Josh: The Podcast, Episode 68: Health care! Creativity! Routines!

We talk about jumping over creative blocks, launching a website for the Intensely Positive Podcast and what's going on with health care this week.

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Saying goodbye to Cena
JKWD on creativity
Tim Ferriss Radio Hour on Routines
JKWD on morning routines | Evening routines
Mazie Hirono
John McCain
Intensely Positive Podcast
"American Genius"
Trump could replace Sessions with recess appointment

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Our drug problem: Prohibition, ads, incarceration and revenue

We wrote recently here about the new American Prohibition Museum here in Savannah.

Alcohol prohibition had a long rise in the US, starting as far back as the 1820s. States began passing their own temperance laws in the 1840s. We still see remnants of some of these today. Beer laws are changing in Georgia to allow breweries to sell their own product; this follows a similar change in Alabama last year. Pennsylvania is figuring out how to privatize liquor distribution. In some states you can't buy alcohol Sundays, or at least Sunday mornings.

The constitutional amendment that prohibited alcohol in the US (the 18th amendment), was ratified in 1919, and reads thus:

Section 1. After one year from the ratification of this article the manufacture, sale, or transportation of intoxicating liquors within, the importation thereof into, or the exportation thereof from the United States and all territory subject to the jurisdiction thereof for beverage purposes is hereby prohibited.
 
Section 2. The Congress and the several States shall have concurrent power to enforce this article by appropriate legislation.
 
Section 3. This article shall be inoperative unless it shall have been ratified as an amendment to the Constitution by the legislatures of the several States, as provided in the Constitution, within seven years from the date of the submission hereof to the States by the Congress.

Fourteen years later, in 1933, the 21st amendment to the US constitution was ratified. It reads:

Section 1. The eighteenth article of amendment to the Constitution of the United States is hereby repealed.
 
Section 2. The transportation or importation into any State, Territory, or possession of the United States for delivery or use therein of intoxicating liquors, in violation of the laws thereof, is hereby prohibited.
 
Section 3. This article shall be inoperative unless it shall have been ratified as an amendment to the Constitution by conventions in the several States, as provided in the Constitution, within seven years from the date of the submission hereof to the States by the Congress.

If Section 2 of the 21st amendment sounds a lot like Section 1 of the 18th amendment, read it again closely. The 18th amendment prohibits the manufacture, sale, transport, import and export of alcohol. The 21st amendment prohibits the illegal transport, import, possession or use of alcohol.

In other words, we went from no booze to don't be stupid with booze.


During the years of alcohol prohibition, we saw the rise of Al Capone, who made sure Americans drank their fill. We saw the rise of Walgreens, which expanded from a couple of stores to hundreds filling prescriptions for medical whiskey. Bootleggers were the first at-home auto tinkerers, and prohibition gave rise to NASCAR.

The years of prohibition also cost the US $11 billion in taxes and $300 million in enforcement. Adjusting to today's rates, that's $207.1 billion in lost taxes and $5.6 billion in enforcement.

Today, alcohol sales are a $211.6 billion industry in the US. The federal government makes about $10 billion a year in taxes on that, and states and municipalities take in around $5.5 billion.

Extrapolated over 13 years and assuming no change, that's about $201.5 billion, pretty close to what we calculated for the prohibition years.


The CDC estimates there are about 88,000 alcohol-related deaths per year. Add to that 480,000 smoking-related deaths each year and 33,000 heroin- and opioid-related deaths.

Cocaine overdose deaths are now under 10,000 a year.

Deaths related to LSD appear to be too low to measure.

The best (read: no political agenda) stats I've found on marijuana-related deaths show that traffic deaths in which one driver had marijuana in his or her system increased in Colorado after legalization. The numbers are somewhat tempered in this case by multi-drug use, meaning that if the driver had used marijuana and alcohol, or marijuana and some other drug, it was still classified as a marijuana-related death (and also an alcohol-related, other drug-related, death).


Colorado saw $1 billion in legal marijuana sales in 2016 and took in $141 million in taxes during fiscal year 2015-2016, a 60-percent increase over the previous year. That will likely be up another 50 percent when we get the final numbers for 2016-2017 in a few weeks. Near as I can tell (the data are presented differently), Colorado is pulling in $5 million a month or so in alcohol-related taxes, or about 45 percent of what te state brings in from taxing marijuana.

Washington state is also selling about $1 billion a year in marijuana sales, and is pulling around $7 million a month in state and local taxes, which extrapolates to around $85 million a year. Washington gets about three times that in alcohol-related taxes.

