An Assault Weapons Ban Is An Assault on the Notion of "Common-Sense Gun Policy"

Mass shootings have been making their way into the news cycle once more. There were two mass shootings of note that took place in May. One was in a supermarket in Buffalo, New York that killed ten people and injured three others with a semiautomatic rifle. The other was at an elementary school in Uvalde, Texas. This school shooting was the deadliest in about a decade, which took the lives of 21 individuals with 18 additional injuries. Mass shootings, especially ones that take place at school, are emotionally jarring events. These shootings were so disturbing that some Republicans are treading lightly. Texas Lieutenant Governor Dan Patrick and Congressman Dan Crenshaw (R-TX) cancelled their appearances at the National Rifle Association (NRA) Convention. Congressman Adam Kinzinger (R-IL) responded to the shootings by saying that he is open to an assault weapons ban. I would like to spend today focused on that policy proposal.  

First, what is an assault weapon? The definition of an assault weapon can vary from jurisdiction, but the most common one is a semi-automatic firearm with a detachable magazine. An assault weapon could also include such features as a vertical forward grip, barrel shroud, and a flash suppressor. The premise behind banning what the American Academy of Pediatrics calls "dangerous, military-style guns" is to prevent would-be killers from maximizing their kill count in the shortest amount of time. Plus, the combat-style features allow for shooters to have better control of the weapon while discharging large amounts of ammunition. This sounds like a fine example of what gun control advocates like to refer to as "common-sense gun policy." However, upon closer examination, an assault weapons ban is anything but. 

Yes, mass shootings strike quite the chord. The amount of senseless violence in a civilian setting outside of a war zone is unnerving. It is equally true that mass shootings are statistically rare in the United States, in spite of what you see on the news. I have made this point multiple times in my blogging, most recently in 2018. I pointed out that from 1999 to 2013, mass shootings never exceeded 300 victims per annum. Pew Research looked at 2020 data, which included 19,384 gun homicides in 2020. Pew said it mattered on the definition of "mass shooting" used. The FBI's definition had it at 38 homicides (0.2 percent), whereas the Gun Violence Archive had it at 513 deaths (or 2.6 percent of all gun homicides). Pew Research admits that "regardless of the definition used, fatalities in mass shooting incidents in the U.S. account for a small fraction of gun murders that occur nationwide each year." 

Furthermore, gun homicides do not account for a majority of gun deaths; gun suicides do. In 2019, gun suicides were 60 percent of gun deaths (UC-Davis). In 2020, it was 54 percent (Pew Research), which means that mass shootings account for less than one percent of gun deaths in the U.S. As perturbing as mass shootings are, we should not make major shifts on policy that are based on statistically rare events. 

Another issue is that an assault weapons ban is poorly targeted policy. Mass shootings constitute a small fraction of overall gun homicides. Even if you wanted to focus on this small subset of gun homicides, an assault weapons ban is not the best way to go about it. Why? Because a majority of mass shootings have historically not been carried out using rifles. The Department of Justice's National Institute of Justice conducted research on mass shootings from 1969 to 2019. One of the findings was that 77.2 percent of mass shootings were committed with handguns, whereas 25.1 percent of mass shootings were committed with rifles. In overall gun homicides, the figure is even smaller. In 2019, rifles were used in six percent of gun-related homicides (or 394 homicides), according to FBI data. Consider that there are 20 million AR-15 rifles in the United States, which means that in a given year, over 99.999 percent of rifles are not used to murder anyone. 

Another reason that assault weapons bans are not effective is because what constitutes as an assault weapons is based on such cosmetics as pistol-grip design or folding stock. In other words, certain "assault weapons" are banned because the gun looks scary. When people bring up such a weapon as the AR-15 rifle, it's not about caliber, muzzle velocity, rate of fire, or anything else having to do with the lethality of the weapon. Once you get past the looks of an AR-15 rifle, it is functionally more similar to a handgun than it is an automatic, military-grade rifle. Plus, as an article from the Left-leaning Vox points out, an AR-15 rifle has multiple legitimate uses, including hunting, target shoot, and home defense. I covered the topic of defensive gun usage last November, but I will add that assault weapons are especially helpful in self-defense of marginalized groups, senior citizens, and the physically disadvantaged. 

None of this covers the fact that during the Clinton Administration, Congress enacted a Federal Assault Weapons Ban. This Ban was in effect from 1994 to 2003. A subsequent study from the U.S. Department of Justice did not find any evidence that the ban worked (Koper, 2004). The study's main takeaway? "Should it be renewed, the ban's effects on gun violence are likely to be small at best and perhaps too small for reliable measurement." The effects were so minimal that "we cannot clearly credit the ban with any of the nation's drop in gun violence." This net neutral effect on gun homicide rates might have something to do with the substitution effect, i.e., offenders ended up buying guns that were not covered by the assault weapons ban. This is not the only research showing a lack of evidence for assault weapons bans:

• The Journal of General Internal Medicine looked at state-level gun policy, which included assault weapons bans. The study concluded that there was no correlation between state-level assault weapons bans and homicide rates (Siegel et al., 2019). 
• Research from Applied Economics Letters found that "assault weapon bans did not significantly affect murder rates at the state level" (Gius, 2013).
• A report from the Journal of the American Medical Association, or JAMA, similarly concluded that assault weapons bans are not associated with changes in firearm homicide rates (Lee et al., 2017). 
• A 2020 analysis from the renowned RAND Corporation found the evidence of assault weapons bans on mass shootings (as opposed to gun homicides generally) to be inconclusive. 
• Another study from RAND (this one from 2018) concluded that there are no qualifying studies that bans on the sales of assault weapons decreased any of the eight outcomes that RAND studied, including the impact on violent crime. 

Conclusion

Assault weapons bans miss the mark on multiple levels. These bans are enacted to try to prevent a statistically rare occurrence. The bans are poorly targeted not only because they focus on the cosmetic appearances of the guns over functionality. Most mass shootings and gun homicides generally are not committed with semi-automatic rifles, which means such a policy would not cover the majority of gun homicides. Most importantly, assault weapons have been tried on the federal and state levels in the United States. In spite of such laws in place, they have shown to be ineffective in lowering homicide rates. Instead of having emotional knee-jerk reactions, we should ask ourselves what works best. Much like we have seen with the bump stock ban, a high-capacity magazine ban, or a gun buyback program, assault weapon bans are another example of good-intentioned gun policy that are a far cry from being a silver bullet. We should strive for better instead of clinging to policies that do not work. 

