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Dignified Work Requires It To Be Useful

February 15, 2019 in Economics

By Ryan Bourne

Ryan Bourne

Should public policy focus more on the dignity of work? An
increasing number of intellectuals and policy experts think so.

American conservative scholar Oren Cass has written that
“a labour market in which workers can support strong families
and communities is the central determinant of long-term
prosperity”. Rob Halfon, the Conservative MP for Harlow, has
called for the Tories to rebrand as “The Workers’
Party”, championing their National Living Wage and commitment
to workers’ rights.

The Labour Party and Democrats in the US take up the mantle by
pushing for stronger unions, more employment legislation and even
higher statutory wage floors.

Zero-hours contracts and low pay are front-line gripes of Jeremy
Corbyn and John McDonnell.

All these views are underpinned by the correct belief that work
is an important component of human well-being and flourishing.

Yet notice a pattern. Policymakers prioritise enhancing either
dignity at work (working conditions and treatment) or the dignity
that comes from the returns of work (earning income to provide for
your family).

In doing so, they miss something important: that the dignity of
work comes in large part from the activity being genuinely useful
or valuable too.

Being treated with respect and having the means to provide a
decent standard of living are important. But feeling self-worth
also necessitates your endeavours being in demand or thought
socially productive.

That’s one thing that makes so many suggestions for how to
strengthen labour markets misguided.

The American Left is infatuated with the idea of the government
funding well-paid roles for anyone that desires a job in
infrastructure provision, environmental activities or
caregiving.

They call it a “jobs guarantee”. Yet make-work
schemes funded by taxpayers are never going to induce the same
dignity as putting your labour to the service of others’ real
demands. Indeed, the very term “guarantee” grants
rights without obligations.

There is nothing inherently dignified about work that only
exists because of government protectionism or favouritism
either.

Donald Trump and some American conservatives seem obsessed with
preserving certain forms of employment in aspic, not least in heavy
industries, such as steel production, and manufacturing.

But keeping alive inefficient sectors cannot guarantee long-term
dignity. How dignified did the UK miners feel when the Thatcher
government liberalised the energy sector? Economies change over
time and attempts to romanticise these industries are ahistorical:
children of the workers often longed to escape to work in the
newer, safer sectors of the future.

Policies designed to help workers by improving conditions or pay
rates can likewise beget problems.

Higher minimum wages and new labour market regulations can make
it more difficult for certain demographic groups (particularly the
young and unskilled) to find productive employment in the first
place.

Firms also adjust to increases in their …read more

Source: OP-EDS

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Department of Justice’s Shameful Attempt to Block a Proven Life-Saving Program

February 14, 2019 in Economics

By Jeffrey A. Singer

Jeffrey A. Singer

On February 6, prosecutors from the Office of the U.S. Attorney
in Eastern Pennsylvania joined with prosecutors from the US
Department of Justice in Washington, D.C. in an attempt to block a group of privately funded citizens from
establishing the first-in-the-nation Safe Injection Facility in
Philadelphia. Last year Philadelphia city officials gave the OK for the group to establish a
“Safehouse.” Recently Pittsburgh’s Mayor
expressed an interest in allowing the same in his city. In
the last year, leaders of Seattle, Denver, and New York City have
also shown an interest. Yet it is the position of the Department of
Justice, expressed by Deputy Attorney General Rod
Rosenstein last summer, that it violates federal law to permit and
“facilitate” the use of federally banned substances,
and the February 6 lawsuit seeks a preemptive opinion from a
federal judge. This obstruction of a method of harm reduction that
has been shown for decades to save lives and reduce the spread of
disease is shameful and medieval.

Harm reduction strategies begin with the
realistic, nonjudgmental premise that there has never been and will
never be a drug-free society. Akin to my profession’s
credo—“First, do no harm”—harm reduction
seeks to mitigate the harms caused by black market drugs, fueled by
drug prohibition. Instead it aims at reducing the spread of disease
and death from drug use.

“Safe syringe programs,” endorsed by the Centers for Disease Control and
Prevention as well as the American Medical Association, reduce the spread of
HIV, hepatitis C, and other infectious diseases. One form,
needle-exchange, has existed in the U.S since 1988, and has reduced
the spread of HIV by up to 58
percent
. Unfortunately, once they exchange their needles, no
one is around to rescue a user in the event of an overdose. And
users eventually can sell or share the replacement needles and
syringes.