Colorado has slightly under the average population for a US state; Washington is slightly higher, according to 2013 Census estimates.


Alcohol and marijuana prohibition are probably the most parallel examples we have — both were at one time illegal and they brought about big business thanks to some combination of illegal trading and legal prescriptions.

Cocaine is rarely (if ever) still prescribed, though it used to be. Most of the opioid overdose deaths we see start with prescriptions.

There's good evidence that SSRIs — often prescribed to fight depression — lead to higher rates of suicide. From strictly a social science standpoint, it's impossible to tell if people on SSRIs who commit suicide would not have committed suicide if they weren't taking them. You don't get a do-over with suicide, and you can't ask reflective questions of someone who has committed suicide.

The National Institutes for Health have a deep-dive on the pros and cons of direct-to-consumer advertising of prescription drugs, but one stats-gathering organization says that for every dollar spent on advertising, we see an increase of $4.20 in sales of prescription drugs, so the advertising is getting better than a four-to-one return right now.


You probably, by now, have figured out where this is going, but I'm going to take it farther than you think.

First, I should disclose my drug practices. I am an occasional (two to three times per week) alcohol user; I will smoke several cigars a year (tobacco); and I have used marijuana recreationally fewer than three times in my life. I have not tried any of the other drugs mentioned here.

All drugs should be legal, taxed and regulated. You've read 1,000 words at this point; don't bail on me just yet.

I think alcohol serves as the best precedent we have to work from as a model. We have:

• An agency that controls the quality of the ingredients
• A uniform way to measure how much alcohol we get (ABV, paired with volume)
• A measure describing legal impairment
• A minimum age for purchase and consumption
• Rules on who can make, distribute and sell alcohol

Those are the basics. We need them for every drug, and legalizing everything allows us to write a catch-all for synthetics that haven't been invented.


It would, of course, take some research. We've learned that the brain finishes maturing around age 25. We should, then, wait until someone is 25 or 26 before we let them buy and use psychedelics.

If there's not a good way to measure levels of consumption (we use blood-alcohol content for alcohol, with a level of 0.8 percent meaning impairment, as far as driving is concerned), then there's a zero-tolerance policy. You can use the drug in your own home or whatever, but if you operate a vehicle or commit a crime such as theft or assault and have any of the drug active in your system, the penalties are higher because you're impaired.

If a drug is so dangerous it shouldn't be used, use fines and/or property forfeiture as the penalty. Some 46 percent of inmates in the US are in prison on drug offenses; many of them have also committed other jailable offenses, so it wouldn't decrease our prison population by half, but it would get 15 million or so people producing in the economy instead of costing governments money by sitting in prison.

[I got that 15 million number by taking Five Thirty-Eight's numbers that a quarter of the US population is in prison and 16 percent of those prisoners have drug offenses as the primary reason they're incarcerated.]

Even if a drug is so dangerous it shouldn't be used, you should probably be able to use it in your living room if you're just going to take the drug and leave everyone alone until it's out of your system.


The average prisoner in the US costs taxpayers nearly $32,000 a year, with places like New York skewing it a little high ($60,000 per prisoner across the state and over $167,000 per perisoner in New York City).

I'm having trouble finding good numbers for welfare programs (there are over 130 of them, with 72 of them assisting individuals), but I know from my days in retail banking that supplemental income (SSI) requires you to either work 30 hours per week or be permanently disabled. SNAP benefits (food stamps) are said to help 4.8 million people a year — and nothing on the order of what it costs to feed and house a prisoner.

We're starting to wander a little far afield here, but the point there is that even if every single person in prison on drug offenses alone was to be released and put onto SNAP rolls instead of contributing to the US economy via jobs, it would still cost less than keeping them in prison for nonviolent offenses.


In case you missed it in all the reading above we're not only talking about spending less money on people in prison (and also in not having to pay people to enforce drug laws including expensive long-term investigations and undercover stings), we're talking about more income from because all those newly legal drugs are regulated and taxed. Shops pay money to get licensed the way bars and liquor stores pay for licenses. If you have a product to distribute, it needs agency (something like the FDA, if not the actual FDA) approval. And then there are taxes on both the property from which the drugs are sold (new businesses, yay!) and on the drugs themselves — and that tax, like the taxes on alcohol and tobacco, can be higher than sales tax.

I think that about covers it. Your thoughts?

Josh: The Podcast, Episode 67: Frogs, health care and Dudesons

We talk mainly about health care. And frogs. Short one today.