Lockdown Advocates Were Wrong to Mock Sweden's COVID Policy Strategy

When the pandemic began, multiple countries reacted in panic with lockdowns, school closures, mask mandates, and travel bans. There was one country that tried a light-touch, more laissez-faire approach: Sweden. Sweden had mask recommendations starting in June 2020, but never a mandate. Sweden never locked down or imposed curfews, although there were bans on crowds over five-hundred people, and later fifty people. Restaurants and bars in Sweden had more restrictions, but businesses by and large stayed open. There were moments where secondary schools went to remote learning, but primary schools and preschools stayed open. Sweden did not have a complete travel ban, but did ban those outside of the European Union, a policy that has since been rescinded. 

It is not as if Sweden did nothing to slow the spread. Sweden still had COVID-related restrictions in place, but that did not stop Sweden from getting walloped with criticism. Fortune called Sweden a failure. The New York Times referred to Sweden as "the world's cautionary tale." Foreign Policy thought Sweden's approach was botched. The Guardian believed it was a catastrophe. The fear ramped up to the point where being strict, regardless of outcome, was optimal. Anything else was seen as selfish, careless, and bordering on sociopathic. It turns out that the lockdown advocates were wrong to mock Sweden. Here are five reasons as to why:

1. Sweden's economy held up without lockdowns. There were those who thought that there was no tradeoff between lockdowns and the economy. Some prominent economists thought that we needed more aggressive lockdowns at the beginning because earlier control of the virus would have meant a smoother return to a pre-pandemic level of economic productivity. If short-term pain in the form of lockdowns were the solution, Sweden's economy should have performed terribly since they never had a lockdown. However, that was not the case. The Economist ranked 23 wealthy countries on their economic performance during the pandemic using multiple factors, including GDP, household per income, share prices, investment, and public debt to GDP. Sweden ended up ranking third on this list. Sweden's performance helped to disprove the hypothesis that the lockdowns were needed for longer-term economic performance. 

2. Number of total COVID deaths in Sweden have been way fewer than predicted. The Imperial College model, which was the model that scared the United Kingdom into locking down in 2020, predicted that in early 2020, as many as 40 million people would die if we did not take drastic measures (e.g., lockdowns). The Imperial College model inspired a similar study in Sweden (Gardner et al., 2020). This study's modeling predicted that without lockdowns, Sweden would have experienced a median 96,000 COVID deaths by the end of July 2020. That sounds scary, doesn't it? That would have been terrible for Sweden. Where did Sweden actually end up by the end of July 2020? According to the Swedish Health Minister's data from Folkhälsomyndigheten, at 5,723 deaths. The scary modeling exaggerated the threat by a factor of almost seventeen. This is May 2022. Where is Sweden at now? As of May 22, 2022, Sweden has had 18,941 COVID deaths, which is still about a fifth of the deaths that the scary modeling predicted. 

3. Sweden's COVID death rate in comparison to other countries is relatively low. Mortality data from Johns Hopkins University show Sweden has one of the lowest COVID death rates per 100,000 people in Europe. As of May 22, 2022, Sweden has 187.55 deaths per 100,000 people. Sweden has fared better than about 50 countries that had more heavy-handed COVID regulations, including Peru (646), the United States (304), Chile (302), Argentina (285), Greece (284), Belgium (276), Italy (274), the United Kingdom (273), France (228), and Spain (226).

4. Sweden's mortality rate did not spike due to COVID. If Sweden's policy were really that careless, we would have seen a huge surge of death in Sweden. However, the historical mortality rate data from the Swedish government's Statistiska Centralbyrån show that COVID did not cause major spikes in Sweden's death rate. The 2010-2019 average morality rate for Sweden was 9.27 deaths per 1,000. In 2020, that figure was 9.48 deaths, which was a 2.3 percent increase. In 2021, the mortality rate dropped to 8.83 deaths per 1,000, which is a 6.9 decrease from the previous year. When comparing Sweden to past years within its own history, its COVID response does not suggest a calamity befell Sweden. 

5. Sweden's excess death rate is one of the lowest among developed nations. A more superior metric is the excess death rate. As the Left-leaning Washington Monthly illustrates, excess mortality includes all deaths, whether from COVID, deaths caused by COVID policy (e.g., lockdowns, delayed non-COVID healthcare, mental health caused by social isolation), or another cause. It removes underlying differences between regions and countries. Another point I would like to make is that excess deaths are a better metric in the sense that you do not need to get into the debate of "death with COVID" (i.e., incidental death) versus "death because COVID" versus "COVID was not the primary cause, but was a contributing factor."

Using this metric of excess death rate, Sweden fared even better than it did on COVID-specific death rates. A Kaiser Family Foundation found that Sweden was the only wealthy country that did not have any excess mortality for those under 75 years old (Amin and Cox, 2021). Earlier this month, the World Health Organization released global data on excess death rates in 2020 and 2021. It turns out that in 2020 and 2021, Sweden had one of the lowest excess death rates in Europe (see below).  

This does not surprise me in the least. When I took the time in June 2021 to analyze the available literature on lockdowns, I came across a study from scholars at Rand Corporation and the University of South California (Agrawal et al., 2021). The study analyzed 43 countries and all 50 states in the United States, and found that lockdowns actually increased excess death rates. 

Side Note About Comparing Other Nordic Countries to Sweden

There are some that like to lambast Sweden because their death rates are higher than their Nordic counterparts of Denmark, Finland, and Norway. While the the WHO shows that was indeed the case, I have pointed out in response that for much of the pandemic, Oxford's COVID-19 Stringency Index showed that Sweden was more stringent than the other Nordic countries for much of the pandemic. There is also the "dry tinder" hypothesis, which states that Sweden had higher deaths in 2020 and 2021 because they had fewer flulike deaths in previous years (e.g., Klein et al, 2020). There was also the issue with the Swedish strategy shielding the elderly (Rizzi et al., 2022), a point I made in August 2020. The "dry tinder" likely exacerbated the nursing home policy in Sweden. Since this was likely the major driver in Sweden's COVID deaths, it still has no bearing on the discussion of whether lockdowns, mask mandates, or school closures were necessary. 

