Restricting E-Cigarette Flavors Endangers Public Health: New at Reason

Critics of the vaping industry portray the flavors that the Food and Drug Administration wants to ban from stores that admit minors as evidence of a conspiracy to hook the youth of America on nicotine. The FDA itself has a more sophisticated understanding of the market, Jacob Sullum says, but is still far too willing to sacrifice the interests of adult smokers in the name of fighting an “epidemic” of underage e-cigarette use.

“We recognize [e-cigarettes] as a viable alternative for adult smokers who want to get access to satisfying levels of nicotine without all the harmful effects of combustion,” FDA Commissioner Scott Gottlieb told CNBC last month. “If we could switch every adult smoker to an e-cigarette, it would have a profound public health impact.”

It follows that making e-cigarettes less appealing and less accessible has a public health cost, measured in smoking-related diseases and deaths that otherwise would not have occurred. Yet that is what the FDA’s new restrictions on e-cigarettes, which limit the flavor options in most stores to menthol, mint, and tobacco, will do.

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from Hit & Run

The Case Against Single-Payer Health Care: New at Reason

America needs single-payer health care, say progressives. Canada, England, Norway, Cuba, and a few other countries have it, and we’re constantly told that it works well—people get good care and never have to worry about a bill. They spend less on health care and live longer.

But that claim, explains John Stossel, is both naive and misleading.

View this article.

from Hit & Run

Brickbat: London’s Burning

Grenfell TowerBritish police have arrested five people on suspicion of a public order offense after video of them burning a mock-up of the Grenfell Tower in a bonfire went viral. The Grenfell Tower, a residential building, burned in 2017 killing 72 people. Prime Minister Theresa May was among those who condemned the individuals in the video.

from Hit & Run

The FBI Says Hate Crimes Rose 17% in 2017, But That Doesn’t Mean Things Are Actually Getting Worse

FBIOn Tuesday, the Federal Bureau of Investigation released hate crime data for last year. The main finding, which appears in the headlines of several news stories about it, was that hate crimes rose 17 percent from 2016 to 2017.

Media and activist groups often blame hate crime spikes on President Trump’s divisive rhetoric: the Southern Poverty Law Center has called this “the Trump effect,” and pointed to supposed surges in schoolyard bulling as evidence of such a trend. The latest FBI statistics are producing similar commentary.

“The report covers the first year of President Donald Trump’s time in the White House,” writes Vox‘s German Lopez, “and he’s been repeatedly criticized, from his campaign to his presidential statements and tweets, of stoking racist sentiment, particularly against immigrants and refugees.”

But, as Lopez correctly notes elsewhere in his post, any talk of hate crime increases must be considered in light of a very critical detail: the overall number of law enforcement agencies reporting hate crime data also increased greatly—approximately 1,000 additional agencies contributed figures in 2017 than in 2016. This means it’s not obviously the case that hate crimes are more prevalent in 2017. Maybe the government just did a better job of counting them.

This seems even more plausible when the raw totals are considered. The FBI counted 7,175 hate crimes in in 2017, compared with 6,121 in 2016. That’s a difference of about 1,000. If every agency reporting data for the first time in 2017 reported just one hate crime, this would account for the entire 17 percent increase.

This is the problem with counting hate crimes: the numbers just aren’t that useful, given that not all police agencies participate, or give accurate totals. As I noted in a previous post, Baltimore County—which represents 830,000 people—reported just one hate crime in 2016. This year, Baltimore County reported 10 hate crimes. Did incidents of hate increase tenfold in a single year? Probably not; it’s likelier that the police simply submitted more reliable data this year.

As with the dubious claim that anti-Semitic hate has spiked 57 percent under Trump, the media needs to be careful about encouraging unfounded fatalism.

from Hit & Run

3 Reasons ‘Medicare for All’ Is a Really Bad Idea

“Medicare for All” is, arguably, the rallying cry for progressive Democrats these days. Health care costs were a major issue in the midterm elections and the best way to fix everything once and for all, say progs, is to give all Americans the same sort of coverage given to those of us who are 65 and over. What’s not to like about Medicare, say proponents. Seniors love it and it’s a proven form a single-payer health care.

Er, no, says a concise and persuasive op-ed in The Wall Street Journal, by Scott W. Atlas of the Hoover Institution. For starters, there is the cost problem:

For California alone, single-payer health care would cost about $400 billion a year—more than twice the state’s annual budget. Nationwide “Medicare for all” would cost more than $32 trillion over its first decade. Doubling federal income and corporate taxes wouldn’t be enough to pay for it. No doubt, that cost would be used to justify further restrictions on health-care access.