Supervised injection facilities, also called “safe
consumption sites” or “safe injection sites” go a
step further. They ensure needles don’t subsequently get
shared or sold because they are used under supervision and returned
after use. More importantly, staff are close by with the overdose
antidote naloxone at the ready if needed, and nudge users into
rehab programs. The Lancet reported a 35 percent drop in overdoses
resulting from the safe injection site in Vancouver, British
Columbia. About 120 safe consumption sites exist throughout
Europe, Canada, and Australia. Canada’s first facility,
called “Insite,” opened in the Downtown Eastside
district of Vancouver in 2003.

The Canadian Medical Association Journal reported on Vancouver’s experience with
Safe Injection …read more

Source: OP-EDS

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Arbitration Not the Answer to Fix Surprise Medical Billing

February 13, 2019 in Economics

By David A. Hyman, Benedic Ippolito

David A. Hyman and Benedic Ippolito

Surprise medical billing — when patients are unexpectedly
charged exorbitant prices from providers who do not accept the
patient’s insurance — is squarely on the radar of
policymakers inside the beltway. However, a popular proposed
solution is likely to do more harm than good.

Surprise bills from out-of-network providers can be eye-popping.
Whether it is a $109,000 bill for a heart attack patient rushed
to a nearby out-of-network hospital or a urine test that cost $18,000, everyone has
heard a story about surprise medical bills — and most people
wonder why the legal system can’t figure out a way to protect
patients from them.

Forcing hospitals to
solve the problem of surprise medical bills will work – and will
minimize the chances of unintended consequences.

Surprise medical bills are not random. Instead, they reflect
clear strategic (if not outright abusive) behavior by certain types
of providers. Evidence shows thatphysicians who are least likely
to be chosen
by patients, like anesthesiologists and emergency
department (“ED”) doctors, often set their list prices in a way
that maximizes their ability to engage in “balance billing.”
Indeed, some ED staffing companies have deliberately decided to be
out-of-network for all patients that walk through the door —
again maximizing their ability to balance bill — but leave
patients owing massive amounts.

What can we do to fix this problem? Policymakers have a variety
of tools at their disposal, from explicit price capping to more
market-oriented contract reforms. However, mandatory arbitration
seems to be attracting a lot of attention from policymakers,
particularly since it was implemented in New York in 2015. The
arbitrator can consider a wide array of information (including
proposals from both the provider and insurer), and then settle on a
“fair” price.

At first glance, this approach probably sounds appealing.
Arbitration seems like a fairly light touch policy that sets up a
way for stakeholders to adjudicate their issue with minimal
government intervention.

Policymakers should not be fooled. Arbitration is neither “light
touch” nor a solution to the true problem at hand. Instead of
solving the fundamental issue, it kicks the can down the road to an
arbitrator who faces the same challenges of any rate setter.

Common sense suggests that arbitrators are likely to develop
simple rules of thumb to resolve disputes over surprise medical
bills (New York’s law includes a benchmark). Stated differently, arbitration
is just rate-setting in another guise — and the arbitrator
faces the same challenges of any rate setter. Even the most
knowledgeable rate setter would find it difficult to come up …read more

Source: OP-EDS

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Let America’s Radical Socialists Be a Warning to British Politics

February 12, 2019 in Economics

By Ryan Bourne

Ryan Bourne

It is said that when America sneezes, the world catches a
cold.

Let us hope that the American left’s recent publication of
its “Green New Deal” (GND) won’t be contagious
enough to infect Labour here.

Just over a week ago, Jeremy Corbyn had an in-depth phone
conversation with Alexandria Ocasio-Cortez, the rising socialist
congresswoman. The aim, it was said, was to “build a movement
to take on the billionaires, polluters, and migrant
baiters”.

US politics is generally considered to sit to the right of the
UK landscape. But Ocasio-Cortez’s GND makes the 2017 Labour
manifesto look like Thatcherism on steroids.

Labour hasn’t succumbed
to the allure of this model just yet. But the mood is
shifting.