Conclusion

Pointing out the Swedish case study does not by itself refute the pro-mandate side. A single case study can be suggestive, but you need more evidence than a single case study to prove something true or false. Conversely, if keeping business shut down or having mask mandates were that vital to public health, Swedish health metrics should have been a disaster relative to countries. Yet that was far from being the case. The "Swedish experiment" adds to the evidence base that lockdowns are harmful, mask mandates are ineffective, and school closures were by and large unnecessary. I'm not here to say that Sweden got everything right. The main flaw is that at the beginning of the pandemic, Sweden did not handle its nursing home pandemic policy in a fashion that would have adequately protected its most vulnerable. Even so, as this report from a Swedish government commission concludes, Sweden's light-touch approach to the pandemic was "broadly correct."

The facts mentioned above help explain why the "better safe than sorry" crowd cannot stand the Swedish example. It means that argument of "If we didn't have lockdowns, it would have been much worse" does not withstand scrutiny. It means that the lockdowns were not needed to avoid disaster and mask mandates (or masks generally) were not statistically significant in helping quell COVID transmission. It means that the lockdowns did come with considerable costs. 

I do not think the doubling down of lockdown advocates is simply a matter of ego or an incapability of admitting one was wrong. If these advocates were to accept that Sweden was successful in its overall approach, it would mean that delaying children's education, denying people freedom, disrupting (or in so many cases, causing the loss of) employment of millions, or exacerbating physical and mental health issues were undergone for no reason whatsoever. It is difficult to be on the side that took a sledgehammer to multiple institutions and to our way of life. The takeaway from the Sweden example should not simply be that the overly and unnecessarily stringent approach was the improper approach. It should be that we learn from this painful lesson so that we do not make the same mistake of panicking and ignoring best practices when the next pandemic happens.

5 Government Policies That Brought on the Baby Formula Shortage

Taking care of a baby can be challenging with the sleepless nights and the demands on free time. In 2022, raising an infant has become more challenging because baby formula has become harder to find. As grocery and retail data firm Datasembly shows, the out-of-stock (OOS) rate for baby formula has skyrocketed in the first half of 2022. Major distributors such as Wal-Mart, Target, and Kroger are rationing baby formula. This is significant since CDC data on breastfeeding show that a majority of infants use formula. While switching over to breastfeeding might be possible for some, other mothers might not be able to breastfeed (e.g., allergies, medical conditions) or are have time constraints. This shortage has the potential to truly impact pediatric health. 

So how did we get here in the first place? The most recent shock to the U.S. baby formula market was in February 2022 with a contamination problem at an Abbott plant that produces baby formula. This caused the FDA to recall formula from Abbott. While the OOS rates are higher in recent months, we can see from the above graph that OOS rates were still high in 2021. Part of this was due to the pandemic-induced hoarding in 2020, followed by lower demand in 2021. There is also the inflationary pressure, a phenomenon that the Federal Reserve Bank of San Francisco points out has been more prevalent in the United States than in other countries due to its larger-than-average government stimulus during the pandemic (Jordà et al., 2022). Since 2021, we have more generally found ourselves in a supply chain crisis. As I pointed out in October 2021, some of this was going to happen regardless because of the pandemic. At the same time, there was plenty of government policy that negatively attributed to the supply chain crisis. 

The infant formula manufacturer market was struggling with the same things other manufacturers were struggling with, whether that is labor, materials, transport, and logistics. The extent to which the government is responsible for the trends on a macroeconomic level does not change that the government has a heavy-handed approach when it comes to infant formula. As the New York Times reported in March 2021, "Baby formula is one of the most tightly regulated food products in the U.S." How bad is it? Here are five ways in which the government made the infant formula shortage as dire as it is. 

1. WIC Vouchers and Market Concentration. WIC stands for Women, Infants, and Children. It is a supplemental nutrition option program from the U.S. Department of Agriculture that is aimed to safeguard the health of low-income women, infants, and children. What could such a seemingly innocuous government program have to do with the shortage? Formula companies are heavily subsidized by WIC through the voucher program. In exchange for offering lower prices on infant formula in the form of rebates, the formula companies receive "the exclusive right to provide their product to the state's WIC participants." This means that the companies with the greatest number of lobbyists can vie for this exclusive right to a de facto state-level monopoly in this market segment for infant formula. This cannot be overstated since it is through these WIC vouchers that about 50 percent of infant formula is provided nationwide (Choi et al., 2020). Abbott holds 42 percent of the market share for infant formula, according to market research firm Euromonitor. This favoritism makes it hard for new companies to enter the market, which leads to market concentration. If the WIC vouchers did not attribute to this market concentration, one plant closing would not make mothers in the United States so vulnerable to such a supply shock. 

2. FDA's Non-Tariff Trade Barriers. Not only have FDA regulations gotten in the way of such things as making prescription drugs cheaper or e-cigarettes more available, the latter of which being a healthier alternative to traditional smoking. The FDA has specific labeling requirements and ingredient requirements, as well as a mandate stating that retailers wait 90 days before marketing a new infant formula. The excess of labeling regulations in particular make European infant formula illegal in the U.S. (DiMaggio et al., 2019). These onerous regulations provide little incentive to non-U.S. businesses to sell their formula to U.S. retailers. 

3. Infant Formula Tariffs. For the few brands of formula that can past the FDA gatekeeping, they are subjected to tariffs up to 17.5 percent (also see here). Looking at the economics of tariffs, tariffs are an import tax. Who pays that tax? The domestic consumer through higher costs of foreign goods or services. Between the tariffs and FDA regulations, is it any wonder that 98 percent of baby formula consumed in the United States comes from producers in the United States?  