In 2017, Eric Boehm noted at Reason that a single-payer bill passed by New York’s state assembly would cost $173 billion annually (the state generates about $71 billion a year in revenue). Even when you factor in savings from people not having to pay insurance premiums and co-payments, there’s just no way to raise the revenue on such plans. In 2014, Boehm writes, Vermont had to throw in the towel because it “would have required an extra $2.5 billion annually, almost double the state’s current budget, and would have required an 11.5 percent payroll tax increase and a 9 percent income tax increase.”

But cost isn’t the only problem. Atlas writes that in Great Britain, “a record 4.2 million patients were on England’s [National Health Service] waiting lists.” And there’s this:

In Canada last year, the median wait time between seeing a general practitioner and following up with a specialist was 10.2 weeks, while the wait between seeing a doctor and beginning treatment was about five months. According to a Fraser Institute study, the average Canadian waits three months to see an ophthalmologist, four months for an orthopedist and five months for a neurosurgeon.

In contrast, wait lists are not a major concern in the United States.

Finally, there’s also the development of new drugs. Atlas writes:

Single-payer systems also impose long delays before debuting the newest drugs for cancer and other serious diseases. A 2011 Health Affairs study showed that the Food and Drug Administration approved 32 new cancer drugs in the decade after 2000, while the European Medicines Agency approved 26. All 23 drugs approved by both Europe and the U.S. were available to American patients first. Two-thirds of the 45 “novel” drugs in 2015 were approved in the U.S. before any other country.

Most proponents of Medicare for All say they don’t want to fully nationalize health care, as Canada has done. Instead, they want to guarantee a basic, accessible, free (or near-free) system. Atlas has an answer for that, too: “America’s poor and middle class would suffer the most from a turn to single-payer, because only they would be unable to circumvent the system.” In fact, he warns that,

the nations most experienced with single-payer systems are moving toward private provision. Sweden has increased its spending on private care for the elderly by 50% in the past decade, abolished its government’s monopoly over pharmacies, and made other reforms. Last year alone, the British government spent more than $1 billion on care from private and other non-NHS providers, according to the Financial Times. Patients using single-payer care in Denmark can now choose a private hospital or a hospital outside the country if their wait time exceeds one month.

Read the whole article here.

Our health care system is definitely screwed up, but that’s because we refuse to let markets function with the same sort of effectiveness they do in other parts of the economy. There are ways to take care of people who have pre-existing conditions that don’t end up causing costs for everyone to go berserk. We can speed up drug trials without compromising safety, and we also need to rethink how we certify and license doctors, nurses, and everyone else who provides some dimension of health care.

Given the way the Republicans refused to take health-care policy seriously in the wake of Obamacare’s passage, it seems unlikely that we’ll be moving toward market-friendly solutions any time soon. That’s a damn shame and if we do end up with Medicare for All, the bill will be almost incalculable in terms of more than taxes.

Related video (from 2012): Meet Keith Smith, a doctor in Oklahoma who brought market forces to bear on the delivery of surgery.

from Hit & Run

Michelle Obama Didn’t Want to Nag People About School Lunch

In her new book, Becoming, former First Lady Michelle Obama indicates that she wasn’t trying to force healthy food initiatives down people’s throats. But the results of her attempt to get children to eat better tell a different story.

In the months following her move to the White House, Obama tried to “develop the pillars on which our larger effort would be built,” she writes. “We’d give parents better information to help them make healthy choices for their families.” She adds: “We’d work to create healthier schools. We’d try to improve access to nutritious food. And we’d find more ways for young people to be physically active.”

Obama goes on to acknowledge the concern that her efforts might be seen as government overreach. “The West Wing was apparently fretting about my plans, worried I’d come off as a finger-wagging embodiment of the nanny state at a time when controversial bank and car-company bailouts had left Americans extra leery of anything that looked like government intervention,” she writes.

But the former first lady claims that wasn’t her goal. She writes that she wanted to “make this about more than government.” Obama believed a “human appeal” was better than a “regulatory one” in order to convince companies that supply school lunches and produce soft drinks to make changes. It was better to “collaborate,” she writes, than to “pick a fight.”

Obama was wary of using politics to accomplish her goals. “I wasn’t interested in following the tenets of the political world or appearing on Sunday morning news shows,” she writes. Still, it seems like it would be impossible for her to carry out all of her plans without politics. It was a memorandum signed in February 2010 by President Barack Obama, after all, that created what she describes as “a first-of-its-kind federal task force on childhood obesity.”

