Letters

Drug Czar Dangerous?

I am bothered by Jacob Sullum's article on William Bennett ("Bill Bennett's Blinders," Mar.). Mr. Sullum argues a position that is intellectually and morally consistent but is also totally devoid of human compassion.

Sullum notes the libertarian/authoritarian split in Bennett's personality and implies darkly that what the drug czar really wants is power to do things his way. But I see something different driving William Bennett.

I want my son to grow up and enjoy freedom, and to respect the views and rights of fellow Americans. And so I don't mind him mixing with different races and cultures. We don't ban books in our house, and my boy is allowed to debate me on practically any subject. I want him to grow up and become his own person, even if he decides not be a chip off the old block; but most important, I want him not to die before his time.

There are things too dangerous to consider, and one of them is crack. It will, for the most part, utterly destroy you. As a father, I will do whatever I can to keep my boy away from crack, not because I want to rule over my son but because I love him.

Sullum might have a point in wondering about the efficacy of a government trying to protect citizens from themselves; but he cannot take away the love for all Americans that is within William Bennett's heart—and the agony that the drug czar feels for our fellow citizens trapped in the drug miasma.

Rosamond Kay
Philadelphia, PA

When I read the reference to Bill Bennett as the "philosopher-turned-drug czar," I had to laugh. I thought it was some kind of twisted editorial joke. My amusement turned to horror after discovering that he is a former professor of philosophy. To see a thrice-educated philosopher become a militant, intolerant barbarian seems inconsistent with and blasphemous to the field of philosophy. The dilemma is resolved, however, only after realizing that Bill Bennett is also both a lawyer and a politician, thus relieving him of any philosophical or moral responsibilities.

John W. Herrington
Rochester, MI

Jacob Sullum failed to note the appropriateness of the drug czar having played electric guitar in a "rock band called Plato and the Guardians." The former philosophy professor, for whom the presidency is the only elective office that is desirable, would be the nation's first Philosopher King.

Sullum cites evidence for Bennett having libertarian leanings. But such leanings are not libertarian in the political sense. While Bennett may believe "that people are masters of their own destinies," he would have the government define those destinies and even to coerce individuals into mastering them unto the service of the state. Furthermore, he defines individual liberty in a narrow sense: "Drug use is a threat to the individual liberty and domestic tranquility guaranteed by the Constitution." Bennett sees drugs as conflicting with the homogeneous culture for which he longs, conflicting with the "common purposes of our national life," "our common culture," and "our national purpose."

Just as he sought to use the public schools to teach his cultural-conservative values to children, so Bennett attempts to use the drug laws to teach these values to adults.

Andrew Plymale
Richland, WA

Trade Winds

Three cheers for Jim Powell's article ("Forget the Crowbar," Mar.). I am so tired of hearing "free traders" say that we need to use retaliation to open up other countries' markets. Powell's article skillfully details how such policies are self-destructive.

Unfortunately, those policies are often present in the halls of Capitol Hill. Time after time, U.S. congressmen propose legislation that calls for the use of retaliation to force open overseas markets.

Even before the success (or failure) of Super 301 tactics has been assessed, new bills attempting the same type of strategy have been proposed. The most recent rerun is a foreign investment reciprocity bill by Rep. Tom Campbell (R–Calif.).

The bill would require a foreign investor in the United States to be treated the same way a U.S. investor is treated in that foreign country. This will supposedly force open overseas capital markets. But with the United States' insatiable need for foreign capital, a bill that could jeopardize foreign investment in the United States is suicidal for the U.S. economy.

Both congressmen and think tanks alike need to devote more efforts to coming up with "win-win" approaches to opening markets overseas. If the U.S. trade representative used carrots rather than sticks, a trade war would most likely never ensue. Swapping the reduction of trade barriers rather than threatening to create new ones would be a constructive bargaining method.

Another approach might include creating free-trade agreements with open-market countries, putting non-cooperative countries at a competitive disadvantage. For example, if the United States entered into a free-trade agreement with the European Community, new economic pressures might entice Japan to create a more open market.