Consider how radical Labour’s proposed policies seemed
just two years’ ago. The party pledged rail, energy and water
sector nationalisation, and to reverse the privatisation of Royal
Mail.

It would have reintroduced or strengthened price controls, with
an energy price cap, a £10 minimum wage by 2020, and private sector
rent regulation. In energy, it would have banned fracking, but
invested in nuclear and supported renewables to hit existing carbon
emissions targets.

Now consider the GND, endorsed — unbelievably — by
declared Democratic presidential candidates Kamala Harris,
Elizabeth Warren and Kirsten Gillibrand. It would put the US on a
national war footing to collectively achieve a net zero emissions
society within one decade.

That requires gargantuan public investment to ensure that power
demand is met 100 per cent by renewables within 10 years. The
domestic transport system would be completely electrified, new
high-speed rail built, flight availability curbed, and research
programmes into sustainability and renewable technology funded.

Not content with this energy transformation to a near
carbon-free utopia, the GND pledges a social transformation too.
Vital in the fight against climate change, apparently, is free
healthcare and higher education, a jobs guarantee for all who want
to work, economic security for those who don’t, family leave,
extra resources for pensioners, and a family living wage.

One could well think of the GND’s emissions-reducing
veneer as a Trojan Horse for a progressive social policy wet
dream.

The document is, for want of a better term, bonkers. But it is
being treated as a serious proposal that must be assessed on its
merits. The branding helps to insulate it from well-deserved
criticism: if you’re opposed to the “Green New
Deal”, then you want to kill the planet.

The truth though is that the GND goes far beyond reasonable
carbon mitigation, completely denying the existence of trade-offs
or the costs of programmes that it recommends.

While Labour’s 2017 election manifesto would be supremely
damaging to the UK economy, at least there was some economic
reasoning in …read more

Source: OP-EDS

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The Humanization of Human Rights

February 12, 2019 in Economics

By Matt Daniels, Doug Bandow

Matt Daniels and Doug Bandow

Not too long ago, no one would have heard of the plight of a
Saudi teenager seeking refuge from family and cultural oppression
in her home country. But the power of social media made Rahaf
Mohammed al Qunun’s struggle into an international news story.

Junta-ruled Thailand is not known for its fidelity to human
rights norms. But international public attention led Immigration Police chief Maj. Gen. Surachate Hakparn
to allow Rahaf Mohammed temporary refuge in Thailand. She is
one of several Saudi women who has turned to
social media to publicize domestic abuse and seek international
aid.

After traveling with her family to Kuwait, al Qunun broke away
and boarded a flight to Thailand. Upon arriving in Bangkok, she was
escorted to a hotel room and told she would be placed on a flight
back to Saudi Arabia the next morning.

Social media is the
window that Saudi Arabian women are increasingly able to open to
reveal to the world the gross injustices that pervade their
society.

But a woman with the courage to flee her family and board a
flight to an unfamiliar country alone for the first time was not to
be deterred so easily. After barricading her hotel room door, she
sent out a series of calls for help over Twitter that caught eyes around the world – she amassed over 66,000
followers within 48 hours. As a result, the Thai authorities did
not force onto the Saudi-bound flight.

Perhaps most notable about this story is the absence of any
appeal to traditional pre-digital channels of human rights redress.
No one contacted the UN Human Rights Council or any other
international agency. Instead, a desperate teenager electronically
recruited an online following large enough to change the power
calculus facing Thai officials, who would otherwise have routinely
acquiesced to Saudi demands.

At the heart of this story is a beautiful synergy: ordinary
human beings working together to advance human
rights
in ways that were impossible in a pre-digital era.

The oppression is real. The Associated Press reports that “Saudi
females who flee their families are almost always running away from
abusive male relatives, often a father or brother… In other cases,
a woman’s father might be barring from her marriage or forcing her
into marriage. In other cases her salary is being confiscated, or
she’s facing sexual or physical abuse.”

Al-Qunun was at even greater risk. She told the BBC that she had renounced Islam, and
feared she would be killed by her family if forced to return.
Renouncing Islam is …read more

Source: OP-EDS

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Poor Results in Overdose Crisis Management Call for a Shift to Harm Reduction

February 12, 2019 in Economics

By Jeffrey A. Singer

Jeffrey A. Singer

A recent report reveals California’s “Death
Certificate Project,” is terrorizing doctors into
under-prescribing or even abruptly terminating medication for acute
and chronic pain patients. The project investigates doctors who
have treated patients identified as overdoses on death certificates
and considers rescinding their licenses or charging them with
homicide.