4. Trump's Trade Deal and Export Fees. Part of the Trump Presidency was the enactment of NAFTA 2.0, which is better known as the United States-Mexico-Canada Agreement (USMCA). During the negotiations in USMCA, one of the sticking points was with the dairy industry. The U.S. dairy industry wanted certain provisions to protect themselves. Part of this negotiation had to do with China. Prior to the enactment of USMCA, Chinese baby food producer Feihe invested $225 million into building a manufacturing plant in Kingston, Ontario, Canada. Part of USMCA is limiting how much infant formula Canada can export, not only to the United States but globally. If Canada exceeds exporting 40,000 metric tons of infant formula, they are walloped with an export fee of $4.25CAD for each kilogram. While Trump was trying to screw over China, he ended up screwing over the American people by discouraging Canadians from producing baby formula that we clearly need. 

5. Marketing Orders. A marketing order is a series of price and income supports imposed by the USDA (see Cato Institute brief for more information). Looking at the economics of milk marketing orders, such orders drive up the price of milk (e.g., Chouinard et al., 2005). Since dry milk is an essential ingredient in baby formula, it is reasonable to assume that these marketing orders are attributing to the increased cost in baby formula. As Cato Institute scholar Gabriella Beaumont-Smith points out, there are import barrier provisions in the marketing orders that dampen U.S. producers' demand for foreign milk, which makes infant formula all the more scarce in a time of emergency. 

Postscript

Without a doubt, the pandemic threw the infant formula market in disarray, as the pandemic did with so many markets. The panic buying and hoarding in 2020 garbled market signals on infant formula demand in 2020 and 2021. The pandemic also had its role in contributing to the supply chain crisis and affecting various inputs of infant formula production. The factory of the leading domestic producer of infant formula in the United States does not do any favors. But make no mistake: government policy is a major culprit. USDA subsidies for large infant formula manufacturers increased market concentration. If the market were fragmented, the Abbott manufacturing plant closure would not have made the infant formula market so vulnerable. If trade barriers and FDA regulations were not so onerous and excessive, there would have been a U.S. demand for internationally produced infant formula that could have helped fill the gaps while the Abbott manufacturing plant worked on getting open again. In short, if it were not for government meddling in the infant formula market, mothers would not be scrambling to feed their children. This infant formula shortage serves as another reminder that instead of regulating its people to death, the government is much more likely to do a better job at improving our lives by deregulating and getting out of the way.

What Would Happen If Roe v. Wade Were Reversed?

The abortion debate has made the news cycle once more. Last week, Justice Alito's draft opinion on Dobbs v. Jacksons Women's Health Organization was leaked. This case is dealing with whether all pre-viability prohibitions are on abortions are constitutional or not. This opinion is significant not only because it rules that the prohibitions are constitutional, but because it states that Roe v. Wade and Planned Parenthood v. Casey should be reversed. Granted, the draft is not finalized. The majority opinion could end up being narrower than reversing Roe v. Wade. Also, it is not guaranteed that at least four other Justices will sign the opinion. None of this has not stopped political pundits from trying to figure out what would happen if Roe v. Wade were indeed reversed. I am curious as to what would happen, which is why I would like to take a crack at figuring out some possible outcomes here today.   

Impact on Abortion Access

First, let's touch upon how such a ruling would affect abortion access. As frantic as abortion activists have been the past few days, a reversal of Roe v. Wade would not be the end of abortion in the United States. Abortion access would be determined on a state-by-state level. There are 18 states with total or near-total abortion bans. Four states have early-term bans that cover abortions after the sixth week. 

How much will this end up reducing abortion access? Not as much as one would think. In September 2021, Texas had banned abortion with a heartbeat bill. Based on the available data, the ban reduced the abortion rate of Texan women by about 10 percent. What would happen on the national level? One of the amicus briefs filed was by economists in support of the respondents. This amicus brief had calculated that abortion access would be reduced by 14 percent if Roe v. Wade were overturned. Middlebury College economist Caitlin Knowles Myers similarly projected a 14 percent decline. Why are the decreases more modest? 

1. One reason is that there is likely an inelastic demand. In layman's terms, the demand for abortion services is still high enough where people are willing to get on in spite of the restrictions. Even so, there still seems to be at least some effect on abortion services. 
2. Traveling to another state is an option. It is true that those with modest financial means and the furthest to travel will be most impacted (e.g., women in southeastern Texas and Louisiana given the geographical proximity to a location with a clinic). However, that will only deter some women from traveling across state lines to procure an abortion. 
3. Abortion pills can act as a workaround. Mifeprex has been approved by the FDA since 2000, which can be used up to 70 days of gestation. This is noteworthy considering that 79.3 percent of abortions happen nine weeks or earlier, according to 2019 CDC data. Some states might crack down on this medication crossing state lines, but it is possible that the enforcement prove to be too difficult to enact. 
4. Most states will have legal abortion, which is to say that those living in states with greater restrictions plausibly still have access. 
5. States that are likely to have abortion restrictions if Roe v. Wade is reversed already have low abortion rates in comparison to other states. 

Will abortion rates go down as a result? Almost certainly. After all, bans tend to lead to less consumption of goods and services. However, it is not looking to be the dire number that a number of abortion activists were anticipating. 

  

What Will Be the Economic and Health Impacts?

I do not want to reduce abortion down to an economic issue. There are also ethical and philosophical components to the debate that we need to consider (see my 2019 analysis on those components here). At the same time, determining the economic impacts is not so simple, even though some have tried a cost-benefit analysis (e.g., Nelson, 1993). Not only does it cost to carry a child to term, but it also costs money to raise a child. As such, it should not be a surprise that not having access to an abortion would increase a household's costs. For some, that can translate into considerable financial distress (Miller et al., 2020), which can cause other economic and health issues. This potential for financial distress is pronounced by the fact that nearly half of women who procure an abortion are below the federal poverty line (Guttmacher Institute). At the same time, one has to consider what the expected earnings that would have been accrued if the fetus came to term, became an adult working in the labor market, and the extent to which said life would have contributed to society. 

