HEALTH CARE/Joan Retsinas

Costing out the Freedom to be Stupid

We have all done something stupid – or imprudent, to use a kinder adjective. Bicycling without a helmet, driving after too much wine, forgetting the condom, swimming beyond the lifeguard’s vision, hiking off the mountain path. The list goes on. Part of being human is being rash. While computers always act rationally, we humans are innately unpredictable; indeed, sometimes we find joy in those irrational moments of stupidity.

Yet the freedom to be stupid is not an inalienable right. We may accept the consequences to ourselves of our inanity, but the calculus shifts when we harm others. And when people get behind the wheel of a car, the cost of stupidity soars.

So most states have tried to restrict drivers’ freedom to be stupid.

The easiest, and least effective, recourse is nagging. Most states, via health departments and highway councils, have urged “safe driving;” but as nagging parents recognize, many drivers ignore all those admonitions with impunity.

Not surprisingly, states that back up their admonitions with penalties have fared best at squelching stupidity – and, in turn, cutting the incidence of highway injuries and deaths.

Here are some legislative actions that work.

Primary seat belt laws. We know that seat belts save lives. We also know that not everybody buckles up. In thirty-two states, the police can stop, and charge, a driver for not buckling up; those are “primary laws.” Eighteen states have “secondary” laws: police can charge a driver with “not buckling up” only if the police have stopped the driver for another reason, like speeding, or driving erratically. No surprise: in states that have switched from “secondary” to “primary” laws, fatalities fell.

Children benefit from seat belts; indeed, booster seats can anchor a child who, in an accident, becomes a living (and subsequently dying) projectile. Thirty-three states require them.

Drunk drivers are generally a repeat menace, since taking away a license rarely works. Ignition controls, attached to the car, can keep drunk drivers off the roads. A driver breathes into a tube. If the driver has been drinking, the car won’t stop. (Admittedly, a driver can ask a friendly substitute “breather” to start the car, but the friend will surely be liable.) Only 16 states make ignition controls mandatory for repeat offenders.

Motorcycle helmets take some of the thrill out of riding – no wind ruffling through your hair. The helmets also take away some of the danger. Nineteen states require them.

Ditto for bicycle helmets. No wind-ruffling-through-your-hair. But they offer some protection in case of accidents. Twenty-one states require them.

States are just now regulating texters, the “distracted drivers” who stare at their social messages while careening into cars, buses, pedestrians.

The result of this Big Brother intrusiveness: fewer injuries, fewer deaths, fewer hospital, rehab and long-term care bills.

The Trust for America’s Health and the Robert Wood Johnson Foundation have assessed states by injury-related deaths (www.healthyamericans.org). The national average is 57.9. (The average includes some non-highway-related deaths). New Mexico has the highest rate, at 97.; New Jersey, the lowest, at 36.1. The South, the most conservative part of the country, emerges as especially road-lethal. There Big Brother leaves drivers alone, free to drive unfettered by rules.

I wonder how many people who have driven unfettered, and suffered, will argue for that freedom. Often when the government-haters rail against a restriction, they produce a few citizens to argue against the intrusion, even though they are arguing against their own self-interest. A few people with no health insurance, and huge medical debt, will argue against Obamacare. A few people with chronic illnesses will argue against stem-cell experimentation.

Yet I haven’t seen a mother whose son died in a motorcycle accident argue against helmet laws. Or a parent whose unstrapped child ended up in a long-term care hospital argue against primary seat belt laws. And consider people who drove after too many drinks. Wouldn’t the ones who ended up killing a family have welcomed a gizmo that stopped them from turning the ignition?

States that don’t enact these smart measures to save lives are stupid.

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.

From The Progressive Populist, August 15, 2012