It is scandalous that we doctors and our patients are the latest
victims of America’s war on drugs, while deaths from
nonmedical use of licit and illicit drugs continue their
exponential and perpetual climb—with no end in sight. It is
time to change the prevailing approach to the crisis. The goal
should shift from reducing production and prescription of
painkillers to reducing death and harm.

Harm reduction strategies begin with the realistic,
nonjudgmental premise that there has never been and will never be a
drug-free society. Akin to my profession’s
credo—“First, do no harm”—harm reduction
seeks to mitigate the harms caused by black market drugs, fueled by
drug prohibition. Instead it aims at reducing the spread of disease
and death from drug use.

It is scandalous that we
doctors and our patients are the latest victims of America’s war on
drugs, while deaths from nonmedical use of licit and illicit drugs
continue their exponential and perpetual climb-with no end in
sight.

The U.S Centers for Disease Control and Prevention recently
released the latest results of the current strategy: opioid-related
overdose deaths in 2017 continued their steady climb, increasing 13
percent over 2016 totals. This happened despite the fact that per
capita high-dose opioid prescriptions fell 58 percent from 2008 to
2017, while the number of all opioids dispensed fell 29 percent
from 2010 to 2017.

The focus on prescription opioids has only served to change the
make-up of the overdose numbers. In 2017, fentanyl or heroin
accounted for 75 percent of opioid-related overdose deaths and,
according to CDC data, 68 percent of deaths from prescription
opioids involved heroin, fentanyl, cocaine, barbiturates,
benzodiazepines, or ethanol. More people take increasingly greater
risks with nonmedical drug use. Some might even be self-medicating
to deal with stress or despair.

But while the prohibition strategy has been unsuccessful, harm
reduction strategies have been used in much of the developed world,
and to a very small degree in the U.S, for over forty years. A deep
dive into the data from decades of experience with harm reduction
shows a range of methods that are successful in reducing overdose
deaths, the spread of infectious diseases, and, in many cases, the
nonmedical use of dangerous drugs.

Medication-assisted treatment is one harm reduction technique in
use since the 1960s. This employs a medical replacement for the
opioid on which a patient has become dependent, allowing …read more

Source: OP-EDS

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Trump Is Chipping Away at Obama’s Remade Federal Courts

February 11, 2019 in Economics

By Walter Olson

Walter Olson

“President Donald Trump and Senate Republicans are remaking the
federal courts in their own image,”
declared NPR’s Nina Totenberg
recently. Others agree: The
administration’s lower-court selections will change America “for
generations.”

Exciting, no? Unless you take the view that it happens with
pretty much every White House. Barack Obama, too, remade the lower
courts with effects that will last for generations. Federal judges
have life tenure and decide big issues. Same with George W. Bush
and Bill Clinton. All came in with a Senate majority and definite
views on judges they wanted to ­appoint.

Yes, judicial appointments are a core accomplishment of Trump’s
presidency. But keep in perspective just how slowly and
incrementally these things change. For the 851 seats in the federal
judiciary overall — which collectively make final decisions
for all but the 70 or so cases the US Supreme Court agrees to hear
— four or even eight years just isn’t enough to chisel final
triumphs or dash recurring hopes.

What Trump did do was stop what would otherwise have been a 12-
or 16-year stretch of straight liberal appointments — a true
generational shift — if a Hillary Clinton presidency had
succeeded Obama’s.

Consider that when Obama took office, 10 of the 13 federal
circuits had majority Republican-appointed judges. By January 2017,
only four circuits had GOP-appointed majorities, while nine were
Democratic-appointed majorities. Quite the shift.

When Trump came in, thanks in part to Senate Majority Leader
Mitch McConnell, there were a lot of vacancies. His 167 nominations
as of Jan. 29, representing about 20 percent of the 851 seats,
exceed those of his three predecessors, who had between 111 and 140
by this point. When it comes to actual confirmations, Trump is
around the middle of the pack with 85, ahead of Obama (62) but
behind Bush (100) and Clinton (128).