That segues into the value of life, which is an economic value used to determine the benefit of avoiding a fatality. If the fetus is to have some or any ethical consideration or legal protection, there would need to a value of life applied to the fetus. It depends on what value of life you want to use. For a human being that is born, it depends on who is conducting the valuation and how much the value of life is for a fetus. If the fetus is to viewed as more than a clump of cells and should have partial or full legal protection and ethical consideration, then an abortion is decidedly unhealthy for a fetus since abortion means destroying the fetus' life. It would help tilt the argument in favor of the anti-abortion position. 

If a fetus is to have an economic value of zero or a very low value of life, that would change the calculus dramatically in favor of a pro-abortion position. It would also make the arguments for the women's health, labor force participation, and educational attainment even stronger. Given that 59 percent of those who seek abortions are already mothers, one could argue that forcing the mother to carry could put financial or emotional strain on the children and families they already have. 

I also have concerns about what driving abortions to the underground market would do. When a good a service gets relegated to the black, market, it creates more problems than it solves, whether we are talking about marijuana, prostitution, or donating one's own organs. Pro-abortion activists using depiction that we would return to pre-Roe conditions vis-à-vis coat-hanger abortions is inaccurate and unhelpful, much like it is counterproductive when anti-abortion activists use images of aborted fetuses to make their point. The pro-abortion Guttmacher Institute shows that 54 percent of abortions are done in pill form, a number that is expected to grow.  If a woman can cross state lines to procure a surgical abortion or some Mifeprex, the safety concerns are nowhere near what abortion advocates are making them out to be. 

Another cost that concerns me has to do with enforcement. According to Mayo Clinic, 10 to 20 percent of pregnancies end in miscarriage (also known as spontaneous abortion). If a state is going to take the criminalization of abortion that seriously, does that mean the police force is going to investigate miscarriages as if it were a homicide case? There are questions about how implementation would end up. That does not mean there should not be an effort. We do not say that we should not enforce laws pertaining to murder, sexual assault, fraud, or arson simply because there are enforcement costs and challenges. On the other hand, given the nature of miscarriages, it would arguably be more arduous to prove whether or not it was a bona fide miscarriage or if the abortion were induced by medicine. 

Will Reversing Roe v. Wade Upend Democracy and Privacy Rights? 

"It's the end of the world (or at least, democracy) as we know it." That is the argument I have seen on the Left lately in response to the possible reversal of Roe v. Wade. Washington Post calls it "at odds at democracy." The L.A. Times referred to it as "an emphatic and damaging expression of minority rule." Removing Roe v. Wade is not going to be an end to democracy, but I have a few responses:

• It is not as if the United States were this backwards, authoritarian regime until 1973 and Roe v. Wade magically turned this country into a democratic haven. The United States was functioning as a representative republic prior to Roe v. Wade becoming law. 
• 46 states needed to change their abortion laws as a result of Roe v. Wade. This would imply that these 46 states had more restrictive abortion laws pre-Roe given the permissiveness of Roe. If almost every state had abortion restrictions on some level that were less permissive than what Roe allows, that means the expansion of abortion access allowed by Roe circumvented democratic will.
• The pro-abortion crowd reacts as if reversing Supreme Court decisions is unprecedented or radical. It is not. There have been over 200 instances in which the Supreme Court overturned a previous ruling, most notably when Brown v. Board of Education overturned Plessy v. Ferguson. 
• Far from being minority rule, it would be the first time in about a half-century in which popular majorities determine the scope of abortion policy instead of it being determined by unelected federal judges. Even President Biden acknowledged this by saying that he is not "prepared to leave that [the abortion debate] to the whims of the public at the moment in local areas." In other words, Biden's issue is that such a ruling would mean too much democracy, not too little. 
• While a majority of Americans believe that Roe v. Wade should not be overturned (Politico), a recent poll from YouGov/Economist shows that 64 percent of Americans are okay with abortion being banned after 15 weeks. This 15-week mark also happens to be the line that the Mississippi legislature draws in the Dobbs case. The Dobbs case de facto has majority support from Americans, so how is enforcing a law that a sizable majority is fine with an assault on democracy? 
• Yes, the Republicans played procedural hardball to get a majority of Justices on the Supreme Court that were nominated during Republican presidencies. But if you are going to argue "structural bias in favor of the Republicans," would you not want that to be at the state level instead a more centralized decision-making process dictated by the Republicans?  This is what happens when you give political institutions too much power, but I digress. Additionally, state officials are more responsive to constituents' needs. Referenda, elections for judgeships and governors, not to mention Congressmen, would make the process more democratic. 

Then there are those who think removing Roe v. Wade will go beyond abortion and affect other rights, particularly gay rights. In addition to such an argument violating the slippery slope fallacy, there are a few reasons to assume why this would not spill over into gay rights territory. 

1. Support for same-sex marriage is at a high of 70 percent (Gallup). Unlike Roe v. Wade, the fight for gay rights was much more settled and less divisive in society before the Supreme Court caught up and established the right of same-sex marriage vis-à-vis Obergefell v. Hodges. Gay rights have been established as a societal norm and overturning them would contribute to the erosion of the Court's legitimacy. 
2. Justices Gorsuch and Roberts ruled in favor of the Bostock v. Clayton County, which expanded employment discrimination protections to gay and transgender workers. If the "conservative majority" were hellbent on taking away LGBT rights, they would not have expanded LGBT rights. If anything, they would have attempted to take them away, which leads to my next two points.....
3. The Supreme Court's "conservative majority" had two opportunities to strike down Obergefell v. Hodges (i.e., Pavan v. Smith, 2017; Masterpiece Cakeshop v. Colorado Civil Rights Commission, 2018) and it chose not to do so. 
4. Justice Thomas and Alito denied the certiorari in Kim Davis v. David Ermold, which would imply that the two most conservative Justices do not feel like going after gay rights either. 
5. Don't forget about stare decisis, which is the legal doctrine that allows precedent to carry considerable weight in current and future rulings. 
6. Finally, Alito mentions in the leaked draft opinion (p. 5) for Dobbs that abortion is different from intimate sexual relations, contraception, and marriage "because it destroys what those decisions [Roe and Casey] called fetal life," something that was even acknowledged by the plurality in the Casey case (p. 62). Alito emphatically states that "To ensure that our decision is not misunderstood or mischaracterized, we emphasize that our decision concerns the constitutional right to abortion and no other right. Nothing in this opinion should be understood to cast doubt on precedents that do not concern abortion (ibid.)."

