Speaking Of Bad Choices

One of my sons lives in Amsterdam, so when I come across a headline featuring that city, I generally take more than a cursory interest in the report that follows–especially when that report confirms my own impressions.

And especially when the implications confirm my policy conclusions.

A recent article by Jennifer Rubin in The Washington Post hit both of those targets. Rubin began by recounting how, on a recent visit to Amsterdam, she’d walked back to her hotel late on a weeknight. It was a pleasant evening, and a relatively long walk, yet she never felt nervous or unsafe. She acknowledged that there are many New York neighborhoods in which she also feel safe, but unlike her Amsterdam experience, her feeling of security there was largely “because police are everywhere. Visible on the street, in cars, on horseback.”

The experience led her to consider the very different approaches to crime chosen by policymakers in the Netherlands and the U.S.–beginning with gun ownership.

In the Netherlands, there are roughly 2.6 guns for every 100 people; there are more than 120 guns per 100 people in the United States. In the Netherlands, it is very, very hard to get a gun; in the United States, it is ridiculously easy to get guns. In fact, according to a report by Mariel Alper and Lauren G. Beatty in the Bureau of Justice Statistics, roughly “21% of state and 20% of federal prisoners said they possessed a gun during their offense. … About 29% of state and 36% of federal prisoners serving time for a violent offense possessed a gun during the offense.

In the Netherlands there are about 27 gun homicides a year. Not 27 per 100,000. Total. In the United States, the Pew Research Center reports, 48,830 people died from gun-related injuries in 2021. (The U.S. population is about 20 times that of the Netherlands; U.S. gun homicides are more than 1,777 times the number in the Netherlands.)

The differences go well beyond gun policy; Rubin reports that the Dutch don’t incarcerate people for drug addiction, for example, a decision that has allowed them to lock up far fewer people. She cites a report from the Guardian,

“Since 2014, 23 prisons have been shut, turning into temporary asylum centres, housing and hotels. … The number of prison sentences imposed fell from 42,000 in 2008 to 31,000 in 2018 — along with a two-thirds drop in jail terms for young offenders. Registered crimes plummeted by 40% in the same period, to 785,000 in 2018.”

By contrast, a report from the Prison Policy Initiative found that in the United States, “Drug offenses still account for the incarceration of over 350,000 people, and drug convictions remain a defining feature of the federal prison system…. As a result, “Drug arrests continue to give residents of over-policed communities criminal records, hurting their employment prospects and increasing the likelihood of longer sentences for any future offenses.” In short, the United States has 163 times the number of incarcerated people as the Netherlands, more than eight times as many per 100,000 people.

And–just as with our other policy choices (health care comes immediately to mind) our choices have been and continue to be expensive. The United States spends some $300 billion annually on policing and incarceration. And as Rubin points out, that’s just the tip of the iceberg. Overpolicing and over-incarceration costs include lost earnings, adverse health effects, and damage to the families of the incarcerated. Those social costs are estimated to be three times the direct costs.

And none of those fiscal consequences include the ongoing, negative social effects of disproportionate policing of Black and White citizens…

The public safety choices we’ve made might be defensible, if the result was to make Americans safer than the Dutch. But–you knew this was coming, didn’t you?–that clearly isn’t the case. As Rubin says, “Our choices have not made us safer and have cost us dearly.”

In real terms, the U.S. criminal justice system and ubiquitous guns require an industry — ambulances, emergency room personnel, police, courts, judges, prisons, lawyers, private security and more — that the Dutch system does not. As I walked down the streets of Amsterdam, I imagined what we could have bought with the money we spend on the criminal justice system: universal college education, universal medical care, a strong social safety net.

Bottom line: American policy choices feed a “criminal justice industry”–without doing much to eliminate crime. As Rubin writes, different criminal justice policies “very likely could allow us to spend less money, lower incarceration rates, reduce the human and opportunity costs, and increase personal safety.” She says we have the system we do because we’ve “fetishized guns, criminalized addiction, neglected mental and emotional health, and resisted addressing social factors driving crime.”

We could make better choices–but that would require a clear-eyed look at the consequences of the choices we’ve made.


The Drug Culture

Since Mitt Romney’s visit to Israel, there has been a renewed focus by the chattering classes on the role of “culture” in creating social norms. (Romney attributed the fact that Israel’s economy is more robust than that of the Palestinians to a superior “culture.” It caused quite a stir.)

Culture certainly plays a significant role in all societies, albeit not in the linear and highly simplified fashion Romney implied.  Often, being immersed in the culture as we are, we miss the connections.

I thought about the unappreciated ways in which we reinforce cultural cues yesterday morning, while I was dutifully doing my time on the treadmill. The television was in real-time (no TIVO at the gym!) and one commercial after another implored me to talk to my doctor about [insert name of drug here]. The purple pill, the pill for COPD and the cure for a raft of other initials and acronyms for ailments I don’t have.

There are a lot of appropriate reactions to the onslaught of medical ads with which we are all inundated daily. One of my pet peeves is the amount of money being spent by pharmaceutical companies at the same time they defend charging big bucks for medicines by citing research and development costs. The last numbers I saw suggested that the 5+ billion dollars annually being spent on advertising to consumers actually exceeds those R and D outlays.

But yesterday, it suddenly hit me that the message being conveyed–intentionally or not–isn’t the relatively innocuous (if expensive) “buy my aspirin” but “have a problem? Take a pill.” Thinning hair, low “T”, anxiety, trouble sleeping, gas….you name it, there’s a pill for it. An easy fix for whatever ails you.

These messages overwhelm the other ads, the ones imploring parents to talk to their children about the evils of drugs. How believable are those solemn discussions, when teenagers see their parents and grandparents being medicated and over-medicated? How are they supposed to respect the (highly artificial) line between the “good” pills (legal) and the “bad” drugs (illegal). I did a fair amount of research on drug policy a few years ago, and was astonished to discover that nowhere in the convoluted labyrinth that is drug prohibition is there a definition of what constitutes “abuse,” or an objective distinction between use and abuse, or a bright line between narcotics that are illegal and those that are routinely prescribed.

Here is an experiment anyone can do: turn on your television for an hour, and count the number of commercials for drugs. Watch how those ads portray people before and after they take the product being peddled.

In Huxley’s Brave New World, people were constantly being urged to stop worrying and take a drug called soma. ““You do look glum! What you need is a gramme of soma.” Soma was described as having “All the advantages of Christianity and alcohol; none of their defects.” 

Sounds eerily familiar…..