Republicans shouldn’t get
their hopes up too high: Even if Trump manages to place far more
judges on the bench than other presidents, the idea that court
rulings will be solidly conservative for “generations to come” is
far from guaranteed.

That’s despite what is advertised as “unprecedented”
norm-busting on both sides, from the downgrading of senatorial
“blue slips” to the use of delay and forcing of cloture votes for
many more nominees than in the past.

For the 179 active court of appeals judgeships, where much of
the action is, the pace of change doesn’t mostly depend on the
White House’s or McConnell’s intentions. Instead, it is set mostly
by the happenstance of which older judges create vacancies by
taking senior status, a choice that’s up to them.

Of the 13 circuits, only one …read more

Source: OP-EDS

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Why Repeal of the Individual Mandate Hasn't (Yet) Brought Obamacare's Death Spiral

February 11, 2019 in Economics

By Michael D. Tanner

Michael D. Tanner

As you file your tax returns this year, you will be asked
whether or not you had health insurance during 2018. If your answer
is “No,” you could be subject to a penalty of up to
$2,085 per family.

Fortunately, this will be the last year that Americans will face
punishment for failing to comply with ObamaCare’s individual
mandate. That’s because President Trump’s 2017 tax
reform effectively ended the mandate, starting next year. In
typical Washington fashion, Congress didn’t exactly repeal
the mandate, instead setting the penalty at zero starting in
2020.

The individual mandate was always the least popular part of
ObamaCare, and with good reason. The idea that government can force
Americans to buy a product is offensive to American liberty. And
the mandate itself leads to a host of problems, such as forcing
Americans into expensive insurance plans with benefits that they
may not want or need.

But repealing the individual mandate while leaving the rest of
ObamaCare intact also demonstrates the incoherence of Republican
efforts to reform health care. That’s because the individual
mandate was part of ObamaCare in the first place primarily as a
mechanism for dealing with problems stemming from a much more
popular aspect of ObamaCare — its ban against denying
coverage for preexisting conditions.

“Preexisting condition” is simply another name for
“people who are already sick.” Insurers will
necessarily lose money by providing benefits to those sick people.
Therefore, they must offset those losses by charging healthy people
higher premiums than they otherwise would.

That’s one reason why average premiums shot up under
ObamaCare. But faced with these excessively high premiums, younger
and healthier Americans may choose to forgo insurance altogether.
That could destabilize insurance markets, causing an “adverse
selection death spiral” of rising premiums and a smaller,
sicker pool of the insured.

ObamaCare’s “solution” was to force the young
and healthy to buy the overpriced insurance, even if they
didn’t want it.

There are other — better — ways to help people with
preexisting conditions, but Republicans, wilting in the face of
Democratic attack ads, wanted no part of that debate. Thus, they
repealed the unpopular mandate but kept the popular
preexisting-condition provisions. You don’t have to be a
health care expert to see the incoherence of this approach.

Even before the mandate formally expires, young and healthy
Americans have begun to abandon the costly ObamaCare plans they
never wanted. The number of people signing up for ObamaCare plans
on state exchanges has declined nearly 12 percent since 2017,
though some of that may be because the economic recovery has
shifted some people to employer coverage.

New York is an exception. Enrollment on New York’s
exchange is up 10 percent, …read more

Source: OP-EDS

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Alexandria Ocasio-Cortez's Green New Deal Is a Radical Front for Nationalizing Our Economy

February 11, 2019 in Economics

By Ryan Bourne

Ryan Bourne

Details of Rep. Alexandria Ocasio-Cortez’s long-awaited
Green New Deal have dropped. On Thursday,
alongside Sen. Ed Markey of Massachusetts, she published a
resolution and Q&A document that laid out the aims and tools
intended to transform the United States into a zero net emissions
economy.

At least, that’s how it was sold.

Delve into the text, and the climate
change-curbing veneer amounts to a Trojan horse for a bigger
nationalization of the economy than seen under President Franklin
D. Roosevelt. The sponsors themselves say their goal is the
massive transformationof our society” in a
progressive image, rather than simply stopping global warming.

Alexandria
Ocasio-Cortez’s Green New Deal is the biggest single government
expansion since the 1930s, masquerading as climate
policy.