If it is not about upending democracy or other de jure rights already previously acknowledged by the Supreme Court, then what is going on? The Wall Street Journal gives a reply: "The Supreme Court's job is to say what the law is, not to be a body of philosopher kings to impose progressive outcomes." The objection to the draft opinion is not about preserving democratic institutions or making sure the people have their say, as previously illustrated. This is an adverse reaction to the fact that many on the Left think that democracy only happens when the outcomes are ones that they favor. That is not how the democratic process works in the United States. I brought this up with the mask mandates, which is that an independent judiciary is necessary to determine what is legal, not what is ethically and morally palatable per se. This leads to a reason I am happy to see the anticipated reversal of Roe v. Wade. Independent of any moral or policy considerations, the constitutional case for Roe v. Wade is unconvincing: 

• It is hard to imagine that the authors of the 14th Amendment thought that the Amendment referred to abortion when three out of four states banned abortion in 1868. There is no historical basis that "liberty" under the 14th Amendment covers pre-quickening abortion. 
• Justice Blackmun, who authored the Roe v. Wade opinion, did not find words or the history of the Constitution, nor did he quote a provision in the Constitution that allows for abortion legalization. 
• There was not even a pretense to examine the intent of the drafters of the Fourteenth Amendment to see if abortion access were implicitly protected by any constitutional provision. In other words, if people want Roe to become national law, pass it through Congress. If abortion activists cannot do that, they need to fight for it on the state level. 
• Justice Ruth Bader Ginsburg, who was a major advocate of abortion access, thought that Roe's "doctoral limbs were too swiftly shaped, [as] experience teaches, may prove unstable." As Ginsburg illustrates, you can believe that abortion access should be [all but] unfettered and that Roe does not provide constitutional basis for said access. From Ginsburg's point of view, the better approach would have been to argue for abortion access using equal protection principles. 
• John Hart Ely, who taught at Yale University, was one of the most oft-cited constitutional law experts of his time. He was in favor of abortion access, but thought that Roe was a bad decision and was not truly constitutional law (Ely, 1973). Ely said that "this super-protected right is not inferable from the language of the Constitution, the framers' thinking respecting the specific problem in issue, any general value derivable from the provisions they included, or the nation's governmental structure." In other words, the Burger Court pulled the "right to an abortion" out of thin air. 

For more information on the legal arguments that are being presented to the Supreme Court, you can read the amicus briefs that were filed for the Dobbs v. Jackson Women's Health Organization case here.

Postscript

What would happen if Roe v. Wade ends up being reversed? Not the end of the world. The question of the legality of abortion will go back to the states, just as it was before 1973. Yes, there will be a decline in abortion access because that is a common occurrence when one bans or greatly restricts access a good or service. That number is not projected to be as high as some abortion advocates might fear. There are tradeoffs regarding the economic and health components of the abortion debate. How you feel about the fetus or how you valuate the life of an unborn child will greatly determine whether or not you think the cost of greater abortion restrictions are worth it. As for some of the secondary effects, democracy is not going to end with the reversal of Roe v. Wade. If anything, both revoking a piece of slipshod constitutional law while making the process more democratic by returning it to the state level ought to improve the Court's legitimacy. Additionally, it does not look as if this reversal would likely affect other rights to privacy, particularly that of gay rights. One for thing is for certain: the abortion debate in the United States is far from over. If anything, this rematch is only getting started.

Unmasking Maskaholism: Why All Mask Mandates, Including the One for Public Transit, Need To Go (Part II)

Since the beginning of this pandemic, the face mask has been a highly contentious public health measure. Last week, I began my analysis on my mask mandates need to be a relic of the past. The first part of this two-part series covered the science of the face masks. After using randomized control trials (RCT) available and meta-analyses of RCTs, I concluded that face masks had very little, if any, effect on the transmission of COVID-19. Even if the face masks were an effective public health tool, it would not matter because we have reached a point where the pandemic is becoming endemic. Based on various epidemiological metrics and trends, we are no longer in a state of public health emergency that would merit such a mandate. Today, I cover two more facets of the face mask mandate debate. The first is whether the CDC had the legal authority to implement a public transit face mask mandate in the first place (Section III). Second, I cover the social and emotional costs, as well as the moral implications of face masks (Section IV).  

Section III: The Legal Argument Against Public Transit Face Masks

The question that Judge Mizelle was ultimately answering was not a public health question, but a legal question. Did the CDC have the legal authority to mandate masks on public transit? From where was the CDC claiming it had such power? It is not the Department of Justice. It is not President Biden. Per Article I of the Constitution, the CDC's statutory authority comes from Congress. What authority is the Biden administration citing? The Public Health Service Act of 1944, or more specifically, 42 USC §264(a). The statute permits the Surgeon General to "make and enforce such regulations as in [its] judgement are necessary to prevent the introduction, transmission, or spread of communicable diseases." These measures include "inspection, fumigation, disinfection, sanitation, pest extermination, destruction of other animals or articles found so to be infected or contaminated as to be sources of dangerous infection to human beings, and other measures." 

The thing is that during the CDC eviction moratorium case (Alabama Association of Relators et al. v. Department of Health and Human Services), the Supreme Court ruled that the CDC did not have the statutory authority to order landlords to house tenants who could not pay rent. The Biden administration tried using the same Public Health Service Act of 1944 in this case because it believed it had the authority to implement whatever measures necessary to stop the spread of COVID-19. Part of the majority ruling pertained to the phrase "other measures" phrase from 42 USC §264(a). The Supreme Court ruled that the CDC's powers were not that broad, stating that such a broad interpretation would "indeed give the CDC a breathtaking amount of authority. It would be hard to see what measures this interpretation would place outside of the CDC's reach." The ruling also points out that this statute has been rarely and narrowly implemented, either historically having used it to quarantine sick individuals or to prohibit the transmission or sale of animals known to carry disease (e.g., turtles carrying salmonella). 

