Process
Status Items Output None Questions None Claims None Highlights Done See section below
Highlights
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risk compensation.” It’s an idea that comes from the study of road safety and posits that people adjust their behavior in response to perceived risk: the safer you feel, the more risks you’ll take.
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whenever risk compensation has been subjected to empirical scrutiny, the results are usually ambiguous, or the hypothesis fails spectacularly.
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Take motorcycle helmet laws. When Peltzman’s article was published in 1975, California was the only state without a mandatory helmet law. Motorcycle associations, which opposed such mandates as an infringement of personal liberty, mounted a lobbying campaign, one that was well-timed to work thanks to risk compensation entering the zeitgeist. Twenty-eight states repealed their helmet laws, with one prominent advocate claiming that motorcycle helmets actually increased the likelihood of neck injuries. It was a tragic national experiment: As a result of the repeals, motorcycle deaths soared
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the perversity thesis.” The perversity thesis states that well-intentioned rules and regulations ultimately exacerbate the problems they were designed to solve. We hear this sort of argument most prominently in arguments against the welfare state. (“We tried to remove the barriers of escape from poverty and inadvertently built a trap,” wrote Charles Murray in Losing Ground.) As a political tactic, such rhetoric makes for an effective appeal to the status quo, because why change anything if everything backfires? Give poor people money, the argument goes, and they’ll simply spend it on useless goods, making their predicament worse
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perversity arguments dovetailed nicely with laissez-faire economics, and it became nearly axiomatic that any effort to restrain the invisible hand, no matter how worthy, was prone to achieving the precise opposite of its intention. The risk compensation hypothesis fits neatly into this worldview. For free-marketeers, the risk compensation hypothesis (or the “Peltzman effect,” as it was later dubbed) provides the perfect a priori argument to shut down discussion. If any safety measure, by definition, is offset by risk compensation, then why consider safety regulations at all?
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At best, risk compensation is something that happens at the level of the individual but rarely, if ever, fully offsets the social benefits of an effective safety regulation. At its worst, risk compensation is just kneejerk libertarianism masquerading as fundamental insight into human nature.
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When oral contraceptives were first approved by the FDA in 1960, critics at the time warned that “the foundations of contemporary sexual morality may be threatened” by the ensuing promiscuity. What’s more, some experts said, since women—especially poor women—couldn’t be trusted to adhere to daily pill-taking, the pill may not even end up reducing unwanted pregnancies. Doctors and medical experts have raised analogous concerns for syphilis treatment, the morning-after pill, PrEP for HIV prevention, and more recently, HPV vaccination
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Risk compensation has been brought up to question a wide range of public health interventions, including diet soda, low-tar cigarettes, child-safety caps on medication, hypertension treatments, and needle-exchange programs. In each case, the reasoning is that the intervention could backfire because the masses are just too dumb or too undisciplined to act in what the medical community perceives to be in their own best interests.
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For some in the medical community, if the social goal is a healthier population, then we should just educate people to make better choices. It’s easy to see the appeal of this position for the medical establishment: It shifts the onus of health from practitioners to patients.