Opinion

Taxes: the new ‘expert’ quack cure

Once upon a time, health care was simple: If you had a cut or hemorrhoids, you reached for a leech. There was no medical problem that couldn’t be solved, in theory, by applying leeches to the body and letting the wild bloodletting begin. Now, it seems, some public-health experts have found a modern equivalent that will drain America of all its nasty public-health problems: tax increases.

Thomas Frieden, the former New York City health commissioner who’s now director of the Centers for Disease Control, has hailed taxes on sugary sodas as a painless way to reduce obesity — despite much economic research to the contrary.

Now, Dr. Lloyd Sederer, medical director for New York’s state Office of Mental Health, and Eric Goplerud, director of the Center for Integrated Behavioral Health Policy at George Washington University, have waded in: In a Washington Post op-ed, they claim that imposing heavy taxes on alcohol would reduce both the harmful effects of heavy drinking and help pay for health reform. To sex up the unattractive prospect of more taxes, they argue that a tax of just “3 cents per beer would cut youth gonorrhea by 9 percent.”

The logic, at first blush, seems irrefutable: If teens drink less, they’ll have less unprotected sex and therefore a lower risk of sexually transmitted diseases. But when you look into the claim that gonorrhea can be taxed away, you find the economic equivalent of quack medicine.

The claim about gonorrhea comes from a Centers for Disease Control study that was widely mocked when its results were announced nine years ago. The Washington Post called it “loony” — prompting the lead researcher, Harrell Chesson, to protest: “We said higher taxes could reduce the rate. We didn’t say they would.”

Chesson had good reason to be modest about his study’s conclusions: He himself noted that various problems in collecting data could have subjected them to “substantial bias.” But another, more obvious, factor complicated the analysis.

If you delve into the data for STDs, you find that the US gonorrhea rate skyrocketed from 1965 to 1975 (in the sexual revolution’s wake), going from 169.5 cases per 100,000 to 461 cases per 100,000. Then the rate plummeted 74 percent, to 120 cases per 100,000 by 1997 — roughly where it’s stayed.

Chesson et al looked at gonorrhea and beer-tax data from 1981 to 1995 and focused on the effect on gonorrhea rates from a doubling of the excise tax on beer in 1991. “It is an important validation of our hypothesis,” they wrote, “that this major national tax increase be associated with a corresponding nationwide reduction in STD rates in 1991 as compared to 1990.”

In other words, they took a small slice of a large, long drop in gonorrhea rates and found that a period when there was a relatively steeper descent correlated with the tax hike. Of course, they noted, this “in no way proves” that the higher excise duty caused any reduction in gonorrhea, but the findings “are at least consistent with the assertion that alcohol-tax increases can reduce STD rates.”

But when you step back and look at the overall 22-year downward trend, you also see a nearly comparable rate of decline in both 1992 and 1996 — without any alcohol-tax increase.

Maybe something else was behind the drop? Hmm: Americans were then responding to the emergence of AIDS.

Which theory looks more plausible: that the sobering effects of 2.7 cents on 12 ounces of beer led to a decline in gonorrhea cases, or that it was the growing fear of dying from unsafe sex?

Hint: There was also a marked rise in the use of condoms by sexually active teenagers from 1991 onward.

These aren’t the only problems with Sederer and Gopelrud’s claims. But it’s clear that their prescription makes as much sense as calling for the use of leeches to deal with swine flu.

Trevor Butterworth is the editor of STATS.org, an affiliate of George Mason University that looks at how numbers are used in public policy and the media.