So we already have legal precedence from the U.S. Supreme Court that 42 USC §264(a) does not give the CDC a carte blanche to do whatever it wants. Justice Mizelle made that argument in her ruling last week, yet some people take issue with that. NPR cherry-picked some legal experts to say "not even a graduate student in law school would be that careless," while chiding Mizelle for her interpretation of the word "sanitation" in the statute. Based on statutory context and common usage, Justice Mizelle opted for a narrower interpretation of "sanitation," that being measures aimed at cleaning something, which face masks do not do. NPR focused on Georgia State University professor Erin Fuse Brown. Professor Fuse Brown argued that "sanitation was just the old way in public health parlance of taking traditional public health steps to prevent the spread of disease." If "sanitation" were really a generic, catch-all term referring to any public health measure, why would the statute need another sentence to list other measures such as fumigation or pest extermination? Wouldn't those be part of public health measures to slow the spread? Because as the majority of the Supreme Court ruling on eviction moratoriums already pointed out, the list in 42 USC §264(a) is a list of specific examples. An argument of canon against surplusage, which is a longstanding rule of legal interpretation against redundancy in laws, thereby gives Mizelle's argument of interpreting the term "sanitation" narrowly more credence. 

Ultimately, Mizelle cited five reasons as the basis of interpreting the law narrowly: context of nearby words, contemporaneous usage, sweeping implications of the government's argument, history of the provision's application, and the fact it seems to be "limited to property." Additionally, she ruled that the CDC violated the Administrative Procedure Act [APA] by not allowing for the notice-and-commenting process. This is even less acceptable to bypass this democratic process as we are in our third year of the pandemic. Mizelle also made the argument that the mask mandate was too "arbitrary and capricious." The 11th Circuit Court does not need to accept every single one of Mizelle's arguments as ironclad in order to agree with her. One would suffice. Given that the a) Supreme Court already set a precedence in the previous case over the CDC's eviction moratorium and b) the Biden administration signaled a lack of public health emergency by not seeking a stay on the ruling, it would not be unreasonable to assume that Mizelle's ruling would ultimately be upheld if the appeals process goes all the way to the Supreme Court.  

But what is irritating the Biden administration and the maskaholics is they are not getting their way. The CDC cannot do whatever it wants in the name of public health. The executive branch overstepped its statutory authority, much like it did with the CDC's eviction moratorium and OSHA's vaccine mandate. The CDC had two years to ask the Democratic-majority Congress for statutory authority. If the CDC wanted to implement a federal mask mandate on public transit, it would have approached Congress by now and Congress would have enacted it. Whether the Biden administration and Fauci like it or not, that is how judicial independence and rule of law, which are two vital components of a democratic society, work. 

  

A Quick Word About Probability of Dying From COVID

The media, politicians, and the rest of the maskaholics did a fine job spreading fear throughout the pandemic (e.g., Sacerdote et al., 2020). Instead of discussing best practices, cost-benefit analyses, or "following the science," the default was panic. What are maskaholics panicking about at this stage? Dying? What are the odds of dying from COVID? Back in September, I brought up how a vaccinated person under 65 would be more likely to die from a bee sting (which has odds of 1 in 59,507) than from COVID, which at the time was 1 in 137,698. The odds might be even lower still. A study from researchers at the National Institutes of Health (NIH) tracked 1,228,664 vaccinated adults in America from December 2020 to October 2021 (Yek et al., 2022). How many died out of this sample size? 36 people. This would put the odds of dying from COVID at about 1 in 33,333. However, this comes with a huge caveat. 28 out of those 36 were over 65 years old and had at least four comorbidities. If you filter out that demographic and look at everybody else, including the elderly with one or two chronic conditions, the odds of dying from COVID is 1 in 150,000. Let's put that ratio in perspective. If you are vaccinated and have two or fewer chronic conditions, you are more likely to die from a lightning strike or earthquake, both of which are quintessential examples of statistical improbability. 

The odds of dying from COVID are low. The evidence base for face masks was never strong, a reality that becomes more apparent as we collect more data over time. The main epidemiological metrics show that we are over the emergency stage of the pandemic. Effective and readily available vaccines bolstered the case for returning to normal for most while still providing targeted, limited interventions for vulnerable individuals. So why are a significant percent of people still clinging to their masks? 

Section IV: Maskaholism, Social Costs, and Emotional Costs of Mask Mandates

I want to finally cover the idea of social costs surrounding masks since I think it will better answer the question "Why are we still masking?" Social costs are a consideration that economist Bryan Caplan brings up in his analysis on masks. While Caplan finds masks marginally uncomfortable, he hates wearing them and dislikes being around people who wear masks. He brings up the dehumanization of face masks. Faces are such major form of bodily expression. Masks erase our personhood, which makes sense because the number of instances that masks have been used to hide and obfuscate one's actual self, which can be observed in literature and in history. Masks also eliminate a form of non-verbal communication, which is to say that masks symbolically and functionally muzzle us. The considerations that Caplan brings up, particularly that of dehumanization, lead us to the concept of the known unknown, i.e., it cannot be quantified or monetized but it is very something that is in existence and worth taking into account. 

As you have noticed, I have been using the term "maskaholic" to refer to advocates of face masks and face mask mandates. Some of you hear the term "maskaholic" and think I am being unfair, insensitive, or mean to those who still wear masks when they are not obligated. I am using the term "maskaholic" because ever since I was introduced to the term "maskaholic" a couple of weeks ago, I have been looking at the advocacy of face masks through the lens of addiction. 

I can think of a few things that could cause a sense of addiction. One phenomenon is one that I observed when I was an Orthodox Jew: an addiction to stringency. Part of what led me to Orthodox Judaism is because they took it seriously. There was a zeal and a sincere commitment to Jewish life. What I learned quickly is that like anything else, there is too much of a good thing. It was one thing to have standards, but this went to a whole different level. I noticed people taking on personal stringencies, chumrot (חומרות), that went beyond the dictates of Jewish law. The ones who thought this way equated stringency and stricture with being a better Jew; it was a form of getting off on "stringency for its own sake." 

