The money quote:
They found that the biggest impact of a minimum price policy was on “harmful” drinkers in the lowest income quintile (7.6% reduction in alcohol), whereas the impact on harmful drinkers in the highest income quintile was modest (1%). Consumption fell by 1.6% among “responsible” drinkers in the lowest income quintile. That is, the impact is concentrated among low-income harmful drinkers.
Moreover, this Lancet paper found that “Individuals in the lowest socioeconomic group (living in routine or manual worker households and comprising 41·7% of the sample population) would accrue 81·8% of reductions in premature deaths and 87·1% of gains in terms of quality-adjusted life-years.” In the public health field, we seldom see policy packages that have such a notable impact on reducing health inequalities. [** Further comment at end].
The gains come from putting a minimum price of alcohol that prices the poor out from consumption. Consumption that has a benefit – something that is ignored constantly.
Talk about evidence all you want (a lot hopefully – as evidence is central, and I respect the PHB for bringing empirical research up so constantly), but if your ethical framework places zero benefit on consumption choices of the poor your policy conclusion will be restricting the choice of those in poverty – always.
Given I expect some random comment like “you are assuming perfectly rational choice” from people, I’ll cover that upfront. No I’m not, not even close. I’m asking us to actually allow for the fact some benefit may exist – rather than setting it to zero. And that those who are poor actually have the right to some agency. It is the assumptions of those who want to restrict choices that are extreme, and that should be due to more scrutiny.
If we want to help those most in need, surely our focus needs to be on opportunity, capability, and treatment – not on taking away their choices. A minimum price of alcohol works by “pricing out” the poor, limiting their choice set, and thereby removing choice.
This isn’t nit-picking, it is a central point about policy relevance – totally and completely central.
Update: Eric Crampton notes a bunch of posts regarding the issue in this tweet:
— Eric Crampton (@EricCrampton) May 29, 2014
Update 2: I was a bit late reading NZ econ blogs this week, and only just came across this from Eric at Offsetting – it is very good, and very relevant. I am fundamentally and centrally concerned with how economics language is being used to link descriptive analysis and policy in a lot of modern literature – in a way that involves strong, and obfuscated, moral judgements.