, heroin, cocaine, and methamphetamine. In fact, prescription opioids have consistently been a very small component of the drugs involved in overdose deaths for quite some time. We explain that policymakers’ obsession with reducing opioid prescribing has converted the “opioid crisis” into a “street drug crisis.” It has also inflicted great harm on acute and chronic pain patients, driving some, in desperation, to the dangerous black market in search of relief.
While policymakers and prosecutors exact tribute from scapegoats that are soft targets, they let the true offender get away: drug prohibition.
Congress is set to pass a $2.3 trillion spending bill, including $900 billion in further coronavirus relief.
The bill is an astounding 5,585 pages in length, including 544 pages for coronavirus relief, 1,915 pages for appropriations, and 3,126 pages for extensions and corrections.
If it were printed at 11 inches per page, that’s 61,435 inches or 5,120 feet. Since there are 5,280 feet in a mile, the bill is almost a mile of paper end to end.
My colleague David Bier has written and edited two excellent pieces about how the incoming Biden administration and Congress can reform the immigration system. The recommendations are excellent, and I encourage you to read them in full. Of course, politics constrains politicians more than policies. While the above policy recommendations are good ones that would significantly improve the immigration system, ultimately, the incoming administration will choose policies that are politically favorable.
On that front, I offer one piece of advice when implementing the above policies: Do so in a way to increase the perceptions of government control of immigration and reduce the perceptions of chaos in the immigration system. The political psychology literature is clear on this point: Voters tend to oppose any policy where they think the government does not have control of the situation and where they perceive that there is chaos. Perceptions of greater chaos and less government control over immigration reduce support for legal immigration. Migrant caravans, Border Patrol agents firing tear gas, and disorderly crowds that create chaos that frightens people.
Most people react to chaos by supporting greater government control or a greater role for law enforcement. In some cases, more government control and law enforcement can be the correct responses, such as during a riot. But in most cases and especially in immigration, more government control will produce even more chaos that will then attract increased government control and law enforcement in a destructive cycle that will not produce a better immigration policy, will actually reduce real government control, result in more chaos, and increase the perceptions of chaos. Instead, lasting immigration reform will be politically sustainable by a commitment to Make Immigration Boring Again by making it predictable, smooth, and transparent.
The legal immigration system is shockingly complex and restrictive for green cards and temporary work visas. The result of these restrictions is more illegal immigration that has mainly fallen in recent decades due to moderate liberalizations in H-2 visas. Adding more rules on top of these will only lead to more illegal immigration and chaos on the border. The number of Border Patrol agents has climbed about five‐fold over the last 30 years. There’s a border wall along hundreds of miles of the southwest border. More American workers are checked through E‐Verify than ever before. Many of these rules and the extra enforcement intended to enforce them increase the size of black markets and a widespread perception of chaos.
Perceptions of chaos can even increase if more order is achieved. For example, the number of unlawful immigrants apprehended crossing the border, a proxy measurement for the number actually coming across, fell considerably from more than 1.6 million in 2000 to just 331,333 in 2015 when Donald Trump sought the Republican nomination on a “build the wall” platform. Arguably, more Border Patrol agents on hand to report and take pictures of illegal immigrants and asylum seekers who were seemingly overwhelming the system convinced many Republican voters that chaos on the border was worse and the government didn’t have control. In such a situation, more voters considered a border wall, more Border Patrol agents, virtually ending asylum, and voting for Donald Trump.
Every additional rule and regulation creates an incentive to circumvent them that could boost perceptions of chaos, further weakening support for liberalization. The only politically sustainable and long‐term solution to illegal immigration is deregulation, liberalization, and increased legal immigration that would channel migrants into the legal system and create an orderly way for asylum seekers to enter lawfully.
Thus, the Biden administration should do everything it can to expand legal immigration without adding more barriers or legal hurdles. Reforms that boost visa processing overseas, speed family reunification in the United States, increase the pace and number of migrants who can adjust their status once here, and that move people away from trying to enter unlawfully will reduce the perception of chaos. If the Biden administration wants its immigration reforms to last, they should embrace the maxim of Make Immigration Boring Again.
The reforms pitched by Bier will create the order and perceptions of control necessary to Make Immigration Boring Again.
America is losing confidence in its police. According to a recent Gallup poll, public perception of law enforcement is at its lowest point since the organization began tracking that question twenty-seven years ago. For the first time ever, a majority of Americans do not express confidence in the police, with only 48% of people maintaining faith in the institution. The results may come as no surprise: horrific incidents of police violence have dominated headlines as protestors campaign to “defund the police.” It’s a state of affairs that’s become deeply concerning to police themselves. A Pew Research study reveals that 86% of officers believe the tense environment has made their work harder, and nine out of ten report increased concern for their personal safety.
