More on marijuana

Two weeks ago, I put down some thoughts about the philosophical foundation underlying marijuana use and how that "limbo" has extended beyond philosophy to the legal and regulatory sphere.  The Colorado legislature continues to debate new approaches to handle the medical marijuana industry in this state, an industry formed by voter initiative in 2000.  In the meantime, the debate over the place marijuana should ultimately hold in society continues as well.  Here's a piece from Post writer Ed Quillen.

Livability vs. Cost Effectiveness

Administration officials said they were reversing guidelines put in place by the Bush administration that called for evaluating new transit projects largely by how much they cost and how much travel time they would save. . . .

Mr. LaHood said the administration would establish new guidelines that take what he called “livability” into account — evaluating projects not only by how much they shorten commutes but also by their environmental, community and economic benefits.

 

- Administration Loosens Purse Strings for Transit Projects, NY Times, 01/13/2010

Realizing, as its predecessors apparently did not, that alternative transportation is not simply about saving time and money, the Obama administration is altering the criteria by which transit projects will be scrutinized for federal funding.  Rather than a cost effectiveness model, the new guidelines hone in on environmental impacts as well as community benefits and economic development associated with the transit lines.  As posted on the Secretary of Transportation's blog, the DOT is moving away from the "narrow" performance criteria and moving to a set of six broader performance requirements that reflect "key livability factors" - "economic development, mobility improvement, environmental benefits, operating efficiencies, cost effectiveness and land use."  While cost certainly remains a consideration, it, rightly so, is not the only factor by which projects are judged.

 

I will admit that this new system could make individual projects more difficult to judge and could further open fund awards to back-room negotiations and political favors.  The key will be how clearly and thoughtfully the DOT can define some basis of metrics for evaluating the performance criteria that could become more ethereal than concrete.  But in any case, this is a step in the right direction, I believe.  In a land of freedom, liberty, and opportunity, one area where many citizens have no choice is transportation.  Hopefully this policy shift will become and remain an effective tool for providing that choice to more of America's people.

Official DOT Press Release

A report from Houston about how the new guidelines are affecting existing rail plans.

Consitutional Issues in Health Care Reform

For those of you who read here regularly, you know that I am unabashedly in favor of some manner of health care reform.  And I think a lot of folks would agree that, even if they are happy with their personal health care coverage, the system itself needs reform in order to ensure more Americans receive even a portion of that care. 

I am also not afraid to say that the resulting bill is turning into a big hot mess.  Questionable negotiation tactics - such as the "Cornhusker Kickback" that supposedly won Sen. Nelson's vote - and closed-door meetings have a lot of folks questioning the final product that will emerge from the Capitol.

Beyond questions of ethics and policy, the bill may have a greater hurdle to hurdle - namely the U.S. Constitution, as the two linked articles below discuss.

Mike Coffman: Health care bill an affront to Constitution (Denver Post)

George F. Will: That rock in the health care road? It's called the Constitution (Washington Post)

Reports and Analysis of American Needle v. NFL

While I have not been closely following the NFL antitrust saga, I have been checking in from time-to -time.  Mostly I am interested in the outcome of this case because I am leery of the NFL's growing ego.  The NFL is currently the most successful sports league in the United States and possibly the world.  And the league knows as much.  When power is money and money is power and an entity has plenty of both, I become a little concern about how power is wielded.

Anyhow, oral arguments in the case of American Needle v. NFL were heard by the Supreme Court justices yesterday (January 13th).  Basically, the NFL would like the Supreme Court to rule that it  and its thirty-two distinct members function as a single entity for business purposes.  Such a ruling would remove the NFL's activities beyond the reaches of US antitrust law and the Sherman Act.  It seems as though the justices are resisting such an overarching ruling.  Without muddling things up with more of my own analysis, I thought I would share some reports of the action.

ESPN: Justices seem skeptical of arguments

SCOTUSblog: A playoff, or sorts, in store of NFL?

Drew Brees, quarterback for the New Orleans Saints, published this piece in the Washington Post.  Though, I have little doubt the NFL Players Association lawyers had a hand in this one. 