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Links:
Sen. John McCain diagnosed with brain cancer
Another version of the Senate health care bill dies
Straight ACA repeal with no replace would leave 32 million without insurance
I explain (if oversimplify) the problem with moving health care like it's being moved
America is better when Americans have health care
JKWD episode 58: Taking care of people when the jobs go
The Dudesons Vlog

A couple of fave Dudesons videos

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New Savannah spot: American Prohibition Museum

Disclaimer: My wife works for the company that put together the American Prohibition Museum. I was not charged admission on my first visit.

The American Prohibition Museum is an interesting tour through a time in American history I think a lot of people don't know about — a time we can learn a lot from.

That will be a story for another post, though. For now, this is just a look at the museum.

If you're not familiar with Savannah, you should know that booze plays something of a big role here. Our open container law allows you to walk around in the historic district (read: tourist area) with a drink. You can still see openings in basements and walls for tunnels used for rum running or kidnapping.

When Georgia voted to go dry a dozen years before prohibition was ratified as a constitutional amendment, Chatham County seriously considered seceding. It would have formed Chatham State, with Savannah as its capital.

The museum takes us through the temperance movement, from marches and posters and cartoons and editorials as early as the 1850s, through the rise of the political version of the movement, and into prohibition, when alcohol became the realm of mobsters (Al Capone saw his rise through bootlegged liquor), auto tinkerers (people would buy scrapped chassis and outfit them with souped-up engines to outrun the law) and pharmacists (Walgreens never would have become a national chain without being the primary dispensary of medical whiskey during prohibition).

We learn the Charleston. There's a speakeasy (also open after the museum closes for the evening). There's a room dedicated to racing — those souped-up bootlegger cars became the beginning of NASCAR when there was no longer a need to outrun police with a trunk packed full of illegal booze.

We even learn how to distill whiskey and what the penalties would be if you were caught with bootlegged whiskey — or worse, a still. And we learn how much business and tax money was lost during the years of prohibition.

Admission is reasonable, and comes at a discount if you buy online or as part of a package with a trolley tour. Give yourself 45 minutes to an hour inside, longer if you grab a drink. It's located in City Market, with an entrance next to Wild Wing Cafe.

After the museum closes, the speakeasy opens to the public (no hats or shorts, guys).

Josh: The Podcast, Episode 66: What we’re reading

I've been taking a lot of input this week. What are you reading?

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Links:
The Shadow of the Wind by Carlos Ruiz Zafon
Bright Sided: How Positive Thinking is Undermining America by Barbara Ehrenreich
Amusing Ourselves to Death: Public Discourse in the Age of Show Business by Neil Postman
Tribe: On Homecoming and Belonging by Sebastian Junger
Rat Bastards: The South Boston Irish Mobster Who Took the Rap When Everyone Else Ran by John "Red" Shea
Antifragile: Things That Gain from Disorder by Nassim Nicholas Taleb

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Know your audience (or at least get their money before you insult them)


Photo by Jenny Shear

The Waimea Canyon lookout at Pu'u Hinahina on the Hawaiian island of Kaua'i is 13 miles up a winding road. About 10 miles up that road there is another lookout, and the sign makes it unclear which way the road continues and which way the lookout rests.

We accidentally pulled off three miles before the beginning of our planned hike and figured that we'd take in a view before continuing up.

When we got to the lookout, there was a man (pictured above) who told us some of the history and customs of the native Hawaiian people. Before hula became a sensual dance performed by women in coconut bras and grass skirts, it was a war dance performed by men in masks hoping to send the enemy into retreat before combat became necessary.

He taught us a little about the language, about how the word aloha breaks down into alo, meaning a shared presence, and ha, the breath of life.

And then he told us a little about himself and what he does.

You see, a few years ago, he was arrested and charged with being an unlicensed vendor. He'd been coming to this spot with a tip basket and a history lesson for tourists to provide for his family, unsanctioned by the parks service or any state agency.

He argued in his own defense, asking the judge for proof that the prosecuting attorney had jurisdiction to arrest and charge him. He said he didn't recognize the United States' sovereignty over Hawaii. He asked to see the articles of annexation. After five trips to court — five days he couldn't provide for his family because he was in court — his case was dismissed after the prosecutor failed to provide the requested document.

He continued his story about how Kaua'i, the furthest Hawaiian island from the US mainland (outside of one privately owned island with a small, mostly native population) and least developed to date, is being bought up by people who love its unspoiled nature, and are spoiling it. He complained about Mark Zuckerberg's purchase of 700 acres on the island.

At this point, his crowd started to scatter. He'd received one tip from someone who left before he got into his lesson.

