David Boaz

House Minority Leader and former speaker Nancy Pelosi says that the Republican tax bill, “with stiff competition by some of the other things they have put forth, is the worst bill in the history of the United States Congress.”

That is a tall order. A quick search of the history of the United States Congress reveals that Congress has passed:

the Alien and Sedition Acts in 1798

the Indian Removal Act in 1830

the Fugitive Slave Act in 1850

Public Law 503, codifying President Franklin D. Roosevelt’s Executive Order 9066 authorizing the internment of Japanese, German, and Italian Americans, in 1942

the Eighteenth Amendment (Prohibition), the Espionage Act, and the Selective Service Act, and entered World War I, all in 1917

the Universal Military Training and Service Act in 1951

the Tonkin Gulf Resolution in 1964

the USA PATRIOT Act in 2001 (Pelosi voted for this)

the National Defense Authorization Act, featuring indefinite detention, in 2011 (Pelosi voted for this)

I don’t think the current tax bill is even in the running.

I suppose hyperbole is to be expected in Congress. But this was said on the floor of the House by the former speaker, so presumably it was carefully thought out. I do hope that Leader Pelosi will be granted permission to revise and extend her remarks.

The rising level of deaths from opioid overdoses is getting a lot of attention, including from a Nobel laureate economist and the White House. In the rush to find a solution to the problem of opioids, I hope we don’t forget the problem that opioids were intended to cure: chronic severe pain. Living with that kind of pain is awful, and it’s wonderful that science has found ways to help people in pain.

But that’s not the way President Trump’s surgeon general sees it. In an NPR interview this week, Dr. Jerome Adams had this to say:

NPR’s Elise Hu: Much of this crisis started in doctors’ offices. We’ve heard statistics like doctors in the United States prescribe four times the number of pills per person that doctors in the United Kingdom do, for example. What do you think is encouraging doctors to prescribe at those levels?

Dr. Adams: Well, I can tell you, as one of those doctors, that many of my colleagues tell me they feel pressured to prescribe. You have patients who expect an opioid is the only or main way to treat their pain. But I would take issue with one thing you said—I don’t think it started in the doctors’ offices. I think it starts before that. I think that it starts with this expectation that everyone’s going to have no pain, with the idea that a pill can solve everything. And we need to help folks understand there’s a real danger to feeling like we can medicate our way out of any and all problems. 

(Note: that statement appears at about 4:25 in the audio, but not in the related transcript.)

Of course no one should feel that we can “medicate our way out of any and all problems.” But we can relieve some pain. And I am disappointed to hear the surgeon general say that we should get over our attitude that doctors can help to alleviate our pain.

In a 2005 Cato study, Ronald T. Libby argued that opioid therapies for pain had proved successful, but because of criticism and law enforcement efforts “many physicians and pain specialists have shied away from opioid treatment, causing millions of Americans to suffer from chronic pain even as therapies were available to treat it.”

In a recent article, surgeon and Cato senior fellow Jeffrey Singer argues that crackdowns on opioid prescription and the resulting decline in prescriptions are driving more patients to the black market, while “opioid abuse and overdose rates have declined by 25 percent in states where marijuana has been made legally available.”

There are going to be plenty of arguments about the best policy to deal with opioid abuse. But let’s start with the premise that the alleviation of pain is a great thing.

From Cato University 2017: College of History and Philosophy

The Washington Post sums up the situation:

It was a party scarred by the madness, cruelty and famine that one man had prompted through disastrous policies….

Senior officials lined up, one after the other, to laud what they described as [the leader’s] profound, courageous, thrilling, insightful masterpiece of a speech….

And the drumbeat of propaganda about loyalty to his leadership — combined with the constant threat of an unforgiving … campaign that has taken down several powerful rivals — makes it more difficult for anyone who dares challenge him….

[His] message promotes a nationalist, assertive [country] with a much stronger military — a country that he says will not threaten the world but will resolutely defend its interests.

If you are uncertain about which country and which leader, click here.