Michelle Obama’s efforts continued throughout 2010 as she advocated for the passage of the Healthy, Hunger-Free Kids Act, which is most famous for setting nutrition standards for school lunches around the country. Obama notes that while she was “generally happy to stay out of politics and policy making,” this was her “big fight—the issue for which I was willing to hurl myself into the ring.”

It was a fight she won. Republicans took back control of the House in the 2010 midterms, but President Obama “made the effort a priority in his dealings with lawmakers, knowing that his ability to make sweeping legislative changes was about to diminish,” she writes. The president signed the bill into law in December.

The first lady saw this as a big success. Among other things, the bill “added more fresh fruits and vegetables, whole grains, and low-fat dairy to roughly forty-three million meals served daily,” Obama writes. “For me, it was a straightforward good thing—a potent, ground-level way to address childhood obesity.”

Obama’s motives were admirable—healthier children is a worthy goal. The problem is having the federal government tell schools what they can and can’t serve to students. As lawyer and food policy expert Baylen Linnekin has explained in Reason, the changes that came about thanks to the Healthy, Hungry-Free Kids Act were not for the better. Not only did food costs go up, but many students decided the quality of the healthier meals was so bad that the food wasn’t even worth eating, meaning that lots of food went to waste.

In 2014, Reason‘s Robby Soave even took note of the sarcastic Twitter label #ThanksMichelleObama, which students used to share pictures of their less-than-appetizing lunches.

Reason‘s Elizabeth Nolan Brown has noted that school cafeterias should certainly be encouraged to serve healthier food. But as she pointed out, “setting highly specific and ironclad rules for schools across the country crosses the line.” The federal government can’t possibly know what will work best for each school better than local officials and actual school administrators.

In a 2014 piece for Time magazine, Reason‘s Nick Gillespie may have put it best: “If we can’t trust our schools to figure out how best to fill their students’ stomachs, why the hell are we forcing our children to attend such institutions in the first place?”

Michelle Obama seems to have had pure motives when it came to decreasing childhood obesity. Unfortunately, decreasing individual choice wasn’t the answer.

from Hit & Run

Comics Legend Stan Lee Was the Godfather of Shared World Storytelling

Like so many others, I was saddened yesterday to hear about the passing of Marvel Comics impressario Stan Lee.

I spent the formative years of my youth reading stories about superheroes he created. My first publication was in the letters page of Amazing Spider-Man (naturally, I suggested a team-up with the Fantastic Four), and as an adult, I have written thousands of words about movies based on Marvel Comics characters. It is possible that over the course of my lifetime, his creations and co-creations have occupied more of my mental energy than any other pop-culture phenemona. Yes, his legacy is complicated, but he was a legend, and he’ll be missed.

Over at The Washington Post, I’ve got a piece on the way Lee’s particular brand of sprawling, shared-world storytelling changed comics, and eventually movies, forever. Here’s how it starts:

Next time you go to the movies and see a post-credits scene teasing a sequel that is still years away, or a winking reference to some obscure bit of franchise lore, or a cameo appearance by the star of another superhero franchise, think of Stan Lee.

Lee, who died on Monday at age 95, was the driving force behind Marvel Comics. A singular pop-culture visionary, he helped create many of Marvel’s most popular characters, including Iron Man, Thor, Spider-Man, Black Panther and the Fantastic Four. Just as important, however, was how he changed the way these stories were told. As Marvel’s self-promoting maestro, he popularized the serialized, shared-world superhero storytelling that has all but consumed the movie business over the past decade. Without Lee, Hollywood as we know it might not exist.

Be sure to read Brian Doherty and Scott Shackford on Lee’s considerable pop-culture legacy.

from Hit & Run

Here’s What’s Happened So Far in the Florida Recount

|||Paul Hennessy/Polaris/NewscomThough the midterm elections are over for most, one state is still counting ballots.

On election day last Tuesday, Floridians stood in long lines to cast votes for their next governor, senator, and state representatives. Ballots also contained a number of proposed amendments to the state constitution. For weeks, the gubernatorial race between Republican Ron DeSantis, a congressman, and Democrat Andrew Gillum, the mayor of Tallahassee, garnered national attention following accusations of racism, socialism, and Trumpism.