As you might guess, his audience was largely (probably entirely) tourists. All were white. No one wanted to stick around to hear how badly we were destroying things — we knew we had a history of doing that on the US mainland and we were here to get away from, among other things, a particularly nasty bout of political shouting.

Educational vacation? Sure, I like learning things. I don't, however, enjoy being lectured to. If I want your opinion on politics and the local atmosphere, I'll ask. And I probably would have said some

If you rely on people giving you tips for a living, ask for money when you're at a high point in your speech. Don't wait until you're lecturing them on their bad behavior.

Know your audience. Stop talking at the point they're most likely to give you money. If you get to that point and they're not giving you money, cut bait. If you keep talking, you might accidentally find your foot in your mouth.

Josh: The Podcast, Episode 65: And we’re still talking about intellectualism and discourse (sigh)

We talk about NPR tweeting the Declaration of Independence, Trump body slamming CNN and CNN threatening to dox a reddit user.

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Links:
NPR Tweeted The Declaration Of Independence And Some Trump Supporters Were Offended

Trump tweets mock video of himself attacking man with CNN logo over face; network responds
How CNN found the Reddit user behind the Trump wrestling GIF
Text of the Declaration of Independence
Josh: The Podcast, Episode 13, in which I read the Declaration of Independence
Me on Cesspool
The Book Lady
Live Oak Public Libraries
The Shadow of the Wind by Carlos Ruiz Zafon

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Independence Day 2017

On July 2, 1776, the 13 colonies that at that time composed the United States ratified a declaration of independence from Great Britain. It was revised and updated, with the final version gaining passage on July 4 of that year.

So today, we celebrate our independence as a nation. Last year for my podcast, I read the Declaration of Independence. You can hear that below (there's also a remembrance for Elie Wiesel, who had recently died). I'm also dedicating this space today to the text, so you can read along, or read it without listening to it, perhaps for the first time as an adult. The text comes from the National Archives, and the spelling and grammar represent what's on the original document, not the current accepted usages.

In Congress, July 4, 1776.
 
The unanimous Declaration of the thirteen united States of America, When in the Course of human events, it becomes necessary for one people to dissolve the political bands which have connected them with another, and to assume among the powers of the earth, the separate and equal station to which the Laws of Nature and of Nature's God entitle them, a decent respect to the opinions of mankind requires that they should declare the causes which impel them to the separation.
 
We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.--That to secure these rights, Governments are instituted among Men, deriving their just powers from the consent of the governed, --That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter or to abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness. Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shewn, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security.--Such has been the patient sufferance of these Colonies; and such is now the necessity which constrains them to alter their former Systems of Government. The history of the present King of Great Britain is a history of repeated injuries and usurpations, all having in direct object the establishment of an absolute Tyranny over these States. To prove this, let Facts be submitted to a candid world.
 
He has refused his Assent to Laws, the most wholesome and necessary for the public good.
 
He has forbidden his Governors to pass Laws of immediate and pressing importance, unless suspended in their operation till his Assent should be obtained; and when so suspended, he has utterly neglected to attend to them.
 
He has refused to pass other Laws for the accommodation of large districts of people, unless those people would relinquish the right of Representation in the Legislature, a right inestimable to them and formidable to tyrants only.
 
He has called together legislative bodies at places unusual, uncomfortable, and distant from the depository of their public Records, for the sole purpose of fatiguing them into compliance with his measures.
 
He has dissolved Representative Houses repeatedly, for opposing with manly firmness his invasions on the rights of the people.
 
He has refused for a long time, after such dissolutions, to cause others to be elected; whereby the Legislative powers, incapable of Annihilation, have returned to the People at large for their exercise; the State remaining in the mean time exposed to all the dangers of invasion from without, and convulsions within.
 
He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations hither, and raising the conditions of new Appropriations of Lands.
 
He has obstructed the Administration of Justice, by refusing his Assent to Laws for establishing Judiciary powers.
 
He has made Judges dependent on his Will alone, for the tenure of their offices, and the amount and payment of their salaries.
 
He has erected a multitude of New Offices, and sent hither swarms of Officers to harrass our people, and eat out their substance.
 
He has kept among us, in times of peace, Standing Armies without the Consent of our legislatures.
 
He has affected to render the Military independent of and superior to the Civil power.
 
