Time to Rethink the Health Benefits of Drinking?

In order to make any kind of coherent public policy, we have to accept certain claims as fact, even when they are only provisionally supported by data. Almost never are these claims purely borne out by the data once it comes in, but often, the claim has become a treasured chestnut as durable as any actual fact. As a consequence, we keep charging forward on bum assumptions.

Owing to a particular mixture of history, religion, and culture, the United States has always had an awkward relationship with alcohol. You recall that dust-up we had in the late teens of the last century, but that was only the most extreme case. The way we think about alcohol sales, alcohol abuse, and alcohol consumption is colored as much by hoary myth and legend as science--abetted by the fact that until the last decade, there wasn't a whole lot of science to refute the myth. But that's changing, and the overwhelming consensus refutes much of what we have believed about alcohol and its affect on society. Time Magazine recounted some of the more surprising recent findings:

But a new paper in the journal Alcoholism: Clinical and Experimental Research suggests that — for reasons that aren't entirely clear — abstaining from alcohol does actually tend to increase one's risk of dying even when you exclude former drinkers. The most shocking part? Abstainers' mortality rates are higher than those of heavy drinkers....

But even after controlling for nearly all imaginable variables — socioeconomic status, level of physical activity, number of close friends, quality of social support and so on — the researchers (a six-member team led by psychologist Charles Holahan of the University of Texas at Austin) found that over a 20-year period, mortality rates were highest for those who had never been drinkers, second-highest for heavy drinkers and lowest for moderate drinkers.

We have to add a few caveats--correlation is not causation, alcoholism remains a real and serious problem, and drunkenness can lead to a host of bad activities--but these don't refute the underlying message: alcohol is not costing society a massive amount of money. In fact, it looks like the biggest costs come from those who never drank at all and who as a consequence live shorter lives than heavy boozers.

So what effect should this have on law? Well, for one thing, it gives anti-alcohol crusaders less cover for non-moralistic rationales to ban hooch. When the beer tax surfaced last year in Oregon (as it does in every legislative session), one of the principal rationales was that the state had an interest in recouping lost revenue due to alcohol-related health problems--a cluster of costs the state pegged at $5.13 billion a year. But these costs arise from the assumption that drinking alcohol is a social ill that the state needs to spend millions combating and treating. If the state thinks of consumption of alcohol as a health benefit and managing drunkenness as a separate legal matter, the picture changes considerably.

The state has a right to recoup the cost of negative externalities of certain behaviors--smoking, for instance, which causes the state to take on massive health expenses related to lung and heart disease. Economists have created a theory of optimal taxation that compensates the state for the costs of these negative externalities such that the tax would recoup exactly the costs of the behavior. So a cigarette tax would pay for all the health-related consequences of smoking. (For those who don't recognize it, I'm just parroting what I learned from economist Patrick Emerson.)

For generations, we have treated alcohol the same way, assuming there are negative health externalities from drinking. Whether or not alcohol is definitely the cause of better health, these studies pretty clearly show that it isn't a negative. There are other reasons to regulate and control alcohol--underage drinking, drunk driving, and domestic violence spring to mind. But we need to separate those out from the idea that booze is bad for you. It's just not. The state has no right to try to recoup health costs from drinkers. And anti-alcohol crusaders need to acknowledge that their beef liquor has nothing to do with health.