We place confidence in others when they honor their promises, act sincerely, and consistently tell the truth. But rebuilding public confidence in America’s police won’t be easy, in part because police officers themselves aren’t just sporadically and spontaneously dishonest; in fact, American police are trained to lie, and the law-enforcement community itself has embraced deceit as a legitimate investigative tool. A leading handbook on interrogations canonizes false empathy, and our courts have ratified the use of brazen falsehoods to coax confessions out of suspects. Deceit has become central to the American brand of police investigation.
Here’s a classic example of the duplicitous procedures that punctuate police investigations. Police take two suspects from a scene into two separate interrogation rooms. An officer tells one suspect, “Your buddy has already given you up.” But the truth is that the suspect in the other room is insisting he’ll only speak to his lawyer—while another detective feeds him a new variation of the same lie. “You don’t seem like a criminal mastermind. Was this really all your idea, like your friend in the other room says it was?”Read the rest of this post »
The Wall Street Journal asked people of some prominence to name the best books they read in 2020. So I asked my colleagues. Honestly, I like this list better. Of course, we all recommend the books Cato published this year. But we read more widely, and here are some of our favorites:
The Little House By Virginia Lee Burton - This children's story tracks our heroine—a well-built, 19th-century country home enjoying the stars at night and the changing seasons—as modern urban life creeps closer, surrounds her, and takes her land, her enjoyment of nature, and everything else. After skyscrapers have expropriated every inch of her once-peaceful hillside, a family finds the little pink house “sad and lonely” and, in contempt of modern permitting and historical preservation laws, manages to quickly load her onto a truck and return with her to the countryside. Perfect for ages 1-9.
--David Bier, immigration policy analyst
Apollo's Arrow: The Profound and Enduring Impact of Coronavirus on the Way We Live by Nicholas A. Christakis MD PhD (a recent McLaughlin Lecturer at Cato). A very timely overview of the pandemic, touching on a whole host of aspects of the crisis (though not much economics).
The WEIRDest People in the World: How the West Became Psychologically Peculiar and Particularly Prosperous, by Joseph Henrich. A very provocative thesis that suggests that church-pressured social changes in who it was acceptable to marry (not cousins) and then Protestant churches emphasizing individual interpretation and reading provided the foundations for the psychology that allowed individual rights, democracy, markets, and innovation to flourish.
--Ryan Bourne, R. Evan Scharf Chair for the Public Understanding of Economics
Command and Control: Nuclear Weapons, the Damascus Accident, and the Illusion of Safety; by Eric Schlosser (Penguin, 2013). Investigative reporter Eric Schlosser explores the harrowing history of fatal mishaps and near-catastrophes in America's nuclear arsenal, culminating in the explosion of a fully armed Titan ICBM in its silo in Damascus, Arkansas in 1980. Widely heralded upon its publication in 2013, Command and Control was a finalist for the Pulitzer Prize and was the source material for an Oscar-shortlisted PBS documentary of the same name. With a mix of dark humor and painstaking attention to detail, Schlosser explains how the appearance of safety and security surrounding nuclear weapons was always more illusion than fact. The book follows nuclear weapons designers and engineers as they sought to raise the alarm and adopt more stringent safety features from the Manhattan Project to the modern era. It explains how on several occasions America came perilously close to suffering an accidental nuclear detonation, often avoided only by dumb luck. The risk is still real today, and Command and Control offers a compelling libertarian lesson on the fallibility of human institutions and the dangers of assuming government competence.
--Andy Craig, staff writer
I read Animal Farm to the kids. It surprised me how relevant it remains. Now every time someone defends ObamaCare, I hear Squealer: “Surely, comrades, you don’t want discrimination against preexisting conditions back?”
--Michael Cannon, director of health policy studies
A controversial proposal to block foreign providers of digital services from offering their services in Mexico if they fail to comply with Mexico’s digital tax rules has just been signed into law. The scope of the law is broad enough to encompass a whole host of digital services that individuals and businesses consume everyday—from streaming and dating services to online shopping, and virtually anything that exists in the cloud. The economic costs could also be severe—for example, blocking access to YouTube for a single day would cost the economy $18 million USD. As the world pulls itself up from the economic shock of COVID-19, Mexico’s latest action has the potential to dampen recovery efforts, and also to further strain U.S.-Mexico relations.
On December 8, 2020, President Andrés Manuel López Obrador approved the law despite numerous concerns raised about whether the new measure is in breach of Mexico’s obligations under the U.S-Mexico-Canada Agreement (USMCA). His action marks an open provocation of U.S. business interests, as well as Mexican consumers of foreign digital services. Taking a look at the content of the law, it becomes clear that this issue should be high on the incoming U.S. Trade Representative’s agenda, for it is likely to not only violate the USMCA, but also many core principles of digital trade governance the United States is hoping to replicate in other agreements.