Thankfully, Powell's article has documented the failure of retaliatory threats. Perhaps legislators will put their creative juices into devising real solutions to protectionist policies instead of repackaging old ideas that just don't work.

Nancy Oliver
Director of Trade Policy
Citizens for a Sound Economy
Washington, DC

Healthy Disagreement

I agree with Virginia Postrel in her editorial "What Ails Health Care" (Apr.) that having government in the health insurance business is not as good as keeping health insurance in the hands of private business. However, I think an even more important point was missed—the very existence of insurance has grossly inflated the cost of health care.

Insurance distorts incentives. A patient faced with a large medical bill thinks, "It's OK! I've got insurance." The doctor, when he sends in the bill, thinks, "It's OK. He's got insurance." The insurance company, when it gets the bill thinks, "It's OK. We're making a profit." So for at least a generation medical costs have been more and more insulated from market forces. Hence costs have skyrocketed.

A vicious cycle has been set up. Insurance increases costs, thus creating the need for more insurance.

As a nation we have developed an "insurance mentality." We think that uninsured bills are uncollectable. We think uninsured people are not getting medical care. We think insurance is the only way that medical care can be paid for.

The popular view of insurance has become, "You pay in a little, and when you get sick you get a lot back." This is just part of the insurance mentality. By this perspective it is perfectly reasonable to go shopping for insurance when you suspect you have AIDS.

As a result of the insurance mentality we think every $30 office visit ought to be covered by insurance. Vast numbers of small claims go through a bureaucratic process that is wasteful and costly. This violates the basic idea of insurance—that you insure against the unexpected, not against the certain.

This situation has a simple cure. Health insurance with high deductibles should be vigorously promoted. Routine medical costs would come straight out of the patient's pocket. This would restore incentive to its proper place.

Brian D. Rude
Rapid City, SD

Your editorial brought to mind the years 1963 to 1966, when I was working in Brazil. Brazilians said that "Brazil is one vast hospital without walls." Their answer to the lack of adequate health care was "drug store supermarkets" stocked with a variety of medicinal drugs.

Anyone could buy any drug they needed, no questions asked. If the drug needed injecting, a full time injectionist was in the back room to do it very inexpensively. The back room was equal to any injection room found in U.S. hospitals, clean and modern.

Selection of drugs to purchase was by a doctor's recommendation (for those people fortunate enough to be able to afford one), by "common knowledge" (people are smart; they often know what they need), or by asking the pharmacist (the poor man's doctor). Pharmacists in Brazil do much more than American pharmacists are allowed to do. They not only know drugs but also recognize symptoms. This is a safeguard against purchasing the wrong drugs. Pharmacists make their money selling drugs, but they also realize that they are in the front lines for providing better health care, even to those with meager financial resources.

At that time, I thought that was a primitive system, but now, with U.S. health costs "out of sight," that system, implemented in America, would help reduce our medical bills.

Walter Pawly
San Francisco, CA

Yes, Virginia, there is no Santa Claus in health care. We have a continuing prescription need and shopped around for the best price. The range was from $114 to $156. Of course, we went to the $114 pharmacy. We then submitted our claim to Blue Cross, our health-care provider. They will only pay 50 percent of the bill because that pharmacy is not a "Blue Cross" provider. But Blue Cross will pay 70 percent of the high-priced pharmacy ($109) because it is an approved "provider."

The Blue Cross Rules: Don't try to save money on health care. Don't do business with small, independent pharmacies. Don't reward those who keep costs down.

Warren B. Hoit
San Jacinto, CA

It is not fair to say that the U.S. medical system resembles the Soviet economy. The Soviet economy lacks any rewards for competence and depends strongly on slave labor. The American health-care system has many problems, but it also has made significant achievements.

You were silent about one of the main sources of the problems of the American health-care system—the American Medical Association. The AMA has been shown again and again to be no more than a monopoly which artificially restricts entry into the profession and price discriminates in order to transfer the consumer surpluses to its members as unearned economic profit. Such practices always are inflationary. Paraphrasing the words of Mr. Kinnock of the British Labour Party, the AMA "will let their country die for them."