Despite talks of a “blue wave,” DeSantis managed to pull ahead and claim victory. Gillum then conceded the race to his opponent. Though Republicans typically win the Florida governorship, the results in this race were unusually close, with DeSantis carrying a victory margin of just 0.7 percent.

Meanwhile, in the race for U.S. Senate between Democratic Rep. Bill Nelson and Republican Gov. Rick Scott, the results slowly came within a 0.5 percent margin, triggering an automatic recount under state law. (Florida does not have runoff elections for these races.) Though Scott claimed the unofficial victory, Nelson announced on Wednesday morning that his team was “proceeding to a recount.

Much to the irritation of Scott’s campaign, the Nelson campaign’s recount efforts got a boost as the heavily Democratic counties of Broward and Palm Beach were still processing absentee and early voting ballots on the day after the election. State law also gives a 10-day grace period following the election to count overseas absentee ballots.

Then, on Thursday and Friday, pictures of undelivered ballots in mail centers began to cause panic that votes were not being counted. Though some voted as early as October, several voters either had their absentee ballots returned or received word that they were either delivered later than promised or lost altogether. Adding to those concerns was the slow pace at which Broward County officials were counting ballots, even missing a Thursday deadline to submit recounted votes.

Scott filed several lawsuits in response, including one accusing Broward County Supervisor of Elections Brenda Snipes of withholding information about the number of counted and uncounted ballots. Scott initially won those suits.

Yesterday, however, a Broward Circuit Court judge denied one of Scott’s lawsuits requesting that the ballots and machines at the Broward Election office be impounded. Instead, Judge Jack Tuter requested the addition of three deputies who are not affiliated with Snipes. The deputies will monitor cameras and USB drives that contain votes, and also supervise, without reporting to the county supervisor of elections.

Nelson has pursued his own legal action. A suit filed on Monday sought to count absentee ballots that were sent before election day, but delivered after polls closed.

Other issues have arisen outside of Broward and Palm Beach Counties. The Manatee County Supervisor of Elections Office was forced to restart its recount effort when a human error was caught well after 33,000 early voting ballots were processed through a voting machine.

Amid the drama in the Senate race, Democratic gubernatorial candidate Gillum withdrew his concession on Saturday (neither his concession nor the withdrawal are legally binding). Acknowledging that his loss may remain unchanged, Gillum made an “uncompromising and unapologetic call that we count every single vote.”

The move was largely ignored by DeSantis, who has already appointed a transition team in preparation for his governorship.

President Trump has also gotten involved in the Florida recount. On Monday, Trump demanded that the Senate race be called in favor of Scott and insinuated that fraudulent behavior was afoot.

Though Trump did not expand on his accusation, he later tweeted that the “characters” involved will not be able to “find” enough votes to swing the election in Nelson’s favor.

from Hit & Run

Union of Concerned Scientists For Nukes!

NuclearVaclavVolrabDreamstimeThe activists at the Union of Concerned Scientists (UCS) have had a partial change of heart about nuclear power. Back in 2007, the UCS’ Global Warming and Nuclear Power report declared, “prudence dictates that we develop as many options to reduce global warming emissions as possible, and begin by deploying those that achieve the largest reductions most quickly and with the lowest costs and risk. Nuclear power today does not meet these criteria.”

In its new report, The Nuclear Power Dilemma, the UCS now recognizes that nuclear power plays an important role in addressing the problem of man-made global warming by helping to keep U.S. carbon dioxide emissions considerably lower than they would otherwise be. The UCS notes that there has been a 28 percent reduction in U.S. power-sector emissions of carbon dioxide below 2005 levels. This is largely due to the switch from coal to cheap fracked natural gas, to increased energy efficiency, and to the deployment of some solar and wind generation capacity.

The UCS fears that this trend toward lower carbon dioxide emissions will be derailed because many of the currently operating nuclear power plants will close because they are being outcompeted by generation facilities fueled by cheap natural gas and subsidized renewable power generation. “More than one-third of existing plants, representing 22 percent of total U.S. nuclear capacity, are unprofitable or scheduled to close,” notes the report. “The possibility that the nation will replace existing nuclear plants with natural gas and coal rather than low-carbon sources raises serious concerns about our ability to achieve the deep cuts in carbon emissions needed to limit the worst impacts of climate change.” The UCS has evidently come to realize that closing down nuclear power plants will perversely “lock-in” fossil fuels and thus make it harder and more expensive to “save the climate.”