He has combined with others to subject us to a jurisdiction foreign to our constitution, and unacknowledged by our laws; giving his Assent to their Acts of pretended Legislation:
 
For Quartering large bodies of armed troops among us:
 
For protecting them, by a mock Trial, from punishment for any Murders which they should commit on the Inhabitants of these States:
 
For cutting off our Trade with all parts of the world:
 
For imposing Taxes on us without our Consent:
 
For depriving us in many cases, of the benefits of Trial by Jury:
 
For transporting us beyond Seas to be tried for pretended offences
 
For abolishing the free System of English Laws in a neighbouring Province, establishing therein an Arbitrary government, and enlarging its Boundaries so as to render it at once an example and fit instrument for introducing the same absolute rule into these Colonies:
 
For taking away our Charters, abolishing our most valuable Laws, and altering fundamentally the Forms of our Governments:
 
For suspending our own Legislatures, and declaring themselves invested with power to legislate for us in all cases whatsoever.
 
He has abdicated Government here, by declaring us out of his Protection and waging War against us.
 
He has plundered our seas, ravaged our Coasts, burnt our towns, and destroyed the lives of our people.
 
He is at this time transporting large Armies of foreign Mercenaries to compleat the works of death, desolation and tyranny, already begun with circumstances of Cruelty & perfidy scarcely paralleled in the most barbarous ages, and totally unworthy the Head of a civilized nation.
 
He has constrained our fellow Citizens taken Captive on the high Seas to bear Arms against their Country, to become the executioners of their friends and Brethren, or to fall themselves by their Hands.
 
He has excited domestic insurrections amongst us, and has endeavoured to bring on the inhabitants of our frontiers, the merciless Indian Savages, whose known rule of warfare, is an undistinguished destruction of all ages, sexes and conditions.
 
In every stage of these Oppressions We have Petitioned for Redress in the most humble terms: Our repeated Petitions have been answered only by repeated injury. A Prince whose character is thus marked by every act which may define a Tyrant, is unfit to be the ruler of a free people.
 
Nor have We been wanting in attentions to our Brittish brethren. We have warned them from time to time of attempts by their legislature to extend an unwarrantable jurisdiction over us. We have reminded them of the circumstances of our emigration and settlement here. We have appealed to their native justice and magnanimity, and we have conjured them by the ties of our common kindred to disavow these usurpations, which, would inevitably interrupt our connections and correspondence. They too have been deaf to the voice of justice and of consanguinity. We must, therefore, acquiesce in the necessity, which denounces our Separation, and hold them, as we hold the rest of mankind, Enemies in War, in Peace Friends.
 
We, therefore, the Representatives of the united States of America, in General Congress, Assembled, appealing to the Supreme Judge of the world for the rectitude of our intentions, do, in the Name, and by Authority of the good People of these Colonies, solemnly publish and declare, That these United Colonies are, and of Right ought to be Free and Independent States; that they are Absolved from all Allegiance to the British Crown, and that all political connection between them and the State of Great Britain, is and ought to be totally dissolved; and that as Free and Independent States, they have full Power to levy War, conclude Peace, contract Alliances, establish Commerce, and to do all other Acts and Things which Independent States may of right do. And for the support of this Declaration, with a firm reliance on the protection of divine Providence, we mutually pledge to each other our Lives, our Fortunes and our sacred Honor.
 
Signed:
 
Georgia
Button Gwinnett
Lyman Hall
George Walton
 
North Carolina
William Hooper
Joseph Hewes
John Penn
 
South Carolina
Edward Rutledge
Thomas Heyward, Jr.
Thomas Lynch, Jr.
Arthur Middleton
 
Massachusetts
John Hancock
 
Maryland
Samuel Chase
William Paca
Thomas Stone
Charles Carroll of Carrollton
 
Virginia
George Wythe
Richard Henry Lee
Thomas Jefferson
Benjamin Harrison
Thomas Nelson, Jr.
Francis Lightfoot Lee
Carter Braxton
 
Pennsylvania
Robert Morris
Benjamin Rush
Benjamin Franklin
John Morton
George Clymer
James Smith
George Taylor
James Wilson
George Ross
 
Delaware
Caesar Rodney
George Read
Thomas McKean
 
New York
William Floyd
Philip Livingston
Francis Lewis
Lewis Morris
 
New Jersey
Richard Stockton
John Witherspoon
Francis Hopkinson
John Hart
Abraham Clark
 
New Hampshire
Josiah Bartlett
William Whipple
 
Massachusetts
Samuel Adams
John Adams
Robert Treat Paine
Elbridge Gerry
 
Rhode Island
Stephen Hopkins
William Ellery
 
Connecticut
Roger Sherman
Samuel Huntington
William Williams
Oliver Wolcott
 
New Hampshire
Matthew Thornton

Did you learn anything? Did anything surprise you? Did you have any myths about the declaration you were holding onto?