Finally, perhaps my favorite analysis thus.  Clear.  Concise.  From deadspin.com. 

Is it medical, or is it not?

A proposed ordinance in Denver would impose licensing fees on medical marijuana dispensaries that are, according to the bill's sponsor, "based on those paid by adult cabarets."  ($3,000 per year, if you were wondering . . . .)  That's the word from a Denver Post editorial.  That provision says quite  a bit about the attitude of some lawmakers toward medical marijuana.  Rather than a legitimate medical option, they obviously view it as a vice on which governments can capitalize.  Alcohol, tobacco, and medical marijuana.

What word is out of place there?  Oh, right, medical.  Marijuana, in Colorado at least, is in a philosophical limbo.  As a result, it also finds itself in a legal and regulatory limbo.  No one is quite sure what to do with it.  Here's a solution - pick a story and stick with it.

One option is to recognize a legitimate medical use for marijuana.  In that case, its distribution and use ought to be regulated like any other pharmaceutical, period.  Whether Walgreens, Target, and Walmart want to offer medical marijuana in their pharmacies will be up to those companies.  Any other dispensing operation should be regulated like other pharmacies.

The other option is legitimize marijuana use.  That's how governments deal with other intoxicants.  And they generate quite a bit of revenue through special taxes, licenses, and fees.  This approach has a lot of benefits.  Off the top of my head, I can think of three.  One - it eliminates (or at least reduces the need for) a huge illegitimate market and source of crime in this country.  Two - governments can control the quality and quantity of the product in the open market.  Three - As I said, it could help to fill the huge revenue gap that many cities, counties, and states are facing due to the current economic crisis.

A third option is obviously to eliminate legitimate uses of marijuana - i.e., discontinue medical marijuana use.  For a lot of reasons, though, I do not believe this is a workable solution any longer.  As one Denver city councilman said, that would just force patients "back into parks and back alleys" and further exacerbate the crime problems already associated with medical marijuana.  Not to mention depriving patients who actually rely on the various reliefs brought by medical marijuana of a legitimate source of those benefits. 

The key to deciding a real solution for marijuana will be deciding where it fits in society.  Right now, mixed signals abound.  This nebulous legitimacy that surrounds marijuana needs to be more settled.  Not unyielding and stubborn, but more settled.  Is it legit or not?  The answer to that will determine where marijuana policy, law, and regulation goes in the future.

Here are recent Denver Post stories about the medical marijuana issue in Colorado.

Carroll: Dispensaries may work after all

A plan for medical marijuana

New medical-pot bill to restrict providers

Thinking out loud about who really drives policy

I have been thinking quite a bit lately about who drives practical policy decisions in this country.  I am not talking about health care reform or climate change legislation or any other hare-brained scheme that may or may not actually emerge from Washington, D.C., at any point in my lifetime.  Rather, I am referring to actions and reactions, how those become ingrained in our lives, and the unwitting consequences that flow therefrom.  Two illustrations will help.

(1) The first is a story that ran in the Denver Post and later garnered national headlines about a health insurance provider who refused to cover an infant because of its weight.  The child measured in the 99th percentile for weight, and the parents' insurer rejected coverage based on a preexisting condition of obesity.  Eventually - no doubt after its ridiculous policy made national headlines - the insurer reversed course and extended coverage to the baby.  But permit me to muse for a few moments about some of the messages that could be drawn from this story. 

First of all, while obesity is definitely a health concern among adults and children, I find it absolutely absurd that an insurer would even have a policy with weight-based preexisting conditions for infants.  Having a small child of my own, and having more than handful of friends with children in close proximity, infancy is probably the only time in life in which a hefty waistline is not considered a medical problem.  Spare me the 265-pound infant tabloid headlines.  I am attempting to be serious here.  What mother is going to complain about her infant maintaining a healthy weight?  None that I know.  In infants, weight gain and maintenance is indicative of so many aspects of good health.  Why on earth would an insurer punish a child for being healthy?