Why does Mexico want the power to block foreign service providers from providing services in Mexico over the internet?
Mexico enacted changes to its value-added and income tax laws as part of the FY2020 budget proposal, which resulted in certain non-resident (foreign) digital service providers becoming liable for paying its value added tax (VAT). In some cases, platforms such as Airbnb would also have to withhold and surrender income taxes. Digital service providers must also comply with a series of administrative requirements, including registering with the Mexican Tax Administration Service (SAT), designating a legal representative and address on Mexican soil, and processing their advanced electronic signature. Since these changes went into effect on June 1, 2020, 48 foreign digital service providers have obtained registry under the SAT.
When these new rules were first proposed in October 2019, the Ministry of Finance began floating what is referred to as the “kill switch” mechanism, a tax enforcement tool that would essentially block Mexican consumers from having online access to digital services from a company that is purported to not be in compliance with Mexican law. For example, say YouTube was not in compliance with the law—the kill switch would allow the Mexican tax authorities to order YouTube to be blocked—if someone in Mexico tried to access the site on her internet browser, the site could not be viewed.
The Ministry of Finance proposed the kill switch as an enforcement tool because it argued that the new tax obligations would not be effective in achieving compliance with the laws on their own. But the mechanism was ultimately struck from the proposed reforms to Mexico’s tax laws, following amendments submitted by deputies from multiple parties. The issue seemed resolved for the time being.Read the rest of this post »
Will President Joe Biden #MADA: “Make America Dull Again”? Let’s hope so, Joe Ferrullo argues in a column for the Hill this week. Ferrullo’s hardly alone in hoping for a transition from “this is not normal” to a new era of normalcy. “Sleepy Joe,” President Trump’s moniker for Biden, was supposed to be an insult, but to a silent majority of Americans, it might have sounded like a welcome break. Wouldn’t it be nice to forget about the president for hours—even days—at a time?
Alas, that’s not going to happen—or so I argue in a forthcoming piece for Reason magazine: “Good luck forgetting about presidential politics when the president has the power to shape what our health insurance covers or unilaterally forgive student loans; the ability to launch a trade war from his couch—or a shooting war with Iran.” It’s not just Trump’s incontinent and erratic personality that’s made the presidency one of our biggest fault lines of polarization. It’s the fact that the president, increasingly, has the power to reshape vast swathes of American life.
I came across a vivid illustration of that point recently, in, of all places, the New York Times’ monthly “For Kids” supplement. (The banner of every edition features the tag line “THIS SECTION SHOULD NOT BE READ BY GROWN UPS,” but I cheated.)
The presidency‐themed edition that ran just before Election Day promised, among other things, to tell kids “How to Become President” (never explaining why you’d wish such a fate on them).
But what really piqued my interest was a piece billed as “5 Ways the President Can Change Your Life.”
“The president and his administration help determine things that mostly only adults care about,” the Times tells the tykes, “but they also make decisions that directly affect kids’ lives.” He plays a key role in determining what goes into “Your School Lunch,” “How Safe Your Toys Are,” and, using federal aid as leverage, even “What Sports You Can Play”: “Trump’s Department of Education is pressuring Connecticut to prevent trans athletes from competing in track and field.” With authorities granted (and seized) over immigration, the president has the power to determine “Who Can Be a Citizen.” In fact, notes the Times, his authority extends to “Just About Anything.” Though bills are supposed to go through Congress before they become law, “the president can act on his own and issue something called an executive order, which can have the effect of law even though it technically isn’t one.”
As a factual matter, none of that is wrong. But inquiring young minds might wonder whether it’s wise to have a single, nationwide, presidentially‐imposed policy on which sports which kids get to play or which bathrooms they can use. Or why it should be the president’s role to decide who gets to come to America and who gets to stay? And why should he have the power to make law with the stroke of a pen? Those are good questions for the grown‐ups too.
If even schoolchildren, per the Times, don’t have the luxury of forgetting about the president, it’s a sure bet that the rest of us can’t afford to either. You may not want to be interested in the presidency, but the presidency is interested in you. As vice‐president elect Kamala Harris tweeted a week or so after the election: “Know that @JoeBiden and I will wake up every single day thinking about you and your families.” Please… don’t?
Coincidentally or not, right next to the article on five ways the president can change your life, the NYT Kids’ section featured a piece on “Fighting about Politics.” It introduces one Giselle Weingarten, 13, who lately has “gotten really into politics” and “decided she’s a Libertarian, which means she thinks the government should have a minimal role in people’s lives.” “‘It’s very frustrating to talk to people who don’t share my beliefs,’ says Giselle, ‘I just want to yell: that sounds so ridiculous!’” Giselle, I feel your pain.