If you want to compare the American health-care system to an economy, it would be fair to compare it to the economy of Brazil. Brazil produces modern cars, builds freeways, has a trade surplus—yet a significant segment of its population is permanently separated from the benefits of its modern economy, and everybody suffers because of outrageous inflation. What is the reason for such a situation? I submit it is the almost total monopolization of the Brazilian economy, forced by their government.

The American public is offered an ironic alternative in health care: monopolistic capitalism, Brazilian-style, which we have now, or socialism, British, or possibly eventually Soviet-style. The AMA opposes socialization of health care, and we should be grateful to its members for that. However, it also refers to the introduction of ordinary capitalism in health care as "unethical."

Krzysztof Ostaszewski
Louisville, KY

Mad in the U.S.A.

Dr. Melvin Salskin, medical director of the American Psychiatric Association (Letters, Mar.) refers to "overwhelming evidence accumulated through five decades of postwar research producing tens of thousands of scientific papers and numerous Nobel prizes." All this is more than enough to show the prevalence of "the extreme and often destructive and painful emotions and behaviors" which he and his colleagues "accept as mental illness." But there neither is nor ever has been any disagreement about the occurrence of these deplorable phenomena. So we must hope that this enormous research effort has achieved substantially more than Salskin claims for it.

Still in dispute is how many of these phenomena can properly be called symptoms of mental diseases. Dr. Thomas Szasz says none. I and others argue some but surely not all. Nor must Salskin ever be allowed to forget that it was only recently that the American Psychiatric Association abandoned its imperialist claims to treat statistically abnormal sexual orientations as a kind of mental disease, and their physical expressions as symptomatic of that disease.

Antony Flew
Social Philosophy Policy Center
Bowling Green State University
Bowling Green, OH

Less-Filling Arguments

Jacob Sullum's article "Invasion of the Bottle Snatchers" in your February issue was interesting, and it raised some valid points. But much of it was sheer nonsense. First, the term neoprohibitionist is clearly used as an emotionally loaded, propagandistic label, and it's really a cheap shot. Name calling has no place in reasoned arguments. Sullum devotes much space to attacking ridiculous straw-man arguments.

To focus on just the most absurd of his arguments, on page 30 Sullum says, "But, say Koop and others, the $2 billion spent each year on advertising alcoholic beverages encourages drinking…there is no evidence that it is true." Really? Then the alcohol industry is wasting $2 billion a year. And that goes for just about every other commercial industry.

The whole point of advertising any product is to encourage the use of that product. And if advertising has no effect, why on earth should Sullum think it matters if advertising techniques are used to present an anti-alcohol attitude?

The claim that "nobody has been able to demonstrate that advertising does anything more than shift brand preferences" is not a universally held conclusion. I suspect Sullum may be using the quote out of context. When a new type of product is developed, if there is no brand preference, advertising does seem to play an important role in determining the success or failure of the new product. There have been numerous occasions when an increase of advertising for a nonessential product has led to an increase in consumption. Obviously, advertising does do more than just shift brand preferences, when one looks at the broader picture.

All of this does not prove that advertising alcohol products can cause alcohol use that wouldn't occur otherwise. But it does raise the possibility. Sullum's claim that the opposite has been in any way proven is completely lacking in supporting evidence.

Sullum very clearly has elected to put on a set of blinders. He made up his mind, then looked at the facts to pick and choose what suited him. In so doing, he has severely weakened his core arguments.

Delton T. Horn
Amarillo, TX

Mr. Sullum replies: I never said it has been proven that advertising does not increase alcohol consumption. (Proving such a negative proposition would be impossible.) I merely said that the alleged link has not been demonstrated.

David Pittman, a sociologist who has been studying alcohol issues for more than 30 years, was indeed quoted out of context—by Mr. Horn. Professor Pittman's comments pertained to the advertising of alcoholic beverages, not advertising in general. As noted in my article, his conclusion—that research has not shown that advertising increases alcohol consumption—was shared by the Senate Subcommittee on Alcohol and Drug Abuse, which did a survey of the relevant studies in 1985. Furthermore, the National Council on Alcoholism and Drug Dependence was unable to cite any studies showing a link between advertising and consumption levels.