Secondly, the baby in question was exclusively breastfed at the time he was denied health coverage.  This, no doubt, contributed to the weight "problem."  The great irony here is that, despite any drawbacks from his weight (if there were any), this baby is probably ten times as healthy as children of the same age who are exclusively formula-fed, even if those other infants fit more nicely into the insurer's percentile charts.  Infants who are exclusively formula-fed miss out on a host of health benefits from mother's milk early in life, not the least of which is antibody and immune boosters from the mother.  That's right, there's a good chance the obese baby will have fewer sick-child visits at the pediatrician's office.  That's right, insurance company, the baby you initially rejected will probably  cost you less money over time than the 50th percentile babies you take without a glance.

As I said, the insurer in this case eventually reneged and covered the infant, but the cynic in me wonders if that would have happened without the negative publicity.  In that vein, think about the messages that an average person could draw from the insurer's policy.  Do I need to deny my child food to keep their weight within acceptable limits?  Do I need to change what I feed them, even if that means taking away the most nutritive option, to keep them within an insurer's policy? 

Even if the insurer's policy was based on sound criteria - a big if - do we want insurance company policy determining what infants are fed?  I said - but did not promise - that I would avoid opening the can of health care reform worms, but the relevant question today is "Who is driving policy?"  In the medical field, it seems clear that insurers have at least as heavy a hand as care providers, if not more so.  Without the insurance, there may be no access to the care provider.  To pare down the message: money drives policy.  And that is unfortunate.  Opponents of government-sponsored health plans cry that a bureaucratic health care system would remove the human element from medical decisions.  Frankly, I do not see how the two would be all that different.

(2) Enough ranting about health care, and on to the second illustration.  An editorial ran in the New Year's Eve edition of the Denver Post relating airline baggage fees to terrorism.  Simple comparison, right?  If not terrorism, baggage fees must at least be some kind of crime.  In all seriousness, though, the editorial opined that the increase in checked-bag fees has, obviously, led to more travelers carrying more luggage onto flights.  In turn, this means more items for TSA officers to inspect at security checkpoints.  (If any of my loyal readers post a comment stating that they are just willing to wait longer in security lines,  I will know that those readers do not fly that often.)  The point of the editorial was that both of these consequences of the checked-bag fees - more luggage in the cabin of the plane plus less time for security officers to spend on each piece of luggage or individual - expose flights to a greater risk of criminal or terrorist activity.  When two and two are put together in one sentence, that seems like a commonsense proposition.

The Post editors urged airlines to reconsider their policies in light of the Christmas Day terrorist attempt.  But somehow I have a feeling that the $740 million in bag fees collected in the third quarter of 2009 alone will speak just as loudly.  (That stat is from the L.A. Times, via the Post editorial.)  Look, I know that airlines and the air travel industry have suffered mightily since 9/11.  And I know that they have to put measures in place to ensure they can still provide some services.  But at what cost to the rest of us?  When a bottom line drives policy, those with no stake in that line often shoulder the consequences.  In this case, it appears travelers are left with the options of longer security waits and more invasive screening procedures or further heightened fear.

I do realize what I am advocating by arguing against policies like those illustrated in the two instances above.  Do I absolutely and universally favor a heavy government hand in all aspects of life?  No.  But if the alternatives are limited, I may have no choice at all.  The Post editorial summarized the incongruity succinctly and poignantly: "It would be a shame for the industry to be regulated into doing what is best for all concerned, but it very well may come to that."

In my absence . . .

Please enjoy a friendly bump for the "That's What She Said" blog, an effort from the employment lawyers at Ford & Harrison.  The writers here attempt to place a monetary value on the incidents from The Office (American version) that could lead to employment suits.  If you've seen The Office, and I imagine many of you have, you know they have plenty of fresh material with each new episode.  Enjoy.

Also, I have posted feeds to blogs that I enjoy.  You can see their latest updates somewhere along the menu on the left-hand side of the page.  Check them out. 

Thanks to some thoughtful and astute gift-givers . . .

. . . for a topically relevant Christmas present - Bicycle Diaries!  I'm only a few pages in, but I can already tell that Byrne has a unique perspective on urban sociology and city planning, all generated through his bike commuting in cities across the globe.

See previous posts "Cities for Cycling" and its follow-up.