This stringency mindset carries over into the pandemic. Many countries went with the strict approach by implementing lockdowns because "we had to do something." It did not matter that pre-pandemic advice from experts was to not implement lockdowns. It did not matter the damage it caused to the economy, mental health, or the livelihood of millions. It also did not matter that lockdowns actually increased excess deaths. These stringencies show that you take the pandemic seriously and that you want to save lives. A similar "stringency for its own sake" approach has been taken with the face masks. It did not matter if you did not want to wear masks because simply they were too uncomfortable or if you had legitimate concerns about the efficacy of face masks, especially cloth face masks. From the maskaholic point of view, anyone who did not take the pandemic as seriously as you did were selfish assholes that wanted old people to die just so they could have the convenience of living their lives as usual.  

I do not think the "stringency for its own sake" crowd covers the majority of maskaholics, but it does account for a significant subset. A much larger contingency became maskaholics because of fear. I would like to elucidate upon this concept of fear further. In part, those who still want to wear the face masks want to feel a sense of security and certainty in what they deem "unprecedented and uncertain times." Let's forget that there have been pandemics before and life has always been uncertain. In spite of the low probability of dying from COVID, the pandemic has put the theme of death front and center. Prior to the pandemic, death was a topic that was avoided on a societal level. It was much easier to think about happiness, convenience, consumerism, and the rat-race than it was to be faced with the inevitable end that is death. Masks are either a subconscious expression that you are avoiding death in perpetuity or that you are avoiding thinking about death. 

Don't get me wrong. Fear can be a motivator in the short-run. If you are in the woods and a bear is behind you, fear is that emotion that can keep you alive. On on a more positive note, fear can motivate you to getting a promotion at work, pursuing a relationship, or buying a home. Fear can be helpful at times and has its place. The problem with fear in the context of this pandemic is that we have been on pandemic emergency mode for over two years. When your body is under prolonged stress, your body and mind begin to malfunction. The American Journal of Managed Care has a concise list of the effects of long-term fear, including mood swings, obsessive-compulsive thoughts, immune system dysfunction (e.g., headaches turn into migraines, body aches turn into chronic pain), being afraid to leave home because of paranoia, and distorted perception of sensory information, the latter of which makes it harder to make cogent and rational decisions. Is it any wonder that there was a 25 percent increase in anxiety and depression during this pandemic? Pandemic fatigue is real! 

To quote author and former monk Jay Shetty from Think Like a Monk (p. 67), "The problem with fear is that it's not sustainable. When we operate in fear for a long time, we can't work to the best of our abilities. We are too worried about getting the wrong result. We become frantic or paralyzed and are unable to evaluation our situations objectively or to take risks." With the symbolism behind the face masks, the mask and the mask mandates played their role in promoting a culture of fear. Even anecdotally, I generally noticed that my friends and family who did not internalize the fear were enjoying life during the pandemic more than those who did.

Dealing with this level of fear for two years is no way to live. The Egyptian writer Naguib Mahfouz said that "Fear does not prevent death; it prevents life," which is especially true when looking at the longer-term. Boxer Muhammad Ali opined that "He who is not courageous enough to take risks will accomplish nothing in life." Whether it is an addiction to certainty, a security blanket, the false notion that we can live forever, or a sense of purpose that comes from attaching oneself to stringency, the fear of COVID ended up being more paralyzing to society than anything else. 

Conclusion: Moral and Social Implications of Removing Mask Mandates

This is the social and moral argument against mask mandates. For those who take the masks seriously, interacting with people or even being near them triggers a fight-or-flight response. Instead of viewing others as fellow human beings, this culture of fear reduces other people to being viewed as vectors of disease. As long as mask mandates are part of our culture, they will continue to propagate the idea that we should be scared in perpetuity. 

As I already detailed, there is no legitimate public health rationale for face masks. Much like with the lockdowns, the burden of proof should be on the face mask proponents that face masks work. Arguing "why risk it", "what's the harm", or using worst-case scenarios that are divorced from reality does not do us any favors. Using arbitrary rules such as the mask mandates to perpetuate fear that is not based on epidemiological context so the CDC can maintain its power is downright irresponsible. So is making everyone's lives less pleasant because you have internalized overblown fears or because you cannot handle the risk that is an inevitable part of life. 

This might sound harsh, but that is because it is a form of tough love. Removing the mask mandate does not mean you cannot partake in some one-way masking if you feel like it. It just means that it does not compel those who do not want to wear a mask to put on a mask. While the decision to mask is up to you, I will say this. If your risk tolerance is extremely low or nonexistent, then you will have such a hard time adjusting back to living life fully like you did before March 2020. It will mean that you will continue to wear masks, socially distance, not take public transit, or not attend sporting events or concerts because fear of COVID, no matter what the actual risk level of contracting COVID is, becomes one of your most prevailing and defining values in life. This is why I said back in October 2021 that accepting risk once more is a prerequisite to going back to normal. 

Washington Post journalist Megan McArdle wrote that "They [the mask mandates] had to end sometime, and if not now, when?" It is a relevant question, and the answer is that "now is a good time." As McArdle points out, the mask mandates were meant to be a short-term solution to help flatten the curve, not a long-term lifestyle change. McArdle was right in saying that the more that politicians and public health officials move the goalposts in such a fashion (and I would add overstate the efficacy of face masks), the more they undermine their own credibility. 

Regardless of how you feel about face mask effectiveness, we have a high level of natural immunity and vaccine immunity. We have treatments that were not available in 2020. COVID has mutated into the milder Omicron variant. COVID hospitalizations have not been this low since this pandemic has started. Plus, so many of us have reached a level of pandemic fatigue that we are reassessing tradeoffs that we make in our lives. That pandemic fatigue is going to have an impact during an election year and how likely politicians are going to reinstate various COVID restrictions. Given all these trends I mention in this paragraph, I am cautiously optimistic that we are heading towards normalcy. 

Symbolically speaking, removing mask mandates will be a vital part of that transition. It means that we are not just tossing aside the face coverings, but the fear that too many internalized and made part of their being. It means that we accept that risk exists with COVID, much like we accept that anything we do in life comes with risk. It means we can physically and metaphorically breathe once more.