How else can one explain policies that include a federal jobs
guarantee, economic security for those unable to work, provision of
housing, free health care, higher education for all and a family
living wage? Besides the plan’s calls for electrifying the whole
transport system and undertaking a crippling federal financing of
renewable energy over 10 years, it reads like a wish list for
socializing the economy.

It is hard to make a good faith critique of this plan, because
it features a nearly complete denial of trade-offs or costs. This
is surprising given that Ocasio-Cortez herself has a
degree in economics, for which the study of
trade-offs is the basis.

Take the environmental policy proposals, for example.
Most Americans believe that climate change is
happening, is influenced by human activity and has social costs.
The idea that private action alone cannot overcome this, and
governments must act, is a reasonable view.

The cost of going ‘green’

But even in some parallel universe where it was possible to
implement an agenda that would replace the whole country’s energy
supply with government-financed renewables, refurbish every
building to improve energy efficiency, eliminate gas burning cars,
build extensive high-speed rail and cut the number of flights and
cows to near zero, the cost would be astronomical.

Previous estimates from Stanford engineers of meeting power
demand through clean, renewable zero-emission energy sources put
capital costs at $14.6 trillion (almost three-quarters of
current annual GDP). The running costs, coupled with all the
other environmental programs, would therefore take up a huge chunk
of economic resources, effectively cutting vast private sector
activity.

That’s why the resolution seeks to mobilize society as in World
War II, which Ocasio-Cortez claims is the appropriate analogy.If the nation
can be convinced the overwhelming social goal is countering the
existential threat of climate change at all costs, then people
would …read more

Source: OP-EDS

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Yes, Marijuana Legalization Is Working

February 10, 2019 in Economics

By Jeffrey Miron

Jeffrey Miron

In recent decades, U.S. marijuana laws have liberalized
substantially. Recreational marijuana use is now
legal
in 10 states and the District of Columbia, and many more
states have legalized marijuana for medical use. In response,
legalization opponents have
claimed
that marijuana use increases crime, violence and
schizophrenia.

So is marijuana legalization good policy? Yes.

Recent
research
casts doubt on alarmist claims about the effects of
recent state-level marijuana legalization. By looking at the pre-
and post-legalization trends in outcomes such as marijuana use,
other drug or alcohol use, marijuana prices, crime and traffic
accidents, it becomes clear that state-level marijuana legalization
has been associated with, at most, modest changes in these
outcomes. The absence of significant adverse consequences is
especially striking given the dire predictions made by some
legalization opponents.

The absence of
significant adverse consequences is especially striking given the
dire predictions made by some legalization opponents.

In addition, economic logic suggests that drug prohibition,
whether for marijuana or any other drug, is misguided. Drug use
entails risk for some users, and use sometimes harms innocent third
parties. But the adverse effects of prohibition are far worse.

Little
evidence
suggests that prohibition reduces drug use. Instead,
prohibition breeds black markets and pushes consumers into illicit
drug use, which is far more dangerous than legal consumption. Drug
quality control is
poor
in underground markets because reliable suppliers cannot
legally advertise their goods and consumers cannot sue for damages
due to faulty or mislabeled products. Drugs obtained from
underground markets do not come with warning labels, and users
cannot discuss safe use with their physicians, making them more
likely to combine drugs with alcohol or other medications that
suppress respiration.

Legalization opponents claim that drugs increase violent or
criminal tendencies, but any association between drugs and violence
arises mainly from prohibition’s impact on drug markets. Throughout
the 20th century, major fluctuations in the U.S. homicide rate have
been positively
associated
with fluctuations in the enforcement of drug and
alcohol prohibition. Prohibition raises drug prices, which
motivates some consumers to commit crimes to fund their drug
use.

Under prohibition, drug-related disputes between users and
suppliers, such as those over faulty or mislabeled products, are
more likely to be settled with violence since they cannot be tried
in court. Prohibition also
decreases
the marginal cost of committing a crime; a marijuana
supplier who already evades the law has little incentive to obey
the law in other instances. The Mexican drug war has also been

linked
to increases in homicide as captures of kingpins
motivate rival gangs to exploit weakened …read more

Source: OP-EDS