In recent years, advertising has failed even to prevent a decline in alcohol consumption. Does this mean that "the alcohol industry is wasting $2 billion a year"? Only if it were a matter of indifference to each firm whether drinkers chose to buy its products or those of a competitor. Although the pie is shrinking, it is still worthwhile for each company to compete for a piece.

Consenting Adults

I thank Tom Palmer for a review that I, the author of the book, enjoyed reading ("The Choice of Life," Mar.). He does, however, make a couple of serious mistakes. Nowhere in Individuals and Their Rights do I hold that "we can even consent to give away our rights." That would be entirely absurd of me to do, since I believe our basic, natural rights are unalienable. I argue that by exercising our rights in certain ways, we authorize some others to punish us, which they then may do. When I defend implicit consent I also make very clear—over and over again—that such implicit consent may not be given in violation of anyone's (including one's own) rights.

Finally, I never ever "equate rationality with conscious deliberation." I have on numerous occasions argued just the opposite, namely, that rationality does not require deliberation at all: Intentionality is entirely sufficient to make a judgment or action rational.

Tibor R. Machan
Department of Philosophy
Auburn, AL

I'm a bit surprised by comments made by Tom G. Palmer in his book review. Ayn Rand did not base her ethics on a negative commandment: Thou shalt not commit suicide. The thrust of her argument is that it takes a positive effort to live as a human being. Learning and productive work don't just happen. How could anyone—even a pampered, 20th-century American—assume that he could live a full, human life "by default, as it were"?

Then again, it is perceptive of Palmer to be embarrassed at the prospect of "the nature of a thing changing as I learn more about it." He might be interested to learn that Objectivism takes its very name from Rand's innovative solution to this question: A trichotomy of the intrinsic, subjective, and objective. Objective knowledge is contextual, not absolute, but independently verifiable. It depends on the relationship between reality (in the sense of metaphysical intrinsics) and a specific consciousness.

So why is it I know this, and a REASON book reviewer doesn't?

Kevin Martin
Suffern, NY

Mr. Palmer replies: It was a pleasure to receive these criticisms of my review, because they required me to return to the work and its argument. I remain very unhappy with Machan's treatment of implicit consent. He is aware of the dangers of this approach: "Such ideas [tacit consent or implicit consent] carry with them a hint of underhandedness and threaten to introduce that very subjugation of one person's will to others that the individualist demands be excluded." But I think that he does not take his warning seriously enough. Machan states in his letter that "by exercising our rights in certain ways, we authorize some others to punish us, which they may then do"; in his book he writes of authorizing (i.e., consenting to) "the use of force against oneself." This means at least one has consented to give up the right to self-defense. As Machan argues that this right is given to some corporate body (government), I find myself unable to find any hairs so fine that splitting them will differentiate this position from giving away one's right to self-defense.

That this reliance on implicit consent generating the right to punish is of great importance is shown by Machan's equally unsatisfactory treatment of the problem of just how far this consent extends, and whether that includes conscription or taxation (which Machan rightly considers indistinguishable from slavery or theft). Machan argues that "defending a country is possible by hiring people from home or abroad. Financing a country is also possible by charging for services provided by the legal system—via a system of contract fees, post facto charges for police services, and so on." Being possible is not the same as being morally required. The argument from implicit consent can be used to justify just about any form of state coercion as an "implication" of one's participation in social life, and I do not find Machan's response to this argument at all persuasive.

On whether Machan has equated rationality with conscious deliberation: "'Rationality' is meant here in the sense of 'thinking clearly, being perceptive and aware of what we should do and how we should act.'" Further, "A crucial feature, then, of rationality is that it is a capacity that is exercised when one initiates the power of thought, of awareness, of reflection." Machan may have argued on other occasions that there is a distinction between rationality and deliberation (which seems a reasonable distinction), but I wasn't there and it is not in his book.

Kevin Martin has taken me to task for having learned from Machan's book something about an argument I had not previously understood. Rather than berating me for having once been in darkness, perhaps Mr. Martin would do better to welcome me into the light. I am not yet convinced by the argument, but at least now I find it more plausible.