In order to avoid this outcome the UCS advocates either raising the price of electricity generated from burning fossil fuels by putting a price of $25 per ton on carbon dioxide emissions (to be increased at 5 percent annually) or adopting a steadily rising national low-carbon electricity standard. The UCS favorably cites the subsidy schemes adopted by New York, New Jersey and Illinois to keep open nuclear power plants outcompeted by natural gas and subsidized renewable energy generators.

Of course, the UCS’s mild embrace of nuclear power has provoked criticism by some progressives. Gregory Jaczko, former chairman of the Nuclear Regulatory Commission during the Obama administration, said to ThinkProgress that nuclear reactors “are a bad bet for a climate strategy.” Why? Because the costs of building nuclear power plants have risen steeply over the years.

Sadly, it should be noted that the UCS itself has been a loud cheerleader for the very over-regulation that led to the steadily rising costs for deploying new nuclear power plants. In 2017 Australian National University researcher Peter Lang calculated that had the trend of rapidly falling costs and accelerating deployment of nuclear plants in the 1960s and 1970s been allowed to continue, nuclear power could now be around 10 percent of its current cost. Such low cost nuclear power by 2015 could have replaced worldwide up to 100 percent of coal-generated and up to 76 percent of gas-generated electricity. In other words, in an alternative world without the regulatory obstructionism practiced by environmental activists, humanity would already be well on the way toward mitigating the problem of man-made global warming.

It’s welcome news that the UCS has taken this small step towards recognizing the value of low-carbon nuclear power. It would be even better if the activist group would also come around to advocating the rapid development and deployment of new safer nuclear power generation technologies, such as molten salt thorium reactors, small modular reactors, and traveling wave reactors.

from Hit & Run

Juul Announces Preemptive Restrictions on Its E-Cigarette Flavors

Today the company that makes Juul e-cigarettes announced a “Youth Prevention Action Plan” that includes withdrawing most of its flavors from brick-and-mortar stores in response with the Food and Drug Administration’s demands that it do something about underage vaping. The concession illustrates the FDA’s power to impose restrictions on e-cigarette manufacturers even without bothering to issue formal regulations.

“We launched flavors like Mango, Fruit, Creme, and Cucumber as effective tools to help adult smokers switch from combustible cigarettes,” Juul Labs says. “However, we are sensitive to the concern articulated by [FDA] Commissioner [Scott] Gottlieb that ‘[f]lavors play an important role in driving the youth appeal,’ and understand that products that appeal to adults also may appeal to youth. As of this morning, we stopped accepting retail orders for our Mango, Fruit, Creme, and Cucumber JUUL pods [from] the over 90,000 retail stores that sell our product, including traditional tobacco retailers (e.g., convenience stores) and specialty vape shops.”

That move goes beyond the restrictions that the FDA is expected to announce this week, which ban e-cigarette flavors except for tobacco, menthol, and mint from stores that admit minors but allow their sale by tobacconists and vape shops. Altria, which makes MarkTen e-cigarettes, has already said it will stop selling pods in flavors other than tobacco, menthol, and mint anywhere until the FDA approves them. The two companies together account for nearly four-fifths of the U.S. e-cigarette market.

It is still not clear what form the FDA’s new rule will take. The National Association of Convenience Stores notes that the Family Smoking Prevention and Tobacco Control Act, the 2009 law that gave the FDA authority over tobacco products, says the agency may not “prohibit the sale of any tobacco product in face-to-face transactions by a specific category of retail outlets.” But since the FDA has threatened to move up the deadline for approval of e-cigarettes or take flavored varieties off the market altogether, it has a lot of leverage to demand changes short of those actions.

In addition to removing most of its flavors from offline vendors, Juul says it is “adding additional age-verification measures to an already industry-leading online sales system that is restricted to people 21 years old” or older; limiting customers to “two devices and fifteen JUUL pod packages per month, and no more than ten devices per year” in an effort to prevent bulk purchases of e-cigarettes that may be diverted to minors; and “attacking the presence of JUUL Labs on social media in two ways—eliminating our own social media accounts and continuing to monitor and remove inappropriate material from third-party accounts.” That last item suggests the FDA can indirectly censor constitutionally protected speech by holding the threat of ruinous regulatory action over the heads of e-cigarette companies.

Juul evidently has calculated that it will do better in the long run by heading off more drastic measures aimed at fighting what the FDA, based on data the public still has not seen, describes as an “epidemic” of underage vaping. But the immediate effect will be to limit the options available to smokers who might be interested in switching to e-cigarettes, making these harm-reducing products less accessible and less appealing, which may lead to more smoking-related disease and death.

from Hit & Run